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Who’s Taking Care Of The Physicians?

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MSSNY’s Peer Coaching Program Combats Stigma, Offers ‘Safe Space’ for Docs Battling Demons

By: Bari Faye Dean

It’s no secret that physicians live in a pressure cooker of stressors. They want to provide the highest quality care to patients, give the most of themselves to their families and personal life and, all the while, find themselves buried in paperwork and the inexplicable frustrations brought on by the technology required to balance healthcare regulations and insurance red tape.

“Doctors aren’t weak. We are strong and resourceful,” said Frank Dowling, MD, a psychiatrist in private practice on Long Island. “But even steel has a breaking point.”

Without intervention, stress and burnout can lead to severe health issues, including depression, PTSD, substance abuse and even suicide. No question about it: something has to give – before a practitioner gives in to stress, burnout or a personal challenge that has been threatening to sideline them. The bottom line, wonders Bonnie Litvack, MD, a Mount Kisco, NY-based radiologist who specializes in breast imaging, is this: “Who’s taking care of the physicians while physicians take care of everyone around them?”

Confidential Assistance from Trained Peer Coaches
The Medical Society of the State of New York’s (MSSNY) Physician Wellness and Resilience Committee launched a Peer 2 Peer (P2P) program. This program offers a vital lifeline to physicians, residents and medical students who are having emotional difficulties but have decided not to seek help because they are afraid of the stigma attached to mental healthcare – especially for physicians who are “supposed to be able to handle everything,” Dr. Litvak said.

When a participant reaches out for help, they are connected with a P2P Program peer supporter, a fellow medical professional, who has been trained to actively listen and offer feedback during one or two phone calls or video chats.

“We are providing psychological first aid,” said Dr. Dowling, who has been a peer supporter since the inception of the MSSNY program. “It’s therapeutic because it provides support and empathy, but it’s not treatment. If the participant needs a clinical referral and agrees to take one, they will be connected with the help they need.”

To date, almost 100 physicians have been successfully trained in crisis management by MSSNY’s P2P Program. During three-hours of training, peer supporters are trained to know what resources are available and how to guide a physician to get the help they need moving forward. If you would like to learn more about becoming a peer supporter, contact Emily Rento, Program Coordinator, at erento@mssny.org.

“Too many doctors are suffering in silence because they fear that if people knew what was going on in their heads, others would look at them differently,” Dr. Dowling said. “The P2P Program allows doctors to help our peers manage their battles confidentially.”

Indeed, the entire program is 100 percent confidential. There is no paper trail. There is no reason to fear retribution at work. If you need help, reach out now. You can get connected with a peer supporter by emailing P2P@mssny.org or by calling 844-P2P-PEER (844-727-7337).

P2P Provides a Safe, Judgment-Free Space
“There is a real need for this program. Many other fields have these types Physicians are human beings and they need a safe space, where they can be validated and talk about their feelings without judgment,” explained P2P Program peer supporter Dr. Litvack.

Dr. Litvack was president of MSSNY in 2020 2021 during the height of the COVID-19 pandemic, when the P2P Program was launched. “COVID exacerbated everything physicians are dealing with at work and in their personal lives. I am proud we were able to start the P2P Program then, Dr. Litvack said. “But it’s a few years later and we see those life stressors haven’t gone away. Physicians faced them long before COVID and we will be facing them long after.”

Take It From Someone Who’s Been There
Janine L. Fogarty, MD, a diagnostic radiologist in Rochester, NY, is not only a trained peer supporter, but she knows first-hand how a career in medicine can cause a level of stress that can engulf a physician. She has been there and retired from that.

“I retired from a long medical career in 2022 because I was burned out beyond repair,” Dr. Fogarty said. “At work, I had all the responsibility and no control. I couldn’t affect change for my patients. I couldn’t do it anymore. I was so emotionally isolated. No one around me knew I was struggling. My work environment wasn’t healthy for me so I couldn’t reach out there. I could talk with friends but they didn’t really understand because they are not physicians.”

Dr. Fogarty remembers the days of the physicians’ lounge, when a step away, a cup of coffee and a quick chat with a colleague could do wonders to calm a stressed doctor down. Those days are long gone, she said. “You put your head down and move forward. You don’t want to disappoint patients or coworkers.”

This combination, she said, is a recipe for disaster in a physician community where shortages are rising at record rates. Bringing back a sense of comradery could be a real solution for physicians who are struggling and need connection, she said.


At the same time, physicians don’t reach out for help because of the stigma they believe is alive and well throughout the medical community.

“Every day, doctors choose to suck it up and don’t get the help they need,” Dr. Dowling said. “If doctors can get help earlier, without anyone knowing, it can make all the difference. The P2P Program has done this for many physicians all around New York.”

If you need someone to talk with or a physician you know is struggling, MSSNY’s P2P Program is here to help. For more information, email P2P@mssny.org or call 844-P2P-PEER (844-727-7337).

Upstate Golisano Children’s Hospital: Celebrating 15 Years of Excellence in Pediatrics

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By: Elizabeth Landry

Since the Upstate Golisano Children’s Hospital first opened its doors in 2009, the hospital has grown and evolved significantly while remaining true to its founding mission of providing safe, effective, innovative and family centered care for children across the Central New York region. Now celebrating its 15-year anniversary, the children’s hospital has become a 71-bed pediatric healthcare hub serving children in 22 counties that span North to the Canadian border and South to the Pennsylvania border. Under the leadership of Gregory Conners, MD, MPH, MBA, Professor and Chair of Pediatrics and Executive Director of Upstate Golisano Children’s Hospital, who joined the hospital in 2019, the organization is a pillar of Central New York healthcare and has had a strong positive effect on the community.

“It’s the people in the community who really helped us get started,” said Conners. “I frequently meet people whose kids or grandkids, nephews or nieces have been treated here over the past 15 years. I really think people don’t take us for granted because many can remember a time when there wasn’t a children’s hospital here and they notice we have a better community because of the excellent care we provide for the children.”

The children’s hospital has produced significant research that has made an impact on strategies for treating pediatric patients, including research on Covid prevention and vaccination and the prevention of RSV infection. Both research and community improvement are keystones of the robust pediatric residency program, during which the intern year also includes skills in advocacy and global health.

Conners expressed how proud the team is of the program, saying, “We work hard to give our trainees great experiences. We all put a lot of time and energy to make the program the very best it can be.”

Well-Rounded Pediatric Care Through Extensive Subspecialties
To provide children with comprehensive healthcare, the Upstate Golisano Children’s Hospital offers services from a long list of subspecialties. These include experts in pediatric hospital medicine, pediatric cardiology, children’s infectious diseases, rheumatologic conditions, pediatric nephrology, pediatric urology, gastroenterology and nutrition, and many more. Importantly, healthcare providers from the different pediatric subspecialties often function as one holistic pediatric team rather than separate departments.

“Many children need two or three different medical providers at once. We often have multiple physicians from different specialties collaboratively caring for the same child. It’s the whole team of specialty physicians, nurses and other health professionals who work together that makes the children’s hospital so special,” emphasized Conners.

An important distinction the children’s hospital holds is serving as the region’s only ACS verified Level 1 Pediatric Trauma and Burn Center, which is, in fact, one of only eight such trauma centers in the state. The Trauma Center provides around the-clock care for children critically injured by such mechanisms as falls, motor vehicle accidents, bicycle crashes and physical abuse. The summer of 2024 saw a record number of pediatric trauma activations.

Kim Wallenstein, MD, PhD, Pediatric Trauma Medical Director, emphasized the importance of the care her team provides and highlighted the impact of preventing injuries before they happen. “We have a top-notch trauma team in place to provide care whenever it is needed. Additionally, we strive to raise awareness of injury prevention strategies, so children avoid traumatic injuries in the first place,” she said.

The Upstate Trauma Center is staffed by fellowship-trained pediatric surgeons, who also see a wide variety of surgical patients at the hospital’s Center for Children’s Surgery.

“All types of surgery for children should be done by someone with a focus on pediatrics,” noted Tamer Ahmed, MD, Division Chief of Pediatric Surgery.

“Our entire infrastructure as part of a children’s hospital is set up to care for pediatric patients from birth into their teens, and the unique needs of each age. This includes working with pediatric subspecialists, pediatric nursing, child life and others. From evaluation to treatment to follow up care our entire children’s hospital is focused on caring for children and their families, whether they are one day old or 17 years old.”

Inpatient and Outpatient Pediatric Services

In addition to the hundreds of children treated on the inpatient floor of the children’s hospital, Upstate University Hospital also has an extensive network of pediatric outpatient services. Upstate is the only institution in 

Central New York to offer comprehensive pediatric services for children diagnosed with cancer or blood disorders including leukemia, brain tumors, solid tumors, benign blood disorders (anemia and thalassemia, among others), sickle cell anemia and hemophilia. Children needing these services are cared for at the hospital’s Waters Center for Children’s Cancer and Blood Disorders, and patients have immediate access to inpatient services at the Golisano Children’s Hospital as needed. The team at the Waters Center also focuses on research trials and studies aimed at advancing how childhood cancer is cured. Melanie Comito, MD, Director of Children’s Cancer and Division Chief of the Waters Center, explained the importance of devoting time to research studies.

“As members of the International Children’s Oncology Group, a wide-ranging network of pediatric oncology providers, we’re able to actively participate in the advancement of childhood cancer treatment. Each pediatric cancer center doesn’t see many patients of the same type of cancer, so we work together across the country to study new drugs and treatment strategies. Childhood cancer and hematology treatment keeps advancing, and there have been many improvements over the years,” Comito said.

Comito also highlighted the importance of survivorship at the Waters Center, which includes the Survivor Wellness Program to help children prepare for life as adults, assisting them with their health care needs and how to handle their complicated medical histories.

“My passion is watching the children grow up and getting back to their lives again,” stated Comito. “Survivorship is important because we’re monitoring any delayed effects of drugs and treatments and we’re also trying to teach them good habits like nutrition and exercise, taking care of their mental health, and helping them understand that it’s OK to feel different from their peers. We hope that by the time they are late adolescents or young adults they know how to advocate for their adult healthcare. We’ll always remain a resource for them.”

Comprehensive Support Through Child Life

Another major service supporting pediatric patients is the Child Life department led by Regina Lozito, Director of Child Life. The department grew from a team of three to a team of 18, who help children and their families cope with medical experiences. Child Life Specialists offer support in the inpatient setting of the children’s hospital and in many Upstate clinical areas.

“We work very closely with the medical staff to make sure children can tolerate what we’re asking them to do” said Lozito. “For example, if a child needs an MRI or a CT scan, we help assess if they can undergo the procedure without anesthesia, which helps lower their risk, and we use age-appropriate strategies to help them understand what will happen so they can get through the experience as easily as possible.”

Much of the Child Life Department’s work involves helping children use coping strategies such as play, art and music therapy, as well as gaming and tech, but another side of the work involves legacy building when end of life care is needed, whether for a child or for a child’s caregiver. Jewelry made using fingerprints or handprints after a loved one passes away, and heartbeat recordings placed into stuffed animals are some of the ways the Child Life department provides support in difficult situations.

No matter the specific application, the Child Life department makes an impact on children that lasts into adulthood. “We’re teaching them coping skills they can use in any situation, such as at school and eventually as adults,” said Lozito. “They can teach other kids strategies like deep breathing, counting and squeezing a stress ball–generally learning how to deal with really difficult situations in a positive manner.”

The department also will soon have a facility dog, who will be highly trained to be an extension of the Child Life staff. “We’re really excited about this new program because research shows animals help bring down blood pressure and make people less anxious,” Lozito explained.

Community Connections and Continued Expansion
As the Upstate Golisano Children’s Hospital grows and expands, one aim is to continue cultivating meaningful connections in the community. Kali Kearns, MHA, Administrator for the Upstate Golisano Children’s Hospital, recently joined the hospital’s leadership team to focus on strategic planning, growth and expansion, and community relationships and partnerships.

The children’s hospital partners with the Upstate New York Safe Kids Coalition, which uses advocacy, education and preventative strategies to reduce the incidence of injuries in children in the community. Kearns emphasized plans for developing further ties in the community as well as ways the hospital aims to increase service offerings.

“We are excited to develop new partnerships so we can continue to provide important preventative services in the community,” said Kearns. “With Micron coming to the area, we need to think about the potential influx of pediatric patients and make sure we can continue to meet patient needs in both the inpatient and outpatient setting. We really put the patient and their family at the center of everything we do, and our aim is to continue to provide the best experience possible.”

Conners also echoed the sentiment that patients and their families are at the heart of the hospital’s strategies for continued expansion into the next 15 years and beyond.


“When I first came to the hospital, I immediately liked the culture, the collaborative nature of the team and the mission that we have of caring for the children in our community,” explained Conners. “I’m looking forward to continuing our growth and being able to care for more and more children and families over time. We’re not growing the organization and increasing our connection to the community because we want to be the biggest, but because we truly want to serve as many kids as we can.”

Serving on a Board

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By: Kathryn Ruscitto, Advisor

Throughout my career I have served on a variety of Not for Profit Boards. It’s a way to serve the community, open doors, connect people and causes, and to learn Boards can help you to build new skills, connect with new parts of the community, begin to plan for things you want to do in your free time or in retirement. Good Board members want to learn and aren’t afraid to ask questions. Recently I was at the View Arts Center in Old Forge and met a new surgeon who had moved to Syracuse. She had taken the time to explore not for profit arts organizations in the region and was visiting them to get to know the region.

Boards function differently, and expectations of Board members can vary. It really is important to think through why you are joining a Board and what your expectations are for that service.

Some simple guidelines should always be part of a Board members thinking: What is expected of me: time, donations, terms of service.

What do I expect from the organization: following state and federal guidelines, communications on meetings and important issues.

How do you go about deciding on a Board or getting to know what organizations might be a good fit? Talk to colleagues, look at their current Board list, call and talk to the Executive Director. Many of you attend community fundraisers, also a good place to ask about Board service.

The Boards I have enjoyed the most, pushed what I knew, and connected me to best practice ideas. The Boards I found frustrating provided information but didn’t use my skills or ask for help. 

Not for profits are local, regional and national. Some belong to larger associations or organizations that have Boards at multiple levels. Board service in a not for profit is as a volunteer and is uncompensated. Organizations carry Board and officer insurance coverage to protect Board members.

There are also For Profit Boards of start ups and businesses that seek certain disciplines for their Boards and do provide compensation and other benefits. These Boards choose members primarily through other Board members. The services that promise to get you a Board seat in exchange for a fee are unproven.

Some mix of Board service across for profits and not for profits during a career is desirable.

Resources:
www.councilofnonprofits.o g/running-nonprofit/ governance leadership/board-roles and-responsibilities

www.boardeffect.com/blog pros-cons-nonprofit-board-membership/

www.boardsource.org/fundamental-topics-of-nonprofit-boardservice/roles-responsibilities/

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com

Grieving Families Act 3.0: What’s Changed?

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By: Jenn Negley, Vice President, Risk Strategies Company

Most in healthcare and medical malpractice have been keeping an eye on the GFA legislation for several years now knowing the negative effect it would have on an already stressed sector. While all involved are assumed to have good intentions, it appears they have a blind spot when it comes to the GFA’s impact on the State’s medical malpractice insurance market and in turn healthcare. This failure to address the concerns continues with GFA 3.0 despite being clearly indicated in past vetoes.

While GFA 3.0 did eliminate “disorders” as a category of damages it maintained “grief or anguish.” The GFA 3.0 also still looks to broaden the current statute of limitations from two years to three years. GFA 3.0 originally scaled back the “eligible” family members that could recover damages to the current law’s definition only to propose assembly bill AB 9232B/S8485B that would result in the expansion of eligible family members once again. What is most troubling to industry experts is the current GFA calls for an immediate implementation effective for all wrongful death that occurs on or after January 1, 2021.

As I mentioned last year when discussing the GFA 2.0, malpractice carriers are already struggling with upticks in claim frequency and a dramatic rise in payout amounts. A recent study released in April 2024 by the New York Civil Justice Institute titled Consumers in Crisis How New York’s Hostile Liability Environment Inflates Insurance Cost and Fleeces Empire State Families (www.nycji.org/research) details the issues already contributing to a difficult insurance market. If signed as is, it will add to the pressures already in play. With no caps in place, more time to file, and the broadening of who can file the deck will be stacked against malpractice carriers. In addition, adding the change retroactively eliminates a carrier’s ability to make the necessary financial adjustments potentially forcing some out of the market. To maintain solvency, carriers as well as the insurance department will keep a close eye on these trends which might indicate the need for increased rates. Milliman, an independent actuary determined with the new inclusion of grief and aguish only, rates would need to be increased by 40%. As this has dragged out for several years, I have had the opportunity to speak to many of New York’s carriers’ upper management and everyone agrees such an increase would be a disaster for New York’s healthcare market, but all also note their fear that the New York State Department of Financial Services will see it as a necessity for admitted carriers to remains solvent.

To be clear, none of the admitted carriers are looking to take these steps but cannot ignore the independent statistical analysis of the GFA’s impact on their ability to defend New York’s healthcare providers and facilities. With little change, the “New” GFA the Governor’s veto message from last year still rings true. “Legitimate concerns have been raised that the bill would likely lead to increased insurance premiums for the vast majority of consumers, as well as risk the financial well-being of our healthcare facilities – most notably, for public hospitals that serve disadvantaged communities.” For the health safety of all New Yorkers GFA 3.0 in its current form needs to be vetoed once again.

Reach out to Governor Hochul now.
Facebook: @Governor Kathy Hochul

Twitter: @govkathyhochul

Instagram: @govkathyhochul

For more information, please contact Jenn Negley, Vice President, Risk Strategies Company at 267-251-2233 or JNegley@Risk Strategies.com.

The views expressed in this article on pending legislation are solely those of the author and do not necessarily reflect the official stance, policies, or opinions of Risk Strategies. This article is intended for informational purposes only and should not be construed as professional advice.

CPR Gave Patient CriticalTime to Get to Crouse

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FOR LIFESAVING CARDIAC CARE

Steve Gorczynski, 55, remembers very little of what happened on the morning of Aug. 30, 2023, but his wife, Julie, will never forget it.

She woke up when she heard a “thud” and found her husband unresponsive on the floor. Julie immediately called 911. She hadn’t taken CPR since their children were small, but with the help of the 911 operator, she was able to administer it to her husband until a police officer arrived within minutes and took over. EMTs quickly showed up, continuing CPR and using a defibrillator on Gorczynski twice. Julie asked the first responders to transport her husband specifically to Crouse Hospital, acknowledging that the well-known tagline: “Take Me to Crouse,” was echoing in her head.

These quick actions were critical to Gorczynski’s survival and successful recovery, according to his cardiologist Anil George, MD, FACC, a member of Crouse Medical Practice. “Time is heart muscle,” says George. “Steve’s heart took a big hit, and had he not received CPR almost immediately, he may have had a very different outcome.”

Ready at Crouse
George and the team at Crouse were ready when Gorczynski arrived at the hospital. “Once we got his EKG, we rushed him to the cardiac cath lab on arrival and quickly inserted a stent into his blocked artery,” says George. “Crouse’s average ‘door to balloon time’ is 63 minutes — in comparison to the national guidelines recommendation of 90 minutes or less — and we work hard to maintain that critical window. We’ve developed a smooth transition to minimize delays and get patients into the cardiac cath lab as quickly as possible.”

Gorczynski had a lethal arrhythmia of the left anterior descending (LAD) artery. Commonly known as the “widow maker,” only 12% of those who experience this condition outside of a healthcare facility survive, according to the American Heart Association (AHA). If CPR is not given within five minutes or less, the heart and brain are deprived of oxygen, causing irreparable damage to the heart muscle and cognitive issues, and, in many cases, death.

After the cardiac team inserted a stent to open the blockage, Gorczynski was put into a medically induced coma. The Crouse team was there every step of the way to ensure his full recovery. He doesn’t remember much until Day 5. On Day 8, he was able to go home to continue his healing.

Road to Recovery
“My doctor and nurses were very surprised that I had such an accelerated recovery,” explains Gorczynski. “It’s kind of miraculous. I did have some cognitive issues due to the medication I was on, and I needed some occupational therapy, but my post checkup showed no scar tissue from the heart attack, and I felt almost normal after a couple of weeks.”

Before his heart attack, Gorczynski never had indications of cardiac issues, and he was physically fit. In fact, a check-up shortly before this event had given him a clean bill of health. Today, as he marks the one year anniversary of his heart attack, he is back to his full exercise routine, and while he never had high cholesterol or weight issues, he has improved his diet.

Bank Employees Learn the
Importance of CPR

Gorczynski is the Central New York regional president of M&T Bank, and after his experience he thought it was important to offer basic CPR and AED (automatic external defibrillator) training to bank employees and their families with the help of Crouse and the local chapter of AHA. More than 80 employees learned CPR, including Gorczynski himself. The group was joined by seven nurses from Crouse, led by Lynne Shopiro, RN, chief nursing officer and cardiac nurse, who is also president of the Central New York Chapter of the AHA’s advisory board.

“You don’t have to be a medical professional to learn hands-on CPR,” Shopiro says, noting that the current method involves hands-only chest compressions with no mouth-to-mouth resuscitation. “Learning basic CPR takes five minutes and gives you the confidence as a bystander to help someone in need. I think it’s important for people to remember that CPR can double or triple the chance of someone surviving a cardiac event.”

The CPR training at M&T was a success, and Gorczynski hopes to offer it again in the future. In addition, he and Julie helped coordinate CPR training in their Manlius neighborhood this past year.

“I’m a big proponent of learning CPR, and I’ll continue to spread that message,” Gorczynski says. “The experience is still very surreal. I’m not sure I realized how serious it could have been at the time, and I’m sure I was a bit of a challenge as a patient, but I’m very thankful for my wife, the 911 operator, the local police, EMTs and everyone at Crouse who helped save my life with the excellent level of cardiac care and compassion that the hospital offers. There were a lot of people rooting for me and a lot of people who made sure that I’m here today — healthy and grateful.”

 

Women In Healthcare- Setting No Limits: Recognize Your Dreams and Make Them Your Reality

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By Erin L.W. Zacholl

Swans move across water with such dignity and (what appears to be) effortless ability that it’s easy to admire what they achieve as they glide to their destination. Unless we really ponder what’s being done beneath the surface, we rarely see the hard work that’s propelling them. There are people among us with this same amazing trait. Dr. Tanya Paul is a shining example of someone with a calm and dignified quality that’s perfectly blended with a tenacious spirit that drives her to achieve her goals and then, set new ones.

Dr. Paul is a physician specializing in Obstetrics & Gynecology at Auburn Community Hospital. “Anything is possible if you want to work for it,” she says from a lifetime of experience. “Even as a young child, I have worked toward the direction of accomplishing my dreams.” Originally from Queens, New York, Dr. Paul graduated from the University of Virginia School of Medicine and completed her internship and residency at SUNY Upstate Medical University in Syracuse. “I knew from a very young age that medicine would be a large part of my future,” Dr. Paul reflects on the dreams of a school-aged child, “Although the type of medicine I’ve built my career on is different from my childhood goals, I knew I would become a doctor.”

“My medical ambitions began when I lost two grandparents in one year to cancer,” Dr. Paul remembers that this impacted her so profoundly, that she wanted to cure cancer. “I was so young, but this childhood tragedy opened my mind to practicing medicine. I was determined.” As a young girl, her medical direction would change, “When I was in 5th grade, a friend of mine endured a serious eye injury,” she details, “after seeing her appearance as she had been treated and was recovering, I wanted to be an eye doctor.” It was this dream that Dr. Paul clung close to through the rest of her adolescence and even through her medical school interview.

In medical school, Dr. Paul entertained her various rotations as a young student. “I kept an open mind to possibilities beyond my long-time dream, but was still focused on ophthalmology.” On her first night during her rotation in obstetrics, however, everything changed. “On that very first night, I was able to assist in the delivery of a baby,” she remembers with joy, “and that was it! Being a part of delivering that new life and interacting with the mother sparked a fire in me.” Dr. Paul recounts that everything about obstetrics and women’s medicine was interesting to her from that first night, “I followed through with my other rotations, including satisfying my life-dream of ophthalmology, but I knew being an OB/GYN was where my heart was leading me. Helping women through all the changes in their lives is where I belong.”

As a general obstetrician and gynecologist, Dr. Paul has more than 20 years of experience specializing in comprehensive health care in women of all ages. She is certified by the American Board of Obstetrics and Gynecology and prides her work on providing quality and compassionate care. “As important as my work is in serving medical care to my patients,” Dr. Paul says, “empowering women to take an active role in their healthcare is equally important. It’s so important for women to be healthy and to be heard. If I can help empower women to speak up for themselves, then I’ve been successful.” She says, “there is no distinct blueprint as an OB/GYN and every patient / woman deserves to be heard.”

Her confident and kind demeanor radiates in her voice. Dr. Paul’s ambitions have always been from a place of deep compassion. “I was the first person in my family to graduate college,” she says, “helping other women care for themselves is just part of my goal. Women, who come from a humble place, don’t always see their value and potential. If I can help boost them to realize not just their potential, but help them find the direction to their goals, then I’ve done my job.”

Identifying her own ambitions and reaching past them has always been the motor driving Dr. Paul. Throughout her entire career, she has taken on leadership roles including being the president of the medical staff at Auburn for two years. “I’ve been able to attain my goals and often strive beyond them, because of my support system,” Dr. Paul credits the strength of community. “It is important to have your community around you, to help you fill the gaps. Even if it’s a community of one, a strong support system is essential for all of us to boost ourselves toward our dreams.”

She also believes that what individuals need changes at different points in life and that it’s important to recognize change. “Throughout my career, when I take a job, I make sure that it fits into my life at that time,” Dr. Paul says, “Every person needs to figure out what works best for them where they are in their lives.”

As a physician, Dr. Paul loves the patient interactions the most. “When patients open up to me and I can humanize medicine to them, it’s very rewarding,” she says. “I try to give everyone a voice. Everyone wants to be, and should be, heard.” Dr. Paul believes that a person’s mental health is important in all aspects of medicine, “All doctors should encourage mental health as one of the standard check ups, like visiting the dentist or going for an annual physical.” She believes that all patients would be able to advocate best for themselves if mental health checkups were more universally practiced.

With so much already accomplished in her career, Dr. Paul continues to look forward, “There are always new goals in my scope,” she says, “I ask myself; how can I have the best impact on my community?” Right now, the answer to that self inquiry is her desire to help lower the Maternal Morbidity and Mortality Rate in our CNY Community. “This is such a large problem, and I want to be able to help our most vulnerable mothers.” Another career goal she has in her sight is truly assisting women transition through menopause and perimenopause with a healthy mindset and with accurate information. “This is an aspect of women’s medicine that is so unique to each patient that it’s difficult to generalize and yet, that’s what happens all too often.”

For Dr. Paul, the circumstances may change a bit, but she says, “What has allowed me to be who I am, at all stages of my life and career, is my strong faith and my amazing support system which includes my husband, three sons and extended family as well as the community that I live in. Raising my sons and seeing them grow into strong, compassionate young men is a tremendous inspiration. I feel blessed to have such a source of strength in my life. Everyone needs support to move ahead in life and I only hope that I can help those that need it the most, find it.”

Rome Health Here. Delivering the Best Care Out There.

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By Tami S. Scott

Rome Health is making positive and significant changes to local, community based healthcare. By investing in new technology and a comprehensive master facility plan, the hospital is prepared to deliver the best care “here” — in Rome, N.Y. – so local patients can stay local.

Now in the final phases of a years-long master facility plan, administrators will soon see the fruits of their labor come to life with the construction of a 30,000 square-foot, three-floor modernized addition that will replace the hospital’s current operating rooms and intensive care unit.

Its advancements in new technology, including the Da Vinci Xi surgical system, the 7D Image-guided surgical system for spine care, and EUS and ERCP equipment for GI purposes, benefit both surgeons and patients, particularly those with complex cases. And with its recent expansion of gastroenterology services, patient needs will be fully met without the hassle of long distance travel or months-long waiting periods.

“Our goal was to match the skill set of our physicians with the desire of our community to receive local healthcare here, and match that with the technology we have available to them to provide those services,” said Chief Medical Officer Cristian Andrade, MD.

A new surgical center and intensive care unit
The new Kaplan Center for Surgical Services (named in honor of philanthropists Charles and Florence Kaplan) will be transformed from its existing design to a contemporary, stateof- the-art surgical center with four new operating rooms, two new procedure rooms, and a pre- and post-op area that will be located directly next to the ORs — important for not only flow of care but also patient satisfaction, said 

Chief Operating Officer Ryan Thompson, MBA, FACHE. The front entrance, lobby and waiting room are also being
remade.

Construction will be completed in three phases. The addition for the ORs and ICU is under construction and will be open in mid-2025. In the second phase, the old ORs will be repurposed for pre-op and post-op space. The third phase creates staff support space and will be complete by mid-2026.

“When we make facility changes in our design, we really focus on making sure that we’re finding the balance first and foremost of how it’s going to impact the patient,” Thompson said. “Second, how it’s going to work for the teams that are providing care, including the physicians and advanced practice clinicians and nurses, and even the workflow of our environmental services staff. And then third, to make sure that staff has a space they can go to provide respite during the day, as they’re very busy providing care.”

The new nine-bed ICU considers all aspects of patient and care team needs. Among the highlights are larger individual rooms to accommodate not only the critical care team and necessary equipment but also family members so they too can participate in their loved one’s healing journey.

“We all know that family participation and loved ones’ care lends itself to better patient outcomes,” said Acute Care Director Kelly West, R.N., B.S.N. “And that’s very important to us.”

The rooms also boast specialty beds to reduce the risk of pressure wounds, specialty rooms for behavioral health population, private restrooms with accessibility features, an advanced ventilation system for infection control, more natural daylight to aid in healing, and charting located at pods adjacent to the bedside to allow for closer connection with the patient.

King + King Architects and Haynor Hoyt Corporation built a mockup of the ICU and the OR in the hospital garage so staff could experience what the rooms would look like and how large they would be. “We put the outlets on the walls where we wanted them, we put monitors on the walls where we would want them,” said Vicki Weiss, R.N., OR nurse manager. “Some of the small things that you wouldn’t think were important are so important to the staff.”

The $45.7 million capital project is being funded through a partnership of more than $29 million in public funding and private philanthropy, including a $26 million New York State Transformation Grant and $3 million in ARPA funds from the City of Rome. The Rome Health Foundation kicked off the public phase of the capital campaign in January with $14.2 million already raised. The goal is to raise $16.5 million.

“We’re about a million and a half dollars away from hitting that overall goal,” Thompson said. “It’s just tremendous support from the community to be able to hit that.”

Advanced technology, gastroenterology services

“The DaVinci Xi Surgical System was among the first new pieces of equipment that Rome Health acquired and was very well received by our medical staff colleagues,” said Chief Medical Officer Cristian Andrade, MD. The goal was to get staff trained and able to utilize the robot well before the new surgical center is open, and the plan “went seamlessly,” he said. “We had our first non-proctored surgery with robotic assistance performed on June 12 by our general surgeon, Dr. [Keneth] Hall,” — also a bariatric surgeon.

Since then, Rome Health has equipped other general surgeons and gynecologists to perform robotic assisted surgery. “We will likely be doing some urologic procedures in the near future as well,” Dr. Andrade added.

Dr. Hall explained the benefits of robotic-assisted surgeries as enhancing surgical precision, control, and efficiency. “This advanced system enables smaller incisions, leading to reduced pain, scarring, and faster recovery times. It also decreases the risk of complications and improves surgical outcomes,” he said. “The robot’s capabilities streamline surgeries, allowing for more efficient use of operating room time and potentially increasing patient throughput.”

General surgeon Dr. Samuel Molica, DO is hopeful that the advanced technology will prevent the more difficult minimally invasive procedures from being converted to open.

The same benefits and even more apply to the 7D Image-guided surgical system for spinal surgeries.

“The advantages we have received from using the 7D technology is that infection rates are minimal to non existent and patients who may have been at high risk now have the opportunity to receive the needed surgery due to the smaller incisions and how minimally invasive the procedure can be,” said Dr. Nicholas Qandah (aka Dr. Q), a leading back and spine surgeon in the CNY region.

Rome Health administrators also found a way to combat the regional shortage of gastroenterologists by establishing a GI practice this past spring at the Medical Center on the main campus of the hospital.

“When we got together as an administrative team to develop a physician development plan, it became very clear from a community needs assessment that there was a significant need for gastroenterology services to be provided here locally,” Dr. Andrade said. “If you look at that specific specialty, lots of times, patients here would have to be transferred sometimes two or three hours away to be able to get the level of care we’re going to be able to provide right here at home.”

Rome Health recruited two board certified gastroenterologists, Dr. Aamer Mirza, MD, who has been practicing for more than 24 years, and most recently Dr. W. Asher Wolf, MD. “They’ve been very well-received by the community. We’ve already seen the demand for their services skyrocket,” Dr. Andrade said. Dr. Wolf ’s advanced background includes providing patients with endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) services. Consequently, Rome Health invested in the equipment to perform these procedures.

“There’s only a handful of other gastroenterologists in the Central New York region that provide these procedures,” Dr. Andrade said. Additionally, with Dr. Wolf on board, Rome Health is now offering weekend appointments for colonoscopies, providing greater accessibility and convenience for patients.

Keeping it local

Rome Health decided long ago to set its sights on the needs and wants of its community — to have access to the best physicians with advanced technology — locally.

“When we decided to acquire these different technologies, first of all, the patient was at the center of it, really keeping in mind what the desire for the community has been, and [it] really has been to receive quality care right here at home,” Dr. Andrade said. Dr. Qandah drove it home: “Our top priority is to bring ideal health care to our region. That way we can deliver the care locally and patients can get better quicker in their own home, in their own
community.” 

Nursing Work Force Shortages

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By: Kathryn Ruscitto,
Advisor

I was recently asked to moderate a panel in NYC sponsored by the Mother Cabrini Health Foundation , on the shortage in the nursing workforce.

Leaders from a variety of settings discussed the challenges facing nursing and the opportunities to improve recruitment and retention.

The Center for Workforce Studies specifically detailed options to address recruitment ranging from scholarships, and tuition assistance to nursing residencies, and mentors. Among retentions strategies were nursing councils within programs like Magnet and Pathways to Excellence. Clearly the demand for nurses is increasing and the challenges facing nurses are also increasing.

The issue that struck me the most listening to this panel was the dramatic increase in workplace violence. Many public facing employees in our society have seen an increase in violence, health professionals are seeing that same increase. There are no easy answers, but there are many research projects that have looked at the issues and have detailed violence prevention programs and interventions. Public Health Services have identified the same process model to be used across all violence prevention in areas from domestic violence to health care.

Fig. 1: 10 Essential Public Health Services
Currently the focus in most health settings is on training for assessing and managing risks, leading to reporting and assigning resources for the most at risk patients. One of the clearest messages from the panel was on leaders placing a priority on training, and reporting.

It is also not just nurses facing these challenges, but all those who are part of the health care team. Violence prevention training must be part of all onboarding and communications across the team must be ongoing.

Resolving conflict avoids violence and is a skill to learn for all aspects of life. Take any training offered and look for resources on conflict resolution, violence prevention, and policies. Syracuse University offers unique training through PARCC, the Program for the Advancement of Colloboration and Conflict Resolution.   https://www.maxwell.syr. edu/research/program-for-the-advancement- research-on-conflict-collaboration

Health professionals need our advocacy and support in bringing attention to these challenges. While we all must focus on first preventing violence, when it occurs action needs to be taken to protect health professionals in all settings.

Resources:
Center for Workforce Studies
https://www.chwsny.org/

NIH
https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC9536186/

Journal of Emergency Nursing
https://www.jenonline.org/article/S0099-
1767(23)00059-4/fulltext

Kathryn Ruscitto, Advisor, can be reached
at linkedin.com/in/kathrynruscitto or
at krusct@gmail.com

5 Points Your Physician Employment Agreement Should Address Regarding Med Mal Coverage

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By: Jenn Negley

Physician employment agreement clauses regarding your medical malpractice coverage are complex issues that are often muddled at best, and some even create more questions than they would if they just didn’t deal with the important malpractice insurance issues. Confusion and ambiguous wording in contracts create lawsuits so fully understanding these five points will help immensely:

1. Who will be purchasing what coverage?

Most Physician employment agreements at least state if the employer or employed physician will be purchasing coverage. The issues go well beyond that, but most agreements only hit the broad-brush basics.

2. Retro coverage or not when joining a new practice?

Will retroactive coverage be purchased for the employed doctor’s possible previous exposure? If not, who will pay for the expensive “tail” coverage? If retroactive coverage is being brought into the new practice who will be paying the difference between the “mature” policy cost and a first-year claims-made policy cost? Tail coverage allows a physician to extend coverage after the cancellation of a claims made policy. With tail coverage, if a claim is filed that reflects the period of the expired policy, coverage is provided even though the policy is no longer in effect. An important portion of the employment agreement should address any professional liability insurance coverage that will be required, as well as which party will be responsible for acquiring and paying for the coverage. If the professional liability insurance is a “claims made” policy, then tail coverage needs to be addressed in the agreement as well in case of departure or termination.

3. What limits will be required to be purchased?

There are differing opinions on purchasing low or high liability limits so the physician employment agreement needs to address the limits issues, as well as situations in which the employed doctor might want higher limits than most in the group, which brings up if this will be allowed and, if so, who will pay for the increased costs of a higher limits policy.

4. Quality of insurance company:

To say the least, not all insurers are created equal and there are vastly different thoughts on the risks versus costs of purchasing coverage from a financially unstable insurer versus an A.M. Best toprated insurer.

5. Departing physician’s tail issues:

Will a tail purchase be required, or will it be acceptable to purchase continuing coverage, keeping the in-force retroactive coverage date for at least five years after leaving a group? Will the choice between those two depend upon termination with cause or not, and/or termination by which party? Since there is now a stand alone tail market, what quality of tail insurer is acceptable, and how long of a tail must be purchased, since even one year tails can be bought but do not begin to offer relief for the much longer liability risk window?

The physician employment  agreement should outline all these terms on whether the group or the individual physician is obligated to pay for and purchase these coverages. By clearly stating the expectations and requirements in the employment agreement there should be no question about what is expected surrounding the beginning, duration, and termination of the employment relationship. All parties in an employment agreement need to fully  educate themselves with a knowledgeable and experienced malpractice insurance expert to prevent any unrealized expectations or miscommunications about the key issues, and a misstep in this area can lead to coverage gaps or coverage issues which can lead to very costly legal actions.

Women In Healthcare Look For The Beacons: Building Hope Through Behavioral Health

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By Erin L.W. Zacholl

There is a special glimmer when you realize that you are in the presence of someone who didn’t necessarily find the right course in life but were simply placed on it. Perhaps by serendipity or fate, Stephanie Montgomery was led to a small path at an early age. She recognized its direction, worked hard, persevered over tough times and forged a mighty highway out of its humble start.

Stephanie is the Administrative Director of Behavioral Health at Syracuse Community Health. Her SCH career began almost 30 years ago when she served as the receptionist for the Counseling Addiction and Psychological Services (or CAPS) department of SCH. Every promotion she has earned since serving as receptionist was created for her. She has truly pioneered her own career while making opportunities for others to follow. “I firmly believe that all of us must stay focused and use what we have in front of us as an advantage, nota hurdle,” Stephanie speaks these words with a laser focus.

At an early age, she found herself the victim of domestic violence and used this experience as a building block, not a crushing boulder. “Syracuse Community Health was my safe place,” Stephanie recalls with accomplishment. “I used this period of my life to propel myself. I kept pulling myself up and that experience helps me with much of what we do in Behavioral Health.” Stephanie continued, “It’s not always easy, but we all must recognize our own strengths and stay committed. Keeping my word is so important; to the people I serve and to myself.”

Stephanie feels that is both her responsibility and honor to especially reach areas of our general population that are often misheard and misunderstood. “As a biracial woman, I understand what it’s like to feel connected to more than one place, but not necessarily feel grounded in either,” she speaks from the heart, “I am proud to help other biracial women, as well as others in our community who are most vulnerable. We all need to recognize our value and belonging, and SCH is such a wonderful platform for this purpose,” her words are spoken with a smile. “There is so much here to offer our community.”

Through her own journey at SCH, Stephanie attests that her years at SCH have seen, much change, yet much has also stayed the same. “While the stigma of mental health has alleviated over time, I would love to see it gone,” Stephanie reflects, “it’s still a roadblock.” When Stephanie speaks, her words are annunciated from such a place of solid experience, ,“When someone is diagnosed with cancer, there is no judgment when the patient needs help and treatment. Society needs to treat people facing addiction and mental illness the same as they would treat someone with a terminal disease.” She believes that the department title Behavioral Health helps integrate all the services the SCH offers while hopefully helping to eliminate the stigma associated with the “addiction” portion of CAPS. “The majority of addiction patients are navigating a deeper illness,” Stephanie says, “often, overdosing is a result of self-medicating for an underlying condition.” Through her decades at SCH, Stephanie has seen the, addiction crisis evolve from crack cocaine toward opioids. “It’s eye-opening when you look around,” she says, “mental health and the opioid addiction have exploded; waiting lists are long, but hope exists.”

Stephanie’s department at SCH offers a personalized approach to care and treatment. Their individualized method of care is respectful, educational and focuses on a person-centered journey. “We treat the whole person,” Stephanie explains the approach to SCH’s services. “It’s important to respect each person’s perspective by listening to them and by supporting  improvements in their mind, body and spiritual well-being.” She also stresses the importance of seeing someone in person. “Since COVID, there is such a shortage of mental health providers, social workers, marriage-family and crisis therapists.” Additionally, the pandemic found many providers with their own issues and unable to provide services to others. Since COVID, New York State has also started telehealth, services, to include mental health. While this helps broaden the possibilities for more people to seek help, Stephanie cautions that “many professionals went into private practice with the convenience of telehealth, even though providers really do need to see people in person (at least sometimes).”

The Behavioral Health Department at SCH is small and intimate, but large in the services offered and the accreditations of their team. “It’s important that our community understands all that is offered here,” Stephanie proudly states. “W are a unique behavioral health department with a team that specializes in Medication Assistance Treatment Services, Out-patient Addiction Services (inclusive of impaired driver assessments) as well as Individual and Family Therapy.” Stephanie says that she loves watching the transformation in people that are seeking help and pursuing help, “I was brought up here and to be able to work in such a place that is so patient focused and understanding about the populations we serve is a tremendous feeling.”

At SCH, Stephanie Montgomery makes every day intentional. “Did I do my best today?” she asks herself nightly. “I have gone through seasons of my careers at SCH and each one found me right where I needed to be,” reflecting on her years. “I feel so blessed to be part of this humbly wonderful team.” Stephanie is often asked how she balances her work and professional lives. In addition to her gratitude for the environment at SCH, she always replies, “My simple answer is Faith, Family and a good support system; no matter how large or small that system may be.”