ISSUE #124 WWW.MD-UPDATE.COM THE BUSINESS MAGAZINE OF KENTUCKIANA PHYSICIANS AND HEALTHCARE PROFESSIONALS VOLUME 9 • #6 • O CTO b E r 2019 ALSO IN THIS ISSUE FORMER MARINE PRACTICES DERMATOLOGY IN BOWLING GREEN ONCOFERTILITY PRACTICE IN LOUISVILLE THE COLON CANCER PREVENTION PROJECT IMMUNOTHERAPY RESEARCH AT UofL Dr. Jones Speaks: Going on Offense Against Cancer Whitney Jones, MD, embraces preventative measures to beat colon cancer before it startsKnow A Good Doctor? We Do. YOUR RESOURCE FOR THE BEST IN KENTUCKY HEALTHCARE Now available online • Over 50,000 visits! www.md-update.com .com2 MD-UPDATE MD-UPDATE MD-Update.com Volume 9, Number 6 ISSUE #124 PUBLISHER Gil Dunn gdunn@md-update.com GRAPHIC DESIGN Laura Doolittle, Provations Group COPY EDITOR Amanda Debord CONTRIBUTORS: Jan Anderson, PSYD, LPPC Scott Neal, CPA, CFP Laura ross Stephanie Wurdock, Esq. CONTACT US: ADVERTISING AND INTEGRATED PHYSICIAN MARKETING: Gil Dunn gdunn@md-update.com Mentelle Media , LLC 38 Mentelle Park Lexington KY 40502 (859) 309-0720 phone and fax Standard class mail paid in Lebanon Junction, Ky. Postmaster: Please send notices on Form 3579 to 38 Mentelle Park Lexington KY 40502 MD-Update is peer reviewed for accuracy. However, we cannot warrant the facts supplied nor be held responsible for the opinions expressed in our published materials. Copyright 2019 Mentelle Media, LLC. All rights reserved. No part of this publication may be reproduced, stored, or transmitted in any form or by any means-electronic, photocopying, recording or otherwise-without the prior written permission of the publisher. Please contact Mentelle Media for rates to: purchase hardcopies of our articles to distribute to your colleagues or customers: to purchase digital reprints of our articles to host on your company or team websites and/or newsletter. Thank you. Individual copies of MD-Update are available for $9.95. SEND YOUR LETTERS TO THE EDITOR TO: Gil Dunn, Publisher . . . gdunn@md-update.com, or 859.309.0720 phone and fax Until then, all the best. Gil Dunn Publisher Welcome to the Cancer Care Issue of MD-Update LEXINGTON It was a very busy several weeks from late September through early October, begin- ning with the Kentucky Medical Association’s Annual Meeting, followed quickly by the Medical Marijuana Fact and Fiction Forum presented by the Foundation for a Healthy Kentucky, and the fall meeting of the Lexington Medical Society with the past-presidents’ dinner. One constant presence at those events was the newly elected president of the KMA, Brent Wright, MD, MMA, who spoke, moderated, and was accessible to all who approached him. The youthful and engaging Dr. Wright has been touring the Commonwealth lately, meeting with various individual physicians and physician groups as he spreads his message promoting “Collaboration, because there’s great work in medicine going on in this state.” Wright says he wants to doctors to text him (270. 670. 9319) with their concerns. He is also encouraging physicians to call the KMA Legislative Action Line (800.372.7181) to relay their thoughts to their legislators in Frankfort. The legislators get a tally of the pros and cons on issues from their constituents, says Wright, and “It really has an impact on them.” I predict that Dr. Wright’s leadership will have an energizing effect in Kentucky healthcare. He is a new generation of physician leaders, a graduate of the KMA Physician Leadership Institute, and a Community Connector. His background includes UK for under- graduate; the UofL School of Medicine; the University of Southern California for a master’s degree in medical management; Associate Dean at UofL for Rural Health Innovation and residency director for UofL/Glasgow Family Medicine. He is steeped in Kentucky traditions and geography and knows first-hand the challenges. He is an avid user of digital social media and he meets people face to face. He is the right man at the right time for addressing Kentucky’s public health issues. Another doctor, Whitney Jones, MD, who has been instrumental in changing the health of Kentuckians is the subject of this issue’s cover story. Because of his dynamic leadership in found- ing the Kentucky Cancer Foundation and the Colon Cancer Prevention Project, Kentucky has dramatically lowered its colon cancer rates, from 49th in the nation to 17th, earning the American Cancer Society’s Achievement Award for most improved state for colorectal screening. Read what Dr. Jones has to say on page 10. The MD-Update 2020 editorial calendar is available for you to review on the inside back cover. Please take a look at it. When you see your specialty, contact me. I’d like to hear your story. brent Wright, MD, MMA, president KMA LETTEr FrOM THE PUbLISHErISSUE #124 3 CANCEr CArE ISSUE #124 14 GASTROENTEROLOGY15 ONCOFERTILITY15 ONCOFERTILITY19 DERMATOLOGY21 IMMUNOTHERAPY RESEARCH CONTENTS SPECIAL SECTION 10 Dr. Jones Speaks: Going on Offense Against Cancer Whitney Jones, MD, embraces preventative measures to beat colon cancer before it starts COVEr AND TAbLE OF CONTENTS PHOTOGrAPHY bY ALEXANDrA rOGErS 4 HEADLINES 6 FINANCE 8 LEGAL 10 COVER STORY SPECIAL SECTION: CANCER CARE 14 GASTROENTEROLOGY 15 ONCOLOGY & OB-GYN 19 DERMATOLOGY 21 ONCOLOGY 25 MENTAL WELLNESS 27 NEWS 30 EVENTS4 MD-UPDATE KMA 2019 Annual Meeting: “Moving Medicine, Together for Tomorrow” A full house packed the room for KET’s town hall forum LOUISVILLE The Kentucky Medical Association’s Annual Meeting, held September 20-22, 2019 at the Marriott East, was a bountiful presenta- tion of information and insights from leaders from outside of the medical community about issues that face the medical community. On Saturday’s session, after welcoming remarks by KMA president Bruce A. Scott, MD, one of the topics addressed was opioids and federal prosecution, presented by Russell Coleman, US Attorney and chief federal law enforcement officer for Kentucky’s Western District, an area that encompasses 53 counties and 2.2 million Kentuckians. While discussing opioid misuse and abuse, Coleman repeatedly stated that “We prose- cute egregious conduct in healthcare fraud. That’s conduct that is outside of legitimate medical needs and practices.” He emphasized his department’s deep respect for the medical community. “We’re not anti-physician, we’re not here to prosecute doctors,” he said. Coleman added that most of his depart- ment’s investigations arise from “whistleblow- er complaints, the False Claims Act, and high prescription rates for opioids.” Targeting Tobacco and Vaping “Status of Public Health in Kentucky,” a report on public health in the Commonwealth was presented by Ben Chandler, president & CEO of the Foundation for a Healthy Kentucky. The Foundation was founded in 2001 and according to Chandler has awarded nearly $28 million in grants through June 2019. Chandler pointed to some of the Foundation’s successes such as advocating for the passage in 2019 of an increase in the sales tax on cigarettes, significantly increas- ing the number of tobacco-free school dis- tricts in Kentucky from six to 72, and the Foundation’s new effort to tax and regulate e-cigs and vaping products in Kentucky. He showed a video of the Foundation’s public service TV ad campaign, “I Just Didn’t Know” (ijustdidn’tknow.org), featuring a compelling performance by eleven year old Claire, from Henry county. “I could get addicted to these,” she said, pointing to a small vaping device. “It has as much nicotine as a pack of cigarettes. I just didn’t know.” Additional initiatives of the Foundation are access to healthcare, obesity prevention, child- hood health, and preventing and reducing the long-term impact of adverse childhood experiences. Social Media: Like It or Not A presentation on social media and advo- cacy by Emily Schott, KMA director of com- munications, stressed that physicians would benefit by some understanding of and use of social media. “You have a social media presence, whether you want one or not,” said Schott, as she demonstrated Facebook’s ability to create a page for a physician or practice that does not have one. Schott discussed various social media plat- forms and their audiences, such as Facebook, Instagram and Twitter. She offered her assis- tance to physicians who want to find out more. Contact her at schott@kyma.org. KET Town Hall Forum Taping A new media experience for the KMA took over the meeting at 3pm when KET filmed an upcoming KET Forum town hall session of “Prescription for Health,” which was hosted by KET’s Renee Shaw and included interviews by Wayne Tuckson, MD, a gastroenterology surgeon and host of KET’s “Kentucky Health.” Among others, Tuckson spoke with Chandler on the efforts of the Foundation for Healthy Kentucky; to Fred Williams, MD, an endocrinologist and past-president of the KMA on diabetes and obesity; and Danesh Mazloomdoost, MD, anesthesiologist and regenerative medicine practitioner on pain and opioid use and misuse. The KET Forum session at the KMA aired on October 7 and is on the KET website. New KMA President The Saturday night KMA Leadership Dinner included the new president’s instal- lation. R. Brent Wright, MD, MMM, from Glasgow, Kentucky, became the new KMA president. In an earlier interview, Wright told MD-Update that his initiatives included pass- ing legislation to improve health in Kentucky. “I’m going to focus on collaboration,” said Wright. “That includes policy, our Kentucky population, best practices for prescribing by our providers, and our philosophy of patient-centered care.” HeadlinesISSUE #124 5 PHOTOs BY Gil dUnn R. Brent Wright, Md, MMM, of Glasgow, KY, is the new KMa president Bruce a. scott, Md, outgoing president of KMa, welcomed the attendees to the saturday session Russell Coleman, Us attorney and chief federal law enforcement officer for Kentucky’s Western district Ben Chandler, president & CeO, Foundation for a Healthy Kentucky Jan anderson, Psyd, and shawn C. Jones, Md, past- president of KMa Wayne Tuckson, Md, host of KeT’s “Kentucky Health” William C. Thornbury, Jr., Md, KMa trustee, and Fred a. Williams, Jr., Md, past president of KMa Gordon R. Tobin, Md, past president of KMa and Tuyen T. Tran, Md, KMa trustee and past president of lexington Medical society danesh Mazloomdoost, Md, KMa speaker, House of delegates, and K. John Yun, Md, KMa trustee Headlines6 MD-UPDATE Were you ever a member of the Book-of-the- Month-Club? I joined BOMC back in the 80s, but I quickly decided that I wanted to choose my books more intentionally and more strategically. I still read a lot; non-fiction most- ly, and books have been known to wreck my budget. There are a few authors that have truly been instrumental in shaping my ideas about financial planning and investments. I believe that I am where I am today “by standing on the shoulders of giants.” My favorites are those who have set out a theoretical framework in a book or books and then update their ideas through periodic newsletters or memos. By the way, I often find some of my giants have ideas that differ from the others. An enjoyable part of my job is to think criti- cally about these things and to continue to dig to resolve the questions. In short, these giants have earned my respect, but not blind discipleship. I share here a sample of those I consider more significant. • H. Woody Brock, PhD, president of Strategic Economic Decisions is, in my opinion, a world-class economist. I first became acquainted with Woody in May 2007 at a conference in Chicago. I came home and started reading what he had written over his long career. We subscribed to his service, i.e. we pay him money for his thoughts, but you can sample it on his website www.sedinc.com. His 2012 book, American Gridlock, Why the Right and the Left are Both Wrong probably needs to be updated but is still worth reading, given the loftiness of the stock market. Of importance to the readers of MD-Update, he addresses the supply / demand of the Affordable Care Act and the dynamics of total health care expenditures in the appen- dices to his book. • Ed Easterling, founder of Crestmont Research. Ed has written two books, Unexpected Returns: Understanding Secular Stock Market Cycles and Probable Outcomes: Standing on the Shoulders of Giants BY SCOTT NEAL When you need a good malpractice defense and you need it stat. 201 East Main Street, Suite 900 Lexington, Kentucky 40507 (859) 231-8780 | www.mcbrayerfirm.com Corporate Government Affairs Healthcare Regulation Medical Malpractice Defense Litigation Real Estate FiNANCEISSUE #124 7 When you are treated fairly you are confident in your coverage • 800.282.6242 • ProAssurance.com Healthcare Professional Liability Insurance & Risk Resource Services healthy vitals ProAssurance has been monitoring risk and protecting healthcare industry professionals for more than 40 years, with key specialists on duty to diagnose complex risk exposures. Work with a team that understands the importance of delivering flexible healthcare professional liability solutions. Secular Stock Market Insights. His concep- tion of “financial physics” is most compel- ling. As importantly, his free website www. crestmontresearch.com provides an update to market valuation, interest rates, and the economy in a way that is accessible for the non-financial professional. His graphical representations are unique and informa- tive. In his words, Crestmont is “keenly focused on the outlook for most investors’ horizons—periods of five to twenty years.” If you read his work, I suggest that you start with a piece that he added to his web- site this year, “Outlook: How Crestmont Research Forecasts.” • Howard Marks, CFA, co-chairman of Oaktree Capital Management, publishes a free memo (although you might have to subscribe to get it) a few times a year and is always an insightful read on the markets. Find nearly 20 years of Marks’ memos at www.oaktreecapital.com He is, admittedly, not an economist. One of his most compelling memos was “This Time is Different” written in June 2019. In it, he recalls Black Monday (October 19, 1987), and he introduces several ideas that any investor should consider. (HINT: He warns against thinking this time is different and offers solid reasons why.) His books, The Most Important Thing Illuminated: Uncommon Sense for the Thoughtful Investor and Mastering the Market Cycle: Getting the Odds on Your Side, are both widely acclaimed by investment professionals. • Laurence Kotlikoff, PhD, professor of eco- nomics at Boston University, has greatly influenced the way we do financial planning at D. Scott Neal, Inc. He introduced us to consumption-smoothing to model the impact of current financial decisions on a family’s standard of living. His book, Spend ‘til the End: Raising Your Living Standard in Today’s Economy and When You Retire, is both enter- taining and informative. It fits nicely with my theory that there are only 5 things to do with all the money that comes to you: pay your taxes, service your debt, give some, save some, and spend the rest. Thanks to mod- ern computing technology and Kotlikoff’s tools, we can calculate the maximum level of spending, adjusted for inflation, that will allow a smooth standard of living for the rest of your life. His book, Get What’s Yours: The Secret to Maxing Out Your Social Security is a must-read for anyone before they claim their social security benefit. And if you have inter- est in the what our current policies are doing to future generations, I suggest his book, The Coming Generational Storm. For other resources check out the tab What We Think on our website www.dsneal.com Scott Neal is resident of D. Scott Neal, Inc., a fee-only financial planning and investment advisory firm with offices in Lexington and Louisville. Write to him at scott@dsneal.com or call 1-800-344-9098.Next >