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Pulse Magazine Winter 03 Issue

In this issue...

Life Beyond Medicine (Cover Story)

In Their Other Lives

Public Health 101

MBA Program Gives Physicians Business Expertise

LIFE BEYOND MEDICINE
By Cameka L. Crawford and Amy Kiker

A career in medicine is a fulfilling, albeit challenging, experience. Patients demand constant attention, and work often isn't something that can be left at the office. It is easy to overlook the fact that medical professionals have interests outside of the office that reflect their diverse personalities and ideals.

Texas Tech University Health Sciences Center alumni are proof that medical professionals can achieve great things not only on a professional level, but on a personal one as well. The message these individuals convey through their desire to step beyond their roles as medical professionals is simple: Some very great rewards in life can come to those who experience life beyond medicine.

Ellen Clark, M.D.

During the aftermath of the wars in Bosnia, Croatia and Serbia, Texas Tech University Health Sciences Center graduate and forensic pathologist Ellen Clark, M.D., served with the team Physicians for Human Rights. In this capacity, she conducted autopsies and examinations on bodies recovered from mass gravesites in the area formerly known as Yugoslavia.

The information gathered by the team was used in war crime trials that brought attention to that region in the 1990s. Ultimately, the team's work helped to avenge many of the war's victims and is considered a significant part of this chapter in history. According to Clark, the information gathered was vital; however, that was not the most important aspect of the service.

"I felt that the most important humanitarian service was in providing grieving families with positive identifications and details about lost loved ones," she said.

Clark graduated from TTUHSC in 1984 and said she enjoyed her education. "I am convinced that I was provided with a wonderful education and the demands to meet the demands of my profession," she said.

Clark currently serves as a forensic pathologist for the Washoe County coroner in Reno, Nev., and revealed in the Reno-Gazette Journal that when she decided to specialize in forensic pathology, her mentors said she was crazy because she would only be working with dead people. However, Clark said that is completely untrue.

"I work with some of the most fascinating, living people with diverse backgrounds," she said.

As a forensic pathologist, Clark has a crucial role on an investigative team, but that is not the most important role in her life. Clark has been married for 25 years and enjoys the antics of their three sons, herd of cattle, seven horses, three cats and three dogs.

Carmen Garza, M.D.

When Carmen Garza, M.D., graduated from Texas Tech University Health Sciences Center in 1985, she had no idea she would embark on a nonmedical adventure in Brazil. Garza and her husband, Henrique Levcovitz, M.D., lived on a chocolate plantation from 1991 to 1994 in Ileus, Bahia, a town in a northern state in Brazil.

According to Garza, this region is known for its rich history and chocolate plantations that have existed for more than 200 years. During her first drive on the outskirts of Ileus, Garza remembered passing through a cluster of trees wondering when she and her husband would come to the chocolate trees.

"I never realized these very trees were the cacao trees that are the origin of my favorite chocolate candy bar," she said.

On the chocolate plantation, Garza worked alongside the people whom she admired because of their strong "mañana," or sense of living. In addition to this, she worked in a missionary clinic treating illnesses, like leprosy and hookworm infestation, that she only saw in a textbook as a second-year medical student.

According to Garza, working in this clinic taught her to have appreciation for her patients, and in return, her patients always made an effort to pay.

"People who had poor means would cook you a cake or invite you to Sunday lunch," she said. "Once, we even received a live chicken as a token of appreciation."

Today, Garza and her husband live in San Antonio with their two sons. She is also a pediatrician at Medical Center Pediatrics.

"I believe that I am lucky to be a pediatrician because I can be a child everyday at work with the children," Garza said.

Tim Howell, R.N., M.S.N.

As the vice president of patient care services and chief nursing officer at University Medical Center and a commander in the Naval Reserves, Tim Howell, a 1999 Texas Tech University Health Sciences Center graduate, knows all about service.

Howell joined the Naval Reserves because he was brought up to value military service. Many of his uncles and his father were in the Navy during World War II. Howell also said his father raised him with the understanding that many people sacrificed a great deal to protect his personal freedoms.

"I believe that if I am able to have even some small part to protect our freedoms, then I should take that opportunity, regardless of personal convenience or cost," he said.

In March 2002, Howell received the Naval and Marine Corps Commendation Medal. He was honored for his work as an officer in charge of a two-week exercise that involved the detachment of 100 Fleet Hospital Dallas personnel to care for 3,000 Marines in a desert environment.

Howell was drawn to medicine because he is a service-oriented person and likes to be helpful. While at UMC, he has improved patient satisfaction and decreased the length of stay and cost of care for patients. In 1999, Howell received UMC's Lead By Example Award for his work in patient care.

In spite of all this, Howell said his greatest achievement was riding a bicycle across the U.S. while in high school.

Gary Mangold, M.D.

The view from atop Pike's Peak was so breathtaking that it inspired Katherine Lee Bates to compose the lyrics to the song "America the Beautiful." Since that time, millions of people have experienced the view firsthand; however, few have had the opportunity to experience Pike's Peak like Gary Mangold, M.D.

Mangold, a 1976 graduate of Texas Tech University Health Sciences Center School of Medicine, has run the Pike's Peak Ascent seven times since 1984. Pike's Peak Ascent is a 14,110-foot trail that leads to the top of the mountain, and Mangold said that the ascent is a treacherous trail and climbing it is one of the most difficult things he has done.

"The weather changes are very dramatic and sometimes dangerous, and the altitude's effect on one's body can be very scary," he said. "However, the feeling of accomplishment you get when you reach the top is indescribable."

Like his adventures with Pike's Peak, Mangold's career has been both challenging and satisfying. In 1979, Mangold joined his father in practice in Lockney, and for eight years they were the only two doctors in the area. "My father passed in 1992, so I had 13 years to practice at his side," he said. "I would not trade that learning and growing experience for anything."

The Lockney native became a physician because he wanted to follow in his father's footsteps. He currently performs surgery and practices obstetrics in the hospital in which his father delivered him. "I have known since I was 6 years old what I wanted to be; I wanted to be like my dad," he said. "He built a very special clinic and hospital through plain old hard work, dedication and caring."

However, Mangold is not just a physician and marathon runner, he also restores cars. He said most of the cars that he works on have always been in his family, including his first car, a 1962 Ford Falcon Futura. He also said although his cars are not especially valuable, they all mean something to him. "I really enjoy getting out and working on them when I have the time," he said. "That is good relaxation and a good challenge."

Mangold believes that his greatest achievement to date has been his 28-year marriage and raising his three daughters. He also said he has enjoyed his career in Lockney. "I truly believe West Texas people are the finest people around," Mangold said.

Chris Soares, M.D.

You might call Chris Soares, M.D., a master of balance - but not just because he loves exploring the country on two wheels. Soares, a long-time cross-country bike riding enthusiast, prides himself on his ability to balance spending time with his family, devoting time to his career in ophthalmology and riding close to 4,000 miles on his bike each year.

A 1988 Texas Tech University Health Sciences Center School of Medicine graduate, Soares lives and practices pediatric and general ophthalmology in a rural Vermont town. Practicing medicine in a small town is a dream Soares first had in high school. "I envisioned becoming a country doctor in a rural setting," Soares said. "I wanted a chance for me to get to know my patients and for them to know me."

And as if cross-country biking and a practice in which he sees more than 3,000 patients each year weren't enough, Soares also serves as an assistant professor of ophthalmology for Dartmouth Hitchcock Medical Center. He teaches both Dartmouth and University of Vermont medical students during two-week clinical rotations through his clinic.

Some of the most beautiful vistas in North America have provided the backdrop for Soares' biking adventures. His first bike trip took place nearly 20 years ago when he and his wife Laura traveled 1,750 miles from Glacier National Park in Montana to the Grand Canyon. "We still have fond memories of how life was on the bike trip," Soares said. "Each stroke of the pedals brought us one revolution closer to majestic places."

Since that excursion, Soares has traveled the Oregon coast, ridden the Washington state coastline from Canada to the Oregon border, and trekked from the Golden Gate Bridge in San Francisco to Tijuana, Mexico. For the past two years, Soares also has competed in the Mt. Washington Bike Race, a 7.6-mile climb up New England's tallest mountain. "There are few sensations that can rival the feeling of wind blowing through your hair as you descend a mountain pass after a long, arduous climb," Soares said.

After so many biking accomplishments, physical balance has served Soares well. But Soares prides himself more on a completely different kind of balance.

"My greatest achievement is being able to balance the things I love most in my life," Soares said. His top priority is his wife of nearly 20 years, Laura, and their three children, Nicholas, Nathaniel and Lauren. Although his career and bicycling are also very important to him, Soares feels his role as a family man is the most significant aspect of his life.

Traversing the country on his bike has taught Soares some truly remarkable lessons, and he uses the knowledge he has gained from his travels each and every day.

"The world is a beautiful place; slow down and take time to see it," he said. "The destination is important, but the journey is where we live each day."

Ruth Zimmer, M.D.

In 1998, a documentary entitled "A Healing Story" won an Academy Award for best short documentary. This award winning crew included a 10-member medical team and a documentary film crew. Among them was Ruth Zimmer, M.D., an anesthesiologist and Texas Tech University Health Sciences Center graduate.

According to Zimmer, the film chronicled a 1997 mission trip with Interplast to the Mekong Delta where the team treated a total of 160 patients in two cities.

"The main patient in the field is a 16-year-old boy who had a cleft lip repaired," she said. "It shows the transformation of his life and is really quite emotional."

The goal of these two-week trips is not only to repair cosmetic and functional birth and acquired defects in children but to also educate the local physicians on treatment care and management of these problems.

Zimmer is currently completing a two-year associate fellowship in complementary and alternative medicine via the Internet. Zimmer said she is astounded at the amount of CAM being used by the mainstream public.

"I am not a primary care provider," she said. "However, I have found many ways to include CAM in the care and treatment of my patients."

As if her teaching responsibilities and studies were not enough, Zimmer and her husband, Robert Neubecker, have two daughters – 3-year-old Isabel Ruth and 3-month-old Josephine Grace.

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IN THEIR OTHER LIVES
By Suzanna Cisneros Martinez

He is a chancellor and former president of the Health Sciences Center. But many people may not know that David R. Smith, M.D., is also an avid ice hockey and water polo player. The School of Pharmacy's CA Bond, Pharm.D., works with colored glass for art work; physical therapy professor Chad Cook is an avid triathlete and marathoner who competes in Iron Man contests; the School of Nursing's Kenneth Ketner operates a station in a Federal Amateur Radio service; the School of Nursing's Assistant Professor Alyce Ashcraft collects the medical figures of Star Trek; Professor of Physiology Tom Pressley is a glider pilot; and Pharmacology's Dr. Arthur Freeman races cars. Many of the Health Sciences Center's faculty and staff have other lives or interests away from the medical field. These are some of their stories.

She calls them her 45 mile per hour couch potatoes. Carol McPike, secretary for the department of Obstetrics and Gynecology at the Health Sciences Center, speaks of her greyhound dogs with admiration and love as if they were her children. But as you look closely one may notice that these dogs have not led normal lives. These dogs were once raced in tracks throughout the United States and Mexico.

McPike and her husband, Steve, lived in Florida when they first went to the race tracks to see the greyhounds run. "We thought they were the most elegant and wonderful animals," said McPike. "We just had no idea of what went on behind the scenes."

The McPikes began to research more about greyhounds out of interest, and found out the not-so-glamorous side of the breed's lives. "Dogs that are money makers will receive better treatment. Dogs with poor racing records receive minimal care and can be washed out of the system and destroyed before the age of 2."

"Many greyhounds receive serious injuries while racing," said McPike. "You have to remember that these greyhounds are clocked at 45 miles per hour. Some get caught in the track lure mechanism and others take terrible spills getting broken bones, and many never receive any medical attention."

Wanting to get involved and help these greyhounds, McPike found out about a program called The National Adopt a Greyhound Adoption Program. Once the industry has no use for the greyhounds, this organization steps in with people who adopt the canines, rescuing them before they are destroyed. According to the American Greyhound Council, this organization has placed more than 80,000 retired greyhounds that are living in homes in Canada and the United States. "Ferrari, a senior dog, was the first greyhound we adopted. She was missing a toe and had numerous scars," said McPike. "Racing had taken a terrible toll on her body, but not on her spirit. She used to always keep her blue stuffed monkey with her wherever she went. She had a sweetness to her."

McPike said that although these animals suffer through terrible ordeals, they are affectionate and friendly dogs. "They are beautiful animals that crave attention and love to have a warm place to sleep. We have adopted many greyhounds that each had their own story, some good and some bad. But each one, Ferrari, Annie, Banjo, Clarence and Chili were all the most loving animals a person could imagine." She added that it takes compassion and commitment to foster or adopt greyhounds. "They are running to save their lives, and we give them a second chance to be in a loving environment."

Research to Restoring Cars

On any given day you can find Johannes Evers, Ph.D., professor in the Department of Cell Biology and Biochemistry, in his laboratory conducting research on sensors for an artificial pancreas for diabetics. Eversé has been with the Health Sciences Center since 1976. "I came here just before we moved from Drane Hall into this building in 1976. Our department was the first to move in."

Eversé is a researcher, but when he is not in his laboratory, he may be found restoring his Kaiser cars. The Kaiser-Frazer cars were first shown to the public at the Waldorf Astoria Hotel in New York City in 1946. After World War II, there was a demand for new cars. Henry Kaiser and Joseph Frazer joined together to manufacture the Kaiser cars. "They sold like hot cakes at the time," said Eversé. "Unfortunately the Big 3 (Ford, GM and Chrysler) came into the picture aénd started to compete, literally running them out of business."

The Kaiser-Frazer cars were manufactured from 1946 to 1954. Eversé said there are a handful of 1955s that are actually 54s that did not sell. "I guess I have a fascination with these cars because it was the car I learned to drive in back in 1955 when I lived in Holland," said Eversé. "Most people get attached to their first car."

He came to America in 1960, and many years later in 1987, he and his wife were driving to St. Louis and saw a Kaiser sitting along a freeway. "We made a U-turn and I ended up buying it. It didn't have a floor board, but I drove it all the way home to Lubbock."

The second Kaiser he purchased was from a minister in upstate New York. He then drove it to Ohio, but ran into mechanical problems with the transmission. He had to tow it the rest of the way to Lubbock.

Eversé restores the cars by first taking them apart piece by piece. "If it is not welded on I take it apart." This is called a "frame-off" restoration, which includes a rebuilding of all essential parts, including the engine, transmission, rear end, steering gear, etc. Each piece is sandblasted, primed and painted before the car is reassembled. The process is lengthy, but Eversé said the finished product is worth the outcome.

Now Eversé has a total of five Kaiser-Frazer cars, one 1953, three 1954s, and one 1955 model. Of the 1954 and 1955 two-door models, only 179 and 44 were built, respectively. Only a dozen of the 1954 models and six of the 1955 models still exist. Eversé has two 1954 two-door models and one of the 1955 models.

The restoration of the 1953 model is virtually finished, and it can be seen occasionally at the Health Sciences Center's parking lot. All others are at various stages of completion. The body of the 1955 model, Eversé's last acquisition, is still sitting on his back porch as an empty "shell," patiently waiting its turn to be put together again.

His fascination for restoring old and rare cars gets him away from the regular routine, and will allow him to leave something of his behind when he is gone. "I enjoy mechanical things," said Eversé. " One Kaiser, the 1954 four-door model, I found in Sacramento, California in 1990 in a 92-year-old carpenter's back yard where it had been sitting for 26 years. The engine had a burnt valve, but otherwise it was in remarkably good shape." Eversé bought it for $200. Most likely, it would have been taken to a junkyard and crushed. "But this way maybe one day it will end up in a museum for people to see and enjoy. It makes it worthwhile," Eversé said.

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PUBLIC HEALTH 101: Bringing health care to those who do without enriches lives of nurses, doctors
By Andrea Watson

Although most Americans don't admit it, they tend to take things like indoor plumbing and access to medical care for granted. But, for much of the world's population, especially those in developing countries, these and many other every day items would be considered luxuries.

That's why medical mission trips can be such a godsend to the people of these countries. These trips give them the chance to have the type of medical care most Americans receive daily. For them, however, it may only be once a year or even once a lifetime.

"Most of the people we see tell us they've prayed for years for someone to come help them," said Patti Patterson, M.D., vice president for rural and community health at Texas Tech University Health Sciences Center. She added that it's not uncommon for patients to travel great distances to have access to the care provided on the medical mission trips.

On the trips, the doctors, nurses and other medical personnel provide primary care, dentistry, eye glasses and prescription medications to the patients they see, often in school rooms divided into examination areas. Patterson said in some countries medical personnel have simply had to set up clinics beneath trees because no facilities existed to house the clinic.

Patterson, who has gone on more than 20 medical mission trips and recently returned from El Salvador, said it can be fascinating to see the experiences of people who are on their first medical mission.

"It helps you see the experiences through new eyes," she said. "One of the things I love to do is take high school or college students on the trips because it completely changes their world view. It shows them that middle-class America is not reality for most of the world."

Watching current nursing students interact with patients was a fascinating part of the mission trip, said Susan Andersen, R.N., an associate professor in the School of Nursing who went on her first trip to Guyana in March.

"One of the best things the students learned is that people are the same everywhere," she said. "They have the same basic needs and desires, the settings are just different. Everybody wants their children to grow up healthy and safe and become productive members of society. We all need food, shelter and care when we're sick. That's important for the students to learn."

Andersen admitted that while she's used to seeing discrepancies in the availability of health care, going to Guyana gave her a new appreciation for the true accessibility of care in the United States.

"I work with underserved people all the time so I never take health care for granted, but when you see people who truly lack any type of health care, it really makes you appreciate the safety nets we have here," Andersen said. "The poorest people in this country still have a much higher standard of living than anyone in the village we went to. They don't even have safe water to drink."

Both Patterson and Andersen admit the mission trips can be frustrating because of the limited resources and capabilities of the temporary clinics established, but that they know they've still made an impact on people's lives.

"It is frustrating that we can't do more," Patterson said. "You're seeing things that would be easily fixable in this country but there they can't be. You just try to help people get the services they need and do the best you can. In the end, everyone is just so thankful for the care they received."

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MBA PROGRAM GIVES PHYSICIANS BUSINESS EXPERTISE
By Donneva Crowell

There was a time when a doctor could complete medical school, begin a practice somewhere, and then help people get well. But in the modern world of medicine, it's become much more complicated, much more competitive - much more businesslike. Now physicians must be experts in insurance and billing procedures, at handling bureaucratic red tape, and in hiring specialized office personnel. It has become necessary for physicians to know as much about the business side of their practices as they know about the medical side.

Texas Tech University Health Sciences Center School of Medicine and the Jerry S. Rawls College of Business at Texas Tech University, already has in place one program - the M.D./M.B.A. Program. In this program, students enrolled in medical school can receive both M.D. and M.B.A. degrees concurrently during their four years of medical school. Another business/health program, the health organization management program, prepares students for managerial positions in the health care industry with special emphasis on medical groups and ambulatory care. Yet neither of these programs addresses the needs of already practicing physicians in the midst of expanding their own medical practices or working as administrators in existing medical organizations.

Two years ago, the Rawls College of Business launched the M.B.A. Program for Physician Leaders - the Physician M.B.A. program.

According to Jim Hoffman, Ph.D., professor of management at the Rawls College of Business and director of the Physician M.B.A. program, "What differentiates our Physician M.B.A. program from other executive M.B.A. programs is that we are really focusing on teaching physicians how to better manage their practices and health care organizations."

Rawls College of Business Dean Allen T. McInnes, Ph.D., is excited about the program. "I think there is a growing need for physicians who are capable of moving into management positions as well as managing their own practices because they have a thorough understanding of business practices, theories and activities," he said. "There are not many universities in the country that have a program like this." The schools that do offer such programs include the University of Tennessee, Auburn and Southern Florida.

The Rawls College Physician M.B.A. program at Texas Tech provides many advantages for practicing physicians who want more business expertise: classes suited to their busy schedules, curriculum relevant to their specialized field of medicine and a reasonably priced program compared to the other programs. "The Texas Tech program costs thousands of dollars less than the programs at these schools," said Hoffman, "and this doesn't even count the travel costs those programs would require."

The Physician M.B.A. program is a fully accredited M.B.A. program designed exclusively for physicians and taught in an executive M.B.A. format with classes held one weekend each month for 24 months. The doctors eat their breakfasts and lunches together at the school, which not only saves time and trouble, but also promotes a sense of camaraderie. In fact, it's the combination of the condensed weekend schedule once a month and the distance education component that make the program work for the physicians.

Although the curriculum in the program covers many traditional elements of an M.B.A. program, other courses focus specifically on the health care industry. For example, the operations and production management class covers patient flow, billing and collection processes and productivity. "Each weekend the program meets, we try to provide the physicians with knowledge and skills that they can take away from the classroom and apply to their practices the next day," said Hoffman. "We try to make the material covered on homework assignments and on take-home exams directly applicable to improving the overall management of the physician's practice/health care organization."

Nellie Otero, M.D., director of the family medicine residency program at the medical school campus in Odessa, believes her participation has helped put her department in the black. "We started with a negative cash flow and now we're positive," she said, "because after this course, I started looking at the numbers differently and trying to find solutions in a different way. I decided to look at where and why we were losing money instead of simply asking for more (to spend)."

Another goal of the program is to make doctors better equipped to deal with insurance companies and health maintenance organizations. According to Hoffman, all of the physicians in the program have a much better idea of how to create a compliance plan for their practices and also how to better negotiate managed care contracts, with several of the participants saying this is exactly what they have done.

Two semesters into the program, participating doctors say they are gaining a new outlook toward the business side of their practices. Hoffman said, "After one year, we have 17 very satisfied physicians who feel that the program has been a great investment of their time and money. Several have said they are saving or generating thousands of dollars of additional income because of what they have learned in the program."

Dawn LaGrone, M.D., a psychiatrist who recently moved from Amarillo to Dallas, said that although she is only halfway through the program, she learned enough to be able to negotiate a lease for her new Dallas office space that saved her $13,000 over a three-year term. "This program has made me realize just how much I didn't know about business," she said.

The program has also been beneficial for Della Dillard, M.D., a family practitioner who six years ago moved to Hale Center, a rural area south of Plainview, to work in the hospital there with five other physicians. Last year, the hospital closed, filing for bankruptcy and leaving the small town with two doctors, Dillard and one other physician, a 79-year old who plans to soon retire. "I didn't want to move and didn't think it would be fair to the people since they were basically surprised when the hospital closed," she said. So she opened up a practice where she now has to wear two hats. "As soon as the exam is complete, I do the financial stuff." Dillard has learned through the hospital's closing that "nobody can manage your business better than you yourself can, even if you make mistakes."

Of the variety of skills and knowledge doctors say they have acquired from the program, what they all seem to value the most are the leadership skills they have learned.

Otero said she experienced a lot of turmoil in her department before she enrolled in the program. "The first class I encountered dealt with personnel management, leadership and communication," she said. "So from day one, I started using those skills, theories and exercises in my department. Things started going more smoothly, I started communicating better, and the people really began to change."

Sari Nabulsi, M.D., currently in the process of starting his own practice, said the knowledge he values the most so far has been about "how to be an effective boss." He said, "When I came out of residency, I had absolutely no idea how to run a business, and learning how to be in charge is one of the hardest things in the world because you have to strike a balance between your emotions and the business when it comes to your employees. My whole way of thinking about how to run a business has turned 180 degrees since I started these classes."

Currently, physicians from Lubbock, Amarillo, Midland, Odessa, Hale Center and Dallas are participating. They represent physicians of all types: family practitioners, surgeons and specialists. Hoffman would eventually like to see physicians from all over Texas and the Southwest participating. In fact, he is currently exploring the possibility of offering the course in the Dallas area since no program of this sort exists there for those area physicians.

For more information about the Physician M.B.A. program, call Hoffman at (806) 742-1236 or 742-4004, e-mail him at hoffman@ba.ttu.edu, or visit the Web site mba4physicians@ba.ttu.edu for tentative class schedules and a complete list of application procedures.

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