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GA SB 158

GA SB 158

Cindy Zeldin and Donald Palmisano, Jr talk GA SB 158

GA SB 158

This week we continue our monthly series with Medical Association of Georgia.  I hosted MAG CEO/Executive Director, Donald J. Palmisano, Jr., and Cindy Zeldin, Executive Director for Georgians for a Healthy Future.  We talked about the challenges Georgians face regarding the lack of information available to them about how inclusive health plans are regarding what physicians, hospitals, etc., are included in the plans.

Donald talked about how on the healthcare exchanges, patients must review every plan one at a time, checking the physician directories for each one to see if the physician(s) they need are there.  In many cases, this means going through as many as 30-80 unique plans.

This is complicated by the fact that in many cases, the listed physician directories are incorrect, or change frequently, leading patients to make their choices based on outdated/inaccurate information.

In the Georgia legislature, the senate is considering SB 158, aimed at addressing the issue of transparency in the health insurance space so patients and physicians can make sense out of this important part of how we access healthcare today.

Cindy joined Donald to talk about how Georgians for a Healthy Future has been advocating on behalf of the state’s citizens to help them get signed up for the newly-available health plans on the exchange.  She shared how last year, over 500,000 people gained access to new health plans.

We discussed the need for these patients to get educated about how to

Special Guestsplan for the financial obligations they will face regarding co-pays, co-insurance, deductibles, etc.  Folks need to learn what each of these are and have a plan for how to handle them.  One such strategy is having a health savings account, which allows them to pay for their healthcare costs with pre-tax dollars out of an account that will grow over time.

We also talked about how important it is for physicians and citizens to engage with their state legislators to talk about how these issues affect them in their daily lives.  SB 158 is still in the early stages, with decisions being made on it coming next spring.

Special Guests:

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia  twitter_logo_small  linkedin_small1  facebook_logo_small3

Medical Association of Georgia

  • JD Law, Loyola School of Law
  • Board of Directors, Physician Advocacy Institute
  • Medical Payment Subcommitte Member, State Board of Workers’ Compensation
  • Treasurer, Board of Directors, Physicians’ Institute for Excellence in Medicine
  • Former Director, Government Relations/General Counsel/Director, GAMPAC

Cindy Zeldin, Executive Director, Georgians for a Healthy Future  linkedin_small1  twitter_logo_small-e1403698475314

Georgians for a Healthy Future

  • Master of Arts, Public Policy with focus on Women’s Studies, The George Washington University
  • Master of Public Health, Public Policy, Emory University
  • Previous Principal Management Analyst, Healthcare Div., Dept. of Audits, State of Georgia
  • Former Senior Program Associate, Health Policy Program, New America Foundation

Atlanta Plastic & Reconstructive Specialists


Atlanta Plastic & Reconstructive Specialists

This week I featured 3 of the physicians from Atlanta Plastic & Reconstructive Specialists.  They are known for providing expert care for patients in need of reconstructive surgery after cancer treatment or trauma as well as for those who are seeking aesthetic procedures.

Dr. Donald Nunn is a triple-boarded surgeon and unique in the fact that he completed residencies and board certification in 3 specialties, Oral & Maxillofacial Surgery, Ear, Nose, & Throat, and Plastic surgery.  He is able to bring this range of training and experience to bear for his patients who need facial surgery as well as the full scope of plastic surgery procedures.

Dr. Bahair Ghazi shared how he benefited from spending several months training in Belgiam, learning some subtle differences in approach that he’s able to apply in his work when it can enhance the final outcome of his surgeries.  It’s clear talking with Dr. Ghazi he is passionate about plastic surgery and how it can have such a positive impact on quality of life for the patients he sees.  He shared some great information on the tummy tuck and pandectomy procedures for patients who have lost significant amounts of weight or that are wanting to become more active but excess body fat inhibits doing so.

Dr. Susann Bedford talked about how she feels a special relationship with the women she’s treating with breast surgery, whether reconstructive after cancer treatment, or aesthetic for women wanting to change their look for improved body image.  She shared how she was able to spend time during her training with some of the world’s highly-regarded specialists in breast and plastic surgery, helping her provide some of the best techniques available to achieve the best aesthetic result possible for a given case.

Special Guests:

Dr. Donald Nunn, MD, of Atlanta Plastic & Reconstructive Specialists  facebook_logo_small3  twitter_logo_small-e1403698475314  linkedin_small1  youtube logo  Pinterest-logo  google-plus-logo-red-265px


  • Doctor of Dental Surgery, Medical College of Virginia
  • Residency, Oral & Maxillofacial Surgery, University of North Carolina
  • American Board of Oral & Maxillofacial Surgery
  • Doctor of Medicine, Medical College of Virginia
  • Residency, Neck and Head Surgery, Medical College of Virginia
  • Residency, Plastic Surgery, University of California
  • American Board of Plastic Surgery
  • American Board of Otolaryngology/Head and Neck Surgery

Dr. Bahair Ghazi, MD, of Atlanta Plastic & Reconstructive Specialists  twitter_logo_small-e1403698475314  facebook_logo_small3  linkedin_small1


  • Surgical Training

    Emory University Plastic & Reconstructive Surgery
    Emory University General Surgery
    West Virginia University, M.D.

  • Externships

    Cosmetic Surgery Sint Martens Latem, Belgium
    Cosmetic & Breast Reconstruction Brussels, Belgium
    Microsurgical Breast Reconstruction Ghent, Belgium

  • Board Certifications

    American Board of Plastic Surgery
    American Board of Surgery

Dr. Susann Beford, MD, of Atlanta Plastic & Reconstructive Specialists  facebook_logo_small3  linkedin_small1


  • Doctor of Medicine, University of Pittsburgh, School of Medicine
  • Residency, Plastic Surgery, Barnes-Jewish Hospital of Washington University Hospital
  • Fellowship, Breast & Aesthetic Surgery, Georgetown University
  • American Board of Surgery
  • American Board of Plastic Surgery



MAG 2015 Legislative Update

Medical Association of Georgia


MAG 2015 Legislative Update

This week we continued our ongoing series with Medical Association of Georgia to get the MAG 2015 legislative update.  MAG CEO, Donald Palmisano, Jr. and Director of Government Relations, Marcus Downs came by with Georgia Representative, Rick Jasperse.  We talked about several of the health-related issues Rick and his colleagues have been and continue to work on in the Georgia legislature to promote and protect the health outcomes, safety, and access to care for the citizens of our state.

Rep. Rick Jasperse represents Georgia’s 11th district, which includes all of Pickens and parts of Gordon and Bartow counties. He serves on a number of committees in the House of Representatives – and he is the vice chair of the House Health and Human Services Committee. Rep. Jasperse graduated from UGA with a degree in food science. He retired in 2009 after 29 years as a county agriculture agent.

H.B. 416 by Rep. Carl Rogers (R-Gainesville) will require licensed health care practitioners to wear an ID on their “lab coats or similar distinguishing clothing or uniforms” that states their name and license or educational degree. The only exceptions include optometrists, dentists and chiropractors – except those who practice in hospitals and nursing homes. This has been one of MAG’s legislative priorities for the last two years as voted on by MAG’s Board of Directors. A number of other groups also supported the bill, including speech language pathologists, audiologists, respiratory therapists, marriage and family therapists, ophthalmic technicians, registered dieticians, and APRNs.

The FY 2016 budget (H.B. 76) includes some $23 million in additional funds to increase the reimbursement rate for select Medicaid primary care and OB-GYN codes. This included $17.1 million for primary care physicians (i.e., 90 percent of the 2014 Medicare fee schedule for the applicable codes) and $5.9 million for OB/GYN physicians (90 percent of the 2014 Medicare fee schedule for the applicable codes).

The FY 2016 budget also includes $199,000 to maintain the Prescription Drug Monitoring Program in the state.

H.B. 504 by Rep. Sharon Cooper (R-Marietta) extends the flu vaccine protocol that is in place between physicians and pharmacists and nurses for adults to pneumococcal, shingles, and meningitis. MAG’s Board Directors voted to support this kind of measure given strict limits and notification requirements. MAG worked with Rep. Cooper to ensure that appropriate sanctions are in place for any violations.

S.B. 158 by Sen. Dean Burke, M.D. (R-Bainbridge) would have addressed rental networks, all-products clauses, and other key issues. MAG’s Board of Directors voted to support this measure. The bill evolved into S.R. 561, which is a “study bill” – which means that a group of legislators will develop a report for the General Assembly’s consideration in 2016.

Special Guests:

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia  twitter_logo_small  linkedin_small1  facebook_logo_small3

Medical Association of Georgia

  • JD Law, Loyola School of Law
  • Board of Directors, Physician Advocacy Institute
  • Medical Payment Subcommitte Member, State Board of Workers’ Compensation
  • Treasurer, Board of Directors, Physicians’ Institute for Excellence in Medicine
  • Former Director, Government Relations/General Counsel/Director, GAMPAC

Marcus Downs, Director of Government Relations, MAG  linkedin_small1  

Medical Association of Georgia

  • Recipient, 2012, Outstanding Advocate Award, National Association of School Psychologists
  • National Institutes of Health Research Fellow, 2000
  • Former Director, Government Relations/External Coalitions/Research, Georgia Association of Educators

Representative Rick Jasperse, Georgia 11th District  facebook_logo_small3  twitter_logo_small-e1403698475314  youtube logo  flickr (2)


  • BS, Food Science, University of Georgia School of Agriculture
  • Member, House Committees: Agriculture & Consumer Affairs, Appropriations, Human Relations & Aging, Public Safety and Homeland Security
  • Vice Chair, Health & Human Services Committee
  • Served on numerous boards:  Mountain Conservation Trust Board, Chattahoochee Technical Collegeand Appalachian Cattlemen’s Association’s Board

Cholesterol Isn’t The Bad Guy In Heart Disease

Cholesterol Isn’t The Bad Guy In Heart Disease

I recently read an article by a former heart surgeon that talked about the fact that cholesterol isn’t the bad guy in heart disease.  Instead, he argued that inflammation of the lining of the blood vessels caused by sugars and even the “healthy” oils we eat such as corn, canola (Omega-6 oils) is the real cause of what is still the #1 cause of death in America today.

I sat down with Dr. Ellie Campbell of Campbell Family Medicine in Cumming, GA to talk about the article and she was eager to discuss it.  She completely agrees with the premise of the article and shared how the ratio of Omega-3 oils  to Omega-6 oils has grown from ~1:1 or 1:2 to as much as 25:1 Omega-6 to Omega-3.

She also talked about the fact that higher levels of cholesterol in the blood don’t necessarily equate to plaque and heart disease/stroke.  It’s when cholesterol molecules are oxidized and corrupted by inflammatory substances we eat that they become “sticky” and attach to the irritated walls of the blood vessels.

Dr. Campbell shared numerous suggestions for basic changes we can make that will not only serve to reduce our risk for heart disease but in some cases can actually reverse damage already done.

I also brought back Leana Kart, a chiropractor whose practice, Northwest Chiropractic and a member of the Georgia Chiropractic Association to talk about the fact that May is National Posture Awareness Month.  She shared several tips on how to avoid “tech neck”, damage to the spine and neck caused by long periods of chin-down angles to look at a device in our lap.  She also talked about why good posture contributes to keeping us healthy.

Special Guests:

Special Guests:

Dr. Ellie Campbell, DO, Family Practice & Integrative Medicine at Campbell Family Medicine

twitter_logo_small  linkedin_small1  facebook_logo_small3

Campbell Family Medicine

  • Doctor of Osteopathic Medicine, Kirksville College of Osteopathic Medicine
  • Family Medicine Residency, Medical College of Georgia
  • Board Certified Family Medicine

Dr. Leana Kart, DC, of NW Chiropractic  linkedin_small1


  • Doctor of Chiropractic, Life University
  • Owner of NW Chiropractic for over 26 years
  • Board Member, Georgia Chiropractic Association


Dr. Rolf Meinhold MDVIP



Dr. Rolf Meinhold MDVIP

On this week’s show I was joined in studio by Dr. Rolf Meinhold MDVIP.  We were introduced to him by Justin Knott of Intrepy, LLC, a marketing firm with numerous local physician practices they serve.  He’s a family practice physician who’s been practicing in the Atlanta area for around thirty years.  He recently joined MDVIP to provide primary care services in their personalized healthcare program.  Through their service MDVIP and its doctors are able to include access to the physician 24/7, coupled with online resources that give patients access to their health information.  MDVIP offers a membership-based plan that provides such extended access to one’s physician with same-day or next-day appointments and 30 min appointment slots, Dr. Meinhold’s patients get significant time and access to their doctor.

Meinhold Family Practice is a MDVIP-affiliated practice utilizing the MDVIP Wellness Program to prevent little things from becoming big things…enabling patients to enjoy life and stay healthy. 
Patients that truly value their health will appreciate having an enhanced doctor-patient relationship. Our practice through MDVIP has dramatically decreased our practice size to closely work with you. Within our smaller practice, you will receive the comprehensive care and personalized service you deserve to keep you healthy.

Dr. Meinhold’s Approach to Your Wellness: Improving the quality of people’s lives one patient at a time, speaks to two essential elements: Quality and Personalization. Improving quality is all about wellness. The better someone is and feels the more possibilities of enjoying the richness that life has to offer. Being person-oriented means giving respect and reverence to the unique relationship that exists between a doctor and a patient. Only by optimizing trust and care can wellness be achieved.

Because of Dr. Meinhold’s specialized training, he is able to manage middle to late childhood, adolescent and adult patients. He has an ongoing interest in the primary prevention of diabetes and heart disease through nutrition and weight management. In addition,  he is a strong proponent of exploring the scientific basis for the mind-body connection in medicine.

Special Guest:

Dr. Rolf Meinhold, MD, Meinhold Family Medicine/MDVIP  facebook_logo_small3  twitter_logo_small-e1403698475314


  • Doctorate of Medicine, Vanderbilt University School of Medicine
  • Internship, Riverside Regional Medical Center
  • Board Certified, American Board of Family Medicine
  • Fluent in English and German

Justin Knott, Co-Founder, Intrepy, LLC  twitter_logo_small-e1403698475314  linkedin_small1

Intrepy, LLC

  •  Previous VP Business Development, TAGin
  • Former Director, Investments, I4 Capital Partners
  • Previous Team Leader, B.A.S.E. Camp Children’s Cancer Foundation
  • BS, Finance, Investments, & Securities, University of Central Florida

Senate Bill 158

Medical Association of Georgia


Senate Bill 158

On this week’s show we continued our monthly series with the Medical Association of Georgia.  MAG’s CEO/Executive Director, Donald J. Palmisano, Jr. stopped by for a discussion on the state of Senate Bill 158, changes in the insurance contracting arena, and other topics on the MAG agenda.  Donald also shared how he and a colleague were able to raise over $40,000 to support the Think About It campaign to raise awareness and fight prescription drug abuse/addiction in Georgia, participating in a 100 mile race and completing it in under 24 hours.  In the days since Donald joined us on the show, Senate Bill 158 was passed.

MAG continues to take steps to enhance the relationship between health insurer Blue Cross Blue Shield of Georgia, Inc. (BCBSGa) and physicians in the state.

At the end of 2014, Georgia Insurance Commissioner Ralph Hudgens rescinded physician contract amendments that BCBSGa had put into place in Georgia following “numerous complaints from physicians (and their practices).”

First MAG/BCBSGa “Physician Advisory Group” meeting took place on February 12. It is forum for physicians to express their concerns, it will give Blue Cross the opportunity to disseminate information about new payer initiatives, it will be a venue for improving communications, and it will serve as a mechanism for physicians to weigh in on Blue Cross’ clinical policies, operations and contracting practices.

The advisory group consists of four MAG member physicians as well as MAG Health Policy and Third Party Payer Advocacy Department Director Susan Moore and BCBSGa Senior Clinical Officer Mark Kishel, M.D., and BCBSGa Director of Network Management/Georgia Provider Solutions Hayden Mathieson. They will meet a minimum of three times a year.

Rental Networks


MAG supports legislation that would limit rental networks in Georgia. A rental network involves a health insurer that rents or sells its network of physicians to another health insurer. These second-level insurers then include the physicians in their health insurance plans – and pay the physicians an even deeper discount – even though they don’t have a contract with the physicians.


It’s not uncommon for physicians to offer their services to a health insurer at a discounted rate because the higher patient volume offsets the costs. However, the aforementioned insurers rent or sell their networks without the physician’s knowledge – so the physicians often aren’t aware that they are in a given network or that they are contractually obligated to deliver patient care at a greater discount.


Rental networks result in mass confusion and higher administrative costs (e.g., the additional staff time that is required to verify a patient’s health insurance coverage and/or confirm the proper payment). Rental networks can also reduce the accessibility of care because physicians are forced to accept the lower (i.e., “re-priced” or “re-rented”) payment or refuse to see the patient for any follow-up or future care.


Rental networks are an inappropriate, profit-driven tactic that undermines the practice environment in Georgia that will exacerbate the physician shortage in the state. Sixteen states have now adopted laws that regulate or limit or prohibit rental networks.


Insurers are prohibited from using rental networks in federal employee health benefits plan contracts.



All-Products Clauses


Insurance companies use ‘all-products or all-or-nothing’ clauses as a cost-control tactic to force physicians to participate in every health insurance product that they offer or be blocked from caring for patients in the insurer’s plan altogether.


By forcing physicians and their practices to agree to all-products clauses, health insurers are undermining the economic viability of the medical profession in Georgia – keeping in mind that a report that was prepared by IMS Health for the American Medical Association determined that physicians in Georgia “created a total of $29.7 billion in direct and indirect economic output (i.e., sales revenues) in 2012… [and] each physician supported $1,559,494 in [economic] output.” It is also worth noting that the report found that “…physicians supported 205,869 jobs (including their own)…[and] $1,089.6 million in local and state tax revenues in 2012.”


Because physicians are constantly wrestling with these manipulative contract provisions, they have less time to spend with their patients.


All-products clauses violate several individual rights, including the right to contract and an owner’s right to operate a business in a free and autonomous way.


Physicians and medical practices in Georgia should be free to accept the health insurance products of their choice versus the ones that’s imposed on them by profit-driven insurance companies.


Eleven states have enacted prohibitions on all-products clauses, including Alaska, Arkansas, Florida, Indiana, Kansas, Kentucky, Maryland, Massachusetts, Minnesota, Ohio, and Virginia – as well as Washington, D.C.


Special Guest

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia  twitter_logo_small  linkedin_small1  facebook_logo_small3

Medical Association of Georgia

  • JD Law, Loyola School of Law
  • Board of Directors, Physician Advocacy Institute
  • Medical Payment Subcommitte Member, State Board of Workers’ Compensation
  • Treasurer, Board of Directors, Physicians’ Institute for Excellence in Medicine
  • Former Director, Government Relations/General Counsel/Director, GAMPAC


True North Partnering

Peter North talks Mindfulness on Top Docs Radio



This week I sat down with Peter Vajda.  He’s a Certified Professional Coach and PhD in Education and Cognitive Psychology.  We talked about how we can apply the practice of meditation and mindfulness to bring about a more centered “You”, becoming better able to handle conflict and reduce one’s over-all level of anxiety.  Peter is an astute observer of the human condition and is a passionate pioneer in the field of mind-body-spirit integrative functioning and development. Dr. Vajda is dedicated to supporting individuals and groups to enhance their understanding of how to live consciously – from the inside out – which deeply supports an individual’s ability to change, grow and evolve.

Peter brings a diversified base of professional expertise – as an entrepreneur, an educator, a facilitator, and a manager. He is sensitive to the diverse perspectives,  demands and dynamics of relationships. Since 1981, he has facilitated individuals, couples, groups and organizations.

His life and the orientation he brings to coaching, consulting, facilitating and writing are deeply influenced by his understanding of, and his experience in, the psychology of personal growth and development.

For over thirty years, Peter’s has been committed to his own personal and spiritual development. His experience in working with the “whole body” is based on his studies of psychodynamics, ego development, bioenergetics as well as energy healing.

Peter earned his Ph.D. in Education and Cognitive Psychology from Fordham University. His post-graduate work is in organizational behavior at NYU’s Stern School of Business.

For six years, Dr. Vajda has written a weekly column – “Know Thyself” – for the widely-acclaimed international Management-Issues website.

His book– Becoming a Better You, Who You Are vs. Who You Think You Are – was published in October, 2013.

Special Guest:

Peter Vajda, Phd, CPC, True North Partnering  facebook_logo_small3  linkedin_small1

True North Partnering

  • PhD, Education-Cognitive Psychology, Fordham University
  • Former Director, Academic Services, Information Technology Institute, New York University
  • Previous Manager, Instructional Design Dept. , Gulliver Ritchie Associates
  • Published Author



Start Exercise Fitness Training Without Injury



Start Exercise Fitness Training Without Injury

This week, our new monthly partner, Dr. Andrew Pugliese stopped by to introduce us to Randy Nicholson, of Fitness Firm Studio.  He’s a certified trainer who shared some very helpful information on how folks who have not previously trained or former athletes who haven’t trained in a while start exercise fitness training without injury.

As a former athlete who has experience in high intensity and high volume cardiovascular and weight/resistance training, I know too well what it’s like to resume working out after a prolonged layoff and experience overuse injuries.  These come from a burst of activity with or without heavy weight/resistance.  Too much exercise too soon can easily result in a incapacitating measure of pain or even injury that prevents continuing without another break to recover.

Randy shared what a person who’s motivated to start or resume training should ask a prospective personal trainer to determine what their philosophy is regarding the initial training phase.  He also shared the value of using a roller to help facilitate muscle recovery as well as releasing trigger points that can cause muscle spasm.

We talked about the best way to approach beginning training in a step-wise fashion to insure that muscular imbalances, postural weaknesses, and flexibility have been improved upon before moving on to more intense training moves/activities.  If you or someone you care about is thinking about resuming or wants to start exercise fitness training without injury they need to check out this week’s episode.

Special Guests:

Randy Nicholson  Fitness Firm Studio  facebook_logo_small3  twitter_logo_small-e1403698475314


  • NASM
  • 4th Degree Black Belt in Tae Kwon Do
  • BS Engineering, University of Chattanooga

Andrew Pugliese, MD, Infectious Disease Consultants twitter_logo_small  linkedin_small1  facebook_logo_small3  Blogger 2


  • Doctorate in Medicine, St. George University School of Medicine
  • Fellowship, Infectious Disease, Winthrop University Hospital
  • Triple Board Certified in Internal Medicine and Infectious Disease
  • Pioneer in non-surgical treatment of acute and chronic sinusitis
  • President of Sinus Solutions

Medical Reserve Corps

Medical Associaiton of Georgia


Medical Reserve Corps

The U.S. Department of Health and Human Services (HHS) has approved MAG’s request to form the nation’s first medical society-sponsored statewide volunteer medical reserve corps (MRC). MAG and the Georgia Department of Public Health would oversee MAG’s MRC. MAG is now eligible for limited federal capacity building funds and has in fact received a 2015 grant for $2,500 – though the MAG MRC will require funding from private sources to fully maximize its vision.

The MAG MRC will train physicians to respond to declared emergencies in Georgia, and it will establish a system to coordinate the deployment of those physicians during any such emergencies. The MAG MRC will supplement the official medical and public health and emergency services resources that are available in the state. MAG MRC units will be capable of setting up mobile hospital systems. And under extreme circumstances (e.g., a shortage of health care providers in a given area), MAG MRC units can be called upon to perform some of the functions that would otherwise be performed by the full-time emergency medical response personnel in the state. MAG formed the MRC as a result of 2013 House of Delegates meeting action.

The MRC is a national network of volunteers, organized locally to improve the health and safety of their communities. The MRC network comprises 993 community-based units and 207,783 volunteers located throughout the United States and its territories. Georgia has 19 approved MRCs.

MRC volunteers include medical and public health professionals, as well as other community members without healthcare backgrounds. MRC units engage these volunteers to strengthen public health, improve emergency response capabilities and build community resiliency. They prepare for and respond to natural disasters, such as wildfires, hurricanes, tornados, blizzards, and floods, as well as other emergencies affecting public health, such as disease outbreaks. They frequently contribute to community health activities that promote healthy habits.

The designated point of contact is the Director of Health Protection with DPH. The MAG MRC may also be activated by MAG MRC leadership team as necessary. The MAG MRC Unit will supplement the State of Georgia Public Health Emergency Preparedness’ and Response Unit. The unit will not replace or supplant the existing emergency medical response system or its resources including locally based MRC units.

Special Guests:

John S. Harvey, M.D.

  • Chief of Surgery, Gwinnett Medical Center
  • Acting Colonel and Command Surgeon, Georgia State Defense Force
  • MAG’s President-elect.
  • Missions have included the Katrina/Rita hurricane and Haiti earthquake victim airlifts. He dealt with the Centennial Park bombing that took place during the 1996 Olympics as a medical command officer.
  • Doctor of Medicine, Medical College of Georgia

Susan Moore

Susan Moore has been MAG’s Director of Health Policy and Third Party Payer Advocacy since 2013. She helps MAG members resolve third party payer claim disputes and grievances. She has spent 30 years in the health care industry – more than half of those focused on patient safety and health care quality. Moore has a degree in nursing from the Emory University School of Nursing and a Master’s Degree in Public Health from the Yale School of Public Health at Yale University.

Paul Hildreth

Paul Hildreth is the emergency management coordinator/grant coordinator for REMS for the Fulton County School District. He has 14 years of experience in emergency response and crisis management. He is a certified emergency manager and master certified emergency manager. He has been an integral part of the Georgia State Defense Force for 10 years. He has a degree in business operations from DeVry University and an MBA from the University of Phoenix.


Peripheral Arterial Disease

Peripheral Arterial Disease

As many as 12 million Americans are dealing with peripheral arterial disease (PAD), a progressive blockage of the blood vessels that carry blood to the lower extremities.  For many of these patients, amputation is the outcome, leaving them without a foot, or in others, half or more of their leg.  Medical literature has shown that in these patients, their risk of death within 1 to 5 years of their amputation they have a 40% likelihood of amputation of the remaining leg and a significant risk of death.  It’s clearly a serious problem.

But we can reduce the rate of amputation among these patients and we can also reduce the severity of intervention required to address the problem if we catch it early.  Dr. Joseph Ricotta, vascular surgeon and director of the Northside Hearth & Vascular program, stopped by the studio to talk about what can be done to improve patient outcomes for those with PAD.  We talked about the troublesome statistics around peripheral arterial disease, including the fact that among diabetics with PAD who develop a non-healing wound resulting in amputation, as many as 50% of them never receive a non-invasive study that could prevent the loss of their leg.

That means we need our partners in primary care and foot/ankle surgery to take an aggressive stance when presented with patients who are at risk for PAD or who have a poorly-healing wound on their leg or foot.  There are numerous non-invasive studies that take only minutes in the vascular surgeon’s office that can readily identify patients who have blockage affecting blood flow to their feet.  In these cases, if caught early, surgeons like Dr. Ricotta have more options and greater probability they can reestablish adequate blood flow that helps a wound to heal, preventing or mitigating extent of amputation.

We talked about the fact that Northside offers access to 2 of the country’s 10 robotic devices that significantly improves the effectiveness of minimally-invasive procedures by allowing the vascular surgeons to access and treat previously-inaccessible locations.  Additionally, with the assistance of the robot, the surgeons are able to reduce damage that can occur on the inside of the vessel being treated, which reduces the likelihood that scarring after the procedure will block the vessel off again (a leading cause of reocclusion in PAD lesions).

I also spoke with foot and ankle surgeon, Dr. Michael Bednarz of Ankle & Foot Centers of Georgia, whose office is located in Woodstock, just north of Marietta.  He talked about treating PAD patients with wounds from the perspective of the specialist who is tasked with managing the wound and ultimately, treating it surgically as necessary (including amputation when efforts to heal the wound fail and serious infection is a risk).

We talked about the fact that amputation should be viewed as a last-ditch option.  And Mike shared that no patient should face amputation without having had a vascular study to determine if poor flow is contributing to the wound not healing.  He talked about the fact that when he’s presented with a poorly-healing wound, particularly in a patient with PAD risk factors such as diabetes, one of the first things he does is request a vascular study to assess blood flow.  He also utilizes Transcutaneous Oximetry, a non-invasive test that shows how well the tissue at the surface where a wound is located is getting oxygen.

With the results of those studies, he is able to address poor blow flow by referral to a vascular surgeon and/or to hyperbaric medicine (readily available in Atlanta and surrounding suburbs) to address poor oxygen levels in the skin.  He also evaluates other risk factors such as glucose levels and presence of infection, often resulting in consults with infectious disease and/or endocrine specialists to help heal the limb-threatening wound.  We talked about the fact that a multi-specialty approach insures that more patients can avoid amputation and the resultant high mortality rates that come with them.

Early involvement with an experienced wound specialist, vascular diagnostics/intervention, infection control, and endocrinology are all vital in helping patients avoid an amputation that might also cost them their life.

Special Guests:

Joseph Ricotta, MD, Medical Director, Heart & Vascular Institute, Northside Hospital  linkedin_small1  twitter_logo_small  facebook_logo_small3  youtube logo

Northside Vascular

  • Doctor of Medicine, Thomas Jefferson University School of Medicine
  • Surgical Residency, Johns Hopkins University School of Medicine
  • Fellowship, Vascular Surgery, Mayo Clinic
  • Fellowship, Advanced Endovascular Surgery, Cleveland Clinic Foundation
  • Associate Professor of Surgery, Georgia Regents University, University of Georgia School of Medicine

Michael Bednarz, DPM, Ankle & Foot Centers of Georgia  linkedin_small1  facebook_logo_small3  twitter_logo_small  youtube logo

Ankle & Foot Centers of Georgia

  • Doctor of Podiatric Medicine, Kent State University School of Podiatric Medicine
  • Residency, Department of Veteran Affairs Medical Center, Miami
  • Board Certified, American Board of Foot/Ankle Surgery
  • Recognized as a “Top Doc” in the WellStar Health System