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ARH, MCHC, UK discuss plans




Pictured at a luncheon at Pine Mountain Grill to celebrate the partnership of Appalachian Regional Healthcare (ARH), Mountain Comprehensive Health Corporation (MCHC) and the University of Kentucky’s Gill Heart Institute are Dr. Van Breeding, MCHC director of clinical affairs; Mike Caudill, CEO of MCHC; Dr. Mike Karpf, executive vice president for health affairs at the University of Kentucky; Dena Sparkman, Whitesburg ARH Community CEO; Susan Smyth, chief of cardiovascular medicine at UK’s Gill Heart Institute; and Joe Grossman, CEO of ARH system.

Pictured at a luncheon at Pine Mountain Grill to celebrate the partnership of Appalachian Regional Healthcare (ARH), Mountain Comprehensive Health Corporation (MCHC) and the University of Kentucky’s Gill Heart Institute are Dr. Van Breeding, MCHC director of clinical affairs; Mike Caudill, CEO of MCHC; Dr. Mike Karpf, executive vice president for health affairs at the University of Kentucky; Dena Sparkman, Whitesburg ARH Community CEO; Susan Smyth, chief of cardiovascular medicine at UK’s Gill Heart Institute; and Joe Grossman, CEO of ARH system.

Appalachian Regional Healthcare (ARH) and Mountain Comprehensive Health Corporation (MCHC) have joined forces with the University of Kentucky’s Gill Heart Institute to provide cardiac care around the clock in Letcher County.

“We know that we have very high levels of heart disease here so we need that type of cardiac care,” said Dr. Van Breeding, MCHC director of clinical affairs. “We need that cardiologist here at 2 o’clock in the morning when we are having chest pains. We need that cardiologist here on Sunday afternoon when we are having a heart attack. Now, we have that.”

ARH Cardiology Associates Whitesburg, which is backed by the UK Gill Heart Institute, is now located at the MCHC clinic. Dr. Syed Bokhari, MD, FACC will see patients from 8:30 a.m. until 5 p.m. on Mondays. Dr. Kenneth R. Dulnuan, MD will see patients from 8:30 a.m. until 8 p.m. on Wednesdays and from 8:30 a.m. to 5 p.m. on Thursdays.

Dr. P.S. Chandrashekar, MD, of Mountain Heart Center, will help provide coverage out of his office when the other cardiologists aren’t at the clinic. Chandrashekar will perform heart catheterizations and place stents in arteries at Hazard ARH.

Beginning July 1, Dr. Pablo Lopez will come onboard as a fulltime cardiologist at ARH Cardiology Associates- Whitesburg.

If someone is experiencing heart complications when the clinic is closed, the person should call 9-1-1 or go to the ARH emergency room where a cardiologist will be consulted.

“Local folks taking care of local folks in local facilities is what I am all about,” said Breeding.

ARH, MCHC and UK’s Gill Heart Institute are uniting to build a cardiology services practice in Whitesburg that is affordable, friendly and seamless, said Joe Grossman, chief executive officer of the ARH system.

Grossman said ARH’s mission is to “make sure that the people in our communities receive the best possible healthcare in the most appropriate setting and that it is delivered in a very affordable way.”

“We started doing open heart procedures about 10 years ago and we realized we needed a partner to make sure that the care that the patients receive from us in Perry County was world class,” said Grossman. “We have dabbled, as many of you know, with various partners over the years and some of those didn’t work out for various reasons. I am very happy to say that we have the best partners that we have ever had right now in the UK Medical Center and the Gill Heart Institute.”

Grossman said UK’s vision is inline with ARH’s vision.

“They don’t want all of the folks in the mountains to necessarily travel to Lexington,” said Grossman. “They want to make sure if it can be done here, it’s done here. If it needs to move on to a higher level, it moves on in a way that it is as seamless as possible for the patient and their family. By that, what I mean is we are working together to make sure that the care our patients that you all receive when you need us will be the same procedures and care that you would get if you have to be moved along to the Gill Heart Institute.”

The new partnership between ARH, MCHC and UK’s Gill Heart Institute emphasizes local care first.

“Working with Mountain Comp and with ARH, we really hope to be able to expand cardiac services in Whitesburg so people can stay in Whitesburg for the vast majority of their cardiac care,” said Dr. Michael Karpf, executive vice president for health affairs at the University of Kentucky. “If they need to go to the next level of care, it is going to be down the road in Perry County and will only have to go to Lexington if they need extraordinary levels of care like transplantation or fancy stuff like that.”

Mike Caudill, MCHC chief executive officer, said the three entities are “a team that together raises the bar to provide our citizens a level of cardiac services never before seen in eastern Kentucky.”

“Based upon our success, it is only natural then when the opportunity presented itself the board of directors of MCHC saw the wisdom in entering into a partnership with the University of Kentucky’s Gill Heart Institute, a national and state leader in cardiac care, and Appalachian Regional Healthcare, the largest and dominant provider of in-patient care in eastern Kentucky, and ourselves, Mountain Comprehensive Health Corporation, the largest provider of primary care services in eastern Kentucky,” said Caudill.

One question remains, Caudill said, among boards and among patients.

“ Why did we wait so long?” said Caudill.

Positive results have already been seen with the new partnership, Caudill said, “Lives have been saved already,” said Caudill.

Dorothy Moore, a patient of Breeding’s had aortic stenosis, which can cause heart failure, chest pain and fainting.

“Dorothy Moore was told that there was nothing else to do,” said Breeding. “Go home. Live out your last few days. See your family. We didn’t accept that. We dug deeper.”

Dr. John C. Gurley, MD, an interventional cardiologist with UK’s Gill Heart Institute, used a new procedure called transcatheter aortic valve replacement (TAVR).

“She got a valve put in in a very unique way through a cath that had only been done a few times in the United States,” said Breeding. “She is home now and doing fantastic. We have had success story after success story. This is why we partner up with people like ARH and UK because we can deliver that kind of care that other people cannot do because we are not willing to say we give up.”

Dr. Breeding said he sends his patients where they will receive the best care.

“There is nothing better than to know when you send a patient to an ARH facility or you send a patient to UK that you have a friend that is watching after them,” said Breeding. “When I put a patient in the hospital I really put all of my effort into taking care of them. Our doctors work together to make sure they have the best care.”

None of us want to be sick, Breeding said, but when we are sick we want to go to a place that feels like home.

“We want to stay close to our families because we know with our family’s help, with our pastor’s help, with our friends’ help, that is what makes us get well quicker,” said Breeding. “We don’t want to be 150 miles away unless that is where we have to go to get treated. It’s a lot easier to go 150 miles away than it is to go 1,000 miles away to another facility like Cleveland Clinic or the Mayo Clinic. We no longer have that need. Dr. Karpf has provided that kind of care at the University of Kentucky.”

Karpf said a strong cardiologist needs to be in Whitesburg with the next level of care in Hazard. And the Gill Heart Institute has to be a national level facility, Karpf said.

“I said that we need to be able to do everything that the Mayo Clinic (and) the Cleveland Clinic can do in cardiology and I really feel that we’re at that level,” said Karpf. “There is literally nothing that any other major center can do that we can’t do and there are some things that we can do that some of them can’t do.”

Karpf said he and his staff are fundamentally committed to making the partnership work for Letcher County.

Susan Smyth, chief of cardiovascular medicine at UK’s Gill Heart Institute, said the partnership with ARH, MCHC and UK is absolutely essential to changing cardiovascular health in Kentucky.

“We all know that the burden of cardiovascular disease in our state is substantial,” said Smyth. “It has resulted in some of our counties having the lowest life expectancy in the country. We are currently the second highest mortality, highest death rates after heart attacks. That is not the second rating we want in the country. In order to change that, we really are going to have to think differently about our approaches to cardiovascular health.”

The Gill Institute serves as the hub for the most advanced, state of the art technologies, Smyth said.

“In doing this, we have to have partners that really are all committed to the highest level of cardiovascular care,” said Symth. “And so that is one of the reasons we are so delighted to be able to partner with Mountain Comp and ARH who all share with us these properties and expectations for high quality cardiovascular care.”

The Gill Heart Institute provides innovative, advanced state-of-the-art care, Smyth said.

“It is true that no one in Kentucky should have to leave our state to receive cardiovascular care,” said Smyth. “That is something that we take tremendous pride in at the Gill and we think that not only is it true now but it should be true for all of the future that no one should ever have to leave Kentucky for a type of procedure or treatment. It’s something we have worked tirelessly over for the last five or six years and indeed today I think we can all stand here today and say that has been accomplished.”

On January 23, 10 patients received extracorporeal membrane oxygenation (ECMO) at the Gill Heart Institute.

“We hook patients up to these circuits where literally their blood is taken out of their body, it’s oxygenated and then it’s returned to their body,” said Smyth. “This is for patients whose heart and lungs are no longer working. In our flu epidemic season this year we required substantial support of patients with ECMO.”

Most major medical centers can offer ECMO to three to six patients, said Smyth.

“ Eventually, some of these patients may require a heart or lung transplant and we are capable of providing all of those services for those patients that in critical need of that type of very advanced care in Lexington,” said Smyth.

The Gill Institute has the latest technology in cardiovascular imaging. “We can now use MRI to image the heart,” said Smyth. “We can acquire all of the images as the heart is literally in the midst of one beat. It’s these types of innovations and advances that we will be providing with this partnership.”

At the end of a luncheon held at the Pine Mountain Grill on Jan. 23 to celebrate the new partnership, Karpf recognized the late Lois Baker, who was instrumental in starting MCHC.

“She was committed to this community,” said Karpf. “Because of her, I think you have an extraordinary medical facility in Whitesburg and Letcher County.”


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