Blog Posts


Physician of the Year: Acute Care Surgery

Posted on Mon, Apr 13, 2015
Physician of the Year: Acute Care Surgery

2015 Acute Award Presented to Orange Park Surgeon
EmCare Honors Dr. Alexander Rose with National Recognition

ORLANDO, FLA. (April 7, 2015) – The medical director of surgery at Orange Park Medical Center in Orange Park, Fla., Alexander Rose, M.D., has been honored with the prestigious Acute Award for 2015. The award is presented by EmCare, a leading national provider of physician practice management services, and honors a single surgeon for the award each year.

 “It’s a tremendous honor,” said Dr. Rose of receiving the award. “These recognitions aren’t singular things. My wife, my staff, the administration at Orange Park and the staff at EmCare have been really created an environment where surgeons can thrive.”

“Dr. Rose is a great surgeon and a wonderful leader,” said John Josephs, M.D., CEO of EmCare Acute Care Surgery. “His work with robotic surgery has been innovative, and his collaboration with peers in helping to increase robotic surgery at his hospital has really been pioneering.”

Dr. Rose has been very involved in training and growing the types of robotic surgeries available at Orange Park Medical Center. The hospital’s administration praises his surgical skills, leadership skills and patient care. The hospital’s CEO, Chad Patrick, even drove from Charleston, S.C. to Orange Park while suffering from appendicitis so that Dr. Rose could personally perform the appendectomy.

Dr. Rose was honored with the Acute Award during EmCare’s annual Leadership Conference. The 2015 convention was held at the Coronado Springs Resort in Orlando, Fla. While the Acute Award recognizes a single surgeon from across the United States, EmCare also annually honors individuals from emergency medicine, hospital medicine and anesthesiology as its Physicians of the Year


Rx: Laughter?

Posted on Tue, Jan 27, 2015
Rx: Laughter?

A few weeks ago, I was in a meeting, when during the lunch break, I was so tickled that I ended up laughing for the rest of the day. There was nothing earth-shatteringly funny happening; I was simply enjoying the fact that I was sitting in a room with a group of people that I enjoy. And, well into the next day, I found myself smiling about the incident and I realized that the apples of my cheeks were still somewhat sore from smiling.

This experience led me to research laughter and how it affects our health. 

There's actually a wealth of information that suggests there is great value in incorporating some aspect of humor and laughter in the care plans of our patients, even in emergency medicine. French surgeon, Henri de Mondeville, famously wrote, "Let the surgeon take care to regulate the whole regimen of the patient's life for joy and happiness, allowing his relatives and special friends to cheer him, and by having someone tell him jokes."

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Here are some of the benefits of laughter:

  1. Laughter dissolves tension, stress, anxiety, irritation, anger, grief, and depression. Like crying, laughter lowers inhibitions, allowing the release of pent-up emotions. There is no doubt that after an episode of intense laughter, you will experience a sense of well-being. We have all heard the phrase “he who laughs, lasts.” So true!
  2. Medical researchers have found that laughter boosts the immune system.
  3. Laughter reduces pain by releasing endorphins that are more potent than equivalent amounts of morphine.
  4. Humor helps integrate both hemispheres of our brain, for the left hemisphere is used to decipher the verbal content of a joke while the right hemisphere interprets whether it is funny or not.
  5. Laughter  can help you be more productive, engaging and help you be more of a team player
  6. Everyone loves someone who can make them laugh. People want to surround themselves with those who have a good sense of humor and can tell a joke or two.
  7. Humor brings the balance we need to get through the turbulence of life comfortably.
  8. According to Dr James Walsh, laughter is even equivalent to a small amount of exercise. You can feel the muscles of the diaphragm, abdominals, face (remember when I mentioned having sore cheeks?), leg and back get a good workout.
  9. A sense of humor can help you accept the inevitable, rise to any challenge, handle the unexpected with ease, and come out of any difficulty smiling.
  10. Lower blood pressure.
  11. Increase vascular blood flow and oxygenation of the blood.
  12. Reduce certain stress hormones such as cortisol and adrenaline.
  13. Defend against respiratory infections–even reducing the frequency of colds–by immunoglobulin in saliva.
  14. Increase memory and learning; in a study at Johns Hopkins University Medical School, humor during instruction led to increased test scores
  15. Improve alertness, creativity, and memory

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One of the other things about laughter is that it is incredibly contagious.  Like a yawn that's passed on from one to another, you can’t help but smile or join in when someone around you is laughing. I am convinced that if we can share some laughter, even in stressful situations, we can have a positive impact on overall health -- not only our own but those around us.

Ginger joined EmCare in 2013 as a Divisional Director of Clinical Services for the South Division with the strong belief that she could continue to make positive changes within healthcare by helping others focus on quality, excellence and the overall patient experience. Ginger Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20+ year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.



Hospital Staff Say 'Crisis Mode' Obstructs Communication

Posted on Sun, Jan 04, 2015
Hospital Staff Say 'Crisis Mode' Obstructs Communication

Workers who perceive high stress at work think it interferes with exchange of patient information

WEDNESDAY, Dec. 17, 2014 (HealthDay News) -- Staff members who perceive a work climate of crisis mode in their hospital units say that it leads to problems in exchanging patient information, according to research published online Dec. 10 in the Journal of Hospital Medicine.

Mark E. Patterson, Ph.D., M.P.H., of the University of Missouri in Kansas City, and colleagues analyzed self-reported data from 247,140 hospital staff members across 884 hospitals. The authors sought to assess the association between perceived crisis mode work climate and problems with patient information exchange.

The researchers found that hospital staff members who agreed that the unit in which they work tries to do too much too quickly, compared with those who disagreed, were more likely to perceive problems with exchanging patient information across hospital units (odds ratio, 1.6; 95 percent confidence interval, 1.58 to 1.65).

"Because effective communication during handoffs is associated with decreases in medical errors and readmissions, hospitals need to continually ensure that work environments are conducive to effective patient information exchange," the authors write.

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DIY Healthcare System: What is Population Health, Anyway?

Posted on Wed, Dec 17, 2014
DIY Healthcare System: What is Population Health, Anyway?


“You all are in the cat bird’s seat. Because you are in the hospital most of the time and in the ED particularly, the common pathway for entry into the hospital, you know what’s going on better than anyone else. You are in the best position to implement change. You are in the right spot at the right time. Our country needs your help.” With those words, David Nash, MD, MBA, dean of the Jefferson School of Population Health at Thomas Jefferson University in Philadelphia, opened EmCare’s 2014 annual conference with his presentation entitled, “Population Health & Quality in the New World of Health Reform.”

Dr. Nash, an accomplished educator and author, was instrumental in founding the country’s first school of population health. A board certified internist, Dr. Nash is passionate about the need to reform America’s healthcare system.

He divided his presentation into five parts:

  • How did we get into this jam?
  • What is quality in healthcare?
  • What’s population health, anyway?
  • What is health reform and what’s its special connection to quality, safety and accountability?
  • What’s in the future?

Over the next few weeks, we’ll post key takeaways from Dr. Nash’s presentation.

What is Population Health, Anyway?

In an effort to address the challenges outlined in the IOM report, one approach has emerged as promising – population health management. What is population health and is it the answer? Dr. Nash said the concept is attributed to David Kindig, who espoused it 35 years ago. The concept looks at health outcomes (morbidity, mortality and quality of life) and their distribution within a population, health determinants (medical care, socioeconomic status, genetics) that influence the distribution and policies and intervention (social, environmental and individual) that impact these determinants.

"The take home message," said Dr. Nash, "is that medical care is 15 percent of the story the other 85 percent are the messy social determinants of health. Four determinants– smoking, unhealthy diet, physical inactivity and alcohol use -- account for 40 percent of all deaths in the US."

A study by the Bipartisan Policy Center examined what makes us healthy. The results showed that individual behaviors such as diet, exercise and education determine 50 percent of an individual’s overall health status while genetics comprise 20 percent and access to care makes up the remaining 10 percent. The ironic fact is that as a country, the US spends 88 percent on medical services, eight percent on other activities and only four percent on healthy behaviors.

While population health seems to be the magic pill to cure the healthcare system of its ills the facts are that most healthcare organizations don’t have the resources or scope to build a comprehensive population health management program. Doing more of what we are already doing won’t address the many factors that affect the health of a population that extend beyond the realm of traditional medicine. Successful population health management initiatives will cover between 250,000 and 500,000 lives so healthcare organizations will be required to add new components to their care delivery infrastructure, recruit new talent and develop a culture of innovation.

Dr. Nash’s organization, Thomas Jefferson School of Population Health, published the first textbook on the subject, Population Health, Creating A Culture of Wellness. The school also publishes a population health management journal. Dr. Nash also cited the Trust for America’s Health Report, A Healthier America 2013: Strategies to Move from Sick Car to Health Care in the Next Four Years, as an important addition to the library of knowledge on the subject.

Consider this fact: the US spends under two percent of its health dollars on population health and there is no dedicated federal funding stream to address chronic diseases that comprise 80 percent of the total disease burden in America. It’s sad but true that only three percent of the US population exercises for at least 20 minutes three times a week, doesn’t smoke, eats fruit and vegetables regularly, wears seat belts regularly and is at its appropriate body mass index.


In Case You Missed It: Week of Dec. 12, 2014

Posted on Fri, Dec 12, 2014

“In Case You Missed It” is a weekly roundup of popular healthcare headlines.

  • What a Bad Flu Season Could Cost the U.S. Economy. This year's flu season looks worse than usual. The Centers for Disease Control (CDC) warned last week that the dominant influenza virus right now, H3N2, typically signals a severe flu season ... continue on
  • An Argument With No Clear Winner. “You’re going to the hospital.”
    “I’m NOT going to the hospital. There’s nothing they’d do and it would cost us thousands of dollars for nothing. Besides … we have to leave. We’re already late.” >> continue reading at
  • Whooping Cough Outbreak Strikes Undervaccinated Michigan County. A major outbreak of whooping cough has struck a Michigan area where many people opted out of vaccinations against the disease... continue reading at
  • Limits to resident hours don't improve patient safety. Efforts to cut down on the hours logged by doctors in training have had no measurable impact on patient outcomes ... continue reading at
  • Do good, and don't complain: Q&A with Dr. Steven Gabbe, CEO of OSU Wexner Medical Center. "I've never heard someone tell me, 'You just don't understand,' because they know I do." Steven Gabbe, MD, took the helm of Ohio State University Wexner Medical Center in 2008 ... continue to

Want to know what our clinicians are reading? Read the collection below!

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