Home (Sandbox)

2012 has been a year of tremendous growth for our Medical Group. We've been preparing for the opening of Doctor's Hospital of Williamsburg and adding specialist capacity where access has been an issue. Most importantly, in preparation for changes in health care delivery and payment reform, we've been widening the primary care "funnel" of our health system. As emphasis shifts from rewarding intervention in illness to management of health, we expect a smaller percentage of patients to require hospital admission. If we are to manage our facilities efficiently, we will need to keep our beds full and we'll need to have a larger base of patients in order to accomplish that.

The election has passed and the Patient Protection and Affordable Care Act is here to stay. However, there remains a great deal of uncertainty. As usual this time of year, we are facing a potential 27% reduction in Medicare physician payments under the SGR formula that Congress refuses to permanently fix. We face a possible 2% reduction in hospital payments and the Fiscal Cliff. We will be challenged to negotiate favorable contracts based on quality and service measures and shared savings with many payors and form Accountable Care partnerships with others.

Fortunately, we are realizing great results from the efforts all of us have been making in our practices. Our quality scores have never been higher. This quarter, we reached the 75th national percentile in the "Likelihood to Recommend" score in our patient satisfaction surveys. Access is greatly improved. Our provider engagement and team member satisfaction is increasing.

The articles below outline many of the efforts and great work that has been accomplished. Please take the time to look them over. Please also take special note of the new provider biographies and make the time to introduce yourself in person or by phone, flag, or email to the many new providers we've added over the past few months. The best medical groups across the country are built on relationships, partnership, and transparency. Our continued success and further improvement will require that we are all engaged in the effort.

Thanks to all for what you are doing for our patients and best wishes for success in the New Year.

** Primary Care Strategy and Initiatives

Pick up any payer publication, news article on healthcare reform, or description of Accountable Care Organizations, and the importance of primary care capacity and reach cannot go unnoticed. We know that our primary care foundation drives much of our health systems growth and success, directing patients to our specialty partners, using our diagnostic resources, and managing care for patients post-acute care settings. Our data shows that the average spend for a Medicare patient that is not assigned to an RMG PCP is just 2/3 of a patient who uses Riverside services but has a RMG PCP. It comes as no surprise then that we have a commitment to expand our primary care reach and lead the market in transforming how patient care is provided across the continuum of services. Our success in this area will lead to success for our specialist physicians, our acute care settings, and our diagnostic services, no matter what payer models may exist in the future.

Greater Market Penetration
We have several strategic and operational initiatives to increase the number of patients and to increase the services patients receive in primary care. Recruitment strategies are at the heart of expanding capacity in some areas. In 2011 and 2012, 15 new primary care providers joined the RMG team. The plan for 2013 is to bring aboard another six to eight new providers system-wide. Studies are currently underway to determine other potential locations, including Theatre Road and surrounding Riverside Doctor's Hospital of Williamsburg.

Access is another important component of market penetration, and our primary care offices have incorporated same day appointment scheduling. We are piloting clinical team models of care that focus attention on preventive services, offering new covered benefits like the annual wellness visit, outreach to patients who have not been seen, and quality measure monitoring and follow up. These team models will also be at the heart of improved transitions of care between specialists and acute care settings.

Product Development
A significant part of our primary care strategy is to begin transforming the model of care for current and future industry changes. At the heart of product development is our effort to achieve level III NCQA Patient Centered Medical Home certification (see article below.) This effort is helping us rethink how we provide care to patients in our primary care offices as well as address the population health issues that exist.

We are exploring technology options, including piloting a central scheduling initiative with our three primary care offices in Williamsburg. Our goal is to integrate our telephone technologies at the individual offices with our call center technologies to improve service to our patients and expand contact hours. On the EMR front, Dr. Frazier, the medical home team, and our IT partners have created new tools, shortcuts and dashboards to help us better manage our chronic patients, focus on quality measures and conduct pre – visit preparations more efficiently.

We are also redesigning our primary care offices when expansion occurs to incorporate more efficient workflow, space for care management activities and flexible space for patient training and group services.

Making sure we are successful at acquiring new patients and retaining those patients, we been hard at work determining what will be the most effective tactics. Our primary care physicians and APPs have always been committed to outstanding quality, safety and patient service. Our strategies reflect our commitment to respond to patient needs and preferences, payer obligations and industry transformation.

** RMG Submits First 11 Practices for Patient-Centered Medical Home Recognition

NCQA's Patient-Centered Medical Home (PCMH) is an innovative program for improving primary care. In a set of standards that describe clear and specific criteria, the program gives practices information about organizing care around patients, working in teams and coordinating and tracking care over time. The NCQA Patient-Centered Medical Home standards strengthen and add to the issues addressed by NCQA's original program.

The PCMH is a healthcare setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient's family. Care is facilitated by providers, other healthcare professionals, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.

NCQA has established formal relationships with a large number of public and private payer organizations who sponsor programs that offer incentives to clinical sites to become NCQA-Recognized medical homes. Most of these sponsoring organizations pay a regular bonus or offer enhanced reimbursement to recognized clinical sites or their clinicians.

This month, RMG completed the vigorous requirements and documentation required to submit the first 11 RMG primary care practices to the NCAQ for recognition as a PCMH. They include:

  • Riverside Bay Harbor Medical Center
  • Riverside Family Practice and Extended Care
  • Riverside Hayes Medical Center
  • Riverside Hilton Family Practice
  • Riverside Internal Medicine of Denbigh
  • Riverside King William Medical Center
  • Riverside Mercury West
  • Riverside Warsaw Medical Arts
  • Riverside Warwick Primary Care
  • Riverside White Stone Family Practice
  • Riverside White Stone Family Practice – Tangier Island

Results from these submissions should be received within 30-60 days per NCQA guidelines.

** Subcommittee Reports

Finance and Operations Subcommittee

  • The Tricare Prime agreement with RMG was reviewed and the committee agreed to move forward.
  • Brad Miller presented an overview of the 2013 physician compensation model. The new model will be presented to the Board for approval.
  • Discussion ensued regarding input fields for encounter codes and the committee agreed to eliminate some fields in the EMR. They also discussed how practices differentiate between a new vs. established patient.
  • Charlie Graham discussed plans to acquire both Cape Charles Medical Center and Eastern Virginia Rheumatology.
  • Mr. Graham also discussed: a) the promotion of Andrew Woughter to Vice President of Revenue Cycle; provider based billing updates; status of the current budget process; and results from the PEA and BPA surveys.

Peer Review Committee

  • The committee will develop and distribute a survey to all RMG practices re: ultrasound in ambulatory office settings.
  • The committee discussed the appropriateness of evaluating and acting upon Midas-generated concerns involving RMG offices.
  • Conclusions or decisions regarding several peer review issues, i.e., credentialing, non-core privileges in reference to gastroenterology, impaired physician policy, yearly review, and a confidential chat room will be tabled pending further investigation.

Advanced Practice Provider Affairs Committee

  • Sally Hartman, VP of Human Resources presented information on the Wellness and Health Plan.
  • Changes to the proposed Charter have been made and will be presented to the RMG board for approval.
  • In recognition of National Nurse Practitioner and National Physician Assistant weeks, Terry Thompson discussed activities planned to acknowledge RMG providers.
  • The committee discussed developing an APP planning calendar and break-out sessions at the provider retreat for RMG APPs.
  • Tammy Hedspath reported on the Culture and Communications Committee meeting (see below).
  • An update was provided regarding the Student Preceptor Program and activity with local universities regarding potential students.

Culture and Communications Committee

  • Liz Williams, VP of Marketing, Strategy and Development discussed plans to develop a patient introduction video to be developed and used by RMG providers.
  • Discussion related to developing awards for excellence using measurable metrics was held.
  • Dr. Lesnick reviewed the 2012 PEA results.
  • Dr. Eric Stone and Dr. Daniel Muench will join the committee.
  • It was reported that evaluations from New Provider Orientation continue to be positive.
  • The committee discussed avenues for sharing clinical stories of excellence.

** "Grateful Patients" Recognize RMG Physicians

Last May, the Riverside Health System Foundation received a generous anonymous donation in recognition of the care provided by Dr. Joseph Wilson at Riverside ENT Physicians and Surgeons. This month they received a second anonymous donation by another patient also wishing to recognize Dr. Wilson for his compassionate care.

These RMG physicians have also been recognized with accompanying donations to the Foundation – read what their patients had to say.

About Dr. Christine Paul, Riverside Warsaw Medical Arts

"She is the best doctor anywhere! She empowers you to own your health. She is a blessing!"

About Dr. James Dudley, RTH Emergency Department

"Dr. Dudley is somebody who can give you hope to live, he's an angel doctor."

About Dr. Thomas Cleary, RTH Emergency Department

"Dr. Cleary was very professional, informative and caring."

About Dr. Randy Ferrance and Dr. Alexander Ogedegbe, RTH Hospitalists

"Drs. Ferrance and Dr. Ogedegbe were most helpful to a patient's family member's understanding of his brother's condition while he was in ICU. They were most understanding and sympathetic of the physical inability that kept the family member from traveling to be at his brother's bedside. Their professionalism and compassion were most appreciated and speak highly of your hospital's level of care….appreciated his caring attitude and expertise."

About Dr. Dean Kostov, Hampton Roads Neurosurgical and Spine Specialists

"Dr. Kostov is kind and extremely skillful at what he does. I highly recommend him to anyone who needs his service."

About Dr. John Miller, Peninsula Cancer Institute, Riverside Cancer Care Center in Gloucester

and RTH Hospice

"The family wishes to thank John Miller, MD, and the nurses and staff at the Riverside Cancer Center in Gloucester for their kindness and care during his illness. In addition, the family would like to thank everyone associated with Riverside Hospice in Tappahannock for their gracious and gentle care given him during the last days of his life."

About Dr. Aqeel Jafri, RTH Hospitalist

"Dr. Jafri is special to me because of his caring attitude and expertise."

About Dr. Jeffrey Haskins, Riverside Tappahannock Urological Center

"He is caring, skilled, sharing and always smiling – GREAT DOCTOR!"

About Dr. Bill Irvin, Riverside Gynecologic Oncology

"Dr. Irvin – He changed his schedule to move my surgery sooner and was so caring and compassionate."

About Dr. Lori Gillespie, Radiation Oncology Specialists and the

Team at the Riverside Cancer Care Center

"I appreciate how Dr. Gillespie and the staff at the Riverside Cancer Care Center continue to care about my health. Although I have no further signs of cancer, they make me feel safe as they continue to monitor my recovery. I feel they truly care about my well-being. They are friendly, thoughtful and conscientious. I thank them all for the care they give each patient."

About Dr. Mashour Yousef and the PCI Cancer Care Team

"Their information – wonderfully cheerful attitude – willingness to help in the act of giving persistent service and loving care to all patients no matter who or what situation exists at the time. There are no words that can explain the feelings of kindness that a smile and kind word can provide to someone in distress or illness which they see each day. My feeling is that they must love their mission in this life. They will always be remembered as earthly angels with gratitude and thanks which is heartfelt."

About Dr. Bill Irvin, Riverside Gynecologic Oncology

"I have made this gift in honor of my daughter, Amy who has shown much compassion to me along with providing whatever I needed her for; whether it was providing meals, transportation to and from treatments and doctor's visits, grocery shopping, running errands or just providing a listening ear. I also had great support from Dr William Irvin and his staff at Peninsula Cancer Institute."

About Dr. Lori Gillespie, Phyllis and the entire Radiation Team

"I was frightened and felt sad, no appetite, losing weight, depressed, and felt as if no one understood, but – all the staff was kind and down to earth friendly. That made my visits easier, less stressful and made the outlook for me less of an ordeal and less bleak. Like Margie's letter said each one certainly did feel like family. A big HUG TO EVERYONE!!! And Thanks."

About Dr. Veronica Eisen, Radiation Oncology Specialists

"You make a difference to me with your smile and caring way. Thank you for the excellent treatment – I'm feeling better each day."

About Dr. Kim Schlesinger, Riverside Peninsula Cancer Institute

"She keeps me alive – but of course there is more. She does her job with such grace, kindness and humor. I look forward to my appointments. She is smart, focused and always on top of things. I would like to compliment her parents for raising such a fine young woman and Riverside for being smart enough to hire her. Please hold on to her."

Donations have also been received in honor of Dr. Marshall Cross, Riverside Hampton Roads Surgical Specialists, Dr. Magi Khalil, Riverside PCI – Gloucester, and Dr. Peter Zullo, Riverside Gloucester Internal Medicine Associates.

To all of our physicians, thank you for all you do for our patients and their families. And for supporting the Riverside Health System Foundation so that we may continue to provide quality healthcare to the communities we serve, for years to come.

** The RVU Assignment Process

Submitted by Roger E. Schultz, MD, FACS

"I am a urology advisor for the American Urological Association, so I represent the AUA at the CPT and RUC committees. I hope to explain how codes are born and RVU's get assigned.

Each year there are 3 CPT (Current Procedural Terminology) meetings to update the CPT book, followed by three RUC (Relative Value Update Committee) meetings to assign RVU's to new or revised CPT codes.

The CPT Editorial Board is comprised of physicians and representatives from CMS, the American Hospital Association, and the insurance industries. Assisting the panel are volunteers from all medical specialties and industries who can offer opinions. The panel adds, deletes, or modifies CPT codes as needed to accurately reflect medical practice. To protect the integrity of the process, no one who actively participates can have a conflict of interest, and no one can lobby to influence decisions.

Every new CPT code is sent to the appropriate primary care or specialty societies to propose an RVU recommendation. Societies often survey their membership for thoughts on the time, the work, and the risk of doing the procedure. They send specialty advisors to the RUC meeting to present and defend their proposal for the RVU assignment.

The Relative Value Update Committee (RUC) includes primary care and specialist providers, and representatives of the AMA, American Osteopathic Association, Health Care Professionals Advisory Committee, and Chairs of the CPT Editorial Panel and Practice Expense Committee. The RUC panel listens to the specialty advisors who have surveyed their members and chosen an RVU assignment.

The RUC can accept this number or modify it. The RUC recommendations go to CMS in May of each year for final review. CMS can accept or change them. The Medicare Physician payment schedule, including CMS's final decision on the RUC value, is published in the fall every year.

There is a cyclical review process of the RVU values assigned to CPT codes. Under particular scrutiny are those codes that are billed frequently and codes that are commonly bundled with other codes. If a procedure has evolved and is now less expensive and/or takes less time to perform, the RUC may advise a reduction in RVU's. On the other hand, if they feel a code has been undervalued, it may get a higher RVU assignment. Once again, CMS gets the final word on revisions.

If you ever receive a request for a RUC survey of a code that you use, I strongly recommend that you complete it carefully and honestly. Your input and the work of your representatives at CPT and the RUC, help to protect and defend the RVU's that you will receive.

** Top Docs

When Hampton Roads Magazine asked all licensed physicians in the area who they'd want if they or a loved one needed medical care, the 53 Riverside doctors listed below were among those selected.

Dennis T. Bartol, M.D.

Brian J. Billings, M.D.

John W. Boyd, M.D.

Scott V. Burgess, M.D.

Lisa A. Casanova, M.D.

Anthony J. Caterine, M.D.

Denise R. Chamblee, M.D.

Edward Chu, M.D.

David J. Connito, M.D.

Marshall A. Cross, M.D.

Jonathan H. DeMeo, M.D.

Denise Y. Duhon, M.D.

Richard R. Edwards, M.D.

Paul L. Evans, Jr., M.D.

James A. Fish, Jr., M.D.

Jay W. Floyd, M.D.

Craig Franzman, M.D.

Peter T. Galantich, M.D.

Frederick M. Gessner, M.D.

Ron Gharbo, D.O.

C. Delp Givens, Jr., M.D.

John C. Gretes, M.D.

Robert R. Harding, M.D.

William O. Harris III, M.D.

Ray L. James, Jr., M.D.

Eric A. Weiner, M.D.

Joseph F. Wilson, M.D.

Gary S. Kavit, M.D.

Steven E. Kitay, M.D.

John N. Livingstone II, M.D.

William H. McAllister IV, MD

John C. Maddox, M.D.

H. B. Marsteller, M.D.

Pierre T. Martin, M.D.

Paul J. Micale, M.D.

Janice Newsome, M.D.

John C. Perry, M.D.

Charles K. Phillips, M.D.

Thomas A. Pincus, M.D.

Joseph J. Piotrowski, M.D.

Henry M. Prillaman, M.D.

Robert J. Pusateri, M.D.

Kimberly A. Ratcliffe, M.D.

Richard G. Rento II, M.D.

Mark A. Ross, M.D.

David J. Schengber, M.D.

Kimberly W. Schlesinger, M.D.

Mark E. Souther, M.D.

Steven G. Spellman, M.D.

Gary A. Tanner, M.D.

Mark A. Titus, M.D.

Charles M. Vaughan, M.D.

Stanley D. Yeatts II, M.D.


Congratulations to all our Riverside physician partners for being named a 2012 Top Doc in Hampton Roads.

** BRIEFS 

Groundbreaking for Riverside Shore Memorial Hospital Planned
At the Accomack County Board of Supervisors meeting held on October 21, 2012, the Supervisors approved a conditional use permit for Riverside Shore Memorial Hospital which allows Riverside to proceed in relocating the hospital. The new hospital will be located behind Four Corner Plaza.

The hospital and medical office buildings will each sit approximately 1,000 feet from Route 13 and Market Street. The new site provides ample and convenient parking for visitors and staff.

The floor plans include 78 private patient rooms and a minimum of 260 additional square feet in each room to accommodate equipment, hospital staff and visitors along with the patient.

The elevations of the outside of the building show many windows to allow natural light into interior spaces. The materials selected to construct the hospital are traditional in appearance and are designed to withstand hurricane-force winds.

Groundbreaking for the new facility will be in the spring of 2013.

Congratulations to RMG APPs
Fall is a time when our Advance Practice Providers are celebrated and recognized by their professional organizations. October 6-12 marked National Physician Assistant week and November 7-12 marked National Nurse Practitioner week.

At Riverside Medical Group, we're proud of our 32 physician assistants and 64 nurse practitioners. Their clinical as well as operational contributions are immeasurable. Thank you for all you do.

Dr. Barry Gross Appointed to EVMS Board
On Friday August 17, Governor Bob McDonnell's office announced the appointment of Dr. Barry Gross to one of two at-large Eastern Virginia Medical School Board of Visitors positions. The Board of Visitors is the governing body of Eastern Virginia Medical School and is composed of 17 members as follows:

  • two non-legislative members to be appointed at large by the Governor of Virginia
  • two non-legislative members to be appointed by the Senate Committee on Rules
  • three non-legislative members to be appointed by the Speaker of the Virginia House of Delegates
  • six members to be appointed by the Eastern Virginia Medical School Foundation
  • four members who shall be appointed by their respective city councils

Dr. Gross, Executive Vice President and Chief Medical Officer for Riverside Health System, is the first Riverside executive named to the EVMS board. He will serve a three year term.

Riverside Doctors' Hospital of Williamsburg Nears Completion
The hospital will be a 2-story, approximately 100,000 square foot facility and is scheduled to open first quarter 2013. The hospital is licensed for 40 private rooms, 33 medical/surgical rooms and seven intensive care rooms. The full-service emergency department will have 12 private patient rooms. Surgical services features two operating rooms, in addition to the two ORs already located at Doctor's Surgery Center, and eight private patient preparation and recovery rooms dedicated to patients undergoing surgical procedures.

The ground floor of the new hospital will feature a lobby/public area; café; chapel; community education/conference space; emergency department; radiology; cardio/pulmonary services; and outpatient diagnostic services. The second floor will include inpatient and outpatient Surgery; a medical/surgical unit; an intensive care unit; the pharmacy; and a Lifelong Health Center which will focus on simplifying the transition from inpatient acute care to other settings outside the hospital.

To watch the construction progress, visit Riverside's webcam at www.riversideonline.com.

Tangier Island Supporters Continue Dr. Nichols' Legacy
Iris Treakle, a friend of Dr. David Nichols and the residents of Tangier Island, was recently named one of the Library of Virginia's "Virginia Women in History." Iris is a strong supporter of Dr. Nichol's vision of providing quality healthcare to the residents of Tangier Island. She was recognized for her work not only in housing on the island but in continuing Dr. Nichol's mission by organizing a health fair to include information on assistance programs, presentations, and screenings by Riverside providers. "Iris's enthusiasm to the work and to educating and helping others is so exciting to see. She is doing a wonderful job and the Islanders are very grateful," said Inez Pruitt, Physician Assistant at Riverside White Stone Family Practice on Tangier Island. Congratulations to Ms. Treakle and thank you for your continued work on achieving Dr. Nichols' mission.

** New Guide Helps Providers Make Effective Connection with Senior Patients

On October 15, The Gerontological Society of America made available "Communicating with Older Adults: An Evidence-Based Review of What Really Works." The following is a media release describing the new guide. You can download the entire 40-page guide by visiting their website at www.geron.org.

"Communicating With Older Adults: An Evidence-Based Review of What Really Works," the latest report

from The Gerontological Society of America (GSA), provides 40 pages of recommended guidelines for

healthcare providers interacting with the fastest growing age segment of America's population. This publication is intended for physicians, nurses, pharmacists, biologists, psychologists, social workers, caregivers, economists, and health policy experts — anyone who seeks to have the best possible interactions with older patients. It was developed by GSA and supported by McNeil Consumer Healthcare.

"The report is based in the scientific literature, yet the contributors created something extremely

accessible," said Jake Harwood, PhD, head of the Advisory Board that crafted the report. "It covers the full range of communication issues experienced by older adults and healthcare providers, and gives concrete suggestions for dealing with problems when they arise."

The U.S. Administration on Aging forecasts that nearly one in five Americans will be 65 or older by 2030.

At present, those age 65 and above make nearly twice as many physician office visits per year as do adults 45 to 65. According to the U.S. Centers for Disease Control and Prevention, two-thirds of older people are unable to understand the information given to them about their prescription medications.

The report provides 29 specific recommendations in four categories: general tips for improving interactions with older adults, general tips for improving face-to-face communication with older adults, tips for optimizing interactions between healthcare professionals and older patients, and tips for communicating with older adults with dementia.

The recommendations were contributed by experts in the fields of gerontology and communications. Each is accompanied by a brief explanation of the rationale, tips for implementing the recommendation in busy health care settings, and selected references for further reading. The objective is to encourage behaviors that consider the unique abilities and challenges of older adult patients and produce positive, effective interactions among everyone involved.

"The report distills a large body of empirical research findings and scholarship from several disciplines into a set of concrete recommendations for effective communication with older adults," said Advisory Board member Daniel G. Morrow, PhD. "The recommendations include nonverbal and verbal strategies that are often grounded in compelling examples that involve common communication challenges."

Among the specific steps outlined in the report, care providers are encouraged to avoid speech that might be seen as patronizing to an older person, verify listener comprehension during a conversation, and pay close attention to sentence structure when conveying critical information.

"This resource will be of great benefit to healthcare providers, and would also make good reading for older adults. Increasing awareness of some of these issues among the older population could help them seek more appropriate accommodation when needed," Harwood said.

GSA will distribute the report to its own members, as well as members of the American Geriatrics Society, the American Academy of Physical Medicine and Rehabilitation, the American Medical Association, the American Public Health Association, the American Society of Consultant Pharmacists, and the National Association of Professional Geriatric Care Managers.

"While focused on older adults, the recommendations are relevant to communication across the lifespan,"Morrow said.

The Gerontological Society of America (GSA) is the nation's oldest and largest interdisciplinary

organization devoted to research, education, and practice in the field of aging. The principal mission of the Society — and its 5,400+ members — is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA's structure also includes a policy institute, the National Academy on an Aging Society, and an educational branch, the Association for Gerontology in Higher Education.

** Welcome

Ebtehal Abdelaal, M.D., has joined Riverside Gloucester Family Practice. Dr. Abdelaal earned her medical degree at Faculty of Medicine, University of Alexandria. She completed residency training in family medicine at VCU-Riverside Family Medicine.

Robert Ackerman, M.D., has joined the PACE team. Dr. Ackerman earned his medical degree at New Jersey Medical School in Newark. He completed his residency in family medicine at Washington Hospital in Washington, Pennsylvania. Dr. Ackerman is board-certified by the American Board of Family Medicine.

Krystal Ainsley, M.D., has joined Riverside WomanCare of Williamsburg. Dr. Ainsley earned her medical degree at the University of Nebraska Medical Center and completed her internal medicine residency with a women's health track at the Medical College of Virginia, Virginia Commonwealth University.

Benjamin Barlow, M.D., has joined the team at Riverside Emergency Physicians. Dr. Barlow earned his medical degree at Uniformed Services University School of Medicine in Bethesda. He completed his residency in emergency medicine at Wright Patterson AFB/Wright State University School of Medicine.

Marie Claude Bettencourt, M.D., has joined Riverside Hampton Roads Urology. Dr. Battencourt earned her medical degree at F. Edward Herbert School of Medicine, Uniformed Services University in Bethesda. She completed her residency in urology at Walter Reed Army Medical Center in Washington, D.C. Dr. Bettencourt is board-certified by the American Board of Urology.

Victor Clark, M.D., has joined the hospitalist team at Riverside Regional Medical Center. Dr. Clark earned his medical degree at Eastern Virginia Medical School where he also completed his residency in internal medicine. He is board-certified by the American Board of Internal Medicine.

Samuel Critides, M.D., has joined Riverside Hampton Roads Neurosurgical and Spine Specialists. Dr. Critides earned his medical degree at the University of Medicine and Dentistry of New Jersey. He completed a residency in neurological surgery at Penn State Milton S. Hershey Medical Center and at 1 University of New Mexico. Dr. Critides also completed a fellowship in complex spinal surgery at Cleveland Clinic Spine Institute and is board-certified by the American Board of Neurological Surgeons.

Monilla Dent, M.D., has joined, Riverside Women's HealthCare Associates. Dr. Dent earned her medical degree at Northeastern Universities College in Ohio. She completed her residency in OB/GYN at Michigan State University/Grand Rapids Medical Education Partners.

Janet H. Dehoux, NP, has joined Riverside Women's HealthCare in Gloucester. Ms. Dehoux earned her bachelor of science in nursing at the Medical College of Virginia where he also completed her master's of science degree.

Luis Eljaiek, Jr., M.D., has joined the Emergency Department at Riverside Regional Medical Center. Dr. Eljaiek earned his medical degree at Eastern Virginia Medical School where he also completed his residency in internal medicine. Dr. Eljaiek also completed a residency and fellowship in emergency medicine at The Johns Hopkins Hospital in Baltimore. He is board-certified by the American Board of Emergency Medicine.

David Forsythe, M.D., has joined Riverside Orthopaedics and Sports Medicine. Dr. Forsythe earned his medical degree at the University of South Carolina, School of Medicine in Columbia. He completed his residency training in orthopaedic surgery at the Medical College of Georgia. Dr. Forsythe is board-certified by the American Board of Orthopaedic Surgeons.

Shawn Flanagan, M.D., has joined Fast Track at Riverside Regional Medical Center's Emergency Department. Dr. Flanagan earned his medical degree at the University of Maryland School of Medicine and completed his residency in family medicine at the University of Nebraska Family Medicine Residency. Dr. Flanagan is board-certified by the American Board of Family Medicine.

Sarita Golikeri, M.D., has joined the PACE Center in Manchester. Dr. Golikeri earned her medical degree at St. George's University School of Medicine. She completed her residency in family medicine at Somerset Family Practice in Somerville, New Jersey and fellowship training in geriatrics at UPMC St. Margaret in Pittsburgh. Dr. Golikeri is board-certified by the American Board of Family Medicine.

Nicole Gray, N.P., has joined the Emergency Department at Riverside Regional Medical Center. Ms. Gray earned her master's in nursing from Old Dominion University. She is certified as a Family Nurse Practitioner by the American Nurse Credentialing Center.

Robert Grzonka, M.D., has joined Riverside Hampton Roads Urology. Dr. Grzonka earned his medical degree at Northwestern University Medical School. He completed his residency in urology at University of South Florida in Tampa. Dr. Grzonka also completed a fellowship in Uro-Oncology at the University of South Florida. He is board-certified by the American Board of Urology.

Thomas Hare, P.A., has joined Riverside Shore Orthopaedic Center. Mr. Hare earned his master of science in athletic training at Indiana University in Bloomingdale and his bachelors of science in Physician Assistant Studies at Stony Brook University in New York. He is certified by the American Commission of the Certification of Physician Assistants.

Do Hwang, M.D., has joined Riverside Warwick Primary Care. Dr. Hwang earned her medical degree at St. Matthew's University, Grand Cayman and completed her family medicine residency at the University of Toledo/St. Luke's Hospital. She is board-certified by the American Board of Family Medicine.

James Hess, M.D., has joined the Riverside Center for Excellence in Aging. Dr. Hess earned his medical degree at the Medical College of Virginia where he also completed his residency in internal medicine and fellowship training. Dr.Hess is board-certified by the American Board of Internal Medicine and the American Board of Emergency Medicine.

Todd Allen Jenkins, M.D., has joined Riverside Peninsula Vascular Surgery. Dr. Jenkins earned his medical degree at Eastern Virginia Medical School and completed his surgical residency at The Carillion Clinic, Virginia. Following residency Dr. Jenkins completed fellowship training in Vascular Surgery at University of Tennessee-Health Science Center.

Jill Jertson, M.D., has joined Riverside WomanCare of Williamsburg. Dr. Jertson earned her medical degree at Tufts University of Medicine in Boston and completed her obstetrics & gynecology residency at Fletcher Allen Health Care, University of Vermont. Dr. Jertson is board-certified by the American Board of Obstetrics & Gynecology.

Cindy Kirkland, NP, has joined Riverside Hampton Roads Neurosurgical and Spine Specialists. Ms. Kirkland received her bachelor of science in nursing at California State University and her master of science, adult nurse practitioner degree at the University of South Florida.

Darlene Knight, P.A., has joined Riverside Hampton Roads Neurology. Ms. Knight earned her bachelor of science degree in physician assistant studies at the University of Nebraska, IPAP, San Antonia, Texas. She is certified by the American Commission of the Certification of Physician Assistants.

Paul Lanfranchi, P.A., has joined Riverside Orthopaedics and Sports Medicine. Mr. Lanfranchi earned his master of physician assistant studies at Eastern Virginia Medical School in Norfolk.

John Kenyon Larsen, P.A., has joined Riverside Peninsula Pulmonology. Mr. Larsen earned his master of physician assistant studies at Eastern Virginia Medical School.

John Damian Long, M.D., has joined Riverside Williamsburg Gastroenterology. Dr. Long earned his medical degree at Eastern Virginia Medical School. He completed his internal medicine residency at Winthrop-University Hospital in New York. Dr. Long also completed fellowship training in Gastroenterology at Tulane University School of Medicine in New Orleans.

Lanny Littlejohn, M.D., has joined the team at Riverside Emergency Physicians. Dr. Littlejohn earned his medical degree at USC School of Medicine. He completed his residency in emergency medicine at the Naval Medical Center in Portsmouth.

Darine Moukalled, M.D., has joined Riverside Warwick OB/GYN & Women's Healthcare Associates.

Dr. Moukalled earned her medical degree at Saint-Joseph University, Beirut. She completed her Obstetrics & Gynecology residency at the American University of Beirut followed by a second Obstetrics & Gynecology residency at Eastern Virginia Medical School.

David Newton, M.D., has joined Riverside Urgent Care in Hayes.Dr. Newton earned his medical degree at the Medical College of Virginia, Virginia Commonwealth University. He completed his family medicine residency at Riverside Regional Medical Center and is board-certified by the American Board of Family Medicine.

Sean A. Nix, D.O., has joined Riverside Hampton Roads Surgical Specialists. Dr. Nix earned his medical degree at University of Health Sciences College of Osteopathic Medicine. He completed his general surgery residency at Des Peres Hospital in Saint Louis. Dr. Nix also completed fellowship training in surgical critical care at Washington University/Barnes Jewish Hospital.

Elizabeth Nowell, N.P., has joined Patriots Colony. Ms. Nowell earned her RN at Riverside School of Professional Nursing and her master's in nursing at Virginia Commonwealth University.

Alexander Ogedegbe, M.D., has joined the hospitalist team at Riverside Tappahannock Hospital. Dr. Ogedegbe earned his medical degree at Albany Medical College in New York. He completed his internal medicine residency at Albany Medical Center.

Zane Paul Osborne, M.D., has joined the Emergency Department at Riverside Walter Reed Hospital.Dr. Osborne earned his medical degree at the University of South Carolina School of Medicine. He completed his emergency medicine residency at the University of Illinois at Chicago. Dr. Osborne is board-certified by the American Board of Emergency Medicine.

Ankur Patel, M.D., has joined the hospitalist team at Riverside Regional Medical Center. Dr. Patel earned his medical degree at St. James School of Medicine in the Netherlands Antilles. He completed his family medicine residency at the University of Alabama. Dr. Patel also completed fellowship training in geriatrics at EVMS.

Nisha Patel, N.P., has joined the PACE Center in Manchester. Ms. Patel earned her master's in science at Old Dominion University. She is a certified family nurse practitioner.

Angelica Perry, D.O., has joined Riverside Eastern Shore Physicians & Surgeons.Dr. Perry earned her medical degree at the Virginia College of Osteopathic Medicine. She completed her residency training in family medicine at Riverside Regional Medical Center.

Alvaro Andres Puig Rodriguez, M.D., has joined the hospitalist team at Riverside Tappahannock Hospital. Dr. Puig earned his medical degree at Universidad Nacional de Colombia, Bogota D.C. Colombia. He completed his internal medicine residency at Jackson Memorial Hospital/Jackson Health System Program. Following residency Dr. Puig completed an endocrinology diabetes and metabolism fellowship at Jackson Memorial Hospital/Jackson Health System in Miami.

Candace L. Ross-Cleary, NP, has joined Riverside Hampton Roads Neurosurgical and Spine Specialists. Ms. Ross-Cleary earned her bachelor of science in Nursing at Eastern Mennonite University and her master of science in nursing at Millersville University in Pennsylvania.

Jackson B. Salvant, Jr., M.D., has joined Riverside Hampton Roads Neurosurgical and Spine Specialists. Dr. Salvant earned his medical degree at the Medical College of Virginia where he also completed his residency in Neurosurgery. He is board certified by the American Board of Neurological Surgeons.

Christopher Scibelli, M.D., has joined Riverside Peninsula Vascular Center. Dr. Scibelli earned his medical degree at Temple University School of Medicine. He completed residency training in general surgery at Christiana Care Health Services in Delaware. Dr. Scibelli also completed fellowship training in vascular surgery at Eastern Virginia Medical School. He is board-certified by the American Board of General Surgery/Vascular Surgery.

Jason A. Smith, D.O., has joined Riverside Orthopaedics and Sports Medicine. Dr. Smith earned his medical degree at Philadelphia College of Osteopathic Medicine. He completed his family medicine residency at South Pointe Hospital, Cleveland Clinic Foundation. Following his residency Dr. Smith completed a Primary Care Sports Medicine fellowship at Cleveland Clinic Foundation.

Bharati Srivastava, M.D., has joined the team at Riverside Lifelong Health & Aging Services at Patriots Colony. Dr. Srivastava earned her medical degree at M.L.B. Medical College, Jhansi, India. She completed her internal medicine residency at Wayne State University in Detroit. Following residency she completed a geriatric fellowship at the University of Michigan. Dr. Srivastava is board-certified by the American Board of Internal Medicine and the American Board of Geriatric Medicine.

Virginia Stewart, M.D., has joined the Emergency Services division. Dr. Stewart earned her medical degree at Brody School of Medicine at East Carolina University. She completed her residency in emergency medicine at Eastern Virginia Medical School. Dr. Stewart also completed fellowship training in emergency medicine ultrasound at EVMS. Dr. Stewart is board-certified by the American Board of Emergency Medicine.

Vincent Stravino, M.D., has joined the hospitalist team at Riverside Shore Memorial Hospital. Dr. Stravino earned his medical degree at Hahnemann University School of Medicine in Philadelphia. He completed residency training in internal medicine at the University of Tennessee Medical Center in Knoxville. Dr. Stravino is board-certified by the American Board of Internal Medicine.

Nehemiah Thrash, Jr., M.D., has joined the hospitalist team at Riverside Regional Medical Center. Dr Thrash earned his medical degree at Eastern Virginia Medical School where he also completed his internal medicine residency. Dr. Thrash is board-certified by the American Board of Internal Medicine.

Madelyn Tingly, P.A., has joined the hospitalist team at Riverside Regional Medical Center. Ms. Tingly earned her master's in science in physician assistant studies at Philadelphia College of Osteopathic Medicine. She is certified by the American Commission of the Certification of Physician Assistants.

Morgan A. Vanderhorst-Albaugh, M.D., has joined Riverside Tappahannock Urgent Care. Dr. Vanderhorst-Albaugh earned her medical degree at Northeastern Ohio Universities College of Medicine. She completed her family medicine residency at VCU-Shenandoah Valley Family Practice Residency Program. Dr. VanderHorst-Albaugh is board-certified by the American Board of Family Medicine.

Naveen Voore, M.D., has joined the hospitalist team at Riverside Shore Memorial Hospital. Dr. Voore earned his medical degree at Gandhi Medical College in Hyderabad, India. He completed his residency in internal medicine at Franklin Square Hospital in Baltimore.

Jennifer Whalen, P.A., has joined the Riverside Neuro-Intervention Center. Ms. Whalen earned her master's of health sciences in physician assistant studies at Duke University in Durham. She is certified by the American Commission of the Certification of Physician Assistants.

Tyler Wind, M.D., has joined The Northern Neck Bone & Joint Center in Tappahannock.Dr. Wind earned his medical degree rom the University of Virginia. He completed his orthopaedic surgery residency at the Medical University of South Carolina (MUSC) in Charleston. Following residency Dr. Wind completed a fellowship largely focused on direct anterior hip replacements.

Jun Zhao, M.D., has joined Riverside Hampton Roads Neurology. Dr. Zhao earned her medical degree at Fourth Military Medical University. She completed her neurology residency at University of Tennessee Health Science Center. Following residency Dr. Zhao completed a fellowship in clinical neurophysiology at the University of Maryland Medical Center.

Ernest F. Zichal, D.O., has joined Riverside Peninsula Vascular Surgery. Dr. Zichal earned his medical degree at Kansas City University of Medicine and Biosciences. He completed a surgical residency at Palms West Hospital, Loxahatchee in Florida and surgical residency at Saint Barnabas Hospital in New York. Dr. Zichal completed a Vascular Surgery fellowship at Deborah Heart and Lung

Farewell

  • Gregory B. Hughes, M.D., Riverside Endocrinology and Diabetes Center
  • Michael Peyser, M.D., Riverside Hampton Roads Surgical Specialists
  • Bishop P. Read, M.D., Riverside Hampton Roads Urology
  • Charles Reninger III, M.D., Riverside Cancer Specialists of Tidewater
  • Philip Schlobohm, M.D., Riverside Behavioral Health Center
  • James A. Wassum, M.D., Riverside Radiation Oncology Specialists
  • Stacy Brinkley, N.P., PACE Richmond
  • Caroline Lucas, N.P., Riverside Peninsula Cancer Institute

 

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