Enduring Materials - Mar 2, 2023
"Prevention and Treatment of Alcohol Use Disorder in Primary Care"

Speaker: Jess LeBlanc, MD, MPH. Mosaic Medical.

Objectives

1. Understand the epidemiology of AUD.
2. Explain the neuropsychological as well as the physical effects of alcohol on the body.
3. Review Adolescent Predictors of Alcohol Use Disorder.
4. DSM-V criteria for AUD – mild/moderate/severe.
5. AUD prevention strategies for adolescents and adults in Primary Care.
6. AUD treatment strategies for adolescents and adults in Primary Care.
7. Local resources for referral to treatment programs in Central Oregon.

Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of St. Charles Health System and Mosaic Medical. St. Charles Health System is accredited by the ACCME to provide continuing medical education for physicians. St. Charles Health System designates this live virtual activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected]. 

As a child, Steve discovered a love for music and began playing the guitar. After a career in several different trades, his passion for the instrument led him to Breedlove Guitars, where he was able to combine his love for music with the art of building some of the most exceptional stringed instruments available. However, Steve's passion was threatened when he began experiencing pain in both hands. He sought treatment at The Center, where he was diagnosed with carpal tunnel and arthritis in his thumb carpometacarpal (CMC) joint. He was reluctant to undergo surgery, so he opted for injections to alleviate his pain. Unfortunately, after a year, Steve's condition worsened, and he was unable to perform even the simplest daily tasks, let alone play music or do his job without experiencing excruciating pain.

Although Steve was apprehensive about surgery, Dr. Soma Lilly alleviated his fears and earned his trust. As a result, Steve underwent surgery on his left hand, which yielded remarkable results. Following the removal of his stitches, he made rapid progress in his recovery. Although he experienced some discomfort, it paled in comparison to the agony he had endured for years. Steve diligently followed the physical therapist's instructions and even incorporated guitar playing into his therapy. He said, “The feeling I got when I hit that first D chord, I got goosebumps.”

Steve is now back to work and playing music. He knows that he will eventually need surgery on his right hand. However, he is determined not to delay seeking treatment next time so he can continue to live the life he loves, pain free.

The opening of St. Charles’ new Wound Ostomy care clinic in Prineville means people in Crook County who need wound and ostomy services can get the care they need closer to home.

Located in the Prineville hospital, the clinic is open Monday through Friday, 8 a.m.-5 p.m. by appointment only. It is the health system’s third hospital-based, outpatient Wound Ostomy clinic in Central Oregon, joining locations in Bend and Madras, where planned expansions are designed to better serve Jefferson County, too.

For patients traveling to and from appointments multiple times per week, less travel can mean better health outcomes, said Bethany Klier, manager of Wound Ostomy for St. Charles.

"People shouldn’t have to commute 30 miles, 60 miles and even 100 miles to receive care. It is our priority to bring care closer to where our patients reside,” Klier said.

The experienced and board-certified clinicians in Wound Ostomy treat patients with problematic, chronic, or hard-to-treat conditions such as pressure ulcers, diabetic ulcers, surgical wounds, and arterial wounds. They also provide comprehensive ostomy care and management for patients with stomas, ostomies, from pre-op counseling and education to dietary help and support groups.

But more than just providing a medical service, the staff in Wound Ostomy hopes to be a source of support and community for their patients.

“We’ll partner with you to get optimal healing outcomes, but we don’t see it as just providing a service,” Klier said. “We create connections by listening, empathizing, educating, and supporting one another. We truly care about our patients and want to provide a safe healing environment for all.”

The planned Wound Ostomy expansion in Madras includes an additional exam room and more staffing to meet the demand that is higher than anticipated, Klier said.

“We’ve grown pretty consistently as the years have progressed, despite a lot of people not knowing who we are or what we do,” she said. “We weren’t expecting the amount of patient volume when we opened our Madras location, and we’ve found that we really hit a population that we didn’t even know existed or needed our care. It humbled all of us who’ve worked there. It’s obvious that the community needs us more than ever.”

If you think you could benefit from wound and ostomy care or would like more information about ostomy support groups, please contact your primary care provider for a referral. Visit our website to learn more about St. Charles’ wound and ostomy services.

Health care providers and educators are planning and preparing for the launch of the Three Sisters Rural Track Program Family Medicine Residency – the first graduate medical education residency primarily based in Central Oregon.

Officials from St. Charles Madras, St. Charles’ Madras Family Care Clinic, Mosaic Medical, Oregon Health & Science University (OHSU) and Indian Health Service (IHS) have met multiple times over the past few months to discuss details of the program, which is expected to bring six resident physicians to Jefferson County in 2025.

The group met recently in Madras for its third faculty development session, said program director Dr. Jinnell Lewis.

“We’re talking about the details of running a residency, how to teach residents and how to work with residents, plus we’re planning for recruitment, which happens this fall,” she said. “It takes a lot of work and collaboration to launch something like this and we’re deep into that process right now.”

Medical students will apply for residencies in September, and program officials will have less than two weeks to review applications and decide who to offer an interview, Lewis said. They hope to interview 90-100 applicants for six positions in the program’s first class.

That class will spend its first year at OHSU, then two years in Jefferson County. The Three Sisters program is unique because it offers three “continuity sites” in a rural area: Mosaic Medical’s Madras clinic, St. Charles’ Madras clinic and the Warm Springs Health & Wellness Center. Resident physicians will work at each of the three sites and will see their own panel of patients under the supervision of a teaching physician.

“With our three sites, we’re able to give residents an array of experiences, including a hospital-owned clinic, an FQHC in Mosaic and a federally run IHS clinic in Warm Springs,” Lewis said. “It’ll provide a well-rounded education in practice management, as well as exposure to different kinds of health care settings.”

The work has given Lewis a chance to meet and collaborate with a number of individuals and organizations in the area, she said.

“I’ve been to the Confederated Tribes of Warm Springs’ Tribal Council and met with Madras City Council and Jefferson County Commissioners, and everyone is supportive of this huge opportunity for our community,” she said.

The program will look to hire a new coordinator position soon, Lewis said. Resident physicians are expected to arrive in Jefferson County in August of 2025.

Hello St. Charles newsletter readers! I am taking over this month's column to let you know that the health system's Board of Directors, which I chair, is pleased to announce that Dr. Steve Gordon has accepted the position of president and CEO for the health system on a permanent basis. He has been serving as interim president and CEO since July.

In that time, he has launched a new service-line focused structure that groups and manages services that support a patient throughout their health care journey. Under his leadership, St. Charles realized improved financial performance for the second half of 2022 and is committed to returning to a positive operating margin by the end of 2023. Retaining highly experienced caregivers and working to recruit new permanent staff are among his top priorities.

Additionally, Steve is an experienced health care executive and former member of the St. Charles Board of Directors. A primary care and internal medicine physician by training, he has served in executive leadership roles for PeaceHealth in Vancouver, Wash., Providence Health and Services in Portland and Salem Health. He is a graduate of Harvard College, Harvard Medical School and Harvard Kennedy School of Government. 

I can tell you that the Board of Directors has been very appreciative of Steve's leadership over the past seven months, and we desired to have him become the permanent CEO. We are thrilled that he has accepted the position, and we look forward to a productive partnership with him for the benefit of the community and our patients.

The Board did not offer Steve the permanent position without input from others, however. Working with an external search firm, we conducted a survey along with small group and individual meetings with a variety of identified stakeholders to determine the attributes most desired in the next health system CEO. The top qualities identified by more than 1,600 St. Charles caregivers and community partners were:

• Compassion for patients and staff
• Experience as a direct health care provider
• Visibility and presence across all sites of care and in the communities St. Charles serves

Said Ann Rhoads, who chaired the Board's CEO search committee: “During this interim period, Steve has naturally embodied these attributes making him easily the top choice for the position. We heard repeatedly from the listening sessions that caregivers, physicians and community partners would be thrilled to see Steve in the role for the long term. We believe he is the best person to lead St. Charles into the future and that he will drive the system to provide excellence in care, service and organizational culture.”

I couldn't agree more. I’ll close by giving Steve the final word, as I believe it conveys the positive energy and servant’s spirit that he has brought to his role, and it makes me excited for the future of St. Charles under his guidance:

“I am energized to build on what we’ve learned so far from service line development in many areas of the organization,” he said. “Plenty of work still lies ahead, but we’re seeing results from focusing first on clinical excellence and a better experience for our patients, caregivers, physicians and providers. I have enjoyed getting to know this extraordinary organization in a new and deeper way in recent months. We simply have the best people who are committed to providing patients with exceptional care. I want to continue supporting them in that noble endeavor.”

Sincerely,
Jamie Orlikoff
Chairman, St. Charles Health System Board of Directors

St. Charles Health System names Dr. Steve Gordon president and CEO

BEND, Ore. – St. Charles Health System’s Board of Directors is pleased to announce that Dr. Steve Gordon has accepted the position of president and CEO for the health system on a permanent basis. Dr. Gordon has been serving as interim president and CEO since July.

“The board has been very appreciative of Steve’s leadership and desired to have him become the permanent CEO,” said Jamie Orlikoff, chairman of the St. Charles Board of Directors. “We are thrilled that he has accepted the position. We look forward to a productive partnership with him for the benefit of the community and our patients.”

Gordon is an experienced health care executive and former member of the St. Charles Board of Directors. A primary care and internal medicine physician by training, he has served in executive leadership roles for PeaceHealth in Vancouver, Wash., Providence Health and Services in Portland and Salem Health. He is a graduate of Harvard College, Harvard Medical School and Harvard Kennedy School of Government.

“I am energized to build on what we’ve learned so far from service line development in many areas of the organization. Plenty of work still lies ahead, but we’re seeing results from focusing first on clinical excellence and a better experience for our patients, caregivers, physicians and providers,” Gordon said. “I have enjoyed getting to know this extraordinary organization in a new and deeper way in recent months. We simply have the best people who are committed to providing patients with exceptional care. I want to continue supporting them in that noble endeavor.”

Over the past seven months, Gordon has launched a new service-line focused structure that groups and manages services that support a patient throughout their health care journey. Under his leadership, the health system realized improved financial performance for the second half of 2022 and is committed to returning to a positive operating margin by the end of 2023. Retaining highly experienced caregivers and working to recruit new permanent staff are among his top priorities.

Working with an external search firm, the St. Charles Board conducted a survey along with small group and individual meetings with a variety of identified stakeholders to determine the attributes most desired in the next health system CEO. The top qualities identified by more than 1,600 St. Charles caregivers and community partners were compassion for patients and staff, experience as a direct health care provider and visibility and presence across all sites of care and in the communities St. Charles serves.

“During this interim period, Steve has naturally embodied these attributes making him easily the top choice for the position,” said Ann Rhoads, chair of the board’s CEO search committee. “We heard repeatedly from the listening sessions that caregivers, physicians and community partners would be thrilled to see Steve in the role for the long term. We believe he is the best person to lead St. Charles into the future and that he will drive the system to provide excellence in care, service and organizational culture.”

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond, La Pine and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,500 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

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Grand Rounds - Feb. 17, 2023
"Heart Failure Diagnosis and Management"

Speaker: Marc Klapholz, MD, FACC, FSCAI, FAHA. Chair, Department of Medicine, Rutgers New Jersey Medical School.

Objectives

1. Define heart failure.
2. Review expected clinical assessment findings for patients with heart failure.
3. Apply nonpharmacological therapies for the management of heart failure.
4. Examine expected outcomes for the therapeutic management of patients with heart failure.
5. Apply strategies to prevent and reduce readmissions effectively.
6. Communicate prevention strategies to patients and their families adequately, taking into consideration age, ethnicity, and comorbidities.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

Baked salmon with garlic, dijon and lemon

This easy recipe makes a fresh and light entrée packed with healthy omega-3 fats.

Ingredients

1.5 pounds salmon
2-3 garlic cloves
1 sliced lemon
2 Tbsp. parsley
1/2 Tbsp. Dijon mustard
2 Tbsp. lemon juice
1/8 tsp. ground black pepper
1/2 tsp. salt
1/8 cup olive oil

Directions

Preheat oven to 450 degrees. Cut salmon into four even steaks and place on baking sheet lined with foil.

In a small bowl, mix together parsley, garlic, mustard, salt, pepper, olive oil and lemon juice.

Brush all sides of salmon steaks with marinade.

Top with fresh lemon slices and bake for 12-15 minutes.

Grand Rounds - Feb. 10, 2023
"Breast Cancer"

Speaker: Anees B. Chagpar, MD, MSc, MPH, MA, MBA, FRCS(C), FACS. Yale School of Medicine.

Objectives

1. Assess risk factors that may contribute to breast cancer increases, such as hormone replacement therapy, genetics, etc.
2. Examine the pathophysiology and epidemiology of breast cancer and identify prognostic indicators.
3. Follow AJCC clinical and pathologic TNM staging guidelines and choose appropriate evidence-based treatment and management (surgical and nonsurgical) options.
4. Summarize current and future research studies and clinical trials.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

Join Us in Making a Difference 

At St. Charles, we believe in the profound impact of compassionate care. As a hospice volunteer, you have the opportunity to offer support and comfort to patients and families during a crucial time. Whether through companionship, respite care, or helping with daily tasks, your presence makes a meaningful difference in the lives of those we serve. 

Our dedicated team is committed to providing comprehensive training and ongoing support, ensuring that each volunteer feels prepared and valued. Your kindness and empathy can bring solace and a sense of peace, making every moment count. 

If you have a caring heart and a few hours to spare, we invite you to join our community of volunteers and be part of something truly special. Together, we can create moments of light and warmth in the journey of hospice care. 

Ready to make a difference? Apply today to become a hospice volunteer and help enrich lives.

Apply to be a Hospice Volunteer