TMA’s New “Epidemic” Prescribing Course Available Statewide
The Tennessee Medical Association has launched a new continuing medical education (CME) course on proper prescribing with live sessions in major cities across the state beginning this month. The timing couldn’t be better as a new state report finds Tennessee saw a rise of 23 percent in 2011 over the previous year in prescriptions for controlled substances. Tennessee is also among the states with the highest levels of prescription drug abuse in the nation.
EPIDEMIC: Prescribers’ Response to TN’s Rx Drug Abuse Crisis is the third proper prescribing course to be offered by the TMA’s Tennessee Prescription Safety Program (PSP) since 2005 and meets Board of Medical Examiner’s one-hour CME requirement for physician licensure. The course focuses on the proper prescribing of pain medication and responsible management of pain clinics. In addition, attendees will learn about their responsibility to effectively screen, counsel and monitor pain medicine usage and about new laws in Tennessee affecting prescribing.
The class, which costs $30 for TMA members and $60 for non-members, will be held locally on Thursday, July 19 at 6 pm at the Nashville Airport Marriott. Courses are also being held in June in Memphis and Chattanooga and on other dates in July in Knoxville, Johnson City and Jackson. For area physicians unable to attend the local live course, statewide schedule information and an online version of the class are available at www.tnmed.org.
Children’s Hospital Opens $30 Million Expansion
Last month, the Monroe Carell Jr. Children’s Hospital at Vanderbilt celebrated the opening of its highly-anticipated $30 million, 33-bed, 30,000 square-foot expansion to the facility.
The opening of the hospital’s expansion culminates a year of construction, creating additional acute, neonatal intensive care and medical-surgical beds and provides other enhancements such as growth to programs including: Pediatric Bone Marrow Transplant, Cardiac Surgical Intensive Care and Congenital Heart Disease.
A portion of the expansion was designated to accommodate additional premature babies transferred from outlying community hospitals to the Level 3 Neonatal ICU. Another unique feature of the expansion is a lead-lined room to provide pioneering radiation therapy process for patients with neuroblastoma. Fewer than 10 lead-lined rooms exist in the United States, with a majority of these placed within children’s hospitals.
Since opening in 2004, patient occupancy at Children’s Hospital has remained consistently high. The new space positions the hospital with additional capacity to meet the growing demand for the specialty and sub-specialty services. In addition to the hospital’s expansion, more than $20 million in program enhancements have been targeted for fundamental research into treatment and prevention of broad areas of childhood disease prevalent throughout Tennessee and nationwide — including prematurity, childhood cancer and childhood heart disease.
The hospital has seen a series of expansions in space and services. In January, an additional 21,000 square feet of new pediatric clinic space opened in the adjacent Doctors’ Office Tower. In late April, the Junior League of Nashville committed $1.5 million to Monroe Carell to care for children with sickle cell disease and asthma. Balfour Beatty Construction oversaw construction of the latest five-story expansion, which brings the hospital to nearly 650,000 total square feet.
Saint Thomas Health, UTHSC Expand Joint Residency Program
In a joint announcement at the end of April, officials with Saint Thomas Health (STHe) and the University of Tennessee Health Science Center (UTHSC) said they are expanding their partnership in Middle Tennessee. Beginning in 2013, the partners will phase in more medical residents for training at Baptist Hospital, Saint Thomas Hospital and Middle Tennessee Medical Center.
By 2017, when the program is fully developed, nearly 100 medical residents in a range of specialties will be trained in the metro Nashville area. Initially, the partnership will create 225 new jobs with an additional 125 in subsequent years.
Baptist Hospital had been a partner with UTHSC since 1981, and has trained more than 140 medical residents specializing in internal medicine. “The expansion of this residency training program is a significant step forward in our joint efforts to prepare a greater number of physicians with dynamic clinical experiences,” said David M. Stern, MD, executive dean of the UTHSC College of Medicine, who supervises all three UTHSC medical school campuses and oversees clinical affairs statewide.
AMA Reminds Physicians of Impending e-Prescribing Deadline
The American Medical Association (AMA) reminds physicians that June 30, 2012 is the deadline to report on at least 10 electronic scripts to avoid the 2013 Medicare e-prescribing program penalty. Physicians who are not able to meet the requirements of the program should apply for a hardship exemption applicable to their particular case before the deadline.
In November 2011 CMS released the final regulation on the 2013 Medicare e-prescribing penalty program. The penalty for not successfully participating in the program, or not filing for an exemption on time, is a 1.5 percent payment reduction for all Medicare claims based on the 2013 fee schedule amounts during the year.
To apply for an exemption, visit www.qualitynet.org/portal/server.pt/community/communications_support_system/234.
To learn more about the e-prescribing penalty and the reporting requirements, visit www.ama-assn.org/resources/doc/hit/avoid-erx-penalty-tip.pdf.
Baptist Names Smallwood CMO
Baptist Hospital has named Geoffrey H. Smallwood, MD, as chief medical officer for the hospital. Since 1991, Smallwood has been a practicing OB/GYN and member of the Baptist Hospital medical staff.
In his new role, which he assumed on May 14, Smallwood will facilitate and align the interests of the hospital’s leadership and medical staff in an increasingly challenging healthcare environment. Over the past several years, he has taken on increasing leadership roles at the hospital and helped develop, as part of a team, various patient safety initiatives for mothers and infants that align with the Tennessee Initiative for Perinatal Quality Care (TIPQC).
Smallwood attended medical school at Tulane and completed his internship in obstetrics and gynecology at UCLA Medical Center and his OB/GYN residency at Vanderbilt University Medical Center.
SVMIC Declares $18.0 M Dividend
The Board of Directors of State Volunteer Mutual Insurance Company (SVMIC) has approved an $18.0 million dividend to be returned to policyholders as a premium credit on all policies renewing between May 15, 2012 and May 14, 2013.
This is the fifth consecutive year SVMIC has declared dividends for its physician policyholders. Policyholders will receive the dividend in the form of a credit on the renewal premium. Additionally, no adjustments were made for rates on policies renewing during this time.
Steven C. Williams, Chief Executive Officer, said, “In 2011, the average premium for SVMIC-insured physicians was the lowest in a decade. Even with recent premium reductions and returned dividends the company remains strong and secure. SVMIC has an ‘A (Excellent) financial strength rating from A.M. Best Company and has maintained an ‘A (Excellent)’ rating or better for more than 25 years.”
TriStar Names New Administrator of Oncology Services
HCA’s TriStar Health recently named Jonathan Connor as the division’s new administrator of oncology services. Connor will also serve as the associate director of operations for Sarah Cannon Cancer Services.
In his new role, Connor will be responsible for the overall strategic direction of oncology services for TriStar Health, working to ensure all TriStar Sarah Cannon Cancer Centers share the same vision. He will also continue to serve the Sarah Cannon Cancer Services team to help develop programmatic initiatives that are focused on physician-led, patient-centric care throughout core markets in HCA. He has previously worked in multiple roles at the Sarah Cannon Research Institute.
New Matchmaking Site Helps Women Make a Heart Connection
While it might not help participants find true love, the American Heart Association’s first women’s online patient support program just might help someone find a true friend … one who has a similar history and can lend an understanding ear and words of encouragement.
Launched last month, Go Red Heart Match connects women around the country with similar heart stories — whether that is managing a diagnosis, caring for a loved one with heart disease, or working to prevent the nation’s number one killer.
“When something as major as heart disease strikes a woman, emotional support from others is most often times the catalyst that helps pull us through – when we’re feeling our lowest and seeking answers,” said Rolanda Perkins from Smyrna, Tenn., one of Go Red Heart Match’s inaugural participants and a national Go Red For Women spokesperson. “I use it as a way to keep my healthy lifestyle on track – it helps propel me forward.”
Heart Match is also designed to help motivate and encourage adherence to care after diagnosis – including cardiac rehabilitation. Studies show that cardiac rehabilitation/secondary prevention (CR/SP) plays a vital role in the recovery process by restoring individuals to their optimal physiological, psychosocial, nutritional and functional status, but participation rates remain low.
To join Heart Match, women create a profile at www.GoRedForWomen.org/HeartMatch and search for other women with similar heart disease experiences.
Let’s Give Them Something to Talk About!
Awards, Honors, Recognitions
Vanderbilt University Medical Center (VUMC) has been granted its second consecutive Magnet® status by the American Nurses Credentialing Center’s Magnet Recognition Program®, a rigorous multi-year appraisal process reflecting the strength and quality of nursing and interdisciplinary collaboration at Vanderbilt. VUMC received four separate Magnet designations for Vanderbilt University Hospital, Vanderbilt Psychiatric Hospital, Monroe Carell Jr. Children’s Hospital at Vanderbilt, and for the network of Vanderbilt Medical Group Clinics. VUMC joins an elite group of only 392 hospitals in the United States and four international organizations to have achieved Magnet Recognition status. There are only two other hospitals in the state, both located in East Tennessee, to achieve this distinction.
Mid-Tennessee Bone & Joint Clinic orthopaedic surgeon A. Lee Hunter, Jr., MD, was recently elected by the Tennessee Orthopaedic Society to the Board of Councilors (BOC) of the American Academy of Orthopaedic Surgeons (AAOS). BOC members represent orthopaedists in all 50 states and the District of Columbia, the U.S. Military, U.S. Territories and Canada and four of the regional orthopaedic societies.
A recent report from the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN), recognized Tennessee as one of 21 states that has experienced a significant decrease in central line-associated bloodstream infections. The report also recognized the state and its hospitals for exemplary efforts to make certain infections data is accurately reported. The Tennessee Hospital Association along with the BlueCross BlueShield of Tennessee Health Foundation established the Tennessee Center for Patient Safety five years ago.
During National Nurses Week last month, TriStar Centennial presented the annual Florence Nightingale Awards to Judy Solberg, TriStar Ashland City; Mary Beth Ireland, TriStar Centennial Parthenon Pavilion; Jessica Landis, TriStar Centennial Sarah Cannon Cancer Center; Mildred Wardle, TriStar Centennial; and Connie Skipworth, TriStar Centennial Women’s & Children’s hospital.
Two recent events helped Hospital Hospitality House raise nearly $100,000 to serve patients and families. The 2012 Rock the House event raised $48,000, and the 5th Annual HHH Charity Golf Tournament raised a record $50,205. The May 14 tournament, which included celebrity golfers along with local business and healthcare leaders, was hosted by Earl Swensson Associates and presented by Balfour Resource Group and Balfour Beatty Construction.
Three new officers to the Tennessee Medical Association are from the metro Nashville area. Michel A. McDonald, MD, was elected to the TMA Board of Trustees. MD, Yasmine S. Ali, MD, MSCI, FACC, FACP, was elected chair of the Young Physician Section and YPS representative to the TMA Board of Trustees. Omar L. Hamada, MD was elected to the TMA Judicial Council.
United Neighborhood Health Services (UNHS) has received a $1,724,816 grant to renovate its Main Street Clinic, Madison Clinic and Cayce Clinic and to establish a Diabetes Care Center. The grant is funded by the Affordable Care Act.
The American Hospital Association (AHA), in partnership with the Tennessee Hospital Association (THA), has awarded Scott Raynes, president and CEO, NorthCrest Medical Center in Springfield, with the AHA Grassroots Champion Award. He is being recognized for his exceptional leadership in generating grassroots and community activity in support of a hospital’s mission.
Jersey Mike’s has entered into a five-year agreement with the Monroe Carell Children’s Hospital at Vanderbilt to raise $100,000 to assist in providing healthcare services to children. Last month, officials with the restaurant chain presented a check for $50,943 … more than half of the commitment … from the proceeds of a recent campaign entitled, The Month of Giving.
Recent Certifications, Accreditations & Commendations
Heather Greene, a coding and compliance specialist with Nashville-based Kraft Healthcare Consulting, recently added Certified Professional Medical Auditor (CPMA) and Certified Professional Coder (CPC) to her already impressive list of certifications. Greene is also a Registered Health Information Administrator (RHIA) and is approved through the American Health Information Management Association (AHIMA) as an ICD-10 PCS/CM Trainer.
Saint Thomas Health Names Glover Chief Mission Officer
Timm Glover was recently announced as the new chief mission and ministry officer for Saint Thomas Health’s five-hospital health system and network of affiliated ventures, practices and facilities. Since 2002, he has served as vice president for mission integration at Middle Tennessee Medical Center.
Glover, who received his bachelor’s degree in psychology and religion from Belmont University and a master of divinity from The Southern Baptist Theological Seminary, began his new position of leading the health ministry’s efforts in integrating the Catholic identity into the culture, operations and strategies of the system on May 27. Glover has served in various roles with the health system since 1998.
Hickey Named BlueCross COO
J.D. Hickey, MD, has been appointed chief operating officer of BlueCross BlueShield of Tennessee, effective the beginning of last month. He succeeds Bill Gracey, who is set to become chief executive officer on Jan. 1, 2013.
Hickey joined BlueCross in March 2011 as senior vice president, as well as president and CEO of Volunteer State Health Plan, taking on increasing responsibilities since then. Previously, he served on Gov. Phil Bredesen’s cabinet as director of the TennCare Bureau and has also held executive positions with HCA and Qualifacts Systems, Inc. Hickey graduated magna cum laude with a bachelor’s degree from Colgate. He went on to earn medical and law degrees from Duke University.
WPC Adds Eight to Meet Demand
This spring, WPC, a full-service healthcare technology and business process consulting organization in Brentwood, announced the hiring of eight professionals over the past several months to fill key positions in technology, business analysis and marketing to meet the increasing demand from hospitals, health systems and insurers for healthcare information technology and business expertise to enhance performance.
“We continue to experience strong demand for our solutions from providers and payers, who face insurmountable challenges finding solutions to protect the security of their patient data, migrate to ICD-10, integrate disparate systems, and meet regulatory compliance deadlines. The expansion of our workforce will help us sharpen our focus on client delivery and superior customer service, while positioning our company for long-term success,” explained Eric Mueller, services president, WPC.
The company added the following employees to the Brentwood office: Deanna Alvarado and Chaithanya Nallapu, health data business analysts; Todd Cochrane, manager of client services; Stuart Post director of solutions development for the southeast U.S. region; Mandy Sebert, director of solutions development for the northeast U.S. region; Emily Rein, marketing specialist; Stephen Sideris, senior data architect; and Keith Williamson, senior SharePoint architect.
Hargis Joins HFR Design
Beth Hargis has joined Nashville-based Hart Freeland Roberts architects and engineers (HFR Design) in the full-time positions of architectural intern. She will be involved in a variety of projects for the 102-year-old firm, which offers architectural design, healthcare master planning and programming, market research, feasibility studies, interior design, engineering, space planning and other client services.
Hargis, a Cookeville native, is a December 2011 graduate of the University of Tennessee College of Architecture and Design. While attending the university, she was active in the American Institute of Architecture Students and the student chapter of the Construction Specifications Institute, serving as president of the latter for the 18 months prior to graduation.
Med Mart Announces Addition of RHCC as Tenant
The RFID in Healthcare Consortium (RHCC) is the latest tenant to sign on the dotted line for the proposed Nashville Medical Trade Center. Through a three-phase development plan, the not-for-profit trade organization plans to build out 80,000 square feet of space. The group, which is vendor neutral, specializes in the adoption and use of RFID (radio frequency identification) and RTLS (real-time location system) technologies in the healthcare setting.
The organization will develop a showroom to exhibit products from multiple companies specializing in RFID and RTLS technologies in the acute, assisted living and nursing home settings. The three-phase development plan calls for the build-out of the Intelligent Hospital, the Center for Excellence and the International Technology Pavilions.
TriStar Centennial News
TriStar Centennial Medical Center recently opened a new dedicated 8-bed Neurosciences Intensive Care Unit (NSICU). The unit offers a full range of neurological diagnostic and therapeutic treatment options, including invasive and non-invasive monitoring, intra-cranial monitoring, intra-cranial pressure monitoring, and complex medication administration. New technology in use includes telemedicine capabilities for physician consultation, the ability to provide continuous EEG, and state-of-the-art neurological monitoring systems to measure and record a patient’s brain activity.
The Breast Center at TriStar Centennial Medical Center has adopted a new name and moved to a new location in mid-May. The Breast Center is now the Women’s Health & Imaging Center and will be located in the new Medical Park building located at 330 23rd Ave. N., Suite 200 on the Centennial campus.
Cal Turner Family Foundation Provides Historic Gift to Meharry
The Cal Turner Family Foundation recently provided Meharry Medical College with a $3 million lead gift to build a campus center. Preliminary plans for the Cal Turner Family Center at Meharry call for an approximately 80,000 square-foot-building located in the center of campus that will include auditoria, study and classroom space, a food court, space for conferences, events and educational seminars and a visitor’s center. The Cal Turner Family Center will also serve as a community resource available for use by civic organizations, social groups and medical, dental and public health interests.
Veteran Pharm Execs Launch Dampier Consulting
This spring, two pharmaceutical industry veterans — Al Dampier and Jim Aderhold —launched Dampier Consulting Group (DCG), a life sciences consulting firm focused on the biotechnology, pharmaceutical, medical device and medical diagnostic industries.
Comprised exclusively of senior-level consultants with an average of more than 25 years of industry experience, the firm provides commercialization, marketing, sales force planning and effectiveness, business development, managed care, and leadership training and organizational development services to clients ranging from emerging biotechnology firms to Fortune 100 pharmaceutical companies in the U.S. and abroad.
Dampier has more than 25 years experience in consulting, disease and information management and human resources. Aderhold’s background includes more than 40 years in pharmaceutical sales and marketing, including stints at Warner-Lambert and CIBA, where he served as executive director of portfolio management in CIBA’s drug development department.
Fry Named Exec Director of Life Care Center Columbia
Kari Fry has been named executive director of Life Care Center of Columbia, a skilled nursing and rehabilitation facility. Most recently she served in the same position for the company’s Centerville facility and was also previously an interim executive director at the Columbia location. Fry is a graduate of the University of Tennessee – Knoxville. Life Care, headquartered in Cleveland, Tenn., operates and manages more than 220 nursing, post-acute and Alzheimer’s centers in 28 states.
Olson Added to LifePoint Quality Team
LifePoint Hospitals® recently announced the appointment of Barbara Olson to the position of senior patient safety officer. In her new role, she will help implement the hospital company’s Quality Plan and Hospital Engagement Network.
Olson completed a yearlong fellowship in Safe Medication Use at the Institute of Safe Medication Practices and is an American Hospital Association-National Patient Safety Foundation fellow. Most recently, she served HCA’s Clinical Services Group as director of Patient Safety. Olson, a certified inpatient obstetric nurse, holds an undergraduate degree in nursing from Emory University and a master’s from Regis University.
Sy.Med Expands Credentialing Software into Dental Market
Nashville-based Sy.Med, a leading provider of credentialing software in the healthcare industry, recently announced its expansion into the dental market with its Sy.Med OneApp® software.
Sy.Med recently signed four large dental groups — EDI Health Group, Inc., Western Dental Services, Inc., Aspen Dental Management, Inc., and Heartland Dental Care. The four groups, each of which rank amongst Sy.Med’s largest clients, combine to represent more than 11,000 dentists.
The company’s software enables healthcare, dental and chiropractic organizations, as well as revenue cycle management (RCM) companies, to simplify credentialing by streamlining the process of completing enrollment applications and managing provider data.
Healthways Celebrates Successes
After a tough end to 2011, which included the loss of its largest client, Cigna, Healthway’s 2012 is certainly looking up. The company recently celebrated two major new contracts in two of the country’s largest markets.
Franklin-based Healthways has inked a deal running through 2015 with the City of Chicago to provide wellness programming for the city’s nearly 50,000 employees and their dependents. The company has also entered into a 10-year strategic agreement with Texas Health Resources, which runs more tan 20 hospitals in the Dallas-Fort Worth area.
In other news, Healthways recently purchased a company based in the Philadelphia area that markets population health management software and processes, primarily through physician offices.
TriStar Centennial Breaks Ground on Spring Hill ER, MOB
After a prolonged CON battle, construction began last month on the $15 million TriStar Emergency Room and Medical Office Building in Spring Hill. The new 10,768 square-foot facility will provide 24-hour emergency services from board-certified emergency medicine physicians. The emergency room will offer emergency diagnostic and treatment services with a comprehensive laboratory and state-of-the-art imaging capabilities — including 64-slice CT scan technology. A helipad will also be installed to help expedite patient transfer should they need a higher level of care.
The emergency room will occupy the first floor of a three-story, 49,851-square-foot TriStar Medical Office Building on a 125-acre campus near the intersection of Kedron Road and Reserve Boulevard, approximately three miles west of I-65 at Exit 53. Anticipated completion is May 2013.
Also in Spring Hill, board-certified family medicine physician Philip R. Harrelson, MD, has joined Spring Hill Physicians, part of TriStar Medical Group. He received his medical degree and completed his family medicine residency at the Medical College of Georgia.
LBMC Launches Mobile Security App, Adds Security Specialist
Lattimore Black Morgan & Cain, PC and The LBMC Family of Companies have launched a new service line to safeguard information exchanged over mobile devices. To help spearhead this new offering to clients, LBMC has added Ken Swain, a security specialist, as a senior manager in the risk services department.
Swain, previously an engagement manager and senior security engineer at Hewlett-Packard, brings more than 12 years of experience assisting clients with all aspects of their security needs. His areas of expertise include security incident and event management, application security, mobile security, network monitoring, system configuration management, network and system hardening and penetration testing. He is a Certified Information Systems Security Professional (CISSP), Microsoft Certified Systems Engineer (MCSE), and Microsoft Certified Trainer (MCT).
Cole Joins Murfreesboro Dermatology Clinic’s Smyrna Site
Physician Assistant and Smyrna native Kristie Cole has joined Murfreesboro Dermatology Clinic (MDC) and now is seeing patients and clients at MDC’s Smyrna location. A graduate of Trevecca Nazarene University, Cole has specialized in women’s health and dermatology throughout her medical training and practice. Before joining MDC, she worked at Meharry Medical College, with Pharmacia on the Women’s Health Team, and with Genesis Women’s Care. Since 1994, she has been a Fellow Member of the American Academy of Physician Assistants and certified by the National Commission on Certification of Physician Assistants.
Capella Healthcare and Mercy Health Sign Agreement in Principle
Franklin-based Capella Healthcare, parent of National Park Medical Center, and Mercy Health, sponsors of St. Joseph’s Mercy Health System, have signed an Agreement in Principle to build on a century of service to patients that will enhance the future of healthcare for years to come.
The Agreement in Principle contemplates transferring ownership of St. Joseph’s Mercy to Capella and allows the two organizations to engage in exclusive negotiations toward a definitive agreement.
“As separate providers in the Hot Springs area, Mercy and Capella face challenges in serving the community,” said Lynn Britton, Mercy president and CEO. “Mercy has deep roots in the region, and it is our intent to continue our ministry here through other ways of meeting community needs. But given the environment, we have come to believe that the region will be better served by a unification of health services under one provider.”
This agreement reflects a trend across the country of hospitals proactively working with other providers. In fact, last year alone, there were 100 such agreements reached.
New Elder Care Book Helps Families “Put It in Writing”
Elder care expert Becci Bookner has recently published, Put It in Writing, to help pull together instructions, documents, personal history and family heritage information in one place to provide a helpful planning guide and resource.
Put It in Writing is organized in sections — it begins with pages to record personal information and family history and moves on to sections to help organize financial, healthcare and final wishes information. The organizational tool provides an easy step-by-step, page-by-page way to pull information and documents together. While the guide does not replace legal documents, Put It in Writing does provide a way to assemble document copies and to record where documents can be found by listing the names of attorneys or physicians.
Bookner, who founded Family Staffing Solutions, Inc., a personal assistance company in 1999, was inspired to develop Put It in Writing by both personal and professional experience. The book can be purchased online in the Violet Ink Publishing bookstore at www.violetinkbooks.com.
Fifer Succeeds Clarke as HFMA President, CEO
In April, the Healthcare Financial Management Association named Joseph Fifer, a health system executive, to succeed the retiring Richard Clarke as president and CEO of the organization.
Fifer begins his duties this month, joining HFMA from Spectrum Health, where he has been vice president of hospital finance for 11 years.
AMA Releases Online Physician Resource to Help Diagnose, Treat Eating Disorders
The American Medical Association (AMA) has released an online training module to help primary care physicians better screen for and manage eating disorders. According to the Academy for Eating Disorders, about one in 20 young women in the community has an eating disorder, and many more people may engage in unhealthy eating behaviors that may damage their physical and psychological health. Early intervention leads to better health outcomes and a reduced duration of the eating disorder.
This activity, Screening and Managing Eating Disorders in Primary Practice, is a part of the AMA’s Educating Physicians on Controversies and Challenges in Health (EPoCH) program. It provides a basic diagnostic overview of the range of eating disorders, reviews the screening and referral process and briefly describes the role of the primary care physician in treating patients with eating disorders.