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News from Children’s Hospital of Michigan
December 2010
Dear Colleagues,
I
n this issue of Just for Doctors, you will meet DMC Children’s Hospital of
Michigan’s distinguished orthopaedic surgeons and learn about the key roles
they play in the development of new treatments, making access to orthopaedic
services easier, standardizing equipment and protocols to have safer operations and,
in general, delivering high quality care to pediatric patients. They know that children
have unique needs and the Children’s Hospital of Michigan is the place that can
handle all of them, since everyone and every piece of equipment is focused on our
population of pediatric patients. As we grow, and we soon will, all of us at Children’s
will continue to work to be the place to refer patients for top-quality pediatric
treatment.
Herman B. Gray, M.D., M.B.A.
President
Inside
• Physician Profiles
Richard A. K. Reynolds, M.D.
Whalid Khaled Yassir, M.D.
Eric T. Jones, M.D., Ph.D.
Joseph M. Failla, M.D.
Mohammad F. El-Baba, M.D.
• Orthopaedic Surgeon Focuses
on Long-term Outcomes in
Treatment of Clubfeet
• Scoliosis: New DNA Test
Helps Identify Risk of
Curve Progression
• Research in Pediatric
Orthopaedic Surgery
• Pediatric Hand Surgery:
Congenital Hand Differences
May Signal Hidden Problems
• Private Practice Profile
On November 1, the Detroit Medical Center,
Vanguard Health Services and the Children’s Hospital
of Michigan broke ground for the DMC Children’s
Hospital of Michigan Specialty Center – Detroit.
This family-friendly 105,550-square-foot, five-floor
specialty center will house physician office suites as
well as outpatient specialties and services that include:
adolescent medicine; allergy and immunology;
endocrinology; gastroenterology; general pediatrics;
genetic and metabolic disorders; an immunization station; infectious diseases; imaging
services/radiology; nephrology and dialysis; a
lab-draw station; a pharmacy; physical medicine
rehabilitation; pharmacology and toxicology;
pulmonary diseases; and rehabilitation services and
rheumatology, all with adjacent and convenient,
ample and safe, surface-level parking. The
anticipated opening of the new center at 3950
Beaubien is in early 2012.
All of us at the DMC are currently anticipating the
signing of the agreement with Vanguard at year’s
end. We look forward to a new year in 2011, one
that promises to be full of hope and anticipation for a bright future here at the Children’s
Hospital of Michigan and the rest of the DMC. I hope for you a warm and bright holiday
season and an extraordinarily happy 2011.
Sincerely,
Molly O’Shea, M.D.
• New Docs on the Block
• Events and Happenings
• Grand Rounds Schedule
Mary Lu Angelilli, M.D.
Chief of Staff
Shawn Levitt
Vice President/COO
Charles J. Barone II, M.D.
Vice President,
Medical Affairs
Herman B. Gray, M.D., M.B.A.
President, Children’s Hospital of Michigan
Luanne Thomas Ewald
Vice President,
Business Development
and Strategic Planning
Rhonda Foster
Vice President,
Patient Care Services
Linda Jordan
Vice President,
Ambulatory Services
Lori Mouton
Vice President,
Marketing,
Communications and
Community Relations
Tarry Paylor
Vice President,
Human Resource
Operations
Joe Scallen
Vice President,
Finance
Physician Profile: Richard A. K. Reynolds, M.D.
Richard A. K. Reynolds, M.D., MHCM,
FRCSC, FACS
Chief of Pediatric Orthopaedic Surgery
Surgeon-in-Chief
Appointments: 313-745-5227
Education and Training
University of Saskatchewan College of
Medicine, Canada, 1984; University
of Saskatchewan/Royal University
Hospital, Orthopaedic Residency, 19851987; University of British Columbia/
Royal University Hospital, Orthopaedic
Residency, 1987-1988; University of
Saskatchewan/Royal University Hospital,
Orthopaedic Residency, 1988-1989;
Hospital of Sick Children, Pediatric
Orthopaedic Surgery Fellowship, 19891990; Wellesley Hospital, Reconstructive
Orthopaedic Surgery Fellowship, 19901991; Fellow, American College of Surgery,
1996; Harvard School of Public Health,
MHCM, 2006
Certifications: FRCSC Orthopaedic
Surgery, 1990; American Board of
Orthopaedic Surgery, 1994
Clinical Interests
Pediatric Orthopaedic Surgery
Research Interests
Fractures
Dr. Richard Reynolds came to DMC
Children’s Hospital of Michigan in
2006, when the Department of Pediatric
Orthopaedic Surgery was seeing about
4,000 patients a year. In 2010, that number
is closer to 15,000 patient visits and 1,500
procedures. It’s a remarkable increase —
and it’s no accident.
As chief of Pediatric Orthopaedic Surgery,
Dr. Reynolds has been working to rebuild
the department — recruiting nationally
recognized subspecialists, standardizing
surgical protocols and focusing on customer
service. He and his colleagues believe they
are on their way to becoming one of the top
pediatric orthopaedic surgery services in the
country.
With three pediatric orthopaedic surgeons
and three pediatric surgical subspecialists
on staff, the department offers subspecialty
expertise in complex spine procedures,
complex hip reconstruction, sports
medicine, trauma, hand surgery and
orthopaedic oncology.
Just For Doctors recently spoke with Dr.
Reynolds about the department.
Why has the program grown so quickly?
The Children’s Hospital of Michigan
Orthopaedics has applied the business
principles of access, standardization and
quality improvement to our pediatric
orthopaedic service delivery. This has
certainly helped us grow.
We’ve achieved almost immediate access to
orthopaedic services — in many cases the
same day — using central scheduling with a
dedicated phone number for appointments
(313-745-5227). We’re also developing a
special Physician Link line, which enables
referring physicians to call our specialists
directly. Our goal is to follow up with
referring physicians within 24 hours of
seeing a patient.
Standardizing equipment to have safer
operations, working with the Pediatric
Anesthesia Department to standardize
protocols for safer procedures with lower
blood loss — these have been major
accomplishments. They were only possible
due to the teamwork of a dedicated OR
staff and the pediatric anesthesia and
orthopaedic surgical teams.
We have taken steps to make sure it’s easy
for patients and referring physicians to
access our services. We are looking after
our customers, both patients and referring
physicians, by focusing on delivery of highquality care.
Why should physicians refer patients to your
team?
There are many excellent orthopaedic
surgeons in the area. In fact, about 80
to 90 percent of children’s fractures are
treated by adult orthopaedic surgeons.
Many physicians choose to refer their most
complex cases, or cases with a high risk
of complication, to pediatric orthopaedic
surgeons that have experience with these
cases and have access to pediatric anesthesia.
2 Just for Doctors – December, 2010
We only provide orthopaedic surgical care
to children. Plus, everything and everyone
at the Children’s Hospital of Michigan is
focused on the pediatric population. That
means our ORs and equipment are made
for children, our nurses only work with
kids, our patients have access to other
pediatric subspecialists and we have an
excellent pediatric anesthesia team; that’s
very important.
What types of cases are referred to the
department?
Our referrals can be categorized into trauma
and non-trauma cases. For trauma, we often
get referrals from pediatricians, orthopaedic
surgeons and other hospitals for treatments
such as complex femur fractures, growth
plate injuries and fractures around joints.
For non-trauma, we tend to get referrals
for scoliosis, pediatric hip disorders,
developmental dysplasia of the hip, clubfeet,
and complex infections involving the joints.
We also receive many referrals for pediatric
sports medicine and pediatric hand surgery.
How are you working to enhance clinical
quality?
Standardization can be a powerful tool
in improving clinical quality. Here’s an
example: Over the last four years, we’ve
applied business principles to healthcare
delivery in the area of scoliosis treatment.
We developed a dedicated OR team for
orthopaedics. We standardized all of our
surgical spinal equipment. We standardized
our intraoperative anesthesia protocols.
With these initiatives applied to anesthesia
and orthopaedics, we decreased blood loss
by 70 percent, minimized the risk of blood
transfusion to less than 10 percent and
improved the infection rate to no spine
infections in over a four-year period.
Another example: Our postoperative pain
scores have decreased significantly. Working
with the pediatric pain management team,
we standardized our intraoperative and
postoperative pain management protocols.
With a combination of intrathecal
medication, IV medication and a pain
pump that delivers anesthetic along the
skin incisions, we’ve been able to maintain
postoperative pain scores averaging an
amazing 2.8 to 3.2 out of 10 over the first
three days postoperatively.
Children’s Hospital of Michigan
Orthopaedic Surgeon Focuses on Long-term
Outcomes in Treatment of Clubfeet
Walid Yassir, M.D., knows several different
ways to treat clubfeet, but he’s convinced one
way — the Ponseti Method — offers the best
long-term outcomes for most patients.
“Other surgical techniques seem to work
pretty well in the short run — for 10 or
15 years after surgery,” Dr. Yassir said.
“But as these kids get older and into their
20s and 30s, many of them start to have
significant foot problems and significant foot
disabilities.”
The problem is scarring, which often causes
stiffness in the foot over time. But the
Ponseti Method, which tends to be less
invasive than other surgical procedures,
minimizes scarring and stiffness. Long-term
studies of Ponseti Method patients show few
foot problems over time, even after 30 or 40
years.
“The beauty of this technique is it results
in a high percentage of feet that are fully
functional, that fit in a shoe and don’t cause
the kids pain,” Dr. Yassir said. “These kids go
on to have normal lives and rarely have any
complaints later on.”
While other techniques focus on surgical
correction of the clubfoot, the Ponseti
Method uses a special technique for casting
the child’s leg, followed by a minimally
invasive surgical procedure and the use of
special braces and shoes for several years.
“It works remarkably well, but it’s not
without its problems,” Dr. Yassir said.
“The technique relies heavily on patient
compliance for success. Patients really need
to be partners with you in wearing their
braces and shoes.”
Dr. Yassir is the only surgeon in southeast
Michigan who is certified in the Ponseti
Method for treatment of clubfeet. In fact,
he’s probably the only surgeon in the state
who actually trained under the late Ignacio
Ponseti, M.D.
Walid Khaled Yassir, M.D.
Associate Chief of Orthopaedic Surgery
Appointments: 313-745-5227
Education and Training
State University of New York Health Science
Center at Brooklyn College of Medicine,1995
Harvard School of Public Health, Health Care
“Dr. Ponseti was a very generous man and
Management Program, M.S., 2011
a tireless educator,” Dr. Yassir said. “He was
Residency, Tufts Affiliated Hospitals,
willing to teach anybody who wanted to
Orthopaedic Surgery, 2000
learn his technique. I developed my expertise
Fellowships: Children’s Hospital of San Diego,
in this area through his generosity.”
University California at San Diego School of
Medicine, Pediatric Orthopaedic Surgery, 2001
Dr. Yassir leads a multidisciplinary clubfoot
clinic at the Children’s Hospital of Michigan
CAREER
on Wednesday mornings. Seeing all clubfoot
Dr.
Yassir
is
board
certified
in
orthopaedic
patients on the same morning offers
surgery. He currently serves as associate chief of
convenience for patients and families, who
orthopaedic
surgery at the Children’s Hospital of
are able to see several specialists during a
Michigan.
His
clinical interests include clubfeet,
single visit. It’s also a great opportunity for
scoliosis,
trauma
and sports medicine. He is also
families to connect with each other and see
interested
in
healthcare
management and process
kids in various stages of treatment.
improvement and is currently enrolled in the
Harvard School of Public Health’s Health Care
“We might have one child who is four years
Management program.
old, running around and feeling great.
Another child might still have casts on.
Another one might be in braces,” Dr. Yassir
stages of treatment, they can usually tell they
said. “Even though they are in different
are kindred spirits.”
Scoliosis: New DNA Test Helps Identify Risk of Curve Progression
Orthopaedic surgeons at the Children’s
Hospital of Michigan have a powerful new
diagnostic tool to help them choose the
most appropriate treatment plan for patients
with adolescent idiopathic scoliosis (AIS).
M.D., associate chief of orthopaedic surgery.
“Now, with the SCOLISCORE, we have a
highly accurate way of determining whether
the scoliosis will progress.”
SCOLISCORE™ is a genetic test clinically
proven to give physicians insight into the
possible progression of AIS. With a simple
saliva swab, orthopaedic surgeons at the
Children’s Hospital of Michigan can better
understand each child’s risk of spinal curve
progression, which helps them develop
highly personalized treatment plans.
The SCOLISCORE Test assigns a numerical
score between one and 200 to the likelihood
of curve progression based on each child’s
DNA and current spinal curve angle. The
test demonstrates a negative predictive value
of 99%, which means a low SCOLISCORE
is very accurate in identifying curves that are
not likely to progress to the point of needing
surgery.
“Some patients walk in with a very large
curve and we have nothing but surgery to
offer. We prefer to catch them earlier when
bracing is still an option,” said Walid Yassir,
“This test is very valuable,” said Eric Jones,
M.D. “In the patients we have followed
where the SCOLISCORE is low, we have
not seen progression of the scoliosis — even
in the patients we would have otherwise
expected it to progress based on their
X-rays.”
Dr. Yassir agrees. “If the test shows the
curve is not likely to progress, you feel more
comfortable just watching and waiting —
not bracing the patient and putting them
through something like that during a very
vulnerable time in their life,” Dr. Yassir said.
The converse is also true. The test helps
physicians identify patients who should have
surgery sooner rather than later. “If you have
a child who is 10 years old and has a very
high risk of progression and you see brace
treatment is failing, you may want
continued on page 8
Just for Doctors – December, 2010 3
Orthopaedic Surgeon Brings Broad Expertise to
Children’s Hospital of Michigan
Eric T. Jones M.D., Ph.D.
Pediatric Orthopaedic Surgeon
Appointments: 313-745-5227
Education and Training
University of Michigan Medical School,
Ann Arbor, MI 1972
Internship, University of Michigan Medical
Center, General Surgery, 1975
Residency, University of Michigan Medical
Center, Orthopaedic Surgery, 1978
Management of Juvenile Amputee,
Prosthetic-Orthotics, Northwestern
University, 1979
Fellowships: Berg-Sloat Traveling
Fellowship, Toronto, Boston, Wilmington,
1980
Certifications: Diplomat of National Board
of Medical Examiners, 1975; American
Board of Orthopaedic Surgery, 1979;
Fellow, American Academy of Orthopaedic
Surgery, 1982, 1993; Recertified in general
and children’s orthopaedics, American
Board of Orthopaedic Surgery, 1983
CAREER
Dr. Jones is board certified in orthopaedic
surgery. Before joining the Department
of Orthopaedic Surgery at the Children’s
Hospital of Michigan, he served as chief
of pediatric orthopaedic surgery at West
Virginia University. Prior to that, he
worked at the University of Michigan Mott
Children’s Hospital. He currently serves
as clinical associate professor at the Wayne
State University School of Medicine. His
clinical interests include pediatric cervical
spine, scoliosis, trauma and orthopaedic
oncology surgery.
4
Eric T. Jones, M.D., Ph.D., may be the most
experienced pediatric orthopaedic surgeon
in Michigan. He joined the Department
of Orthopaedic Surgery at the Children’s
Hospital of Michigan in 2007, after 28 years
at West Virginia University in Morgantown,
WV. Before that, he worked at the University
of Michigan Mott Children’s Hospital for
two years. For most of his time in West
Virginia, he was the state’s only pediatric
orthopaedic surgeon.
“I worked by myself for all those years, so
I learned to do almost everything,” Dr.
Jones said. “If pediatric patients needed
orthopaedic care somewhere in the state
of West Virginia, they usually came to me.
There just wasn’t anyone else to help them.”
That’s how he became an expert in almost
every type of pediatric orthopaedic
surgery — from trauma care, scoliosis and
clubfeet to sports medicine, hand surgery
and orthopaedic oncology surgery. This
broad experience is one of the reasons the
Children’s Hospital of Michigan recruited
him in 2007.
“He’s really a feather in our cap,” said
Richard Reynolds, M.D., chief of the
Department of Orthopaedic Surgery at
the Children’s Hospital of Michigan. “Dr.
Jones is so experienced, so versatile. He’s an
incredible asset to the hospital and children
in our state.”
While Dr. Jones has broad experience, he
said he’s learning to refer certain types of
patients to other surgeons in the Department
of Orthopaedic Surgery. “Dr. Yassir is very
good at arthroscopic surgery and sports
medicine, so I tend to refer those patients to
him. Dr. Reynolds does an excellent job with
knee replacement and hip replacements,
which aren’t very common in children. He
has developed a great deal of expertise in
Just for Doctors – December, 2010
these areas, so it makes sense to send those
patients to him. And, of course, Dr. Failla
specializes in pediatric hand surgery, so that’s
where I usually send those patients.”
It gives Dr. Jones more time to focus on
one of his own areas of clinical interest: the
pediatric cervical spine.
Dr. Jones sees patients at the Children’s
Hospital of Michigan in Detroit and at the
Children’s Hospital of Michigan Stilson
Specialty Center in Clinton Township. “We
want to be easily available to children from
all over southeast Michigan,” Dr. Jones said.
“The Stilson Center is very convenient for
patients and families on the east side and up
toward Port Huron.”
Research in Pediatric
Orthopaedic Surgery
Surgeons at the Children’s Hospital of
Michigan are advancing the field of
pediatric orthopaedic surgery through
clinical research. In one noteworthy
study, Children’s Hospital surgeons are
investigating a new, adolescent locking
intramedullary femoral nail system
(ALFN), which is designed to stabilize
femur fractures in older children and obese
children. Preliminary results suggest the
technique decreases complications, speeds
recovery and increases mobility.
Other clinical research in the department
includes the study of:
•
•
•
•
New techniques to identify patients
at risk of ulnar nerve injury associated
with the repair of supracondylar
humerus fractures
Pain control in scoliosis surgery
Musculoskeletal infections among
children in Detroit
A new technology to quickly diagnose
infections in the operating room
Children’s Hospital of Michigan
Pediatric Hand Surgery: Congenital Hand
Differences May Signal Hidden Problems
As a pediatric hand surgeon, Joseph M.
Failla, M.D., is a subspecialists’ subspecialist.
While most pediatric orthopaedic surgeons
treat a wide variety of orthopaedic conditions
in children, pediatric hand surgeons take
specialization to a new level.
“In many important ways, the pediatric hand
is entirely different than the adult hand,”
said Dr. Failla, “This is why some surgeons
choose to subspecialize in pediatric hand
surgery.”
Pediatric hand surgeons must have a deep
understanding of many issues and conditions
that are unique to children.
Congenital Differences
With more than 20 years of experience in
pediatric hand surgery, Dr. Failla knows
the most effective ways to treat children
with congenital hand differences — and he
knows to look beyond obvious structural
differences.
“There are a number of congenital
differences that occur in kids pretty
commonly and some of them are associated
with genetic problems,” Dr. Failla said.
“It’s important to understand the patterns
you are seeing and know that certain hand
differences might signal some other unseen
problem.”
As an example, a child might come in with a
thumb deformity and might also be deaf. Or
a certain type of hand difference might be a
clue that a heart valve or the blood cells may
not have formed properly.
“These are most often isolated, sporadic
differences that just show up without a
genetic component, but once in a while they
are associated with a genetic syndrome,” Dr.
Failla said.
In addition to surgical treatment of the
hand, Dr. Failla often orders genetics
consultations to identify hidden health
problems.
Cerebral Palsy and Paralytic Deformities
Dr. Failla also works with children who have
cerebral palsy, which often causes spasticity
and paralytic deformities in the hand, wrist
and elbow. In the classic cerebral palsy
deformity, the elbow is flexed, the wrist
is flexed downward and outward and the
fingers are gripped tightly.
“Parents can’t wash their child’s hands. They
can’t put clothes on. It’s very frustrating for
the child and the family,” Dr. Failla said.
“There are all sorts of treatments like splints
and Botox™ and they work temporarily, but
ultimately these kids may need to have their
muscles rebalanced. The tight things need to
be loosened and the weak muscles need to be
augmented.”
These are incredibly delicate surgeries and
each case is different. The procedures result
in seemingly small improvements — the
ability to unclench a hand, to push buttons
on a keyboard, to operate an electric
wheelchair.
“These might seem like small things to
you and me, but they mean so much to
these kids,” Dr. Failla said. “Appearance is a
concern, but the highest priority for older
kids with cerebral palsy is they want to
function better and be able to communicate
with others. They want to use a cell phone
and talk to their friends. They want to get
on the computer and use Facebook©. But if
their hands aren’t positioned right and their
wrists are bent down, they can’t do it.”
Trauma Care
While many adult hand surgeons treat
children with simple fractures, there are
several types of injuries that adult hand
surgeons usually refer to Dr. Failla.
“Kids’ injuries to the hand are totally
different than adult injuries,” Dr. Failla said.
“With children, you have to worry about
the growth plates. There are certain fractures
and injuries in children that most adult
hand surgeons choose to refer — certain
bones in the wrist, difficult fractures in the
fingers, flexor tendon injuries. These injuries
really need to be treated by a pediatric hand
specialist.”
Joseph M. Failla, M.D.
Medical Director of Neurodiagnostics
Appointments: 313-745-5227
Education and Training
State University of New York at Buffalo,
School of Medicine, M.D., 1982
Residency, State University of New York at
Buffalo, School of Medicine (Orthopaedic
Surgery), 1983-87
Fellowships: Mayo Clinic, Fellowship in Hand
Surgery, 1987-88
Certifications: American Board of
Orthopaedic Surgery, 1990, 2000, 2008;
American Board of Orthopaedic Surgery,
Certificate of Added Qualifications in Surgery
of the Hand, 1992, 2000 and 2008
CAREER
Dr. Failla is board certified in orthopaedic
surgery with a Certificate of Added
Qualifications in Surgery of the Hand. He has
subspecialized in pediatric hand surgery since he
completed fellowship training in hand surgery
at the Mayo Clinic in 1988. He currently serves
as adjunct assistant professor of anatomy at the
Wayne State University School of Medicine.
Clinical Interests
Pediatric orthopaedic hand surgery, including
nerve injury, fractures, wrist injury and
tendonitis.
Research Interests
Hand biomechanics
Clinical Excellence in Spine Surgery
By standardizing surgical equipment, staff and protocols, the Department of Orthopaedic
Surgery at the Children’s Hospital of Michigan is achieving noteworthy quality metrics
in spine surgery.
•
•
•
Blood loss decrease of 70 percent
Blood transfusion risk of less than 10 percent
No spine infections in four years
Just for Doctors – December, 2010 5
Physician Profile: Mohammad F. El-Baba, M.D.
Mohammad F. El-Baba, M.D.
Chief of Pediatric Gastroenterology
Appointments: 313-745-5585
Education and Training
Faculty of Medicine, Jordan, 1982
Residency, the Children’s Hospital of
Michigan, Detroit, MI. (Pediatrics), 1991
Fellowships, the Children’s Hospital of
Michigan, Detroit, MI. (Gastroenterology),
1994
Certifications: American Board of Pediatrics,
1992 and 1999; American Board of
Gastroenterology, 1995, 2003
CAREER
Dr. El-Baba is board certified in pediatrics
and gastroenterology. He joined the
Children’s Hospital of Michigan as chief of
the Division of Gastroenterology in 2006. His
clinical interests include GI mobility disorder,
gastroesophageal reflux, malabsorption,
inflammatory bowel disease, viral hepatitis,
chronic hepatitis and pancreatic diseases.
The Division of Gastroenterology at
the Children’s Hospital of Michigan is
a valuable resource to pediatricians and
family practice physicians in southeast
Michigan. Children’s five pediatric
gastroenterologists and their highly trained
staff, see about 6,000 children a year. Some
patients are referred for expert diagnosis of
GI conditions. Other kids are referred for
advanced treatment of conditions already
diagnosed by their primary care providers.
Either way, they receive expert care from
a staff focused exclusively on pediatric
patients.
Just For Doctors recently spoke with
Mohammad F. El-Baba, M.D., chief of
the Division of Gastroenterology at the
Children’s Hospital of Michigan.
What diseases and conditions do you see most
frequently?
We see it all — gastrointestinal problems
including abdominal pain, failure to thrive,
irritable bowel syndrome, reflux disease,
inflammatory bowel disease, constipation,
6
peptic ulcer disease, celiac disease, liver
disease, pancreatic diseases. We also see
patients with rare GI illnesses such as
metabolic liver disease and malabsorption
syndromes, as well as patients with GI
allergic disorders. We also provide care for
patients with nutritional deficiencies and
feeding disorders, including children who
require feeding tube placement.
When do physicians refer patients to your
team?
There are many common GI problems that
can be treated at the primary care level,
including abdominal pain, constipation
and reflux disease. Pediatricians and family
practice doctors usually do a very good job
treating these conditions. But once it’s clear
a child needs further testing and evaluation,
they often refer to us. In most cases, we can
see a referred patient in one to two weeks.
Or the referring physician can always call us
if he or she believes the patient needs to be
seen sooner than that.
What specialized tests do you offer?
We use many specialized diagnostic
techniques, including endoscopy. This
can be a delicate procedure in children,
but all of our physicians and staff are
very experienced with children. All of
these procedures are performed under
anesthesia with supervision by a pediatric
anesthesiologist. We also offer specialized
endoscopic procedures such as gastrostomy
feeding tube placement, esophageal stricture
dilatation, polypectomy, sclereotherapy
and banding of esophageal varices. Other
diagnostic techniques include a breath
hydrogen test, which is used for diagnosis of
lactose malabsorption and malabsorption of
other sugars. We also diagnose reflux disease
with pH testing and a new technique called
impedance monitoring to detect the flow
of liquids and gas through hollow viscera.
We also offer esophageal and anorectal
manometry, which helps us diagnose
children with motility disorders. These
Just for Doctors – December, 2010
are just a few of the diagnostic techniques
we use; there are many others. We’re even
looking into adding capsule endoscopy for
children.
How does pediatric gastroenterology differ
from adult gastroenterology?
The biggest difference is that children don’t
always have the words they need to describe
what they are experiencing. A child might
be experiencing symptoms that aren’t
readily apparent. So we are trained to be
good listeners, and we spend time observing
the child and asking good questions.
What’s on the horizon for the division?
We’re getting ready to establish an
inflammatory bowel disease center. We
already see a lot of children with IBD,
and we take a multidisciplinary approach
to their treatment. The IBD center will
support this by bringing together all the
different specialists and services these
children need — GI specialists, social
services, nutritionists, and surgeons. The
center will also benefit from our infusion
unit, where we provide Remicade™
infusions for patients with Crohn’s disease.
How are you working to improve access to
care?
We want to make it convenient for patients
and families to see us. That’s why we see
patients in multiple locations. In addition
to seeing patients at the Children’s Hospital
of Michigan in Detroit, we also schedule
appointments at our specialty centers
in Clinton Township, Southfield, West
Bloomfield, Novi and Canton.
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Children’s Hospital of Michigan
Newon
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Private Practice Profile:
Molly O’Shea, M.D.
Molly O’Shea, M.D., F.A.A.P.
Education and Training
University of Michigan Medical School;
Pediatrics residency at Children’s Hospital
of Michigan.
Dr. Molly O’Shea is board certified in
pediatrics. She was part of a large pediatrics
practice for 16 years before opening the
Birmingham Pediatrics + Wellness Center
in Troy in 2008. She is an active member of
the American Academy of Pediatrics, serving
as an associate editor of an AAP journal
and coordinating CME meetings across
the country. She also writes the Ask the
Pediatrician column for The Detroit News.
Why did you start your own practice?
I’d been in practice somewhere else for
about 16 years and just wanted to do things
a different way. I really wanted to create an
office environment that is inviting — one
that doesn’t feel “medical” — because I think
that helps decrease anxiety in kids. I serve a
large population of kids with special needs.
And when they came to see me in a more
traditional office setting, I never heard their
voices. I didn’t feel I could get to know them
in the way I needed to in that environment.
How would you describe your practice?
We like to say we practice traditional
medicine in a non-traditional way. Our
office feels very homelike. Our exam rooms
are furnished with couches and chairs,
so they feel like a den in your home. We
have different artwork in each room.
For example, one room is the Addams
Family room; it has architectural drawings
of what their house would have looked
like. Another room is decorated with old
cross country skis and sports equipment.
The idea was to create an environment
where both parents and kids would feel
comfortable talking to us about whatever
they need to talk about. It’s worked very
well. We even take it a step further. We
don’t wear traditional lab coats and medical
uniforms; we all dress very neatly, but we
don’t look “medical.”
How did you get interested in treating kids
with special needs?
I have a son with special needs, so I feel a
connection to kids and families with special
needs. My son has mild cerebral palsy and
is very functional, but I’ve had experience
with OT, PT, speech therapy and creating
an educational plan for him. I guess parents
can see that I have an interest in helping. I
understand the challenges and the joys of
having a child with special needs. It’s not
the majority of my practice, but it’s an area
I really enjoy.
When do you refer patients to the Children’s
Hospital of Michigan?
Any child who has a serious illness,
I send to the Children’s Hospital of
Michigan. When families need coordinated
multidisciplinary care, I send them to
Children’s. There are several areas of
specialization at the Children’s Hospital
of Michigan that are just extraordinary —
nephrology, urology, infectious disease,
hematology/oncology, ophthalmology,
burn care, cardiology. And the Children’s
Hospital of Michigan is really the only
game in town for neurosurgery and
cardiovascular surgery.
What do you like most about pediatrics?
I’m interested in treating the whole person,
not just the physical. In pediatrics, you get
to help educate the parents for the first few
years. Then you get to influence healthy
habits that will last a lifetime — whether it’s
focusing on emotional health and coping
skills, exercise and being out in nature, or
limiting TV and finding and following
your passion. You get to help children
grow up and become healthy adults. That’s
one of the reasons I really enjoy working
with adolescents, even though they can be
cranky. Give me a surly adolescent and it’s a
good day.
Children’s Hospital of Michigan
welcomes the following
new physicians:
Amita Adhikari, M.D.
Endocrinology
Sara Ahmed, M.D.
Pediatric Hospital Medicine
Pamela Britto-Williams, M.D.
Allergy/Immunology
Sanjay Chawla, M.D.
Neonatology
Brian Dunoski, M.D.
Pediatric Imaging
Gabriella Geiszt, M.D.
Psychiatry/Psychology
Deemah Mahadin, M.D.
Cardiology
Amy L. Marks, D.O.
Allergy/Immunology
Vinod Misra, M.D.
Genetics and Metabolic Disorders
Ramakrishna Mutyala, M.D.
Pediatric Hospital Medicine
Julie Sommerfield, M.D.
Cardiology
Staci Weldon, M.D.
Pediatrics – Sickle Cell Clinic
Just for Doctors – December, 2010 7
Events & Happenings
Grand Rounds Schedule
The Children’s Hospital of Michigan
Auditorium, 8-9 am
January 7
Pediatric EMR - Past, Present and
the Glorious Future
Srinivasan Suresh, M.D.
Medical Director, Emergency Medicine, the
Children’s Hospital of Michigan
January 14
Transfusion Medicine
Bruce Newman, M.D.
American Red Cross
Children’s Hospital of Michigan
Saturday CME Lecture Series
in Pediatric Medicine
January 21
Conversion Reaction
Jimmie Leleszi, D.O.
Child Psychiatry,
Children’s Hospital of Michigan
January 28
TBD
David Rosenberg, M.D.
Chief, Psychiatry and Psychology,
Children’s Hospital of Michigan
Visit www.childrensdmc.org/cme for
additional grand rounds offerings.
continued from page 3
to intervene sooner with surgery. You don’t want them to wear a brace for five or six years
and then still need to have surgery.”
Orthopaedic surgeons at the Children’s Hospital of Michigan have extensive experience
treating patients with AIS. Drs. Richard A. K. Reynolds, Walid Yassir and Eric T. Jones
are among Michigan’s most experienced scoliosis surgeons — performing more than
100 scoliosis surgeries a year. They use a variety of techniques to treat scoliosis, including
bracing, surgery and a new technique called Guided Growth of the Spine.
“With the Guided Growth technique, you don’t fuse the spine; you try to grow a balancing
curve on the other side to neutralize the curve the patient already has,” Dr. Yassir said. “You
can only do this in children you feel quite certain the curve will progress.”
Topic: Date: Time: Location: Cost: Headaches, Rashes, Precocious Puberty, Cancer Survivorship
Saturday, Jan. 15, 2011
8am - 12 noon
Children’s Hospital of Michigan Auditorium
Free (preregistration is required)
For additional information visit
www.childrensdmc.org/cme or call Janet Houghan
at (313) 745-5464 or at [email protected]
This activity has been approved for AMA PRA Category 1 Credit(s)™.
Just for Doctors
is a publication of the
Children’s Hospital of Michigan
Herman B. Gray, M.D., M.B.A.
President
Mary Lu Angelilli, M.D.
Chief of Staff
Luanne Thomas Ewald
Vice President, Business Development
Vickie Dahlman-Anger
Editor
Janet Houghan
Contributing Editor
Thomas Frey, APR
Feature Writer
Alchemy Creative Works
Design and Printing
December 2010
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