Southeast Texas Medical Associates, LLP James L. Holly, M.D. Southeast Texas Medical Associates, LLP


Your Life Your Health - Introduction to the Inauguration of the Joslin Diabetes Center Affiliate at Southeast Texas Medical Associates
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James L. Holly,M.D.
November 25, 2010
Your Life Your Health - The Examiner

(Editorial Comment: The following are my introductory comments for the inauguration of SETMA's affiliation with the Diabetes Center of Excellence. These comments will be delivered at specified times during the ceremony. A copy of the Inauguration Agenda can be found HERE.)

General Introduction

1869 was only seven years after Louis Pasteur proved the germ theory of disease causation and only four years after the conclusion of the United States Civil War. Laudanum - a preparation of opium -- was still sold over the counter as a treatment for many maladies. Patent medicine, affectionately known as "snake oil," was the principle pharmaceutical available to the average person. Proprietary medical schools would sell you a medical degree for a price and for little work.

Into this milieu, in Oxford, Massachusetts, a child was born. Upon his death in 1962 at the age of 92, he would be known as one of the premier physician-scientist of his day. The world would have changed and both he, in his life time, and the institution which he founded, into the present, changed the medical world.

While at Harvard Medical School, his aunt developed diabetes. At that time, the life expectancy of a person with type 1 diabetes was four months. They could live almost two years, but only on a starvation diet and often died of malnutrition. When he chose a career in the treatment of diabetes, it was 25 years before the discovery of insulin which would give those same patients an opportunity for a normal life. And, there were no specialists like him.

Over the years, Dr. Elliott P. Joslin developed theories of treatment of diabetes which were discussed and often challenged by other "experts." It was not until 1993 that research validated all of Dr. Joslin's theories and work. In celebration, the Diabetes Center of Excellence distributed buttons on which appeared the same words which appear on the buttons you wear today, "I told you so. E. P. Joslin."

Today, SETMA humbly yet proudly accepts the mantle of Joslin Diabetes Center Affiliate at Southeast Texas Medical Associates. We do so with the sober realization that we stand on the shoulders of this great man and we walk in company with all of those who worked with him and who came after him. We do so with the solemn commitment to hold in near sacred trust Dr. Joslin's reputation and vision; with the resolution to continue to pursue excellence, and to serve those with diabetes as faithfully, as compassionately and as diligently, as did Elliott P. Joslin.

We welcome you, our neighbors and our guests, to the future of healthcare; we welcome you to The Diabetes Center of Excellence Affiliate at Southeast Texas Medical Associates. Thank you for sharing this day with us.

Invocation

SETMA is a multicultural, multi-ethnic, multi-faith organization, which reflects the people we serve.

At this solemn occasion, we cannot omit our acknowledgement of the source of our strength and success. It is, in our judgment, the providence and beneficence of Almighty God. As we sit and stand here, we are Jew, Muslim, Hindu, Buddhist, Christian and perhaps even atheist. Today we celebrate our common commitment to the good of our fellow man, whatever the fount from which that passion flows.

As we acknowledge God's goodness in human affairs, each of us will do so as we have been taught and as we believe. The exercise of faith by one does not insult nor impugn the faith of another. So, in our pluralistic society, I invite you to pray as you have been taught, as I shall pray as I have been. Whether in your tradition you pray with head bowed and eyes closed, or with eyes open and head elevated, I ask you to join me as I lead us in thanking God for His goodness to us all.

Prayer

"Heavenly Father, in the Name of the Lord Jesus Christ, We thank You for Your goodness to us. We thank You for the life and legacy of Elliott P. Joslin. We thank you for allowing SETMA to be part of an enterprise that brings good to those whom You love and care for. We thank you for our colleagues in the healthcare profession and particularly at the Diabetes Center of Excellence.

"We pray for the wisdom and knowledge to give the best care there is to those who deserve nothing less.

"It is our hope that if we should gather here again in fifty years, we would be able to celebrate improvements in the care of those with diabetes which would be as a noteworthy as the changes for which Elliott P. Joslin and his Center were responsibility in his long and illustrious career. In Christ's Name, Amen."

Special Presentation

The Agenda does not list the following presentation but when I became aware of it, I asked that it be done today. In the past year, SETMA has received recognition by the National Committee for Quality Assurance (NCQA) both as a Patient-Centered Medical Home and for excellence in Diabetes Care. SETMA has also been accredited for Ambulatory Care and as a Medical Home by the Accreditation Association for Ambulatory Health Care.

As part of our transformation into being a medical home, SETMA;s partners organized The SETMA Foundation, with the purpose of assisting our patients with the cost of healthcare when they could not otherwise obtain it. While our resources are meager in contrast to the need and while we cannot meet every need, in the past 14 months, the partners of SETMA have contributed $1,000,000 to the Foundation. Where we have been able to help, we have seen near miracles in the lives of our patients.

Today, Mr. Ted Carpenter, President of the Medicare Advantage Division of Universal American, is going to make a presentation to SETMA. I would ask the partners of SETMA, Drs. Anwar, Aziz, Colbert, Halbert, Murphy, and Leifeste to join me on the platform. Mr. Carpenter...

Introducing Syed Anwar, MD

Dr. Anwar has been a colleague and partner at SETMA his entire professional career. He is one of the principle drivers of SETMA's "I-Care Initiative," for the improvement of care for all residents of long-term care facilities. SETMA is proud that many nursing home administrators and directors of nursing have joined us today. Dr. Anwar will introduce a number of our other "special guest" who are with us for this "special occasion."

Introducing Diabetes Center of Excellence Affiliate at SETMA Staff

Over the past 11 years, SETMA has experienced continuous and uninterrupted improvement in the care of patients with diabetes as demonstrated by our data. In that time, there have been three breakpoints - points at which there have been significant, dramatic, and sustained improvements in our care of patients with diabetes.

The first was when we deployed our Diabetes Disease Management Tool in 2000. The next two involve those who will be the core of the SETMA Affiliate's Joslin Disease Center staff. In 2004, Michelle Satchfield joined SETMA and guided us in the securing of American Diabetes Association accreditation for our Diabetes Self Management Education and Medical Nutrition Therapy program. That year, we had another dramatic improvement in the care of our patients with diabetes. In 2006, Dr. Jehanara Ahmed, board-certified endocrinologist, joined SETMA. In that year, we experienced our third dramatic improvement in diabetes care.

The core members of the Diabetes Center of Excellence at SETMA are:

  • Dr. Jehanara Ahmed, Medical Director of our Affiliate
  • Dr. Damien Luviano, Ophthalmologist
  • Michelle Satchfield, MS, RD, CDE,

Program Coordinator/Center Administrator of our Affiliate

  • Kathryn Smith, RN, CDE
  • Jennifer Gary, MS, RD

Dr Ahmed, as the Medical Director of SETMA's Joslin Affiliate, will you share with us what the Diabetes Center of Excellence means to patients with diabetes in Southeast Texas. Dr. Ahmed

Introducing the Awarding of Joslin's Fifty Year Medal

(This material is copied from the Joslin website and will not all be presented at the ceremony but is included in the published version of my comments)

Remember, patients with type 1 diabetes lived for four months without treatment and less than two years with treatment when Dr. Joslin started his practice in Brookline, Massachusetts in 1898. When insulin was discovered, the life and longevity of patients with diabetes improved dramatically.

Joslin first began awarding medals to people with diabetes in 1948 with a 25-year Victory Medal. Believing that proper self-management was the key to minimizing long-term complications, the program was the vision of Elliott P. Joslin, M.D. and served as an incentive for those committed to good, though challenging, diabetes care. In the early 1950s the name was changed to the Blue Ribbon, and as more and more people lived long healthy lives with diabetes it finally became the 25-year Certificate that is awarded today. In 1970, Joslin expanded the program and began awarding a 50-year bronze medal. And Joslin presented the first 75-year medal in 1996.

Awards to Date

Since 1970, Diabetes Center of Excellence has presented more than 2,905 50-year medals. Joslin has also awarded 28 distinctive 75-year medals from 1996 to present. To date, more than 720 people have received certificates recognizing 25 years with diabetes. The medalist program is far reaching, and Joslin has awarded medals across the country and around the world. Medals have been presented internationally to recipients in Australia, Brazil, Canada, England, Hungary, Japan, the Netherlands, Pakistan, the Philippines, Russia, South America, Spain, Sweden and Switzerland.

50 Year Medalist Study

Joslin's 50-year medalists are invited to participate in a special study, examining outcomes of long-term diabetes. The study attempts to understand what factors contribute to the longevity of individuals who have received this honor. Currently, over 400 medalists are interested in participating in the study. To date, over 300 of these have completed an extensive questionnaire about their life with diabetes. Data from this questionnaire suggest that the risk of kidney, eye, and nerve problems is different after 50 years with type 1 diabetes than the risk among all individuals with the disease.

A second study is currently being undertaken, which examines factors in the blood and DNA that may help in modifying the risk for complications and survival. Participation in this study is open to all individuals residing in the United States who have received the Joslin 50-Year Medal. In coming months, updates for this study and findings from the previous study will be posted on a separate Web site

Introducing Jack Isaacson 50 Year Medalist

Jack has been my friend since shortly after he was diagnosed with diabetes in January, 1961. You would like to know Jack and his wife Barbara. He has been diligent and relentless in his care of himself. Having a wonderful wife who is also a registered nurse has also been a great help.

Dr. Rich Jackson and Dr. Ken Snow will come and present Jack's Medial and his certificate.

Introduction of Dr Martin Abrahamson, Chief Medical Officer and Senior Vice President

Dr. Abrahamson is a native of South Africa. He is Associate Professor of Medicine at Harvard Medical School, and Chief Medical Officer and Senior Vice President of the Diabetes Center of Excellence. He has spearheaded the development of the team approach to diabetes management at the Diabetes Center of Excellence, co-directs the Division of Continuing Medical Education in the Department of Medicine at Beth Israel Deaconess Medical Center, and has been cited on numerous occasions as one of Boston's best doctors in Boston Magazine. He is a gracious and charming man personally and a highly acclaimed physician professionally.

In March, 2010, The American College of Physicians (ACP) awarded Dr. Abrahamson, the inaugural Samuel Eichold II Memorial Award for Contributions in Diabetes, recognizing Dr. Abrahamson's "stellar career." The award is bestowed upon an ACP member or an organization that has made important health care delivery innovations for diabetic patients resulting in improved clinical or economic outcomes; or an ACP member who has conducted research that significantly improves quality of care or clinical management of diabetes.

SETMA and all of Southeast Texas are honored to have Dr. Abrahamson and the other Joslin team members with us today. Dr. Abrahamson will deliver our keynote address before our ribbon cutting. Dr. Abrahamson

Introduction of Dr. Mohammad Aziz

Dr Aziz is SETMA's Managing Partner. He is my friend and my colleague. He will introduce the Mayor of Beaumont and then give further directions for the conclusion of our celebration. Dr. Aziz.

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