sutures newsletter

PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY December 2014 | Archived Issues

P and T Approvals, FDA Warnings

Pharmacy Focus

See highlights of the Oct. 7 meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration has issued warnings about lenalidomide, duloxetine hydrochloride, alglucosidase alfa and methoxy polyethylene glycol-epoetin beta.

» Read more


Mark Your Calendar


Grand Rounds

Click here to view a schedule of all upcoming grand rounds.


Educational Schedule

Click the PDF link below to see the Department of Surgery's educational schedule.

Educational Schedule - December 2014 (PDF)


Surgery Scheduling

Click the "read more" for hours and contact information for surgery scheduling.

» Read more

Amersi Honored as First Recipient of Adashek Award

Farin Amersi, MD, has been named the first winner of the Dr. Kenneth Adashek Surgical Excellence Award. The award was presented Dec. 16 at the Department of Surgery's holiday party. The award comes with a $25,000 prize, which Amersi can use for educational or academic activity.

» Read more

Insurance Update for Patients Who Want Cedars-Sinai Health Coverage (2015 Plan Year)

From Thomas M. Priselac, President and CEO 

Open enrollment for individual and family health insurance runs through Feb. 15, 2015, and many of you may get questions from patients who want to ensure that their plan continues to cover care from Cedars-Sinai. I'd like to share the following information to help you address such questions and let you know about the additional resources Cedars-Sinai has developed to help our patients navigate the changing insurance marketplace.

» Read more

A Very Successful Joint Commission Survey

From Mark R. Gavens, Chief Operating Officer; 
Linda Burnes Bolton, DrPH, RN, FAAN, Chief Nursing Officer

Once again, you have demonstrated your passion, teamwork and commitment to our patients and community during last week's successful Joint Commission survey.

» Read more

Physician Advocates Serve as Attendings' Eyes, Ears

With a role in patient care so new it is literally being defined at Cedars-Sinai, Bill Stanford, MD — a physician advocate — spends a fair amount of time explaining what he does. That's fine with him. As medical director of the Physician Advocate Program, Stanford welcomes the opportunity to discuss how physician advocates are making a difference in quality, efficiency and patient satisfaction.

» Read more

Integrating People, Systems, Technology to Optimize Care

By Ken Catchpole, PhD, Director of Surgical Safety and Human Factors Research

Human factors research helps us to understand how human performance is mediated by the tasks, technologies, teams, environment and organization in which work is conducted. Cedars-Sinai has been growing steadily its reputation and capability in this area.

» Read more

'Lung Coil' Device May Help Emphysema Patients

Cedars-Sinai thoracic surgeons are evaluating an investigational device that, with a relatively simple procedure, could bring significant relief to patients who suffer from severe emphysema.
 

» Read more

Department of Surgery Adds Three Physicians

Three physicians — Timothy Charlton, MD, Carol Lin, MD, and Milton Little, MD — have joined the Cedars-Sinai Department of Surgery.

» Read more

The Wisdom of Hawkeye Pierce

In a column on the Huffington Post website, Bruce Gewertz, MD, Cedars-Sinai surgeon-in-chief and chair of the Department of Surgery, writes that the maverick, wisecracking surgeons on the television show "M*A*S*H" may have been fictional, but they got one thing right: Creating a positive climate in the operating room can put everyone at ease, allowing doctors and nurses to perform at their best. And therein lies a dose of wisdom for those who practice medicine in the real world. Read the column here.

» Read more

Study: Computer's Reports More Effective Than Doctors'

A computer system was more effective than doctors at collecting information about patient symptoms, producing reports that were more complete, organized and useful than narratives generated by physicians during office visits, according to a Cedars-Sinai study.

» Read more

Recognition for Alban, Gordon

Physician News

Rodrigo Alban, MD, won a "poster of exceptional merit" award at the annual meeting of the American College of Surgeons, and Leo Gordon, MD, delivered the keynote address at the annual meeting of the Herb Fred Society.

» Read more

Circle of Friends Honorees for November

The Circle of Friends program honored 204 people in November. Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai.

» Read more

Amersi Honored as First Recipient of Adashek Award

At the award presentation were (from left) Tessa Stephenson Brand, Rich Brand, Toni and Emmet Stephenson, Kenneth W. Adashek, MD, Farin Amersi, MD, and Bruce Gewertz, MD, surgeon-in-chief and chair of the Department of Surgery. The award was made possible by the Stephensons' generosity; the Brands are their daughter and son-in-law.

Farin Amersi, MD

Farin Amersi, MD, has been named the first winner of the Dr. Kenneth Adashek Surgical Excellence Award. The award was presented Dec. 16 at the Department of Surgery's holiday party.

The award comes with a $25,000 prize, which Amersi can use for educational or academic activity.

Amersi, a surgical oncologist, is an attending physician at the Cedars-Sinai Saul and Joyce Brandman Breast Center — A Project of Women's Guild. Her specialty is in surgical oncology with clinical expertise in breast cancer and endocrine, melanoma, sarcoma and gastrointestinal surgery.

The award provides vital resources to a surgeon who is within 10 years of fellowship completion and who exemplifies Adashek's outstanding personal and professional qualities, including surgical excellence, dedication to the field of surgery, exceptional interpersonal skills and complete integrity.

The award recognizes Adashek's significant accomplishments while highlighting Cedars-Sinai's emphasis on compassionate care for each patient. It is made possible by the generosity of Toni and Emmet Stephenson. The award will be given annually to a surgeon on the staff at Cedars-Sinai.

Kenneth W. Adashek, MD, is an attending surgeon at the Cedars-Sinai Thyroid Cancer Center and the Saul and Joyce Brandman Breast Center. He is a former chair of the Cedars-Sinai Division of General Surgery and a former co-director of the breast center.

Insurance Update for Patients Who Want Cedars-Sinai Health Coverage (2015 Plan Year)

From Thomas M. Priselac, President and CEO 

Open enrollment for individual and family health insurance runs through Feb. 15, 2015, and many of you may get questions from patients who want to ensure that their plan continues to cover care from Cedars-Sinai. I'd like to share the following information to help you address such questions and let you know about the additional resources Cedars-Sinai has developed to help our patients navigate the changing insurance marketplace.

Please note that this open enrollment only affects people who purchase their own insurance policies for themselves and their families; it does not affect those who receive health insurance through their employer, such as Cedars-Sinai employees.

The first thing you should know is that the insurance options that include coverage for Cedars-Sinai have changed from the 2014 plan year. This applies to plans available both through the Covered California health benefit exchange and those purchased directly from an insurance company or broker.

The following plans provide coverage for care from Cedars-Sinai:

Through the Covered California health benefit exchange:

  • Anthem Blue Cross Exclusive Provider Organization (EPO) plans (all metal levels — e.g., Platinum, Gold, Silver, Bronze)

Through an insurance broker or insurance company directly (off the exchange):

  • Anthem Blue Cross
    • Anthem Blue Cross EPO plans (all metal levels — e.g., Platinum, Gold, Silver, Bronze)
    • Cedars-Sinai Medical Center is a Tier 1 facility in EPO plans.
    • Patients can keep coverage under a grandfathered Anthem Blue Cross plan that offers their full network of providers as long as they continue to pay premiums under the plan.
  • Assurant Health
    • Assurant Health offers a full range of Preferred Provider Organization (PPO) network plans — using the Aetna PPO physician and hospital network.

At this time, it is unclear whether Cedars-Sinai will be included as a participating provider in Health Net's PPO network. Patients who want coverage for Cedars-Sinai and are interested in making a change for the 2015 plan year should consider switching to an Anthem Blue Cross EPO plan or Assurant Health PPO plan.

Patients also can keep coverage for Cedars-Sinai if they have a grandfathered Blue Shield plan that offers a full network of providers and they continue to pay premiums under the plan. Note that Cedars-Sinai is not a participating hospital in the Blue Shield PPO plans offered through Covered California, directly through Blue Shield, or through an insurance broker.

Those currently enrolled in an individual or family insurance product that will continue to be offered in 2015 were automatically re-enrolled in that product on Dec. 15; however, they will be able to switch plans until Feb. 15.

We recognize that there are many people who want to come to Cedars-Sinai but may be concerned about out-of-pocket costs such as deductibles and co-pays for hospital services. To make things easier for our patients, we offer a variety of financial assistance programs that can help people with some of these costs. These programs are available to a wide range of incomes, and more information is available online or by calling Patient Financial Services at 323-866-8600.

For your reference, linked below are a letter and fact sheet that we recently sent to our patients who likely have individual and family health insurance. For the most up-to-date information and guidance, please access the following resources:

Individual Insurance Patient Letter - December 2014 (PDF)

Plan-By-Plan Fact Sheet (PDF)

A Very Successful Joint Commission Survey

From Mark R. Gavens, Senior Vice President, Clinical Care Services, and Chief Operating Officer
Linda Burnes Bolton, DrPH, RN, FAAN, Vice President, Nursing, and Chief Nursing Officer

Once again, you have demonstrated your passion, teamwork and commitment to our patients and community during last week's successful Joint Commission (TJC) survey.

Six surveyors from TJC spent five full days conducting a comprehensive review of the delivery of patient care and related critical services within the medical center. The survey team was composed of two physicians, two nurses, a life safety engineer and an ambulatory care specialist. They audited our compliance with the several thousand TJC standards, conducted 30 patient "tracers" and 70 medical record reviews, visited more than 75 operating areas and held discussions with hundreds of our staff and patients.

While we will not receive a final accreditation decision for several months, based on comments by the surveyors at the closing conference as well as the preliminary written report, we can share that it was a very successful survey. The surveyors consistently remarked on the exemplary performance of the organization, the exceptional programs in place to care for complex patients and, most importantly, the high level of engagement and pride demonstrated by the staff.

We will be reviewing recommendations made by TJC and the surveyors in the weeks ahead. Some may require further discussions with TJC before a final report is issued, while others will likely require our submitting additional information. A complete summary of the final findings will be provided at your upcoming staff meetings.

Accreditation is but one of the many processes we have in place at Cedars-Sinai that provide insight into our daily operations and systems, and help validate our continuous improvement efforts. Thank you for your efforts that every day deliver outstanding care to our patients and communities.

Physician Advocates Serve as Attendings' Eyes, Ears

Bill Stanford, MD, (left) and Chase Coffey, MD, are among Cedars-Sinai's five physician advocates.

With a role in patient care so new it is literally being defined at Cedars-Sinai, Bill Stanford, MD — a physician advocate — spends a fair amount of time explaining what he does.

That's fine with him. As medical director of the Physician Advocate Program, Stanford welcomes the opportunity to discuss how physician advocates are making a difference in quality, efficiency and patient satisfaction.

"Physician advocates act as the eyes and ears for medical staff attendings during daily multidisciplinary progression of care rounds," said Stanford, whose specialty is hospital medicine. "Cedars-Sinai is a pioneer of this strategy, and the response from attendings has been overwhelmingly positive."

The program, launched in February as part of a broader effort to deliver high-value healthcare, was developed by Scott Weingarten, MD, MPH, senior vice president and chief clinical transformation officer, in conjunction with the High Value Care Committee led by Zab Mosenifar, MD, and Harry Sax, MD.

Preliminary results of the program are encouraging, according to the Cedars-Sinai Department of Resource and Outcomes Management. Current data show that the average length of stay and the length of stay index are significantly lower in units where physician advocates participate in multidisciplinary rounds. For example, the average length of stay on med/surg units with the advocates is 4.37 days, compared to 6.19 days on med/surg units without them.

In addition, the length-of-stay improvements have resulted with no statistically significant increase in the readmission rate.

The program is expanding and now has five physician advocates. In addition to Stanford, who assists attending physicians on 5 Southeast and 5 Southwest, are:

  • Harry Sax, MD, professor and vice chair of Surgery and a physician advocate on 7 Northeast and 7 Northwest
  • Chase Coffey, MD, a hospitalist and advocate on 5 Northeast and 5 Northwest who is working to improve efficiency in Cedars-Sinai intensive care units
  • Nattapaun Thepyasuwan, MD, a hospitalist and advocate on 6 Southwest
  • Henry Horton, MD, a hospitalist and advocate on 7 Southeast.

"We are so fortunate to have these true advocates to facilitate the rapidly changing inpatient care of our patients, especially when we may be busy in the office several miles away, or in the operating room," said Chief of Staff Chris Ng, MD.

The program initially has focused on identifying gaps in care coordination throughout the medical center and improving communication between the healthcare team and attending physicians.

"It's the only program I know of that uses this model of multidisciplinary care that includes an experienced hospitalist to assist private attendings in a pluralistic hospital model," Stanford said.

Stanford noted that physician advocates become familiar with cases prior to multidisciplinary rounds and often spot clinical issues or potential delays in treatment before they would normally come to the attention of attending physicians. Nurses, social workers, case managers, pharmacists and clinical documentation integrity specialists have proven to be the "difference makers" in using the expertise of the advocates to improve care, he said.

"The types of things we discuss and the clinical orientation of these enhanced progression of care rounds empower them to proceed with superior knowledge of what needs to be done," Stanford said.

Among the next steps for the Physician Advocate Program is looking for ways to improve the quality and safety of discharges with the goal of reducing readmissions. For more information, contact Weingarten at scott.weingarten@cshs.org or Stanford at william.stanford@cshs.org.

Integrating People, Systems, Technology to Optimize Care

By Ken Catchpole, PhD
Director of Surgical Safety and Human Factors Research

Human factors research helps us to understand how human performance is mediated by the tasks, technologies, teams, environment and organization in which work is conducted. A variety of research recognizes that successful outcomes relate to a broad range of parameters — such as case volume, teamwork, protocols, bundles and checklists — as well as the skills of individual clinicians. Human factors, or ergonomics, helps us to design tasks, technology and training to make things easier to do right and more difficult to do wrong. Cedars-Sinai has been growing steadily its reputation and capability in this area.

Under our OR 360 initiative, which seeks to re-engineer technology and teamwork for 21st-century care, we recently completed a large Department of Defense-funded research project that developed methods to improve the reliability and safety of trauma care and acute-care handoffs. Some of this work has been published, with much more to come.

The project also has led to the development of a smartphone app that has been successfully tested in simulation and has been commercialized. We are anticipating trials next year at Cedars-Sinai and one other site, possibly in the Paris area. Results of this work can be seen, for example, in the transfers to the adult and congenital heart surgery services, which we continue to support.

Our second area of work is in device testing to ensure usability and safety. In March this year, we were contracted to test a new drug-delivery device in simulated patient and operating room settings. We were extremely grateful that a range of clinical and nonclinical staff volunteered to participate, and the findings identified vital improvements. A relatively simple design change addressed a key problem with the technology, which has since been extremely successful. This demonstrated the value of realistic testing with representative users, because you don't always know what people are going to do with technology.

This philosophy also is being applied to near-term development and implementation of several other operating room technologies. We are now working with a number of startups developing blood-loss monitoring, hand washing, communication technology, augmented reality, intraoperative imaging and even the design of flooring. Some of these projects focus on implementation and design, others on understanding the effects on behavior and decision making of new technologies, and occasionally we seek to identify clinical high-value applications for basic technologies.

Longer-term research also is developing this approach for robotic surgery, in which we are using direct observation in the operating room to examine the effects on process performance of technology design, experience and patient factors. For example, we find that robotic surgery changes communication, equipment and training requirements, which can extend learning curves and reduce safety and efficiency. As we prepare our results for publication, we are enthusiastic to be working with the manufacturer — Intuitive Surgical — to consider new approaches to design and training.

Academic output this year has continued apace, with published data on the use of checklists, teamwork and teamwork training, briefings on length of stay, and a computational model of how small intraoperative events concatenate to create more serious problems in trauma care. We have published book chapters on safety culture, outcomes in congenital heart surgery and the application of human factors models in safety, along with several posters and podium presentations on our handoff and robotic surgery work. We have been invited to speak about our work at a range of conferences nationally, and in the U.K. and Australia.

The value of human factors in healthcare is just starting to be recognized, and we can proudly say at Cedars-Sinai that we are leading the charge.

'Lung Coil' Device May Help Emphysema Patients

Robert McKenna Jr., MD

Heather Merry, MD

Cedars-Sinai thoracic surgeons are evaluating an investigational device that, with a relatively simple procedure, could bring significant relief to patients who suffer from severe emphysema.

"The problem with emphysema is that the lungs inflate very well but don't deflate well. There is no cure for the disease, and the options for effective treatment are generally limited to inhalers and oxygen," said Robert McKenna Jr., MD, medical director of Thoracic Surgery and Trauma.

"Lung volume reduction surgery — taking out the most diseased part of the lung to create more room for the healthy sections — does offer certain patients significant improvement of symptoms and quality of life," McKenna said. "But it is surgery, and most patients with COPD (chronic obstructive pulmonary disease) are not candidates for it."

McKenna says doctors have long sought a minimally invasive procedure that could give more patients the same benefit as an operation.

Throughout 2014, McKenna and thoracic surgeon Heather Merry, MD, have been conducting a randomized prospective study of a device known as a "lung coil," which is inserted into the lungs through the patient's mouth with a bronchoscope. Several coils are used in each lung, and the procedure takes about 30 minutes.

"We look down through the windpipe and implant the devices. The coil is designed to collapse the damaged part of the lung that does not work. The collapse of that ineffective part of the lung makes room for the healthier lung to expand and work better," McKenna said.

The lung coil is inserted into the lungs through the patient's mouth with a bronchoscope. Several coils are used in each lung.

"Most patients who have COPD are not candidates for lung volume reduction surgery, which can help their breathing. They have diffuse, generalized disease throughout their lungs and not disease confined to just one area of the lungs," Merry said. "The lung coil has the potential to open up the therapeutic surgical option to the majority of patients with COPD."

The study is sponsored by PneumRx, the makers of the RePneu Endobronchial Coil used by McKenna and Merry. The multicenter investigation involves medical centers in the U.S., Europe and Canada. The data collected on hundreds of patients will be analyzed to evaluate the lung coil treatment against current best medical management of severe emphysema.

Department of Surgery Adds Three Physicians

Three physicians have joined the Cedars-Sinai Department of Surgery:

Timothy Charlton, MD, is a foot and ankle surgeon with the Cedars-Sinai Orthopaedic Center. Charlton received his bachelor’s degree from St. Lawrence University and his medical degree from Columbia University College of Physicians and Surgeons. At St. Luke’s/Roosevelt Medical Center in Manhattan, Charlton completed his internship in general surgery and served as chief resident in orthopedic surgery. He completed a fellowship in foot and ankle surgery at the Hospital for Special Surgery in New York.

Charlton is a decorated officer in the U.S. Navy.

His clinical interest is focused on tendon pathology in professional dancers. He is the physician to the Los Angeles Ballet, L.A. Dance Project, and the traveling company of the American Ballet Theatre.

Charlton’s research articles have been published in peer-reviewed journals such as Foot and Ankle International, Journal of Dance Medicine and Clinical Orthopaedics and Related Research. He is a reviewer for Foot and Ankle International and the Journal of Bone and Joint Surgery.


Carol Lin, MD, is a faculty physician with the Orthopaedic Center. Lin specializes in orthopedic trauma, including nonunions and mal-unions, pelvis and acetabular fractures, and extremities excluding hands. She also performs hip and total knee replacements for arthritis.

Lin earned bachelor’s degrees in biology and English at Stanford University. She earned her medical degree and a master of arts in clinical research at Washington University in St. Louis, followed by a residency in orthopedic surgery at the University of California, San Francisco. Lin has completed two fellowships: the first in clinical research at Minnesota/Hennepin County Medical Center, and most recently in orthopedic trauma at Cedars-Sinai.

Lin’s research includes acetabular posterior wall fractures, tibial nonunions and arthroplasty, specifically knee and hip arthroplasty among HIV-positive patients. She has authored scientific articles published in the Journal of Arthroplasty and the Journal of Bone and Joint Surgery, among others.


Milton Little, MD, is a faculty physician with the Orthopaedic Center. He specializes in orthopedic trauma, including nonunions and mal-unions, pelvis and acetabular fractures, and extremities excluding hands. He also performs hip and total knee replacements for arthritis.

Little earned his bachelor’s degree in biology from Stanford University and his medical degree from the University of Michigan Medical School. He completed his residency in orthopedics at the Hospital for Special Surgery in New York and a fellowship in orthopaedic surgery at Harborview Medical Center/University of Washington.

Little’s research focuses on supination external rotation ankle fractures, complex proximal humerus fractures and knee fractures. His investigative findings have appeared in scientific journals including the Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery and Foot and Ankle International.

The Wisdom of Hawkeye Pierce

In a column on the Huffington Post website, Bruce Gewertz, MD, Cedars-Sinai surgeon-in-chief and chair of the Department of Surgery, writes that the maverick, wisecracking surgeons on the television show "M*A*S*H" may have been fictional, but they got one thing right: Creating a positive climate in the operating room can put everyone at ease, allowing doctors and nurses to perform at their best. And therein lies a dose of wisdom for those who practice medicine in the real world. Read the column here.

Study: Computer's Reports More Effective Than Doctors'

A computer system was more effective than doctors at collecting information about patient symptoms, producing reports that were more complete, organized and useful than narratives generated by physicians during office visits, according to a Cedars-Sinai study.

Investigators said the research, published in the American Journal of Gastroenterology, highlights the potential of computers to enhance the quality of medical care and improve outcomes by harnessing accurate and thorough patient information.

The authors said they did not expect technology to replace physicians in the exam room. Instead, they said that computers can empower doctors to practice medicine more efficiently and effectively as they face growing requirements to document symptoms, diagnoses and other patient data.

"Our results suggest that computers can help clinicians focus on what they do best — practicing the distinctly human art of medicine," said Brennan Spiegel, MD, a study author and director of Cedars-Sinai Health Services Research. "This study offers initial proof that a computer can create meaningful and relevant patient histories that are useful in the clinical setting."

The researchers conducted their study in outpatient gastrointestinal clinics in Los Angeles, identifying 75 patients who reported a variety of active symptoms, including abdominal pain, heartburn, reflux, nausea, vomiting, constipation and diarrhea.

Patients were seen initially by doctors, who typed or dictated information about illness histories into the electronic health record system. The patients later answered questions about their conditions on a website called My GI Health. An algorithm on the website collected the answers and translated them into patient narratives.

The reports generated by the doctors and the computer system were evaluated by a separate group of physicians who had no knowledge of the study, including the fact that half of the patient histories were written by a computer. The reviewers were told only that they were auditing the quality of reports in gastrointestinal clinics.

The reviewers concluded that the computer-generated summaries were superior, describing them as better organized and more complete, succinct, comprehensive and useful.

"The computer-generated narratives were of higher quality overall," said Christopher V. Almario, MD, a Cedars-Sinai-based gastroenterology fellow and a lead author of the study.

The researchers said computers offer a solution to the problem of doctors entering incomplete or inaccurate information into patients' records. The technology also frees physicians to focus more on patients during office visits and to catch important bits of information and nonverbal cues that might otherwise be missed.

The investigators suggested that patients are comfortable disclosing health information in "virtual human" interviews through the Web-based questionnaire.

"The study reveals that computers can lift at least some of the burden from doctors by collecting and analyzing data," Spiegel said.

The research was funded in part by the National Institutes of Health Patient Reported Outcomes Measurement Information System.

Subsequent Cedars-Sinai research will examine whether computer-generated reports can enhance the physician-patient relationship, and increase patient satisfaction and engagement in healthcare decisions.

Recognition for Alban, Gordon

Physician News

Alban Wins Poster Award at American College of Surgeons Meeting

Rodrigo Alban, MD, won a "poster of exceptional merit" award at the annual meeting of the American College of Surgeons held in October in San Francisco. Out of more than 300 submissions, nine were selected for the award.

The title of the poster is "Implementation of Collaborative Practice Processes Increase Donation After Circulatory Death in a Level I Trauma Center."

Alban, a trauma and acute care surgeon, is associate program director of the General Surgery Residency and associate director of Surgical Performance Improvement.

To see the award-winning poster, click the PDF link below.

Rodrigo Alban, MD, Poster (PDF)


Leo Gordon, MD, at Rice University

Gordon Delivers Keynote Address to Herb Fred Society

Leo Gordon, MD, attending surgeon at Cedars-Sinai, delivered the keynote address at the annual meeting of the Herb Fred Society on Sept. 29 in Houston.

The Herb Fred Society was established by former residents, associates and friends of Herb Fred, MD, a legendary Texas medical educator. The event took place at the Rice University football stadium overlooking the playing field.

Gordon described Cedars-Sinai, its history and its evolution into a premier medical center. He also reviewed Fred's many contributions to medical education and the medical literature. Fred and Gordon share the belief that medical history should be incorporated into every medical education program.

Gordon's formal remarks — "Hail to the Chief Complaint!" — outlined the health problems of seven former presidents.

Circle of Friends Honorees for November

The Circle of Friends program honored 204 people in November.

Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

Click here for more information about the program and for a list of past honorees.

  • Gabrielle L. Adem, RN
  • Keith L. Agre, MD
  • Sonu S. Ahluwalia, MD
  • Simon P. Alarcon
  • Michael J. Alexander, MD
  • Bethel V. Alvaro, RN
  • Michelle Amarillas, RN, CEN, MICN
  • Farin Amersi, MD
  • Mahul B. Amin, MD
  • Neel A. Anand, MD
  • John P. Andreas
  • Ellen Anifantis, LCSW
  • Jisha Antony, RN
  • M. William Audeh, MD
  • David Austin, MD
  • Walid S. Ayoub, MD
  • C. Noel Bairey Merz, MD
  • Todd Alan Barrett, MD
  • Julie M. Beckett, RN
  • Donna M. Bias, BSN, RN
  • Keith L. Black, MD
  • David William Bliss, MD
  • Vivien S. Bonert, MD
  • Swaraj Bose, MD
  • Earl W. Brien, MD
  • Neil A. Buchbinder, MD
  • Matthew H. Bui, MD
  • Christiane Michele J. Burnison, MD
  • Ilana Cass, MD
  • Cheryl G. Charles, MD
  • Vera M. Chesnokova, PhD
  • Arthur K. Cho, MD
  • Sonja M. Clayton
  • Jennifer Clemens
  • Hart C. Cohen, MD
  • Jason S. Cohen, MD
  • Felice E. Cooperman
  • Stephen R. Corday, MD
  • Maria S. Corral
  • Ruth Cousineau, MD
  • Alice C. Cruz, MD
  • Debbie C. Cruz
  • Shaun S. Daneshrad, MD
  • Maria A. de Castro, MD
  • Laura Deary
  • Robert W. Decker, MD
  • Anuj B. Desai, MD
  • Stephen C. Deutsch, MD
  • Jenifer Diorio, BSN, RN, PHN
  • Noam Z. Drazin, MD
  • Julie A. Dunhill, MD
  • Joshua D. Ellenhorn, MD
  • Fardad Esmailian, MD
  • Claudia Espinoza
  • Richard Essner, MD
  • Stephanie Farrant, RN
  • Joel D. Feinstein, MD
  • Laura A. Fellman, RN
  • Morton H. Field, MD
  • Eugene L. Fishman, MD
  • Charles A. Forscher, MD
  • Larry Froch, MD
  • Philip K. Frykman, MD, PhD
  • Steven S. Galen, MD
  • Ruchira Garg, MD
  • Ivor L. Geft, MD
  • Eli Ginsburg, MD
  • Armando E. Giuliano, MD
  • Jay Goldberg, MD
  • Neil J. Goldberg, MD
  • Sherry L. Goldman, RN, NP
  • Jeffrey S. Goodman, MD
  • Martin N. Gordon, MD
  • Steven B. Graff-Radford, DDS
  • Abe Green, MD
  • Rafael O. Grefaldeo
  • Karla J. Gregg, RN
  • Christian Guevara
  • Kapil Gupta, MD
  • Victor Gura, MD
  • Paul B. Hackmeyer, MD
  • Antoine Hage, MD
  • Michele A. Hamilton, MD
  • John G. Harold, MD
  • Michael D. Harris, MD
  • Randy S. Harris, MD
  • Andrew E. Hendifar, MD
  • Allen S. Ho, MD
  • Andrew F. Ippoliti, MD
  • Danilo M. Jacinto
  • Marney Jakubowicz, LVN
  • Stanley C. Jordan, MD
  • David Y. Josephson, MD
  • Scott R. Karlan, MD
  • David Kawashiri, MD
  • Ilan Kedan, MD, MPH
  • Elizabeth B. Kelly, RN
  • Irene Kim, MD
  • Terrence T. Kim, MD
  • Keith J. Kimble, MD
  • Asher Kimchi, MD
  • Lester D. Klein
  • Robert Koblin, MD
  • Ryan H. Kotton, MD
  • Michael A. Kropf, MD
  • Marcella D. Kurtzman, RN, OCN
  • Stuart H. Kuschner, MD
  • Gary E. Leach, MD
  • Caroline E. Leongas, RN
  • Norman E. Lepor, MD
  • Ronald S. Leuchter, MD
  • Phillip L. Levine, MD
  • Richard A. Lewis, MD
  • Andrew J. Li, MD
  • Michael C. Lill, MD
  • Marc Makhani, MD
  • Rajendra Makkar, MD
  • Adam N. Mamelak, MD
  • Cindy Margolis, RN
  • Philomena McAndrew, MD
  • Robert J. McKenna Jr., MD
  • Nathan J. McNeil, MD
  • Farhad Melamed, MD
  • Adolfo Melendez
  • Leslie Memsic, MD
  • Monica M. Mita, MD, MDSc
  • Charles N. Moon, MD
  • Jaime D. Moriguchi, MD
  • Mary C. Nasmyth, MD
  • Youram Nassir, MD
  • Ronald B. Natale, MD
  • Michelle Nealey
  • David G. Ng, MD
  • Nicholas N. Nissen, MD
  • Kenith K. Paresa, MD
  • Chirag G. Patil, MD
  • Debbie Y. Patterson
  • Mark Pimentel, MD
  • Terry E. Podell, MD
  • Julie Pomeroy
  • Edwin M. Posadas, MD
  • David B. Pregerson, MD
  • Shervin Rabizadeh, MD
  • Danny Ramzy, MD, PhD
  • Jeffrey Rapp, MD
  • Alexandre Rasouli, MD
  • Monique Renick, RN
  • Richelle C. Robateau
  • Sepehr Rokhsar, MD
  • Barry E. Rosenbloom, MD
  • Gary G. Rosengarten, PhD
  • Warren L. Roston, MD
  • Jason A. Rothbart, MD
  • Jeremy D. Rudnick, MD
  • Norma E. Ruiz
  • Sulagna C. Saitta, MD
  • Vivian L. Salle, RN
  • Tracy Salseth, ACNP-BC
  • Rafael A. Sanchez
  • Howard M. Sandler, MD, MS
  • Wouter I. Schievink, MD
  • Mary E. Sepulveda
  • Payam Shadi, MD
  • Prediman K. Shah, MD
  • Melanie Sheeter
  • Stephen L. Shiao, MD, PhD
  • Khawar M. Siddique, MD
  • Robert J. Siegel, MD
  • Allan W. Silberman, MD, PhD
  • Stuart L. Silverman, MD
  • R. Kendrick "Ken" Slate, MD
  • Enrique Slodownik, MD
  • Stacey Smyth
  • Marilyn A. Solsky, MD
  • Harmik J. Soukiasian, MD
  • Andrew Ira Spitzer, MD
  • Jasminka Stegic, MS, ANP-BC, CCRN
  • Jay J. Stein, MD
  • Jerrold H. Steiner, MD
  • Sandra Elaine Sternberg
  • Colin Stokol, MD
  • Vinay Sundaram, MD
  • Pamela J. Swan
  • Nicholas R. Szumski, MD
  • Michele Tagliati, MD
  • Mona Talreja
  • Jane Tavyev Asher, MD
  • David B. Thordarson, MD
  • Hitoshi "Tommy" Tomizawa, MD, MPH
  • Tram T. Tran, MD
  • Alfredo Trento, MD
  • Alfredo Valenzuela
  • Jamie S. Vitale, BSN, RN
  • Raquel G. Vivanco, RN
  • Willis Wagner, MD
  • Mary Lynn Walker, BSN, RN
  • Judith G. Weiner, MD
  • Janet Y. White, MD
  • Elizabeth Whiting, MSN, RN
  • Kenyetta Wilson
  • Charles L. Wiseman, MD
  • Edward M. Wolin, MD
  • Rachel Zabner, MD
  • Evan M. Zahn, MD