Tampa Bay Times: Just 9 percent of female medical students want to be surgeons. What one group is doing about it.

Dr. Sharona Ross, center, a surgeon at AdventHealth, helped launch the Women in Surgery Symposium, which works to address a shortage of women in the field. Ross does her part with an all-female surgery team. From left, the team members are: Courtney Adams, Kim Bulter, Kim Jones, Desiree Rivera, Mary Lashres, Dee Springfield (on the gurney), Mary Liviero, and Rosemary Panavelil. [Photo courtesy of AdventHealth]

By Justine Griffin for the Tampa Bay Times

The idea took hold a decade ago, inside Dr. Sharona Ross’ Tampa living room.

She, along with a handful of other physicians, invited women medical residents and students to talk about their interest in the field of surgery. Ross, a surgeon who specializes in gastrointestinal procedures at AdventHealth’s Digestive Health Institute, was stunned to hear what many of them had to say.

“Everything they’d heard about surgery was negative,” she recalled. “It was aggressive to train for, and there was no time for a family or a husband. The training was very male-oriented at the time. A lot of what they were saying was true, but I was still shocked.”

The experience pushed Ross to launch the Women in Surgery Symposium, a two-day conference for female physicians, medical students and undergraduate students who have an interest in pursuing a surgical career. Over the last decade, the annual gathering has attracted hundreds of medical professionals, making it the largest event anywhere for women in surgery. Some come from as far away as Japan, Australia, Mexico and Canada.

While it was founded in Tampa Bay in 2009, the symposium has traveled to other cities. But last weekend it returned home as the surgeons convened at the Sheraton Sand Key in Clearwater.

National data confirms the gaps that Ross found locally, and they point to a much larger problem. Fifty percent of medical students in 2018 were women, but only 9 percent of female medical students pursued a career in surgery, according to the Association of American Medical Colleges.

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Tampa Bay Times: A stem cell transplant with a twist. ‘They are connected in so many ways’

Nicki Kremer, right, poses with her mother, Madelyn Balitz, at Moffitt Cancer Center in Tampa when Kremer was in her 20s. Kremer was diagnosed with acute lymphoblastic leukemia when she was 24. But today, at age 38, she’s in remission, thanks to a stem cell donation from a stranger who lived in Kentucky. [Photo courtesy of Nicki Kremer]

By Justine Griffin for the Tampa Bay Times

It’s been years since they met, but Nicki Kremer and Richard Davis remember every detail.

Kremer, a college student at the time, and her family were waiting at Tampa International Airport for Davis to arrive from Kentucky. Her hair was still short from the chemotherapy.

They knew Davis went by a nickname, “Bubby.” Then he appeared, wearing cowboy boots and holding his daughter.

“Nicki and Bubby looked at each other for the first time, and they just knew,” recalls Madelyn Balitz, Kremer’s mother. “We stood there in the airport crying. They walked out hand-in-hand. They are connected in so many ways.”

It’s been 14 years since Kremer spent months inside the Moffitt Cancer Center in Tampa, unsure if she’d ever find a bone marrow donor who could save her life.

Now 38, she’s in remission, thanks to the stranger from Kentucky who donated stem cells for a transplant. And in just a few months “Bubby” will give her something else.

He’ll officiate at her wedding.

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Tampa General nurses record the last heartbeats of dying patients, making a family memory

By Justine Griffin for the Tampa Bay Times

TAMPA — As John Reisinger waited with family at Tampa General Hospital, grief settled in like a fog. So some of the details are hazy.

But he remembers the moment when three women in white lab coats approached him.

The day before, his niece, Jessica Raubenolt, had been struck and killed by a speeding car as she legally crossed Bayshore Boulevard with her 21-month-old daughter, Lillia.

A bystander had kept the girl’s heart beating. But now, in the neonatal intensive care unit, she was fading.

The women had some paperwork. They asked for permission to record Lillia’s heartbeat.

“Of course with the emotional state of the immediate family, I told them to go ahead and record it, that we’d have the paperwork signed in time,” Reisinger said.

That night, a team of nurses and staff from Tampa General captured audio from the dying child’s heart. They later added music and offered it to the family as a keepsake — part of the hospital’s Beats of Love program, which began last year, with a focus on critical patients.

Anthony Goodwin, a musician by trade who plays guitar for Tampa General patients, uses his audio engineering experience to save the heartbeats for families to listen to on their own.

“We wanted to help families cope with the unfathomable loss of a child,” said Dr. Maya Balakrishnan, a neonatologist at the hospital and an associate professor of pediatrics at the USF Morsani College of Medicine.

She described Goodwin’s role as “creating magic.”

Reisinger remembers Goodwin asking if the family would like the sound of Lillia’s last heartbeats set to music. They said yes, and requested Over the Rainbow.

“It was one of the first songs David and Jessica sang to Lillia when she was born,” he said of Lillia’s parents. “And it was one of the last things David was able to do before she died, is sing it to her again, and then she was taken away for organ donor surgery.”

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In Florida and everywhere, a big shift is underway. It’s changing the way we go to the doctor.

Jewell Hamilton, left, and Andre Curry attend the front desk at Florida Blue in Tampa, where consumers can get wellness checks in addition to buying insurance. [MARTHA ASENCIO RHINE | Times]

By Justine Griffin for the Tampa Bay Times 

The health care business in Florida and across the nation is the midst of monumental change as insurers, hospital chains and even retailers begin to venture outside their traditional roles.

Hospitals are getting into the insurance end of the business. Insurers, along with drug stores, are delivering front-line health care.

And consumers, confronted with blurring lines and a host of new options, may need a scorecard to keep up. The shifting ground continues to change where and how they go to the doctor.

BayCare, which operates 15 hospitals in Tampa Bay and the surrounding area, next month will become the second health system in the state to sell Medicare Advantage plans, the privately offered insurance policies through which many people receive their Medicare benefits.

Two other chains, Florida Hospital and Orlando Health, are providing HMO insurance plans to thousands of Disney employees this year, with hopes of expanding the model to include other employers.

Meanwhile insurance companies, from Florida Blue to UnitedHealth, are gobbling up physicians practices and creating large networks of doctors offices that offer clinical services under new company banners.

And retailers like CVS and Walgreens continue to push more toward the front lines of health care, offering online doctors’ visits and an expanding list of other medical services.

It all adds up to an industry in the middle of a shake out, executives and experts say, with players on all edges trying to stay relevant by expanding what they do.

“This is a trend that’s been emerging over the last five years,” said Peter Young, a hospital consultant. “It’s increasing each year as providers discover that they need to move up the food chain.”

Driving many of the changes is the Affordable Care Act, which helped usher in a shift in thinking about the cost of health care. Hospitals are penalized more often by insurance companies and the government when patients have more frequent stays. The focus now, Young said, is keeping patients out of the emergency room.

“What we’re seeing is that ER visits are flattening or declining all over America as health systems begin to focus on prevention,” he said. “They are redirecting non-emergent people to urgent care, and urgent care is perfect for that. That’s also why you see CVS and Walgreens getting into and expanding their clinic business.”

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Lyme disease is on the rise in Florida, but experts don’t know why

Lyme disease cases are up across the nation, but notably in states like California and Florida, where the disease has not been an issue in the past. The disease comes from bacteria carried by ticks like this one that get it by feeding on an infected animal. Inftected ticks can then transmit it to humans through bites. [Times files]

By Justine Griffin for the Tampa Bay Times 

When Jackie Dube found circular rashes with bullseye points on her stomach, she went to the hospital. Doctors told her she had an allergic reaction to flea bites.

A year later, she became seriously ill. Flu-like symptoms and chronic joint pain would continue on and off for years until she’d eventually be diagnosed with Lyme disease. More than a decade after her misdiagnosis, the 37-year-old Pinellas Park resident says she suffers “flair ups” from Lyme disease annually.

“In the beginning, doctors told me it was psychosomatic, that all of this was in my head,” Dube said. “After years of hearing that, but dealing with my eyes swollen shut, a dislocated jaw and shoulder, fistulas in my thighs, I was finally tested for Lyme and was positive.”

Dube is one of a growing number of Floridians who suffer from Lyme disease, part of a nationwide increase that has researchers stumped.

Historically concentrated in New England, the disease has mostly been a seasonal issue in warmer months when ticks are prevalent in wooded areas. But data collected by Quest Diagnostics, a national clinical laboratory, found increasing Lyme disease cases in all 50 states, with a significant rise in places like California and Florida. Until recently, those two large states have never been associated with high rates of the disease.

“As things get warmer, one would think that the ticks would migrate more north, to Canada, not necessarily to Florida,” said Dr. Harvey Kaufman, senior medical director at Quest. “We’re seeing a rise in cases in Canada and in Florida, but with Florida we’ve got to think of a reason other than climate change.”

While the number of diagnoses in Florida is comparatively small, the steep increase in cases has triggered some concern. Last year, according to Quest, 501 cases of Lyme disease were reported in the state — triple the number five years ago and a spike of 77 percent since 2015.

About 30,000 cases nationwide are documented each year by the Centers For Disease Control and Prevention, but the agency admits many go unreported.

In 2015, researchers from Johns Hopkins estimated that Lyme disease costs the U.S. health care system up to $1.3 billion a year.

“The CDC has some older data that shows that the blacklegged tick is spreading into more parts of the U.S., so that’s likely one explanation for the rise,” Kaufman said. “But Lyme disease has really taken off in the last several years. There is generally more awareness of Lyme disease in places like Florida where you see ticks year-round because there’s no winter freezing.”

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