Archives for November 2016

Focused Ultrasound for Essential Tremor – VIDEO

Non-invasive. Incision-free. The promise is there for focused ultrasound, and UVA is at the forefront in using this technology for treating patients with neurological disorders. Please watch the video below for more information on this groundbreaking work.


Call for Nominations: UPG Board of Directors Affiliated Committees

There are several current opportunities for faculty to become involved in the proceedings of the UPG Board of Directors: One opportunity to serve as a full Board Member, multiple openings on Board-Affiliated Committees, and several opportunities to participate in the meetings as a Board Associate.

The following is a summary of available appointments and pertinent information regarding vacancies. We welcome and encourage nominations for all of these vacancies: Your input is an asset to UPG and the UVA Health System. In the spirit of collaboration, we encourage faculty and the Board to work together toward our shared goals.

Please send nominations to Melanie Evans ( by Tuesday, November 29, 2016. Voting will take place in early December via Survey Monkey.

Board Membership Opportunity

Faculty Director

  • Member of School of Medicine Clinical Faculty to serve on the UPG Board of Directors
  • UPG Board Composition: 10-12 Public Members; six (6) Ex-Officio Members; three (3) Faculty Directors; and two (2) University Representatives
  • Faculty Director serves a three (3) year term; eligible to serve a total of three (3) terms
  • The seat is currently held by Dr. Phillips; his term expires at the end of 2016
  • Appointment is effective January 1, 2017
  • Position to be elected by majority vote of Clinical Staff
  • Bylaws stipulate that no two Faculty Directors should be members of the same department
    • Other two current faculty directors: Radiology and Head + Neck Surgery

Board-Affiliated Committee Opportunities

Audit Committee

  • Committee charge:  Assist UPG Board of Directors in fulfilling oversight responsibilities of UPG internal control systems
    • Review financial information and practices; take responsibility for audit process
  • Five vacancies: Two (2) Medical Departments; Two (2) Surgical Departments; 1 Ancillary Department
  • Term:  Three (3) year term; eligible to serve a total of three (3) terms

Finance Committee

  • Committee charge:  Assist UPG Board of Directors in fulfilling oversight responsibilities of UPG financial operations and related risk
    • Assume responsibility for investing, budgeting and financial reporting
  • One (1) Vacancy
  • Term:  Four (4) year term; eligible to serve a total of three (3) terms

Investment Subcommittee:

  • Committee charge:  Assist Finance Committee in fulfilling its oversight responsibilities
    • Oversee UPG financial operations
    • Assume responsibility for investing and financing activities
  • One (1) Vacancy
  • Term:  Four (4) year term; eligible to serve a total of three (3) terms

Board Associate Opportunity

UPG Board of Directors Faculty Participant

  • While not formal members of the Board, this is an opportunity to expose junior faculty to the business of medicine
  • UPG solicits nominations of Clinical Faculty for three (3) individuals to participate in UPG board meetings and events for one (1) year terms
  • Participants to date: Dr. Brad Kesser,  Dr. Jaideep Kapur, Dr. Quanjuan Cui, Dr. John Jane Jr., Dr. James Browne, and Dr. Jared Christophel


Lean Successes: Zion Crossroads

When the Zion Crossroads Multi-Specialty Clinic opened in August 2013, it represented a new business model of outreach care for the UVA Health System. Housing 22 primary and secondary specialties, a pharmacy and imaging under one roof, the practice was intended to be a “one-stop-shop” of multi-disciplinary UVA health care for the community.

A little over three years later, after what Zion Crossroads Director of Clinical Operations Renee Viette refers to as “a few stumbles along the way”, the practice is thriving and growing, and leads by example when it comes to the high-quality, value-added lean success model. “We think of it as an intersection between the Be Safe initiative in patient care, and administrative process improvement,” says Viette.

According to Supervisor of Practice Teshema Anderson, one of the earliest hurdles they needed to surmount at the new practice was streamlining the scheduling process. “The challenge was to meet the needs of all the physicians and all the patients across the multi-disciplinary practice, but the way the scheduling was originally set up was inefficient and complicated,” says Anderson. The resulting lean project was to redesign the scheduling templates and work closely with physicians to accommodate their calendars and configure the best method for patient access. The results have been successful: Scheduling and referral errors have been reduced to near zero, and the communication between physicians and staff has improved measurably. “Being able to quell the frustrations of our physicians and staff has been really rewarding,” reflects Anderson. “They have all the tools they need to succeed.”

Michelle Young, Assistant Nurse Manager for the clinic, readily admits that at first she questioned whether or not nursing had a place in the lean model. Until, she says, the matter of patient medical records reached a critical juncture. The volume of information on a patient’s history was often extensive and at least partially irrelevant to their current situation. However, determining which information was important and what was obsolete lay outside the area of expertise of the administrative staff who were generally tasked with managing patient records. The result? Often inclusion of extraneous information which takes time and resources to go through. “One day,” Young recalls, “I just looked at it and said, “This is a nursing issue. We have the background to determine what medical history is relevant for a patient’s present care.”

Once nurses took charge of patient medical records, under Young’s leadership, the amount of time taken by physicians to scan records looking for vital information was greatly reduced. “What this translates to is exponentially more face-to-face time between doctor and patient,” says Young. “This allows us to provide the best, most personalized care possible – and that’s our ultimate goal.”

Michelle Young, Renee Viette, Jeffrey Moore, Teshema Anderson



Viette is quick to point out that while the clinic’s lean successes are certainly worth celebrating, the thing she is perhaps most pleased with is their team member engagement. “When I learned that we had measured in the 92nd percentile of employee engagement, I was just floored. I’m so proud of our team,” she says. “The spirit of collaboration can be felt throughout the clinic, from nurses to administration to physicians and housekeeping staff.”

When asked what the future holds for the Zion Crossroads Clinic, Viette answers: “Growth. We have grown so fast, which is wonderful. We’ve maxed out our current operating space and are ready to expand.” She has proposed expanding hours, and the team is ready to make use of the 8000 square feet of reserved space at their facility. “We are clearly meeting a need here,” she remarks. “Both serving regional patients closer to home, and attracting new patients to the UVA Health System.”


ZCR Halloween 2016

Zion Crossroads Halloween Celebration

From the CEO’s Desk: Delay in Pension Plan Changes

Brad Haws

Brad Haws

UPG Executive Leadership is consistently trying to strike a balance between representing our individual employees, and managing our legal and fiscal responsibilities to the group and to the UVA Health System.

Recent discussion about the upcoming changes to the clinicians’ pension plan highlighted the delicacy of that balance, and as a result the UPG Board of Directors has resolved to temporarily delay the plan changes that were to become effective at the end of this calendar year.

The letter below from Jim Rutrough, Chairman of the UPG Board of Directors, and myself, outlines the landscape surrounding this complex matter. This letter was sent out to UPG Clinicians earlier this week.


Dear UPG Clinician,

In anticipation of a January 1, 2017 transition date for revised Clinicians Supplemental Retirement Plan (CSRP) pension benefits, multiple meetings were held to provide faculty members with the opportunity to discuss the upcoming changes. During these meetings, some faculty members indicated that they did not feel that their demographic was adequately represented during the CSRP review process.

We write this letter, and have taken the actions it describes, in response to those identified concerns.

The CSRP, which is the pension plan for full-time clinicians hired since August 1, 1985, has undergone an intensive review over the past two years. The primary reason for review was that the plan has reached a critical point where it is likely to fail federal testing requirements in the near future. Should this occur, all plan participants will immediately be taxed a lump sum amount on the current value of their CSRP benefit. We feel a keen responsibility to prevent this from happening. The secondary reason for review was financial. Over the last few years we have seen increasing spikes in the cost of maintaining the current plan. These spikes were caused by external market forces and changing actuarial tables leading to double digit increases each year in pension expense to the clinical departments. For these reasons we find it necessary, as so many medical centers across the U.S. have already done, to change to a defined contribution plan from a defined benefit plan.

In order to mitigate these risks, the UPG Board of Directors convened a CSRP Review Committee and hired an actuarial firm, AON Hewitt, to evaluate the viability of the CSRP and research alternative options. The Review Committee was comprised of a cross-section of representatives from faculty, the UPG Board, the Dean’s Office, UPG Legal Affairs and School of Medicine Administration. Their objective was to make recommendations that balance offering a competitive plan and the legal and financial constraints: an extraordinarily difficult process due to the many competing variables.

During the course of the Review Committee’s work, the Board received regular progress updates and carefully weighed multiple factors that would affect their decisions. The Board sought to protect the best interests of our clinicians while balancing their fiduciary responsibility.

After substantial actuarial analysis of data, multiple projections and consideration of legal consequences as advised by counsel, the Review Committee brought its recommendation to the UPG Board of Directors for their deliberation at the December 9, 2015 Board Meeting. The Board approved the recommended resolution, and resolved that the changes to the CSRP would become effective January 1, 2017.

Although substantial analysis had been completed by the Committee in arriving at their recommendation, it is important to address the issues raised most recently by members of our faculty before moving forward. With that in mind, UPG convened a Special Board Meeting on November 11, 2016, and passed a resolution to delay any changes to the CSRP to permit time for re-evaluation of potential scenarios.

In the spirit of collaboration with the dedicated, excellent physicians who enable UVA to achieve and maintain our shared goal of providing the highest standard of patient care, this pause in the decision-making process is important. We encourage you to continue to engage in the discussion as we work together through a mutually beneficial outcome.

Please don’t hesitate to reach out with further questions or concerns. Your feedback is most certainly valued, and we will keep you informed of our progress. Please check the website regularly for updates:

As always, thank you for being a part of the UPG community.



Brad Haws

Chief Executive Officer, UPG


Jim Rutrough

Chairman of the Board of Directors, UPG