Contents 2 Welcome 4. Virginia Cancer Institute Takes Part in Medical Revolution. Patient Financial Counselors Give Advice and Encouragement

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2 Dear Reader, The two of us found ourselves sitting in the doctor s lounge at Chippenham Hospital on a Sunday morning years ago. We d been friends since our student days at the Medical College of Virginia. So, it was easy to begin talking about our patients, our practices, our families and how we might find an optimal way to deliver the best care and to strike a sound work-home balance. We tossed around a lot of ideas. One seemed to make immediate and perfect sense we d work together. The concept took hold and led us to form what has become. Today, 30 years later, the practice has grown significantly. We ve expanded from four physicians to 16, and gone from three small offices to four large ones - plus a business center. Frankly, in 1981, we never foresaw the growth in demand for our services that we have experienced. We should hasten to add that we re thankful for what s been achieved. We are grateful to everyone who has made it possible referring physicians, our teammates and, most importantly, the patients who have come to us for help and have trusted us to provide them with the best care possible. To mark our anniversary, we ve published this magazine. In it, you ll meet our dedicated doctors and learn about our history and our current practice. You ll note immediately that much has changed at during three decades. Science, research and remarkable medical advances have provided outstanding treatments that would have seemed unimaginable when we launched this practice. As noted, we ve grown. Not only do doctors comprise our team, but so do highlyskilled nurse practitioners, nurses, technicians and administrative staff. In fact, as this magazine s content shows, it s no exaggeration to describe the past 30 years as the most revolutionary era in the history of cancer care. We re proud to have been a part of it. While change has been the chief hallmark during our careers, one constant has endured from the earliest days. We remain committed to doing all we can to give patients quality, compassionate care, tailored to their physical and emotional needs. No matter what happens in the future, please rest assured that this commitment always will be rock-steady. Warmest regards, James T. May III, M.D. Maurice C. Schwarz, M.D. 2

3 Contents 2 Welcome Takes Part in Medical Revolution 30th Anniversary Marks Years of Growth and Continued Service to Central Virginia Patient Financial Counselors Give Advice and Encouragement Engages in Cutting-Edge Research Meet the Physicians Earns Prestigious QOPI Certification is Chosen for Patient Education Effort Locations Ann C. Schoeneweis, ANP James L. Khatcheressian, M.D. and Joseph P. Evers, M.D. Pablo M. Gonzalez, M.D. Elke K. Friedman, M.D. James L. Khatcheressian, M.D. 3

4 Takes Part in Medical Revolution 30th Anniversary Marks Years of Growth and Continued Service to Central Virginia James T. May III, M.D., F.A.C.P During the past 30 years, healthcare professionals at Virginia Cancer Institute have participated in a medical revolution that now delivers the best cancer care in history. Scientific discoveries fueled this transformation, giving us new drugs, new technologies, new attitudes and remarkable patient outcomes. Even for those who took part in this era, the results seem incredible. For that matter, so does the huge increase in the demand for oncology services a byproduct of the amazing explosion in treatment options. I never thought we d grow in the way that we have during the past three decades. I figured that we d have six to eight doctors and felt that would be more than enough to handle the work, said Maurice C. Schwarz, M.D., who helped form the practice in In fact, the need for cancer care in the Richmond area has multiplied tremendously since the 1980s. Responding to community needs, today has 16 physicians, 6 nurse practitioners and dozens of nurses, technicians and support staff spread across five Central Virginia locations. THE PRACTICE BEGINS Of course, this expansion was far in the future when Schwarz and James T. May III, M.D. first set on the path that led to the practice s 4 creation. That happened on a Sunday in the early 1980s, when the two men met by chance in the doctors lounge at Chippenham Hospital. Classmates at the Medical College of Virginia, they quickly and easily began talking about patients, workloads and a desire to balance family and professional demands. Both of them were in two-man practices. May was with Mario Kuperminc, M.D.; Schwarz was with Frank Call, M.D. May and Schwarz discussed the idea of sharing night calls among the four men. Everyone agreed. The arrangement worked so well that, before long, all the doctors decided to join forces in a four-man practice. The new venture started small with a tiny staff and only three offices at Richmond Memorial Hospital, St. Mary s Hospital and the Johnston-Willis Hospital office building. At each site, everyone shared the workload, and coworkers and patients often became friends. People who were with the practice in those days describe the atmosphere as warm and like a family. We were a small organization. We knew each other. We knew about each other s lives personal and professional, says Kathy Swift, who joined the team in 1982, retired as an office manager, and Maurice C. Schwarz, M.D.

5 Scientific developments during the past 30 years have had a profound impact on how the medical profession views cancer. Priscilla Ambang, RN now works for as a transcriptionist. For Swift, coming to the practice was not an easy decision initially. She had worked at MCV s oncology department and was a cancer survivor. She was unsure how she d respond to working at a cancer practice. Yet, after reflection, she chose to give it a try. That proved to be a wise and fulfilling decision. I thought about it and realized this is where I was meant to be, Swift says. I was given the opportunity to talk to women who wanted to give up. I d tell them: You can t do that. I had cancer, and I survived, and so can you. Other employees shared Swift s commitment to helping patients, and that attitude still pervades today. Another major pharmaceutical event occurred in the 1990s with the introduction of Zofran, May says. In the 1980s and earlier, cancer treatments often produced severe nausea that could lead to hospitalization. Zofran combated the nausea, greatly enhancing patient comfort, improving the patients quality of life and streamlining their care. Like the new drugs, technological innovations also were welcome additions to oncology. Consider just one fairly simple medical device the implantable port. Chemotherapy may require intravenous (IV) drug infusions, and a port can play an important part in the process. A doctor places a port under a patient s skin. The device remains there until treatment ends. The port provides access to a vein through a catheter. This allows for quick, easy injections and increases patient comfort by eliminating repeated needle use for IVs. Advances like the port, have made chemotherapy much easier and quicker than it was in the 1970s. This has led to more outpatient service and far fewer hospitalizations. A MEDICAL REVOLUTION OCCURS At the start, nobody could have known that big changes lay immediately ahead in American cancer treatment. As May put it: In the 1980s and 1990s, a lot of factors came together, and cancer care changed tremendously. It was an exciting time to be in medicine. During the 1980s, three trends new drugs, new technology and new attitudes started reshaping oncology generally and specifically. Arguably, the biggest catalyst for change came from the creation of new drugs. In the 1980s and 1990s, decades of laboratory efforts began bearing fruit, producing pharmaceuticals so important and powerful that May calls them game changers. Some notable examples included Taxol for breast cancer, Rituxan for non- Hodgkins, lymphoma and Carboplatin for ovarian, head and neck, and lung cancers. These and other new pharmaceuticals were far more effective than their predecessors. They also could combat a greater variety of cancers. In addition, researchers found that some drugs, like Carboplatin, worked on several different cancers, greatly expanding care choices. These breakthroughs had a dramatic impact. Doctors could treat many previously untreatable conditions, and patient outcomes improved steadily. Georgie Fielden, BSN, RN, OCN Almost as important as pharmaceutical and technological advances has been a huge shift in public perceptions of cancer in the past 30 years. In the early 1980s, people were afraid of cancer and afraid of treatment. People would not discuss it, and they tended to ignore diseases and symptoms until a change in their condition prompted them to see a doctor. However, public education and information have increased awareness. People are more willing to talk about cancer and to seek treatment, says Georgie Fielden, RN, BSN, OCN, who came to in

6 Molly Wake, Medical Assistant Also affecting public perceptions was the 1980s health and fitness movement, and the willingness of well-known figures to discuss their cancer experiences. These people included President Ronald Reagan (skin, colon and prostate cancer), and first ladies Nancy Reagan (breast cancer) and Betty Ford (breast cancer.) Over time, a greater openness about cancer also has led to another trend patients becoming much more engaged in their care. Far more so than in the past, many people now take time to learn about their condition. Plus, the Internet has made available a wealth of information from a host of reliable sources, including the Mayo Clinic, the National Cancer Institute and the Centers for Disease Control and Prevention. However, the introduction of the Internet can also be viewed as both a blessing and a curse. Yes, more and more patients have become better and more easily informed as they are directed to the right sources. Unfortunately, it also can become detrimental to their care, as outdated and inaccurate information can be found. Overall, patient engagement is a trend that professionally supports wholeheartedly. In fact, we make all efforts to guide our patients to the most reliable sources available. We have placed considerable thought into our own website design and the resources that we have included to that end. Our goal is to provide our patients with sound and reliable information so they can make educated decisions when it comes to their care. We re trying to get patients more involved in their care. We want them to be informed, to understand and to give us more feedback, which allows us to do a better job helping them, said Mindy Boyd, RN, OCN, who began working with Dr. May in For, the net effect of new drugs, new technologies and new attitudes has been growth. The reasons are clear and logical. More people 6 Mindy Boyd, RN, OCN are seeking care than ever before, and patients are enjoying longer and more comfortable lives. WHAT WILL THE FUTURE BRING? Clearly, change is the one word that best describes the last three decades at. It probably will fit the next 30 years as well. So, it s natural to ask: What lies ahead? Drs. May and Schwarz see several major trends affecting the practice in the years ahead. These include: Continuing advances in drugs and technology. Odds are good that these will enhance care, allowing doctors to deal with more types of cancer more effectively than ever before. Genetic treatments appear particularly promising. In fact, the possibilities sound like something from science fiction. It is possible that genetics may prove to be a game changer of a whole new order. A greater understanding of the relationship between genetics and cancer could provide better insights into disease growth and patterns. Look far enough into the future, and genetic knowledge conceivably might allow doctors to deal with cancers before they start to grow. Personalized medicine by increasingly tailoring care to each patient s unique needs. If medical progress keeps accelerating as it is today, physicians soon may reach a place where care will be highly focused on precisely what each individual needs. Many of the new drugs are targeted therapies, meaning they are tailored not only to people with specific cancers but to specific genetic markers in their cancer cells. Testing of the pathology is much more specific regarding

7 Pamela Moore, Medical Office Specialist the markers to determine what has the best chance to be successful for the individual patient. Treating cancer as a chronic disease. Scientific developments during the past 30 years have had a profound impact on how the medical profession views cancer. Before the 1980s, treatments were limited. The means simply did not exist to deal with many cancers. This has changed and probably will continue to do so. If medical advances continue as they have in recent years, then cancer may come to be seen as a serious disease but one that can be treated as a chronic condition, much as diabetes and heart disease are today. Focusing on patient quality of life. Palliative care has become an important aspect of oncology. In the future, this will continue, and patients will find that their treatment touches not only on physical needs but emotional, spiritual and social ones as well. Paying for healthcare. Healthcare expenditures in the United States continue to grow and often outpace any increase received in wages or cost-of-living adjustments. The increase in technology comes at a significant cost. Changing demographics, longer life expectancies and a higher population of older adults also have affected the way healthcare is being delivered. Nobody knows how these factors will continue to affect the cost, methods and efficacy of medical care. Everybody is certain, however, that healthcare coverage will continue to evolve, and will continue to adapt as it does. THE PAST IS PROLOGUE While the future can never be known fully, Virginia Cancer Institute s past accomplishments are crystal clear. Schwarz, for example, takes great pride in the quality of the team the practice has assembled. He describes his co-workers as superb professionals who are intensely dedicated and hardworking people. Fielden is most pleased with how much the practice has achieved for others. Here s the truth. We do a lot of good, she says. The treatment results are so much better than when we started. Good things have happened. Swift sees the situation much like Fielden: It s been a privilege to be part of this practice and have a chance to help other people. While the past has been satisfying and the future remains unclear, people are confident that will remain true to the programs and values that have served it well in the past. For example, research will continue through its participation in clinical trials. We committed at the start that we d have a research program, even if it was a small one, Schwarz says. We believed and still believe that it s good for the patients. Plus, we gain knowledge about new drugs, becoming familiar with their benefits and understanding how and when they are used. One aspect of the practice that will remain rock-steady in the future is its commitment to do the very best possible for the people entrusted to its care. The patients will be here, and we ll be here to help them, Schwarz says. We ll operate with the same philosophy we ve always had. We ll remain committed to delivering quality care and doing all we can to advance the causes of sound science and good medicine. Mary Colucci, Medical Office Specialist 7

8 Sherida Kemp, Patient Financial Counselor Patient Financial Counselors Give Advice and Encouragement Experts Serve As Patients Advocates in Dealing With Insurance, Payments, Paperwork Sherida Kemp, a Patient Financial Counselor, greets every patient she meets at with a cheerful, open attitude and a heartfelt desire to help. I try to think everyday how would I want to be treated? How would I want my mother to be treated? she says. Kemp is one of five Patient Financial Counselors at the Richmondbased medical practice. Her colleagues include Katie Buckingham, Wendy Fuerstenburg, Ramona Fulwider and Jane Simpson. All assist patients with insurance issues related to their treatments. This aid can include getting approvals from insurance carriers for treatments and finding assistance for out-of-pocket expenses, like co-payments and co-insurance. This novel service reflects the complexity of health coverage, which can overwhelm patients in a tidal wave of paperwork, procedures and confusing legal language. Combined, these can cause frustration and needless anxiety at a time when patients and families are dealing with major medical issues. 8 This is an important service, and it s all part of how we view our relationships with our patients. We help people understand how their insurance works and give them peace of mind, Kemp says. All of the counselors are advocates for the people who come to Virginia Cancer Institute. And I find the work very rewarding. Not only are insurance and related legal issues complicated, but cancer care can be expensive, making expert advice in these areas even more important to many patients. For example, many of the newest treatment costs run from $50,000 to $100,000 for a course of therapy. Patients often find themselves responsible for co-insurance payments of 20 to 30 percent. For some, this can be a crushing burden, and it has become a national problem. Statistics recently reported in The American Journal of Medicine show that 62.1 percent of all bankruptcies are tied to medical care for all types of diseases and conditions. While all economic classes are affected, the most hard-hit is the middle class.

9 Traditionally, medical practices have assumed that patients are responsible for understanding their coverage and managing their insurance company relationships. However, given modern realities, physicians at believe that counselors like Kemp are an integral and necessary part of comprehensive and compassionate care. Kemp and her associates perform too many tasks to list them all here. Yet, a short sample gives a good idea of the broad scope of their work. For example, Patient Financial Counselors aid with paperwork; get coverage approval; research questions; explain rules, regulations and insurance procedures; and seek assistance from foundations that aid patients. The latter can be a godsend for cash-strapped individuals, and counselors are proud of the fact that they were able to get patients almost $1.12 million in assistance during Regardless of the specific work they do, Patient Financial Counselors focus on the same goal, Ramona Fulwider says. Our main purpose always is to get the best possible treatment for the patient at the lowest cost to the patient, she says. Being a Patient Financial Counselor requires a stunning and diverse amount of knowledge about a host of arcane subjects. Counselors must understand insurance fundamentals, personal finance, cancer, treatment options, foundation support for patients and the drug Ramona Fulwider, Patient Financial Counselor approval process. They also must know procedures and policies at a wide range of insurance companies, none of which do business exactly the same way. Plus, counselors must apply their knowledge to each patient s unique situation. Sometimes, they feel like detectives trying to solve a mystery. Things are always changing with insurance. There s always something new, and you ve got to stay on your toes. I love the puzzle part of my job, and I love putting all the parts of the puzzle together, says Fulwider, who joined in Perhaps the best part of solving these puzzles is the positive impact it has on patients. Recently, for example, Fulwider assisted a 66-year -old widow with multiple myeloma, a cancer of plasma cells in bone marrow. This patient was retired and living on a fixed income. Under her insurance, she needed to pay 20 percent of the cost for some expensive injections, but she didn t have the money. Fulwider used her contacts and considerable persuasive skills to find the funds at a foundation, ensuring that the patient did not bear this cost for the needed treatment. As Fulwider s story suggests, Patient Financial Counselors also need a human touch, an ability to empathize with people and a willingness to make the extra effort to solve problems. Patients meet the counselors early in their treatments. It is a time when people are vulnerable, anxious, filled with questions, often scared and in need of a friendly face and a reassuring manner. And this is exactly what Kemp, Fulwider and the other counselors provide. Fulwider especially feels connected to patients based on personal experience. My father was a cancer patient, she says. I ve lived with having someone I was close to being very sick. Her dedication also has led her to work closely with the Legal Information Network for Cancer (LINC), a nonprofit, communitybased organization in Central Virginia dedicated to helping people with the business side of cancer. In fact, she was named the group s 2012 Volunteer of the Year. Not surprisingly, the counselors form close bonds with the people they assist. In doing so, they often feel humbled in the presence of people who show great courage, serenity and dignity in challenging circumstances. With such work comes unique satisfaction. We have lots of contact with patients and their families. And I love this, Fulwider says. People are glad to see you. They remember your name. They say thank you, and that s your reward and what makes this job so special. Katie Buckingham, Patient Financial Counselor 9

10 Engages in Cutting-Edge Research Ongoing Clinical Trials Advance Treatment And Provide New Approaches To Patient Care Dozens of patients volunteer every year to participate in clinical trials of new drugs. These tests contribute to improved anti-cancer treatments, better care and improved patient outcomes. Conducting clinical trials is a wellestablished tradition at Virginia Cancer Institute. Since the Richmond, Va, practice was established in 1982, its doctors have committed time, effort, resources and talent to these tests because of a firm belief that this research is of vital importance to improving cancer care. Clinical trials increase scientific knowledge while giving patients access to the results of the latest medical research and treatment breakthroughs. In addition to contributing to breakthrough medicines, gets involved in tests to provide treatment options to patients well before they may become available for widespread use. Patrice Foster and Peggy Lawson, Oncology Pharmacists 10 James L. Khatcheressian, M.D., far right, and s Research Department Because so much good can come from these efforts, participation in clinical trials is a source of deep satisfaction for everyone involved with them at the practice, including patients, clinicians and administrative staff. is proud of the work accomplished here and grateful to the thousands of patients who have been our partners in clinical trials during the past three decades. As a medical practice, we believe that research is an important service to our patients, our community and our profession. We are pleased, too, that our past efforts have contributed to the refinement of drugs now making significant contributions to cancer treatment around the globe, says James L. Khatcheressian, M.D., Medical Director of Research at. Clinical trials at and everywhere else in the country conform to exacting criteria set by the U.S. Food and Drug Administration. Testing requirements are designed to ensure that sound scientific standards are met and that patients health, safety and rights are safeguarded. All drug testing on human subjects follows a four-step process: Phase I involves a small group of people and focuses on safety, dosage and side effects.

11 Clinical trials increase scientific knowledge while giving patients access to the results of the latest medical research and treatment breakthroughs. Phase II includes a larger group, 100 to 300 participants, and concentrates on drug effectiveness and safety. Phase III encompasses even more people, 1,000 to 3,000, and focuses on effectiveness, safety and comparing outcomes against existing treatments. Phase IV occurs after drugs go on the market and seeks added information on a drug s risks, benefits and optimal use. conducts only Phase II and Phase III trials. Before any testing can begin, the most important step in the process must occur the selection of participants, says Susan Moore, MSN, CNS, AOCN. To appreciate why this initial step is vital, it s important to understand that, contrary to common perceptions, cancer is not one disease. In fact, the term covers a number of diseases. These ailments do share a common characteristic the development of abnormal cells, dividing uncontrollably and destroying normal body tissue. However, beyond this similarity, each cancer is unique and, therefore, requires specific treatment. Because of this, a clinical trial will test a drug s effect on one type of cancer. This means that a trial participant must have the specific disease a drug is meant to combat. Once patients are identified as possible trial candidates, a representative reviews with them the study s purpose and methods as well as their rights and roles in the study. All participants are adult volunteers. Drugs for the tests are provided by major manufacturers, like Bristol-Myers Squibb, Genetech, Pfizer and Roche. These anticancer treatments are administered orally, intravenously and by injection. In addition, during a study, a great deal of data is generated, and personnel must focus on collecting and recording accurate information. This data plays a crucial role in gaining FDA approval, refining drugs and helping companies to decide whether or not to put them into production. While data is a key aspect of testing, far more important is how drugs affect patients. Accordingly, Virginia Cancer Institute physicians watch closely how patients react to medication during a trial. This monitoring continues through the trial and often extends for years after the study is completed. Given the substantial commitment trials require, an obvious question arises why does take part in them? Clearly, a major reason is the invaluable role trials play in advancing medical knowledge. Major gains in cancer care have occurred because of testing done in the past. If progress is to continue, then similar research must be done today. Interestingly enough, Virginia Cancer Institute s past efforts contributed to the development of several significant drugs now in use. These include: Alimta, for lung cancer; Avastin, for colorectal cancer; Faslodex, for advanced breast cancer; and Oxaliplatin, for colorectal cancer. In addition to contributing to breakthrough medicines, gets involved in tests to provide treatment options to patients well before they may become available for widespread use. Through these trials, we have access to novel approaches to treating cancers. Many of these agents are cutting edge, and that offers us the opportunity to do the very best we can for our patients, said Dr. Khatcheressian. S. McDonald Wade III, M.D. Patients, of course, are well aware of the potential personal benefits of being in a clinical trial. However, as Moore notes, this is not the only reason that people do so. Frequently, they are motived by a deep sense of generosity. Many patients want to be part of a study because they want to contribute to advancing our understanding of a disease, Moore says. A lot of people also want to do all they can to enhance the treatment of others who have or will have the same cancer that they do. 11

12 Physicians James T. May III, M.D., FACP 1401 Johnston Willis Drive, Suite 100; Richmond, (804) St. Francis Blvd., Suite 1200, Midlothian, (804) Dr. May is board-certified in internal medicine and medical oncology. He received his medical degree from the Medical College of Virginia (MCV) in Richmond. He completed an internship and a residency at MCV and a fellowship at the University of Texas in Galveston. Maurice C. Schwarz, M.D Right Flank Road, Suite 600, Mechanicsville (804) Dr. Schwarz is board-certified in medical oncology and internal medicine. He received his medical degree from the Medical College of Virginia in Richmond. He completed an internship and residency at the Medical College of Georgia in Augusta, and a fellowship at Emory University in Atlanta. M. Kelly Hagan, M.D., FACP 7501 Right Flank Road, Suite 600, Mechanicsville (804) Dr. Hagan is board-certified in internal medicine, medical oncology and hematology. She received her medical degree from Eastern Virginia Medical School in Norfolk. She completed residency training at the Medical College of Pennsylvania, Allegheny Campus in Pittsburgh and a fellowship at Emory University in Atlanta. Joseph P. Evers, M.D W. Broad St., Suite A, Henrico (804) Dr. Evers is board-certified in medical oncology. He received his medical degree from Georgetown University in Washington, D.C. He completed residency training at Emory University in Atlanta and a fellowship at Georgetown University. 12

13 Lawrence M. Lewkow, M.D Johnston Willis Drive, Suite 100; Richmond, (804) St. Francis Blvd., Suite 1200, Midlothian, (804) Dr. Lewkow received his medical degree from New York Medical College in Valhalla. He completed an internship, a residency and a fellowship at Wayne State University in Detroit. David F. Trent, M.D., Ph.D W. Broad St., Suite A, Henrico (804) Dr. Trent is board-certified in internal medicine. He received his medical degree and a doctorate in physiology from the Medical College of Virginia in Richmond. He also completed an internship, residency training and a fellowship at MCV. Pablo M. Gonzalez, M.D Johnston Willis Drive, Suite 100; Richmond, (804) St. Francis Blvd., Suite 1200, Midlothian, (804) Dr. Gonzalez is board-certified in hematology and medical oncology. He received his medical degree from the University of Cordoba in Argentina. He completed a residency at Georgetown University in Washington, D.C., and a fellowship at the University of North Carolina in Chapel Hill. R. Brian Mitchell, M.D W. Broad St., Suite A, Henrico (804) Dr. Mitchell is board-certified in internal medicine, medical oncology and hematology. He received his medical degree from Duke University in Durham, N.C. He completed an internship and a residency at Johns Hopkins Hospital in Baltimore and a fellowship at the University of Chicago. 13

14 Attique Samdani, M.D Johnston Willis Drive, Suite 100; Richmond, (804) St. Francis Blvd., Suite 1200, Midlothian, (804) Dr. Samdani is board-certified in medical oncology, ECFMG and FLEX. He received his medical degree from Khyber Medical College at the University of Peshawar, Pakistan. He completed a residency at the University of Arizona in Tucson and a fellowship at the University of Virginia in Charlottesville. Sharon A. Goble, M.D Johnston Willis Drive, Suite 100, Richmond, (804) St. Francis Blvd., Suite 1200, Midlothian, (804) Dr. Goble is board-certified in medical oncology. She received her medical degree from the Medical College of Virginia in Richmond. She completed a residency and a fellowship at MCV. Elke K. Friedman, M.D W. Broad St., Suite A, Henrico (804) Dr. Friedman is board-certified in internal medicine, medical oncology and hematology. She received her medical degree from the Medical College of Wisconsin in Milwaukee. She also completed a residency and a fellowship at the Medical College of Virginia in Richmond. Gisa Schunn, M.D Johnston Willis Dr., Suite 100, Richmond, Phone (804) St. Francis Blvd, Suite 1200, Midlothian, Phone (804) Dr. Schun is board-certified in medical oncology and internal medicine. She received her medical degree from Ludwig-Maximilians University in Munich, Germany. She also holds a nursing degree from the College of Nursing in Munich. She completed an internship at Boston VA Medical Center, a residency at the University of Pennsylvania in Philadelphia and a fellowship at West Virginia University in Morgantown. 14

15 S. McDonald Wade III, M.D Right Flank Road, Suite 600, Mechanicsville (804) Dr. Wade is board-certified in internal medicine and medical oncology. He received a medical degree from the Medical College of Virginia in Richmond. He completed a residency and a fellowship at MCV. James L. Khatcheressian, M.D W. Broad St., Suite A, Henrico (804) Dr. Khatcheressian is board-certified in medical oncology. He received both his medical degree and a master s degree in health administration from the Medical College of Virginia in Richmond. He completed an internship, a residency and a fellowship at MCV. Joshua J. McFarlane, M.D W. Broad St., Suite A, Henrico (804) Dr. McFarlane is board-certified in internal medicine, medical oncology and hematology. He received his medical degree from the University of Texas in Dallas. He completed an internship and a residency at the Medical College of Virginia in Richmond and a fellowship at the University of Tennessee in Memphis. Will R. Voelzke, M.D Johnston Willis Dr., Suite 100, Richmond, Phone (804) St. Francis Blvd, Suite 1200, Midlothian, Phone (804) Dr. Voelzke is board-certified in hematology, internal medical and medical oncology. He received his medical degree from Baylor College of Medicine in Houston. He completed an internship, a residency and a fellowship at Wake Forest University in Winston-Salem, N.C. 15

16 Earns Prestigious QOPI Certification Richmond Medical Group Recognized for Meeting Highest U.S. Cancer Care Standard has been recognized as meeting the highest standards for cancer care under the Quality Oncology Practice Initiative (QOPI ) Certification Program. The Richmond-based practice is the first in Central Virginia to earn this designation. Only 155 practices nationwide hold this certification. For 30 years, has aimed at delivering the best possible care to patients. Receiving recognition under QOPI shows our commitment to medical excellence, continuous improvement and the pursuit of rigorous professional standards. The certification process has helped us to enhance our treatment of and interactions with patients, says Kelly Hagan, M.D., with Virginia Cancer Institute. The American Society of Clinical Oncology (ASCO) developed the QOPI certification. The program began in January 2010 and is the first of its kind for outpatient oncology in the United States. Receiving certification means that an organization has obtained high scores on quality measures and met exacting safety measures. Based in Alexandria, Va., ASCO is the world s leading professional organization representing physicians caring for cancer patients. With more than 30,000 members, ASCO is committed to improving cancer care through scientific meetings, educational programs and peer-reviewed journals. Cancer patients and their families should expect nothing less than accountability and the highest standards from their cancer care providers, says Allen S. Lichter, M.D., CEO of ASCO and president of the QOPI (R) Certification Program. QOPI participation reflects a commitment to quality of care that leads to fundamental changes in the clinical practice of oncology. Oncology practices that commit to quality and safety are those that provide the most optimal cancer care. The certification program helps practices determine whether they are providing the best treatment and care possible to their patients, and demonstrates a commitment to excellence and ongoing quality improvement in the hematology-oncology outpatient practice. Gisa Schunn, M.D Pablo M. Gonzalez, M.D. and Will R. Voelzke, M.D. decided to pursue certification in spring It emphasizes treatment planning, staff training and education, chemotherapy orders and drug preparation, patient consent and education, safe chemotherapy administration, and monitoring and assessment of patient well-being. The review process included data and documentation collection and review, completion of a detailed questionnaire, medical records review and on-site evaluation conducted by oncology nurses with advanced degrees. At the Richmond practice, inspectors conducted interviews, reviewed policies and certifications, and observed chemotherapy preparation and treatment. An on-site visit occurred in November; the practice received certification in December. Our staff has demonstrated an outstanding commitment to quality care and the QOPI program. In fact, the site auditor described our practice as the best-prepared practice she d reviewed, and she would come here as a patient if she needed treatment, Hagan says. According to Hagan, QOPI certification represents the pinnacle of achievement for hematology-oncology practices. She expects to see a significant increase in the number of practices involved with this project. has been engaged actively and deeply in the development of this certification. The practice was one of seven involved in developing QOPI prior to its launch in The program began as a voluntary self-assessment and quality improvement initiative. Subsequently, this effort evolved into a certification program, developed and enhanced through participant feedback and advances in cancer care standards. Virginia Cancer Institute s initial involvement was due to the efforts to the late Chris Desch, M.D., formerly a partner at the practice. Chris Desch believed passionately in doing everything possible to raise medical standards and to improve patient care, Hagan says. His commitment to excellence is reflected in s involvement in and support of the QOPI Certification Program. We are proud of Chris, his work, his leadership and his legacy in this area.

17 is Chosen for Patient Education Effort Richmond Medical Group is Pilot Partner for NCCS Cancer Survival Toolbox Rollout is participating in a pilot program for distribution of the award-winning Cancer Survival Toolbox. The Toolbox is a National Coalition for Cancer Survivorship (NCCS) initiative designed to help patients and their families deal effectively with every stage of the disease. Richmond-based is the only medical practice in the United States engaged in this phase of the project. Lessons learned here will shape the Toolbox s national launch. As part of the pilot program, is providing the Toolbox free of charge to its patients. This comprehensive kit consists of a resource booklet and 10 CDs. The CDs cover many issues, ranging from communicating with doctors to paying for treatment and caring for caregivers. Commentary is provided by cancer survivors, their families, doctors, nurses, social workers and other healthcare professionals. Advice is practical, based on actual experiences and can be used on a daily basis. Material is arranged so users can focus quickly on and learn about specific issues that interest them most. The kit also contains a resource booklet that serves as a guide to the CDs and provides a glossary, contact information for cancer associations and information on treatment, insurance and survivorship tools. is committed to delivering effective and compassionate care to our patients. We believe strongly in the importance of patient-physician collaboration and patient education. Distributing the Cancer Survival Toolbox is the perfect way to promote both these ideas. Naturally, when the National Coalition for Cancer Survivorship approached us with this opportunity, our entire staff readily agreed, says Dr. Joseph Evers with. Based in Silver Spring, M.D.., NCCS advocates for quality care for all people touched by cancer and provides tools that empower people to advocate for themselves. Founded by and for cancer survivors, NCCS created the widely accepted definition of survivorship, which defines someone as a cancer survivor from the time of diagnosis and for the balance of life. The Coalition believes in evidence-based advocacy that reflects the needs of all cancer survivors to effect policy change at the national level. In June 2011, NCCS asked to take part in the pilot distribution project. Subsequently, a NCCS trainer visited the practice and briefed the staff on the Toolbox contents and how to help patients use it most effectively. Staff members listened to scenarios on the CD. They also completed homework assignments, which familiarized them with the kit and its contents. We re not just handing people the Toolbox and telling them to read its instructions. In fact, our staff is explaining how each patient can tailor the kit s contents to his or her unique needs, Evers says. began offering the kits in November Initial patient reactions have been extremely positive. NCCS periodically meets with the practice s staff to see how the program is progressing. The coalition will survey staff and patients during 2012, seeking ways to improve the Toolbox and its distribution. Although is giving the kit only to its patients, Evers encourages anyone with cancer or their caregivers to access the Toolkit at the NCCS website org/toolbox. Online visitors may either listen to the same information available on the CDs or read a transcript of the recordings. They also can order the entire CD set. The Toolbox distribution pilot program is a collaborative effort of NCCS and the Empowerment and Action for Cancer Care alliance between Genentech and Wellpoint Inc. The goal of this signature NCCS program is to encourage people with cancer and their caregivers to take an active role in their treatment and care. Elke Friedman, M.D. 17

18 Choose Because We Offer. 30 Years of Dedicated Service to the Richmond Community. 16 oncologists specialized in all types of cancer working in collaboration with one another to provide each patient individualized, specialized care. A combined expertise exceeding 250 years. State-of-the-art infusion centers at four locations. CT Department centrally located in our West End office. Two dedicated oncology pharmacists. Six Nurse Practitioners and 26 Registered Oncology Certified Nurses. On-site labs at four locations. Six convenient locations each accessible to major highways and offering convenient parking. 18

19 West End Reynolds Crossing 6605 West Broad, Suite A, Richmond, VA Phone (804) Bell Creek Square Medical Office Park 7501 Right Flank Road, Suite 600, Mechanicsville, VA Phone (804) The Thomas Johns Cancer Hospital 1401 Johnston Willis Drive, Suite 100, Richmond, VA Phone (804) St. Francis St. Francis Boulevard, Suite 12000, Midlothian, VA Phone (804) Quality Care Delivered With Compassion

20 Celebrating 30 years of leading edge cancer treatment, delivered with care. WEST END Parham Doctors Hospital Phone (804) Reynolds Crossing Phone (804) Joseph P. Evers, M.D. Elke K. Friedman, M.D. James L. Khatcheressian, M.D. Joshua J. McFarlane, M.D. R. Brian Mitchell, M.D. David F. Trent, Ph.D., M.D. MECHANICSVILLE Bell Creek Square Medical Office Park Phone (804) M. Kelly Hagan, M.D., F.A.C.P. Maurice C. Schwarz, M.D. S. McDonald Wade, III, M.D. RICHMOND Retreat Hospital Phone (804) Joshua J. McFarlane, M.D. R. Brian Mitchell, M.D. SOUTHSIDE The Thomas Johns Cancer Hospital Phone (804) St. Francis Phone (804) Sharon A. Goble, M.D. Pablo M. Gonzalez, M.D. Lawrence M. Lewkow, M.D. James T. May, III, M.D., F.A.C.P. Attique Samdani, M.D. Gisa Schunn, M.D. Will R. Voelzke, M.D.