In Celebration of Doctors’ Day

Genesis thanks more than 700 great physicians

DAVENPORT, IOWA - More than 700 physicians help make Genesis Health System the regional leader in health care. From cutting-edge treatments to compassionate care, they give us many reasons to celebrate national Doctors’ Day.

To honor these great physicians, the Genesis Physician Satisfaction Team asked staff to share letters about the physician excellence they see each and every day.

From the many letters received, the team then selected three physicians to highlight on Doctors’ Day.

These physicians – Dr. Richard Carruthers, Dr. Kenneth Naylor, and Dr. Robert Pimentel – will be the first of several to be featured throughout the year for exemplifying the Genesis “Never Settle” Spirit. Their contributions put them among the best of the best, and we congratulate them for their tireless pursuit of our mission to provide compassionate, quality health services to all those in need.

Richard Carruthers, D.O.

Dr. Richard Carruthers remembers when patients who had hip and knee replacements experienced such extreme pain after surgery that they needed a selfadministered morphine drip to cope.

The drug’s side effects weren’t pretty. “The patients would often remain painful, frequently have nausea and vomiting and generally feel miserable. It wasn’t fun to make rounds after surgery,” said Dr. Carruthers, an anesthesiologist with Anesthesia & Analgesia, P.C.

Lucky for his patients that a 2004 conference in Florida on post-operative pain management for total joint replacement patients sparked his interest to find a better way. It led to a cutting-edge pain management protocol at Genesis that marshals several medications together to attack postoperative pain. Pain management begins preemptively, before surgery, and continues post-operatively and after patients go home.

The result: Patients recover faster and more comfortably. Nurses care for happier patients who reclaim mobility sooner and experience fewer unpleasant side effects. Surgeons have told him they believe the long-term results are better because patients can tolerate rehabilitation earlier.

“It’s very cutting-edge technology,” Dr. Carruthers said. “When we started doing it here in January 2005, we were one of the earliest hospitals in the country to do so. Now multi-modal, preemptive pain management protocols are far more common and, in my judgment, will become a ‘standard of care’ in the future.”

The protocol treats all of the body’s five pain pathways, instead of just one. “We’re using multiple drugs to treat the various pain pathways,” he said. “What’s happening is we’re getting a very synergistic effect of the pain medications because we’re using pain meds that work at different sites.

“If you wait until the pain is unbearable, then you’re playing catch-up and you’re behind the pain curve. But if you treat all of the pain pathways preemptively – before surgery – and then medicate patients after surgery every eight hours whether they ask for it or not, it works very, very well. Today, these patients are not pain-free, but we’re light-years ahead of where we were in the past.”

Implementing the pain management protocol isn’t his only contribution, say the nurses on the Post-Anesthesia Care Unit at Genesis, West Central Park. He listens to patients. He’s a team-builder who devotes his own personal time to educate staff and physicians on pain management to increase patient satisfaction and decrease length of stay. “Dr. Carruthers’ bedside manner with our patients is wonderful,” they said.

“He explains their choices for pain control, and answers all questions until our patients are satisfied.” Chris Lynn, Manager of the Outpatient Care Center, says Dr. Carruthers works tirelessly to provide  patients the best possible operative experience they can have. “All of the staff love working with him because he provides a safe and secure environment for his patients and for all of us to work.”

He involved operating room, orthopaedic and outpatient department nurses to implement the pain protocol, and even tutored three nurses working to receive advanced certifications. “Dr. Carruthers values each member of the Genesis team, regardless of job title,” Lynn said.

Dr. Carruthers says it’s gratifying to visit happy patients after joint-replacement surgery. “I’ve personally administered anesthesia to approximately 300 total joint replacement patients who have been managed by this protocol over the past two-and-a-half years. Only very few of those patients have required any morphine at all. By and large, the (selfadministered) morphine pumps are virtually unheard of now for these patients. It’s very rewarding to see we’re making a difference.”

Kenneth Naylor, M.D.

On a medical mission trip to Tanzania, Dr. Kenneth Naylor helped deliver a set of premature twins. With no neonatal intensive care unit and only rudimentary technology, hospital staff did all that they could do.

They laid the babies side by side, with heated I.V. bottles to keep them warm.

“We expected to return after the weekend to find that the babies had died, “ said Dr. Naylor of Obstetrics and Gynecology Specialists, P.C. in Davenport. “Instead, we found the babies nursing and doing quite well. It’s amazing what the human body can do.”

Medical mission trips to Tanzania, Peru and Ecuador have taught him that there’s a universal commonality in health care. “Even though these Third World caregivers lack resources and technology, they are still very concerned about their patients,” he said. “They want to provide the very best care that they can.”

At home in the Quad Cities, that’s exactly what Dr. Naylor strives to achieve as he leads the physician charge for childbirth safety initiatives at the Genesis BirthCenter in Davenport. He’s the voluntary physician champion for an interdisciplinary perinatal safety committee of nurses, physicians and nurse-midwives that began a journey in May 2004 to create a culture of safety for the BirthCenter.

Nearly three years later, as new national standards emerge to improve childbirth outcomes, hospitals are calling on the Davenport BirthCenter for advice. New perinatal patient safety practices across the country are responding to increasing medical evidence that inducing labor too early and other labor and delivery practices can be unsafe for mothers and babies.

As a result, hospitals like Genesis are restricting elective labor inductions and C-sections before 39 weeks gestation; reducing dosages of the labor-inducing drug oxytocin; and educating doctors and nurses together on standardized fetal-monitoring language. The Genesis team is guided by standardization of care processes based on scientific studies, best practices and recommendations from national physician and nurse organizations and the Institute for Healthcare Improvement.

Creating a culture change at Genesis has been no small feat, involving more than 150 people, including nurses, obstetricians, nurse-midwives, pediatricians, neonatologists, anesthesiologists and family practice physicians. And it’s achieving that team support and physician buy-in that Dr. Naylor has worked so tirelessly to achieve through his participation in committees and interdisciplinary education, his supporters say.

“He has become an expert on perinatal and general patient safety and lectures regularly on those topics,” said Kristin MacDonald, RN, BSN, a clinical nurse educator who also serves on the committee.

“Dr. Naylor actively contributes to make change happen. Thanks to his vigilance for excellence, many of the leadingedge techniques are being done at Genesis,” said Rebekah McClimon, R.N. Not only does he listen to nurses’ concerns, but he thanks them for their viewpoint, she added.

“He is truly committed to patients receiving the most current evidence-based care in the safest manner possible,” said Carol Wolf, RNC, a BirthCenter staff nurse and a member of the perinatal safety committee.

As part of a Patient Safety Leadership Fellowship with the Health Research Education Trust, Dr. Naylor is working to determine if the perinatal safety efforts at Genesis have made a difference. “Although the data is preliminary, we’re seeing some improved clinical outcomes,” he said.

He’s proud that Genesis is ahead of the curve in providing safer care for mothers and babies. “It takes a real team effort, but everyone wins,” he said. “It’s hard to argue against patient safety and better outcomes.”

Robert Pimentel, M.D.

For many Hispanic women in the Quad Cities, the rigors of being in labor can be frightening when they don’t speak the language of their health care providers.

Their fears and worries subside when Dr. Robert Pimentel enters their Illini Campus BirthCenter room speaking fluent Spanish. The bilingual native of the Dominican Republic has calmed countless Hispanic women in labor who only speak Spanish.

“His communication with these patients makes their labor so much easier,” said Maggie Dubin, Nurse Manager of the Illini Campus BirthCenter. “Even though our nurses know small phrases of Spanish, the women receive so much comfort and reassurance from being able to fully communicate with Dr. Pimentel.”

When he came to the Quad Cities nine years ago, there were no Hispanic-speaking OB/GYNs in the area, said Dr. Pimentel, who treats a significant number of Hispanic women at the Genesis Health Group practice of Physicians for Women’s Health.

“Patients didn’t understand what was being offered to them in terms of therapies and diagnostic modalities,” he said. “It often couldn’t occur because of the language barrier issues. Now, they can communicate with their physician in their own native language.”

Dr. Pimentel offers far more than the Spanish language to Illini Campus patients and staff, however. He offers leadership, chairing both the hospital’s obstetrics and surgical departments. “He’s very focused on patient safety issues and on teamwork with nursing staff. He has been instrumental in getting new policies and procedures in place for the obstetrics department,” Dubin said.

He also offers compassion and generosity. “He’s a very kind-hearted individual who is very well liked by his patients,” said Stephanie Robinson, site supervisor for Physicians for Women’s Health. “He’s also very generous and supportive of his staff. We all think the world of him.”

Those who know him say he is a humble man who gives quietly and consistently to people in need. The Illini Campus staff has a longstanding history of donating each year to the Family Resources Domestic Violence and Advocacy Program. Dr. Pimentel and his family share that passion for helping women in crisis, and a couple of times a year, they shop at Sam’s Club and return with large tubs of food and sundries for the domestic violence shelter, said Mary Suhr, Manager of Senior Health Services at the Illini Campus.

Recently, he also rallied his medical staff peers to fund two portable fetal monitoring telemetry systems that give women in labor the freedom to walk around or sit in the Jacuzzi while their babies’ heartbeats are being monitored, Dubin said. Obstetrics has always been his passion, and he loves the challenge of treating women with high-risk pregnancies. His native country is one of health care contrasts, ranging  from top-notch facilities enjoyed by those who have private insurance and money to free public facilities that lack technology and amenities for those who don’t.

He is proud to work in an expanded and upgraded Illini BirthCenter that provides advanced technology and the comforts of home to all. “Having a baby is a happy opportunity for people to go the hospital,” he said. “The staff at the Illini Campus is very good. Patients feel very comfortable, and so does the medical staff.”

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