USF Health students, staff and faculty during a White Coats 4 Black Lives demonstration outside of the USF Health Morsani Center, in June 2020.

In December 2020, Susan Moore, MD, an Indiana physician, died of COVID-19 after alleging she experienced racial discrimination while undergoing treatment at a hospital operated by Indiana University Health System. “Moore’s story of her pain being dismissed reinforces what studies have repeatedly shown: Even taking wealth, education and insurance status into account, Black patients receive worse medical care and face worse outcomes,” a Washington Post article on Dr. Moore’s death said.

Just one month before Dr. Moore’s death, the Association of American Medical Colleges (AAMC) shared an article that touched on a 2016 study published in the Proceedings of the National Academies of Science which included a survey that revealed that 40% of first- and second-year medical students endorsed the belief that “Black people’s skin is thicker than white people’s.” The study also showed that the trainees who believed this myth were less likely to treat Black people’s pain appropriately.

This article brought to light the continued need for institutions to address racial bias in healthcare starting with health education. USF Health is doing its part by building curriculums that teach the next generation of health care providers about social determinants of health and how to provide value-based and patient-centered care, and recruiting and retaining the diverse educators to teach it.

“Your goal as the practitioner is to truly understand who the patient is and all of the different aspects of the patient which may have some impact on their medical care,” Deborah DeWaay, MD, FACP, associate dean of undergraduate medical education for USF Health Morsani College of Medicine (MCOM), said. “It helps the provider battle unconscious bias because when they individuate patients in their mind, they’re less likely to give biased care.”

In 2016, MCOM started focusing on incorporating course objectives that examine prejudice, assumptions and privilege, such as Safe Zone training and poverty simulation activities. In 2019, Shirley Smith, MA, director of student diversity and enrichment for MCOM, became the College’s integration director for cultural competency. Using the AAMC’s objectives for cultural competency, Smith spent hundreds of hours reviewing the entire MCOM curriculum, and will continue to do so on an annual basis, highlighting places where the objectives were not being met to the highest level. These findings were then presented to the curriculum committee who make the final decision about changes to curriculum and if approved, provide recommendations for moving forward. In addition, Smith provided feedback to faculty about where there may be bias within the didactics. “It’s been really refreshing to have faculty embrace this and leadership like Dr. Lockwood, support this,” Smith said. Students also have the ability to provide real-time feedback to Smith and her team via an anonymous survey. “What we’re really trying to do is not have any judgement attached to the feedback,” Dr. DeWaay said. “We’re trying to create a method for our faculty who are teaching, to deal with their unconscious bias in a safe environment.”

USF College of Public Health Dean Donna Petersen, participating in the 2019 poverty simulation along with other USF Health deans, faculty, staff and students. Pre-Covid Photo.

MCOM is also in the process of partnering with Wake Forest University in North Carolina to create curriculum that can be used at both universities in order to maximize resources and reach more people. This material will become a curricular thread integrated across all four years of medical school which USF MCOM calls Humanism in Action. Smith quoted Bryan Bognar, MD, MPH, vice dean of MCOM educational affairs, when she explained that the important part of this effort is to make sure that they’re “baking things in” and that the curriculum is “not an à la cart menu.” The curriculum teaches students the communication skills necessary to elicit the values of their patients and then integrate those values into the patient’s medical plan. “It’s physically impossible in four years to teach students every single nuance about all the ways a human being or population can be different,” Dr. DeWaay said. “It’s far more important to teach the attitude that they need, the skills to illicit the information from the patient and the skills to keep up on the literature, so that they have the tools that they need moving forward, to take care of any patient that’s in front of them.” According to Smith, the objective is to teach students not to assume anything about their patient, not to project their own values onto the patient and not to deviate from what is fact or what is in the evidence. Janet Roman, DNP, APRN, ACNP-BC, director of the Doctor of Nursing Practice (DNP) program in the USF Health College of Nursing (CON), added that it’s not just about what question is asked, but about how it is asked. The way a question is worded can be loaded with an assumption and be offensive to the patient. “If you ask me, “Do I have access to healthy food?” now you’re assuming that I don’t,” Dr. Roman said. “If you ask me, “Where do I get my groceries?” then that gives you the answer.”

A taskforce is also being formed to include faculty and students who will help build and implement this new Humanism in Action curriculum and be a resource to faculty for recommendations or feedback on revamping lectures, small groups and activities. One component of change cultivated by the COVID-19 pandemic is the acceptance of virtual guest speakers and virtual learning by students and educators. This will allow for a more diverse representation of speakers to be a part of the courses as well as private, small group activities that can foster more vulnerable discussions. “These beliefs have to be socially unwoven through intentional, meaningful conversations and interactions with depth and the goal is to give students that opportunity,” Smith said. “I’m just planting seeds. I may never see the tree, but I must believe that the possibility is there.”

In January 2020, MCOM earned recognition from the Alpha Omega Alpha (AOA) Honor Medical Society for their dedication to diversity and understanding in various patient populations. The medical school was one of two medical schools in Florida to receive an Award for Excellence in Inclusion, Diversity and Equity in Medical Education and Patient Care. The award recognizes medical schools, and their associated AOA chapters, that demonstrate exemplary leadership, innovation, and engagement in fostering an inclusive culture that transforms the ideas of inclusion, diversity and equity into successful programs that support student, staff and faculty diversity in service to the community.

After the murder of George Floyd in May 2020, students pleaded for a call to action for faster implementation of changes to the curriculum. “The morbidity and mortality that social determinants of health, systemic racism, and health care disparities have cost people living in this country, far surpasses the toll COVID will take, and yet we’re not tackling it with the same resources,” Dr. DeWaay said. “With COVID hitting, it shows us on a local, regional and national level, what we’re capable of doing when we’re really worried about something.” Fueled by the same passion as the students who have championed these efforts from the very beginning, Smith and Dr. DeWaay returned to the curriculum committee and presented a 15-point, call to action. The committee mandated the plan in June 2020.

Dr. Deborah DeWaay (center), associate dean of undergraduate medical education for USF Health Morsani College of Medicine, with medical students. Pre-Covid Photo.

According to the Center for Disease Control and Prevention (CDC), there is increasing evidence that Black, Indigenous and Latinx communities are suffering disproportionately from COVID-19. This is the kind of information that can spark a myth about minorities if the root of the cause is misunderstood. Black Americans are infected with COVID-19 at nearly three times the rate of white Americans and are twice as likely to die from the virus, according to a report from the National Urban League based on data from Johns Hopkins University. This is not because of any biological differences between the two groups, but instead, social determinants of health and systemic racism. This is evident in the report which shows that Blacks are more likely to have preexisting conditions that predispose them to COVID-19 infection, less likely to have health insurance, and more likely to work in jobs that do not accommodate remote work. “Your zip code may be the biggest determinate of your health outcome more than anything else,” Kevin Sneed, PharmD, dean of the USF Health Taneja College of Pharmacy (TCOP), said.

Understanding these social determinants of health is instrumental in dispelling myths and providing patient-centered care and is another key component of USF Health education. Social determinants of health are conditions in the places where people live, learn, work and play that affects a wide range of health and quality-of life-risks and outcomes. Factors can include a person’s education, financial literacy, discrimination, and access to healthy food and safe places to exercise. Students in the USF Health College of Nursing learn about disease processes such as heart failure, hypertension and diabetes, and at the same time, “we want to point out to students which populations are disproportionately affected and then give them that background on why, so that we can help close that health disparity gap,” Dr. Roman said.

According to Dr. Sneed, one of the most meaningful courses offered at the Taneja College of Pharmacy, one that has been a requirement for first-years ever since the inaugural class of 2011, is the introduction to public health course. The course was developed by the USF Health College of Public Health (COPH), continues to have input from their faculty, and mainly focuses on social determinants of health. “You spotlight that in a course and then when you give the demographics of what that means for these various communities, it really does help broaden the expanse of how people view communities of color and why we do things like Bridge Clinic and Tampa Bay Street Medicine,” Dr. Sneed said. “We’re going to have to push to a different level of comfort, maybe even discomfort for many people in order for it to really take hold.”

A pharmacist has a unique place in the community. “Not everybody has a physician or has health insurance, but anybody can go to CVS and say, “my child has a fever,” Tricia Penniecook, MD, MPH, vice dean for education and faculty affairs for COPH, said. The patient benefits if the pharmacist has a public health world view and can help make decisions that are best for the patient’s situation.

USF College of Pharmacy Dean Kevin Sneed, PharmD, and Tricia Penniecook, MD, MPH, vice dean for education, participating in a Voices in Leadership panel discussion during USF Health Multicultural Week in 2019. Pre-Covid photo.

While colleges of medicine, nursing and pharmacy focus on helping patients where they are downstream, sick that day, public health looks upstream and tries to address what has happened to bring them to that point. Instead of individual-based care, public health professionals look at the care of groups of people in the population and find and fill gaps in their access to health care or the conditions for people to be healthy. That’s why interprofessional education is a critical part of USF Health because both kinds of roles are important. “As part of the discipline of public health, you’re supposed to take care of those who are at a disadvantage,” Dr. Penniecook, said. “The structures and systems in this country have put certain populations immediately at a disadvantage just because of that’s who they are when they are born.”

An integral part of every accredited college of public health in the United States is making sure that students learn about health inequities that are based on disparities. At USF Health’s COPH, students not only have courses specifically on health inequities, but the topic is addressed in every public health course from the undergraduate to the graduate level. Having this thread at every level means that students learn what the basis of those health inequities are, what they look like and how to address them no matter where their career takes them. According to Dr. Penniecook, this means that if the student is going to be working in the community, they’ve learned about community education and teaching people about self-advocacy in the healthcare system; if the student is going to be working within the system, they’ve learned about how to measure and address health inequities; or if the student is going to have a leadership role, they’ve learned about being proactive in looking for ways to solve the health inequities such as policy development.

Prior to COVID-19, COPH started working on an academic master plan. Dr. Penniecook, described an academic master plan as a road map within the strategic initiatives of the institution, that tells you what you need to do academically to get to your goals. In response to the murder of George Floyd, Dr. Penniecook asked Donna Petersen, ScD, MHS, CPH, dean of the USF Health COPH, if they could integrate structural racism into the academic master plan. Just like MCOM’s Dr. Bognar was previously quoted as saying that these changes have to be “baked in” the curriculum, Dr. Penniecook wanted these efforts to combat structural racism to be more strategic and woven into everything they do and who they are, so that it’s more likely to stick. A variety of work groups will be formed to include faculty, staff and students to look at admissions, curriculum, teaching methods, educational spaces and recruitment, and then make recommendations to the college structure. While this master plan is a work in progress and was paused when COVID-19 first hit, Dr. Petersen has already impacted and set the tone for the two freshman courses she teaches as a part of the Master of Public Health program. She has always had a required summer reading list, but this past summer, the entire list was equipped with books on structural racism. In addition, different aspects of structural racism have been the topic of several of the College’s townhall meetings, some lead by students, as well as episodes of the Activist Lab’s Activist Lab on the Road podcast.

An interprofessional student team across the Colleges of Medicine, Nursing and Public Health, and the School of Physical Therapy, at the 2018 USF Health Research Day. Pre-Covid Photo.

The curriculum used to educate our future health care professionals is only one piece of the puzzle. The faculty who teach it are the other. “Student exposure to those from impoverished backgrounds may occur for the first time when they are in medical school,” Haywood Brown, MD, professor of obstetrics and gynecology, associate dean of diversity for USF MCOM, and vice president for institutional equity for the University of South Florida System, said. “They don’t get that in the classroom because there is so few, diverse faculty teaching the curriculum.” According to a board diversity statement from the American Council on Education (ACE), diversity in university student bodies, faculties and staff, enriches the educational experience, promotes personal growth and a health society, strengthens communities and the workplace, and enhances America’s economic competitiveness. “If you do not have a diverse workforce, the patients don’t benefit as much because you’re learning from each other,” Dr. Brown said.

In November 2020, the USF Health College of Nursing appointed Usha Menon, PhD, RN, FAAN, as the new dean after serving as interim dean of the College since February of that year. According to Dr. Roman, under this new leadership, one of the College’s initiatives is to increase the diversity, equity and inclusion not only in the curriculum, but also in the student, faculty and staff populations. As a part of this initiative, Dr. Menon realigned her senior administrators which included creating a director of diversity role, now filled by Ivonne Hernandez, PhD, RN, IBCLC, assistant professor at the USF CON. “What we are developing now, before we even start recruiting, is a way to retain,” Dr. Roman said. “We are nurse scientists, and we treat our patients and our students by the evidence. We are doing the same thing with diversity, equity and inclusion, and what our data shows is that when we have persons of color, they don’t stay.” CON’s strategic goals include increasing the diversity of research faculty by 35% and of clinical faculty by 10%, by 2023. One retention method coming soon is a mentoring program.

According to Dr. Roman, CON is not making these changes just to check off a box for diversity on a list of requirements. “The College of Nursing is doing a 360,” Dr. Roman said. “We’re changing everything. We are doing the right thing for all people and it’ll be a complete culture change.” A healthy and safe culture and work environment will also help retain high quality, diverse faculty. “We have to reiterate that incivility is not tolerated, and micro and macro aggressions are not tolerated,” Dr. Roman said. “We also have to bring to the forefront what already exists in the University processes for what to do if you feel violated and not to suffer in silence.”

Even outside of the university classrooms, USF Health students are coming together to fight racial disparities in the healthcare system. In August 2020, MCOM became an official chapter of the national White Coats 4 Black Lives. Open to all USF Health students, the goal of the organization is to safeguard the lives and well-being of patients through the elimination of racism. To accomplish this goal, WC4BL and the USF Health chapter look to foster dialogue on racism as a public health concern, end racial discrimination in medical care, and prepare future physicians to be advocates for racial justice. “It’s everyone’s responsibility, but it’s only a priority to some,” Smith said. “For those who make it their priority, we want to give them tools to learn how to engage in these spaces that make it safe for them and make it safe for the other person to have these kinds of courageous conversations. Equipping the next generation of thought leaders so they can change the thoughts out there.”

In the wake of a pandemic that forced the closing of many health care practices, USF Health quickly found a way to keep making life better for patients and families across the Tampa Bay area.  Telehealth appointments have been how patients have stayed connected to our health care teams when in-person visits were reduced.  USF Health recently hit a new milestone for its telehealth efforts.

USF Health recently surpassed 100,000 telehealth appointments.

“This is a stunning number, and truly a testament to the strength of our team to accomplish such a feat amidst a worldwide global pandemic,” said Mark Moseley, MD, USF Health associate vice president and chief medical officer.  “Our telehealth efforts helped the practice plan survive during the early days of the crisis and has continued to enable our road to recovery.“

Top 10 specialties with the most completed telehealth appointments from March 18 to Oct. 30:

• Department of Pediatrics: 16,030
• Department of Cardiology: 12,803
• Department of Psychiatry and Behavioral Neurosciences: 12,583
• Department of Internal Medicine: 12,384
• Department of Neurology: 10,386
• Department of Family Medicine: 6,329
• Department of Obstetrics and Gynecology: 6,161
• Department of Urology: 4,610
• Health Informatics Institute: 4,404
• Department of Neurosurgery: 3,332

*This information was current on July 9, 2020. It is a rapidly moving pandemic thus this information could change.

There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19), so the best way to prevent illness is to avoid being exposed to this virus. The virus is thought to spread mainly from person-to-person. The CDC recommends that you:

• Wash your hands often
  • Soap and water for at least 20 seconds.
  • Use a hand sanitizer that contains at least 60% alcohol if soap and water are not readily available.
• Avoid close contact
  • Inside your home: if possible, maintain 6 feet between the person who is sick and other household members.
  • Outside your home: put 6 feet of distance between yourself and people who don’t live in your household.
• Cover your mouth and nose with a cloth face cover when around others
  • You could spread COVID-19 to others even if you do not feel sick.
  • The cloth face cover is meant to protect other people in case you are infected.
  • The cloth face cover is especially important when other social distancing measures are difficult to maintain, but it is not a substitute for social distancing when it is possible.
  • Surgical masks and N95 respirators are critical supplies that should be reserved for healthcare workers and other first responders, but if you are wearing a disposable mask, please properly dispose of it in a trash can.
• Cover coughs and sneezes
  • Always cover your mouth and nose with a tissue when you cough or sneeze and then throw the used tissue away in the trash.
  • Use the inside of your elbow and do not spit if you do not have a tissue.
  • Immediately wash your hands with soap and water or clean your hands with hand sanitizer.
• Clean and disinfect
  • Clean and disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets and sinks.
• Monitor your health daily
  • Be alert for symptoms and take your temperature if symptoms develop.
  • Follow CDC guidance if symptoms develop.

• Direct exposure to a positive case: the CDC recommendation would be self-isolation for 14 days and testing only if symptoms develop.
• Indirect exposure to a positive case: in general, the recommendation would be self-monitoring. No need to isolate, but always wear a mask and social distance while being on the lookout for subtle symptoms.
• No knowledge of exposure: testing is not needed if you don’t have symptoms and you have no knowledge of an exposure to a positive case.

Symptoms can range from mild to severe illness, and appear 2-14 days after you are exposed to the virus. Be on the lookout for cough, fever, chills, muscle pain, shortness of breath or difficulty breathing, sore throat and new loss of taste or smell. Please do not go directly to the emergency room without contacting your healthcare provider first. Tampa General Hospital is NOT a COVID-19 testing site.

• For early detection, the FDA approved test is a nasal swab analyzed by PCR. The CDC recommends testing only if symptoms develop.
• There are a number of ways to receive a nasal swab test in your area:
  • Call USF Health at (813) 974-2201 to make an appointment. The volume of symptomatic patients is so high, we may not be able to test those without symptoms unless the patient’s doctor recommends the test because of significant risk factors.

• • Hillsborough County walk up or drive-thru testing sites, by appointment only. Insurance not required.
    • For more information or to make an appointment, CALL (888) 513-6321 or register online at HillsboroughCounty.org/Coronavirus

• • Pinellas County walk up testing sites, by appointment only. Insurance not required.
    • CALL (727) 824-6900 to make an appointment. Visit COVID19.PinellasCounty.org/testing/ for more information.
  • Pinellas County drive-thru testing sites, no appointment necessary. Insurance not required.
    • Visit COVID19.PinellasCounty.org/testing/ for testing location information.

• • Sarasota County testing sites, by appointment only. Insurance not required.
    • Testing is prioritized for anyone currently experiencing symptoms and individuals who work in a health care setting.
    • CALL (941) 861-2883 to make an appointment. Visit SCGov.net for testing location information.
  • Sarasota and Manatee County walk up or drive-thru testing sites, no appointment necessary. Insurance not required.
    • Visit SCGov.net for testing location information and requirements.

• An antibody blood test can tell you if you had a previous infection. It is not recommended for early detection because it can take 1-3 weeks after infection to make antibodies. It is unknown at this time if having antibodies to the virus can protect someone from getting infected with the virus again, or how long that protection might last.

• Positive with no symptoms: you should stay home for 10 days according to CDC guidelines. The course is unpredictable and within 5 days, many will develop symptoms. As much as possible, separate yourself from other people in your household.
• Positive with symptoms: you will need to isolate for a complete 10 days starting the first day of symptoms and 3 days of being fever-free without treating to suppress a fever. You need to meet both criteria to be able to stop quarantine. As much as possible, separate yourself from other people in your household.
• Notify anyone who may have been exposed to you within the last two weeks to let them know about your positive test result so they can self-monitor.
• Only go to the hospital or call 911 for help if your symptoms escalate into a medical emergency. Notify the operator that you have COVID-19. If possible, put on a cloth face covering before medical help arrives. Most people with COVID-19 have mild illness and can recover at home without medical care. Do not leave your home, except to get medical care.

• For information, visit USF Health’s COVID-19 patient resources page.
• Learn more about our Telehealth virtual appointments.
• This information was current on July 9, 2020. It is a rapidly moving pandemic thus this information could change.

A short, yet powerful “they saved my life” is how Jeremy Blythe describes the team at the Tampa General Hospital + USF Health Bariatric Center.

Weight had always been a struggle for Jeremy while growing up, but he never let being “the big guy” stand in his way of living his life, even when simple tasks like tying his shoes or putting on a belt became a challenge. Standing over 6 feet tall, Jeremy weighed 612 pounds by his thirties. After seeing his father and other family members pass away before age 60, Jeremy decided that he was not going to follow that same path. “I want a family with my wife, and I want to be able to be around a long time and be able to do things with them,” Jeremy said.

That’s when Jeremy decided to take control of his life and seek professional help from the TGH + USF Health Bariatric Center, a team that came highly recommended to him. The TGH + USF Health Bariatric Center is a Comprehensive Center with Adolescent Accreditation under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Within a supportive and encouraging atmosphere, patients have access to both surgical and non-surgical bariatric services, and the goal of the team approach to care is to help patients not only lose weight but improve their overall health. “When your weight gets that high, your body just can’t tolerate it and it’s not about the illness Jeremy currently had, but all of the future illnesses he was destined to get,” said Christopher DuCoin, MD, MPH, FACS, medical director and bariatric surgeon at the TGH + USF Health Bariatric Center.

Dr. Ashley Mooney and Dr. Christopher DuCoin worked together on Jeremy’s bariatric surgery at the TGH + USF Health Bariatric Center.

The robotic assisted sleeve gastrectomy was selected as the best option for Jeremy because, as Dr. DuCoin describes it, the procedure is extremely safe, even safer than gallbladder surgery, a hysterectomy, or elective knee surgery, and has quick patient recovery. Gastric bypass was considered, but it’s an intense operation that is often used for patients with Type II Diabetes and severe reflux disease. Since Jeremy did not have those comorbidities, there was no need to add any unnecessary risk to his surgery.

“When you combine laparoscopy, or small incisions, with robotic surgery, it really aids the surgeon in the visualization of the operative field, dexterity and the safety profile of the procedure,” Dr. DuCoin said.

The TGH + USF Health Bariatric Center is one of the busiest academic centers in Florida for bariatric robotic surgery. The facility is equipped with chairs, toilet seats, beds, doorframes, wheelchairs and scales that are specifically made for patients of a larger size. Even the operating table and instruments that are used for bariatric surgery are designed with the needs of that patient population in mind. Patients also have access to telehealth appointments to prevent mobility, transportation, or distance impeding a patient getting the services they need. Being a part of a large hospital also means that if a patient suddenly needs intensive care or specialized medical support during or after surgery, the infrastructure would be able to take care of them. The hospital staff and the entire system is trained to care for these patients from a holistic perspective and they not only know the safest way to transfer and move these patients, but also how to empathize.

“The team really facilitates a no-judgement atmosphere where these patients can feel welcome and are somewhere where they can come and be themselves,” said Ashley Mooney, MD, bariatric surgeon at the TGH + USF Health Bariatric Center.

Deciding on the best procedure for Jeremy was only the beginning of the six-month, pre-operative process. In order to be approved for surgery, Jeremy had to be cleared by the entire bariatric team after meeting their designated goals for him such as, “reaching a weight around 577 pounds, getting out of the pre-diabetic range, improving his iron and Vitamin D deficiencies, stopping his vaping habit, and consistently wearing a continuous positive airway pressure (CPAP) sleep apnea machine,” said Erica Francois, DNP, APRN, bariatric nurse practitioner at the TGH + USF Health Bariatric Center. During this part of Jeremy’s journey, he met with nurse practitioners, nutritionists, psychologists, cardiologists, pulmonologists, sleep study therapists, lab technicians, among many others who played a crucial role in Jeremy’s success in the program. This team-based care conveniently falls under one roof and not only makes having a variety of specialty appointments and accessing medical records a seamless process for patients, but it also facilitates collaboration.

“We’re all on the same page, we speak the same language,” Dr. Mooney said. “All the providers meet weekly and discuss difficult patients or patients who are on the path to surgery, so the communication is incredibly effective.”

The TGH + USF Health Bariatric Center team

A critical piece of the pre-operative process for Jeremy was addressing his emotional eating habits.

“This part of the journey was important because for me, and I firmly believe that, for most people, it is a head game,” Jeremy said. “Getting your head right and dealing with the emotional side of your eating issues will make or break you. Mental health is a key factor in the success of this process.”

The Center’s Clinical Bariatric Psychologist Rebecca Chermak, PsyD, explains that receiving cake as a celebratory reward or ice cream when you have a bad day can start from great intentions in childhood, but can quickly turn into an emotional eating habit in adulthood.

“Food is the most easily accessible, readily available, and non-judgmental ways to navigate through some of life’s stressors,” Dr. Chermak said. “Even though Jeremy always had a smile on his face, he acknowledged that he was hurting on the inside and had been struggling with depression ever since he was a young boy and often used food as a way to cope.”

“Dr. Chermak is one of the best psychologists I have ever spoken with,” Jeremy said. “She doesn’t come at you from a medical standpoint as much as a human to human. Her ability to connect with and help her patients is unbelievable.”

Patients also have to understand and prepare for the lifelong commitment they’re making before going into surgery.

“You have to realize that you won’t just wake up and be ‘skinny’ – there is work involved,” Jeremy said. “You must change your eating habits: how you drink, how you eat, when you drink, when you eat. Everything changes, and you have to position yourself to be as ready as you can before going into the surgery.”

Another crucial part in the success of this lifelong commitment is the support of friends and family. Jeremy’s inspiration for changing his life was to be around as long as possible for his family. But in order for him to get to that healthier place, he was going to need their support, too. Luckily, Jeremy was surrounded by an extended family and close friends who are very supportive, especially the love of his life and wife of 10 years, Hannah.

After months of hard work and the support of family and the services offered by the Bariatric Center, Jeremy was able to achieve his goals and was approved for surgery. Jeremy said he was able to stay positive and on track to his goal by keeping his “eye on the prize.”

“In the beginning, you’re going to hate it, I won’t lie,” Jeremy said. “It’s all very difficult. What you have to continue to remind yourself of is, look at what you’re gaining. I’m going to live, hopefully, an additional 20 to 40 years because I am investing in myself. I am taking care of myself for me and my family. As you start to drop weight and feel better, it almost becomes automatic. Be patient, be kind to yourself and listen to your body.”

On January 28, 2020, Jeremy had his surgery and was in and out of the hospital in under 24 hours.

“I was excited, I was scared, I was worried, but most importantly, it was the first time in my life I didn’t feel hopeless,” Jeremy said. “I didn’t feel like I couldn’t fight the weight loss fight any longer. I had hope and to me, that is worth more than my weight in gold! That’s a lot of gold.”

Jeremy has lost 161 pounds since his surgery (Photo: Courtesy of Jeremy Blythe)

Jeremy has lost 161 pounds after five months post-operation. The first 6 to 12 months after surgery is an intense, rapid-weight loss phase in which Jeremy frequently visits with dieticians and nurse practitioners at the TGH + USF Health Bariatric Center as a part of the post-op care program. By the second year, he will visit on an annual basis for continued long-term support. The entire medical staff at the Bariatric Center echoes the sentiment that when you become their patient, you’re their patient for life.

“They are invested with you along the entire process. Everybody there is so supportive and genuine,” Jeremy said.

“I think we all feel much more confident that Jeremy’s going to live a much longer, healthier, hopefully happier life and I think we see that every time we encounter him. It’s really why a lot of us do this because we know we are making a substantial impact in their life,” Dr. DuCoin said.

Jeremy’s goal weight is 275 pounds and he looks forward to the day that he’s able to experience canoeing, horseback riding, and kayaking for the first time because his weight has always restricted him from participating. He also looks forward to once again being able to ride roller coasters and fly on airplanes. “My current weight loss success makes me feel so happy,” Jeremy said. “I feel refreshed and ready to conquer the world and to keep fighting for a healthier body.”

To the team at the TGH + USF Health Bariatric Center, Jeremy says, “Thank you for giving me hope. Thank you for giving me the opportunity to show myself that I can do this. Thank you from the bottom of my ‘no longer enlarged heart due to heavy weight’ for saving my life. You have given me purpose and you have truly done something for me that I will never, ever forget and for doing it with such compassion, poise, and confidence. You are my true miracle workers, my true heroes.”

After gaining his new lease on life, Jeremy wants to encourage others who are significantly struggling with their weight to leave their inhibitions behind, believe in themselves and give the TGH + USF Health Bariatric Center a call. He believes that even though making that first step is scary, the alternative is worse.

“It’s a very humbling experience once you realize that how you have been living is no longer working for you,” Chermak said. “The amount of bravery that it takes to initially call and make that first appointment is one of the most powerful things anyone can do towards their future.”

For more information about the bariatrics services available at the TGH + USF Health Bariatric Center, email bariatriccenter@tgh.org or call (813) 844-7473. 

USF Health pediatric pulmonology has met the extensive requirements to become a cystic fibrosis core center, a designation that offers funding opportunities for research and drug development and access to large data sets related to the clinical care of patients with cystic fibrosis.

“We have an extremely committed team and with the support provided by the CF Foundation and our USF institution, our patients are living happy and healthier lives,” said Marisa Couluris, DO, division chief of USF Health pediatric pulmonology and associate professor for USF Health Morsani College of Medicine. “With new programs involving transition plans for pediatric to adult centers, lung transplant research, mental health support and real time research guidelines only possible with registry data which all the centers provide, patients are living longer, and healthier lives.”

USF Health pediatric pulmonary’s Jason C. Walsh, FNP, Yanerys Colon-Cores, MD FAAP, and Marisa Couluris, DO.

The Cystic Fibrosis Foundation has accredited more than 130 CF care centers nationwide and about 15 of those are in Florida. According to the Cystic Fibrosis Foundation, “the CF Foundation’s care center network combines clinical research with medical care best practices and has been cited by the National Institutes of Health as a model of effective and efficient health care delivery for a chronic disease.”

The requirements to become a core center starts with the care inside the center itself and takes into account the number of patients seen and a review of the registry or clinical data made up of those patients. Then the CF Foundation considers the institution’s location to ensure it has supportive teaching and resources to initiate quality programs, can meet research requirements, and has the multidisciplinary team in place, including a hospital supportive program. Tampa General Hospital’s Adult Cystic Fibrosis Program is also certified and supported by the CF Foundation and TGH’s Lung Transplant Program specializes in lung transplants for adult patients with cystic fibrosis. After application review, the CF Foundation conducted a site visit with two leading experts in the field to review USF Health’s pediatric pulmonology services and support efforts to ensure that high-quality specialized care is provided to people living with CF.

The benefit of becoming accredited by the CF Foundation is the funding, which is used to support research and drug development and the capture and collection of data of the clinical care of patients. This work helps to promote individualized treatment plans and ensures high-quality, specialized care by USF Health’s multidisciplinary team. USF Health pediatric pulmonology’s team is made up of health care providers, nursing staff, registered dieticians, social workers, respiratory therapists and research and clinic coordinator support. Everyone on the team works together for the same goal, to find a cure and provide all people with this disease the opportunity to lead full productive lives, Dr. Couluris said. It was only 70 years ago that a child living with CF rarely lived long enough to attend elementary school and now, with the advancements in specialized CF care, that child can fulfill their dreams of having a career and their own families.

“I have been caring for patients with CF at USF Health for over 15 years and once I became the division chief, it was the goal of our team to become a core center,” Dr. Couluris said. “With the support of our institution both at USF and TGH, we were able to build the team to provide the degree of high-quality, specialized care needed to be a core center. Now the next goal is to advance the research in CF care to find that cure. And then I can retire.”

What is Cystic Fibrosis?

Cystic Fibrosis is a rare genetic disease that causes the mucus in organs, such as the lungs, pancreas and liver, to become thick and sticky. The mucus can clog the airways and trap germs, as well as cause malnutrition and liver disease. According to the Cystic Fibrosis Foundation Patient Registry, CF is found in more than 30,000 people in the U.S. and more than 70,000 worldwide. Thanks to the advocacy of the CF Foundation, every newborn nationwide is now tested for CF. Cystic Fibrosis is a progressive disease, so with early detection and

treatment, CF survivors have a longer life expectancy and a better quality of life. There is no cure for CF, only significant progress in the treatment of the disease.

What are the symptoms of Cystic Fibrosis?

The type and severity of symptoms are different from person to person. People with CF can have a variety of the following:

• Very salty-tasting skin
• Persistent coughing, at times with phlegm
• Frequent lung infections, including pneumonia or bronchitis
• Wheezing or shortness of breath
• Poor growth or weight gain in spite of a good appetite
• Frequent greasy, bulky stools or difficulty with bowel movements
• Male infertility

For an appointment with USF Health Pediatric Pulmonology, call 813-259-8700

USF Health converted to the Epic electronic health records (EHR) system in August 2015, springing the organization into a new era of efficiency, patient care and safety, and a more cohesive system with Tampa General Hospital, USF Health’s primary teaching hospital.

On July 1, USF Health will complete the transition to Epic when they launch the electronic billing system (EBS) associated with Epic, a system that will help deliver a much more streamlined and efficient customer service experience.

One of the problems with the current billing system is inconsistency, according to Rachel Sullivan, USF Health director of Revenue Cycle Operations. The new system will better relay information and data from USF Health to the insurance provider to achieve more accurate and timely billing to the patient’s insurance carrier.  The bi-product of more accurate billing to the insurance provider is more accurate and timely billing to the patient allowing them to pay their bills faster, she said.

“For us to continue to provide a better patient experience, we must keep up with the technology,” said Sullivan. “We are committed to delivering the best possible customer service and patient care.  This is simply another step in that commitment.”

The program also interfaces with My Chart, the program patients can use to access all their medical data, manage appointments, pay bills and communicate with their providers.  In the new system, which goes live July 1, USF Health patients will have the ability to set up payment plans, and automatic withdrawals for bills by keeping payment options on file.

Although the new program will be up and running, USF Health’s legacy program will still be live.  Patients who see their provider before July 1 will still be billed using the legacy program.  Those after July 1 will receive their bills through the new EBS.

Closely huddled by attentive residents and students, USF physician Charles Edwards, MD, performs his daily rounds of patients inside Tampa General Hospital. Dr. Edwards is a hospitalist and as such, he and his team care for hospitalized patients until they are well enough to be discharged. Patient stays range anywhere from 12 hours to many months.

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Regardless of stay length or ailment, these in-house doctors known as hospitalists lead a team of other specialists such as physical therapists, nurses and pharmacists, to best provide safe and efficient patient care.

“We see every type of patient at this hospital so it’s hard to say that there is a typical pattern and that’s one of the unique challenges for a hospitalist,” said Dr. Edwards.

During patient visits, Dr. Charles Edwards takes time to connect with his patients to learn about their lives and individual challenges that may effect health outcomes.

The hospitalist role is fairly new in medical practice, just two decades since the position first began to appear. Its purpose was to eliminate needless transportation time for primary care doctors so they could focus more on office visits and so that the hospital can provide immediate personalized care to their patients. Currently there are 34 USF Health hospitalists working at Tampa General Hospital.

“We are here, we are here 24 hours a day. Available immediately to see patients, if needed,” said Dr. Edwards who takes pride in connecting with his patients, “though [my care] may not continue, while they’re here [I’m] going to care for them as much as their primary care doctor does.”

On a typical morning you’ll find Dr. Edwards and his team reporting on their patients’ progress with details about medication, mental status and sleep or eating patterns. They will see between 15 to 20 patients throughout the day. However, patient care involves more than bedside visits. For physicians like Dr. Edwards, responsibilities extend into his personal life and he is passionate about it. He might read more about the symptoms of a patient he’s not sure about or catch up on the latest from his favorite medical journal.

Residents and students evaluate patients’ progress with Dr. Edward’s guidance.

Dr. Edwards’ profession is not just about patient care, it’s an “innate curiosity about medicine,” and a balance of at least four other roles. In addition to being the director of the Division of Hospital Medicine, vice-chairman for Clinical Operations in the Department of Internal Medicine and chief of staff at TGH, he is also an associate professor at USF Health’s Morsani College of Medicine.

Patient records are updated as Dr. Edwards and his team complete morning rounds.

“Without a doubt teaching is my main inspiration,” said Dr. Edwards. “The one thing I can do and enjoy, [is to] go around with my students, residents and my team to see our patients.”

Many doctors were inspired to pursue their profession by personal reasons, or wanting to do something important in life. Dr. Edwards had these reasons, but his active role as an educator is a daily reminder of the benefits of his kind of work.

“I’m constantly around other people who are learning,” said Dr. Edwards. I constantly have to try and teach younger physicians and that’s one of the best ways to learn, is to teach. They certainly keep you on your toes.”

Dr. Charles Edwards and his team provide non-surgical patient care throughout Tampa General Hospital.

Aside from his patients, mentorships and dedication to keep up with medical advancements, Dr. Edwards has his mind set on the future of hospital medicine.

“We’re constantly looking for ways to make the hospital safer,” said Dr. Edwards. He’s referring to the main challenge his profession faces: The transition of patient care.

Caring for patients has a multi-level set of tasks that include bedside visits, medical charting, preventing infections, avoiding unnecessary tests, not delaying patient stays, and the continuum of patient care beyond their hospital stay.

“One of the things that you must do is make sure you understand the challenges a particular patient is going to face when they’re discharged so that you can try to best address them,” said Dr. Edwards. “But it is often a source of anxiety when patients leave the hospital.”

The final stage of Dr. Edwards’ care involves updating the patient’s records and sharing the hospitalization charts with the primary doctor. Patient medical information is private and protected by federal HIPAA laws, which limit how hospitalists and primary doctors can exchange records.

Medicine, as most professional fields, has been increasingly harnessing the powers of technology. The transition of patient care is eased by the standardization of electronic health records and USF Health’s Physicians Group patients will benefit even more with its transition to EPIC– the same EHR used at TGH, thus providing a stronger continuity of care. With a unified records system, interdisciplinary caregivers can access thorough medical data about a patient. Hospitals, clinics and physicians can share details about their patient’s outcome and will help relieve the worry that hospitalists have when treating or discharging patients. But for Dr. Edwards, the best assurance has a personal touch.

“Technology will certainly play a big role in improving the transition of care in the future, but there’s no substitute for good old-fashioned verbal communication with fellow colleagues.”

Story and multimedia by Sandra C. Roa, USF Health Office of Communications. 

This is the first story in a series highlighting faculty who are shining examples of quality and compassionate patient care and patient safety. Every day, these health care providers put their patients first. In the process, they create successful models of advanced care focused on empathy, safety, technology and evidenced-based medicine, models that carry through everything they do – into their practice, their teaching, their research, their community outreach, and into the USF Physicians Group.

It’s in Dr. Lucy Guerra’s genes to be completely drawn in to the team-based patient care offered at USF Health. Her own Latino heritage includes a close-knit family that is involved in nearly every aspect of life, including each other’s health.

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Knowing she is living true to who she is, she practices team-based medicine every day, putting her patients first, reinforcing the concept to medical students and residents she teaches, and watching the students, in turn, practice it as they provide free care to the local underserved community at the BRIDGE Clinic.

Dr. Lucy Guerra in the midst of teaching medical students and residents at the Morsani Center for Advanced Healthcare.

Dr. Guerra wears multiple hats in her career as a physician. She is associate professor, director of the Division of General Internal Medicine in the USF Health Morsani College of Medicine, co-faculty mentor for the BRIDGE Clinic, and associate director of the Internal Medicine Residency Program.

She doesn’t see them as multiple roles, but as one job, she said, a testament to her preference for working at an academic medical center.

“We all need to change our concept of what medical care is and to think of it as having evolved to a very patient-centric model,” Dr. Guerra said. “It’s more about working as a team to provide the best care and realizing the patient is part of that team. It’s a trend we call value-based care. When patients come to a place like USF Health, they’re going to always meet with the physician and other health care providers – a nurse practitioner, social worker, pharmacist or physician assistant – and it’s always going to include medical students and residents because we are an academic teaching institution.”

But an academic medical center is more than patient care and Dr. Guerra is emphatic in her efforts to incorporate USF Health’s other missions into her world.

“Our other missions – research and teaching—are equally important to patient care because you really can’t do one well without the other,” she said. “If we don’t have the research component then we can’t find better drug therapies and better behavioral therapies to treat patients. And sometimes I think this needs to be emphasized more because patients don’t necessarily realize that. The research part is very ethereal – you just don’t see it in action. Patients think of research as being done in the lab. But when you’re coming here, to an academic institution, you have the opportunity to participate in research studies and get involved. If patients realize they can participate in some kind of research study that will make a difference for the next generation of patients that come after them then wow, what a contribution they’ve made to medicine, as well to the future of their own grandchildren.”

For the teaching mission, Dr. Guerra said that, beyond the science of medicine, she tries to remind her students and residents why they chose medicine as a career.

“People who are learning and in a learning environment sometimes get caught up, just like I did, in studying or trying to get good grades or trying to pass, and you have to keep reminding them why they chose this profession,” she said. “For a physician, a nurse or anyone working in health care, it really needs to be a commitment. You’re making a commitment to somebody else – the patient. If you can ground a student in that, then they’re going to be the better health care provider for it.”

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She conveys that same philosophy to her colleagues, urging them to always remember why they went into medicine, to do their best to block out the added duties, patient charts, and demanding schedules and return to their core reasons for choosing medicine as a career.

Sometimes, she said, it’s as simple as looking at the young and eager medical students and residents to reignite the passions that carried them through medical school.

“Participating in things like BRIDGE, or teaching students and residents, can remind them why they went into health care to begin with,” Dr. Guerra said. “They’re seeing what they were a few years before or a decade before. And that’s the difference we find working at an academic medical center, where you have a lot of younger people around all the time from different disciplines.”

What keeps her motivated, staying on track with a demanding career? Among many things, she looks to her own father, who was a physician in Cuba and Spain before coming to America.

“I admire my father because he was always studying, learning English and trying to pass the medical boards here,” she said. “And he was older when he did that, in his late 30s, and worked three jobs during that same time. I just thought if someone could care so much about something, that’s what I’d like to do.”

Photos and multimedia story by Sandra C. Roa, USF Health Office of Communications. 

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Earlier this year, the USF Parkinson’s Disease and Movement Disorders Center moved from Harbourside Medical Tower on the Tampa General Hospital campus into its new home on the sixth floor of the USF Health Byrd Alzheimer’s Institute.

The relocation nearly doubled the center’s space to nearly 5,700 square feet — adding a larger waiting area, extra exam rooms, and a comfortable infusion room where clinical trial patients receiving intravenous medications can be monitored.

“It’s given us much-needed room to provide care for more patients and expand our research efforts,” said Center Director Robert A. Hauser, MD, MBA, USF Health professor of neurology and molecular pharmacology and physiology, who has led the center since 1994.

There are two other centers where leading USF Health neurologists see patients with Parkinson’s disease and other movement disorders, and offer clinical research opportunities.  Theresa  Zesiewicz, MD, FAAN, directs the USF Parkinson’s Disease and Balance Center at the Morsani Center for Advanced Healthcare and oversees the Frances J. Zesiewicz Foundation for Parkinson’s Disease.  Juan Sanchez-Ramos, MD, PhD, is medical director of the Parkinson Research Foundation Center of Excellence at USF and sees patients at both the Morsani Center and at Parkinson Place in Sarasota.

Dr. Robert Hauser, director of the USF Parkinson’s Disease and Movement Disorders Center, with some of the center’s staff, outside their new space on the sixth floor of the USF Health Byrd Alzheimer’s Institute.

Both Dr. Hauser and David Morgan, PhD, CEO of the USF Health Byrd Alzheimer’s Institute, agree that co-locating scientists and clinicians specializing in Parkinson’s disease with specialists in Alzheimer’s disease and other forms of dementia is beneficial from both a research and clinical perspective.

Though both are progressive diseases of the nervous system, at first glance Parkinson’s and Alzheimer’s may not appear to have much in common.

The symptoms of Parkinson’s – a movement disorder characterized by tremors, muscle rigidity and slowness —  seem to concentrate more on physical disability, while Alzheimer’s afflicts memory and other mental abilities. Yet, about half of all people with Parkinson’s develop some form of dementia in the later stages of the disease.  And, the motor and physical skills of patients with Alzheimer’s disease often deteriorate as the disease advances.

Dr. Hauser checks the reflexes of patient Betsy Barber.

“It’s a very natural fit to bring experts in these two neurodegenerative diseases together under one roof,” Dr. Morgan said. “The underlying processes leading to Parkinson’s disease and Alzheimer’s disease – the accumulation of abnormal proteins in the brain resulting in the death of nerve cells — may be more alike than different.”

“There is a fair amount of overlap,” Dr. Hauser said. “If we can figure out how to attack and slow the progression of one disease, I think it could tell us a lot about how we might attack and slow the progression of the other.”

“In addition, we want to collaborate with investigators here at the Byrd Institute to try to improve our understanding of dementia in Parkinson’s disease and develop better therapies for patients with thinking and memory problems.”

The PET/CT scanner used for clinical research and assistance in diagnosing dementia at the Byrd Alzheimer’s Institute is one of the many resources available to patients of the Parkinson’s Disease Center.

In addition to more opportunities for research collaboration in the laboratory and the clinic, other advantages of the co-location were noted:

• Adding physician expertise — Since some patients with Alzheimer’s disease may eventually develop motor symptoms and those with Parkinson’s may eventually experience cognitive decline, it is convenient for patients and their families to have clinicians trained in each specialty at the same site.
• Expanded access to clinical trials – The USF Parkinson’s Disease and Movement Disorders Center has established a comprehensive, nationally-recognized clinical trials program, and the Byrd Institute’s clinical trials program continues to strengthen.  In addition to leveraging patient-oriented research that may help in understanding and managing both diseases, clinicians have access to more trials for which their interested patients may be eligible.
• Leveraging shared resources – These include a PET/CT scanner used for clinical research and assistance in diagnosing dementia in the Byrd Institute’s Center for Memory C.A.R.E.  There are opportunities for expanded use of this equipment with the development of new imaging techniques incorporating radiopharmaceutical agents to help diagnose Parkinson’s disease and related movement disorders.  Other resources like the Byrd Institute’s driving simulator, mini-apartment to test ability of patients to live on their own, and caregiver library and information center will also be available to patients of the Parkinson’s Center.

Barber, diagnosed with Parkinson’s 11 years ago, has participated in several clinical trials offered by the USF center.

More than the spacious, visually appealing surroundings at the new venue, patients appreciate the medical and support staff’s expertise at the USF Parkinson’s Disease Center, which is designated one of only 43 National Parkinson’s Foundation Centers of Excellence worldwide.

“USF is on the forefront of all the new knowledge and treatments for Parkinson’s disease,” said Betsy Barber, 68, a retired nurse who was diagnosed with Parkinson’s 11 years ago. “I want those latest research advances available to me as a patient.”

Barber says she is doing well on an extended-release medication that helps ameliorate a deficiency of dopamine, the brain chemical depleted as Parkinson’s slowly destroys the nerve cells producing it. She started on the investigational drug while participating in a clinical trial at USF several years ago, and it has since been approved by the U.S. Food and Drug Administration and is commercially available.

“It takes 10 to 15 years to bring a new drug to market,” Barber said. “If you’re enrolled in a study here you get it right away, plus you receive an incredible work-up and a lot of ongoing support from Dr. Hauser and his entire staff.”

Tom Curran, a local Fox-13 news anchor, says the center’s multidisciplinary team works with him to fine-tune a medication regimen that helps him remain active.

Tom Curran, a local Fox-13 News anchor, has been a patient of the USF Parkinson’s Center for more than five years.  For Curran, Parkinson’s started as an index finger twitch as he rested his hand on the steering wheel – a movement so subtle that his wife pointed it out during a car ride.

At USF, he found a multidisciplinary team that worked with him to identify and fine-tune a successful treatment regimen. It’s helped him maintain a demanding work schedule, which requires rising several hours before he begins anchoring the weekday morning news at 5 a.m.

“Dr. Hauser’s team has done a tremendous job of prescribing the right medicine in the right amount for me,” Curran said. “They always seem ready for the next challenge here.  If something wears off, they find something else to put into the mix.”

The medication Curran takes – Stalevo – is just one of several newer anti-Parkinson’s drugs that were tested at USF.  In fact, Dr. Hauser led an international study of patients with early Parkinson’s disease that demonstrated Stalevo provided better symptom control and more improvements in activities of daily living than Sinemet (carbidopa/levadopa), the most widely used treatment for patients.

A third of scientists at the USF Health Byrd Alzheimer’s Institute, including Kevin Nash, PhD, (pictured) are working on research related to Parkinson’s disease as well as Alzheimer’s.

 The Center has also been at the forefront of evaluating a new extended-release version of carbidopa/levadopa, known as //www.youtube.com/watch?v=9d_LVfzSB58

(IPX066), that alleviates motor symptoms quickly and appears to last longer than other levodopa medications currently available. The drug is expected to be approved by the FDA next year.

“USF has been involved in investigating almost every new therapeutic for Parkinson’s disease that’s come to market in the last 20 years,” Dr. Hauser said.

The Center’s clinical research encompasses not only drug studies, but new surgeries and innovative cell-based therapies that may offer hope for patients who no longer benefit from drug therapy.  USF was one of first institutions to participate in trials of deep brain stimulation surgery for the treatment of Parkinson’s and essential tremor.

In recent years, USF researchers have turned their attention to trying to improve the non-motor symptoms of Parkinson’s, such as fatigue and apathy, cognitive dysfunction, anxiety, falls and sleep disorders.  Studies have shown these non-motor symptoms contribute to disability and can impair a patient’s quality of life as much, or more than, motor symptoms.

They are also looking for ways to identify those at high risk for Parkinson’s as early as possible so that the degenerative brain disorder can ultimately be stopped or slowed.

For example, research has shown that loss of smell and rapid eye movement (REM) behavior disorder,  a sleep disorder characterized by acting out dreams with punching, grabbing, kicking or other jerky movements, may be early indicators of Parkinson’s, emerging well before motor symptoms become apparent.

“We’re placing increasing emphasis on finding people with a decreased sense of smell or who are hitting and kicking in their sleep, because they may already have early Parkinson’s disease and will develop slowness, stiffness and tremor in the future,” Dr. Hauser said. “They are the ones we want to bring into clinical trials to try new medications that may slow the disease and prevent motor symptoms before they begin.”

Click here for some highlights of the center’s research, patient care and outreach.

Photos by Eric Younghans and video by Danielle Barta, USF Health Communications