Wednesday, January 4, 2017                                                                        Volume 3. Issue 2.

The CHFM Pulse  

“Without continual growth and progress, such words as improvement, achievement, and success have no meaning.” -Benjamin Franklin



Chair's Message 
Three Missions: Patient Care, Education, & Scholarship
Upcoming Events and Past Event Highlights
Faculty & Staff Spotlight
Link to 2014-2015 Annual Report
Past Grand Rounds Presentations
Past PCP Live Presentations



Fellow CHFM Members,

I would like to welcome you to the latest edition of “The Pulse”, the newsletter for the Department of Community Health and Family Medicine. I hope you find the newsletter informative and take pride in the activities and accomplishments of our department members.

As you will see, our department is productive in all our core mission areas. Of particular note, we had 16 faculty members receive the UF College of Medicine Exemplary Teacher Award for the 2015-16 academic year. Additionally, our faculty members and staff are involved in numerous research and quality improvement projects as well as presenting and publishing the results of their scholarly work. As a department, we continue to strive to provide outstanding education and lead scholarly activities in an environment of outstanding patient care.

Please let me know if you have any suggestions regarding the newsletter. Our department continues to be a very active and productive member of the Gator Nation.

Best regards,

Peter J. Carek, MD, MS
Chair and C. Sue and Louis C. Murray, M.D. Professor of Family Medicine



The Exemplary Teacher Award recognizes outstanding performance in teaching. Faculty are selected based on the excellence of teaching medical students, residents, fellows, graduate students, post-docs and mentorship of other faculty. Exemplary teachers receive an incentive and an award of excellence from the Office of the Dean. The awards are announced each fall for the previous academic year. Congratulations to the following award recipients!

UF College of Medicine Exemplary Teacher Awards, 2015-16:

• Philippa Bright, MD

• Shenary Cotter, MD

• Alpa Desai, DO

• David Feller, MD

• Jocelyn Gravlee, MD

• Helen Hagan, MD

• Lucia Hansen, MD

• J. Grant Harrell, MD

• Robert Hatch, MD, MPH

• Mitul Jones, MD

• John Malaty, MD

• Charlie Michaudet, MD, CAQSM

• David Quillen, MD

• Richard Rathe, MD

• Daniel Rubin, MD

• Althea Tyndall-Smith, MD, MS

Najwa Liscombe became a Certified Instructor through the American Academy of Professional Coders, AAPC, on November 22 and was elected to the Executive Board of the American Academy of Certified Coders Chapter Association, AAPCCA on December 9. Congratulations, Najwa!





The UF Health Family Medicine - Eastside clinic has scheduled team care plan meetings which will occur on a weekly basis starting in January. In addition, efforts continue to reduce emergency department utilization by providing additional assistance to high-risk patients. In efforts to expand appointment access to patients, an additional physician will be hired at Eastside. 


Off to SoCal! The Department is proud to have four presentations accepted for the upcoming STFM Medical Student Education meeting this coming February in Anaheim, California.  The topics include teaching order writing, impact of the CHFM Clerkship on student attitudes and impact of continuity experience on evaluations of students. Authors/presenters include Drs. Harrell, Hatch, Nall, Rubin, Kim Lynch and 5 students – Kate Fahey, Cristi Rabaza, Austin Reed, Jack Stacey and Alex Zirulnik.  The team is looking forward to what is always a great conference.  While it will be a little cold to jump in the Pacific, the team hopes to find some other fun southern California activities while there.

The Residency Program is well into the interviewing season for the upcoming class of 2017-18. Over 80 applicants have been scheduled and are excited about the prospects of the coming year. Research, scholarly and patient safety/quality projects are moving forward, and several posters have been accepted to the Spring STFM conference scheduled in Orlando.

The Department would like to thank Dr. Joe Rush for his donation to the Family Medicine Residency Program. Because of his generous donation, the Residency Program was able to purchase a new point-of-care ultrasound machine as well as an ultrasound simulator which will allow the program to start training residents in this area. The goal is to create a formal ultrasound training curriculum for residents and residency faculty interested in point-of-care ultrasound in primary care. A special thanks to Tina Engstrom whose initiative and leadership led to the donation.

During September and October, Sports Medicine interviewed 16 out of 94 applicants for the two 2017-18 Sports Medicine Fellowship positions. The NRMP Match selection was submitted on December 14; however, results will not be available until January 4, 2017. The interviewees were all highly qualified, which made for tough decisions. We are positive that the 2017-18 fellows will be a great fit!

On November 12, current fellows, Dr. Katie Langely and Dr. Tom Starnes, attended their last UF home football game as part of the medical team on the sidelines. They were able to travel with the team to two big rival games; UF vs. Georgia in Jacksonville and UF vs. FSU in Tallahassee. They have been a great asset this year and have been seen on television and in the Gainesville Sun. In the latter part of November, they assisted with coverage for some of the NCAA Soccer and Volleyball playoffs hosted by UF.

Dr. Katie Langley and Dr. Tom Starnes at their last UF home football game on Nov. 12


Courtesy of Gainesville Sun - Nov. 12 UF vs. South Carolina Football Game

The Sports Medicine fellowship strives to assist with teaching medical students when available as part of its curriculum.  Drs. Langley and Starnes have participated by giving lectures at UF Health Family Medicine - Main, providing ultrasound training at the Harrell Medical Education Building and assisting with anatomy labs with Dr. Rarey.

In December, Drs. Langley and Starnes continued to cover football practices in preparation for the SEC Conference game on December 3 and the Outback Bowl game that is scheduled for January 2. Some Basketball game coverage was added to their schedules as well in December.  They will take a few days of vacation during the holidays to refresh themselves and prepare for the spring sports coverage events.


The BLMP program aims to educate healthcare personnel in order to promote professional development, patient safety and cultural competency. Equipped with a solid foundation in bioethics education, healthcare providers are better able to manage complex ethical questions which may arise during patient care. The program faculty are committed to offering comprehensive instruction on ethical frameworks and contemporary issues in order to train the next generation of quality physicians.

During the Spring 2017 semester, BLMP faculty will be providing lectures and small group learning activities for medical students based on the following topics:

• Abortion and Maternal/Fetal Issues

• Advance Directives and End-of-Life Decision-Making

• Baker and Marchman Acts

• Capacity and Decision-Making

• Distributive Justice in Organ Allocation

• Ethical Dilemmas in Hematology

• Ethics and Health Policy

• Ethics Consultation

• Informed Consent

• Organ Transplantation Issues

• Physician-Assisted Suicide

• Professionalism and the Professional Identity

BLMP faculty will also be directing the following courses:

• CM E 21: Advanced Issues in Medical Ethics and Law

• CM E 29: Financial, Business and Health Systems Aspects of Medicine

• GMS 6931: Ethical/Policy Issues in Clinical Research

• IDH 3931: Medical Ethics and Professionalism in The House of God

Ethics Consult Service
Primarily staffed by BLMP faculty, the Ethics consult service offers solutions to patients and healthcare providers experiencing clinical and organizational ethical issues. Available 24/7 for both outpatient and inpatient consultations, the service provides critical support to care teams, patients and their families in order to optimize ethical outcomes. On-call bioethicists arrange individual and team-based consults to address a variety of concerns, including informed consent inquiries, decisional capacity considerations, execution of advance directives, appointment of social worker proxies, resolution of plan-of-care conflicts, and end-of-life care issues.

A survey will be sent out before year's end to help prioritize topics for the coming year. The series will start with a refresher on "Feedback and the Microskills of Teaching." A date and time for the first Faculty Development session of 2017 is forthcoming with a date likely at the end of January or beginning of February.  Again, lectures will be broadcast from Main Street but faculty are welcome to join in at Main Street as well if time permits. 



New Study

Low Literacy Asthma Plan Study
Drs. Elvira Mercado and Kim Nguyen, in collaboration with Karen Theoktisto, DNP, ARNP are working on a study to test the use of a low literacy asthma plan in order to improve compliance of pediatric patients regarding asthma management and reduce the number of asthma-related emergency room visits and hospital admission rates. Asthma is the most prominent chronic illness in childhood and affects an overall 9.6% of all children in the United States (Gold, et al., 2016). Text-based asthma self-management plans in a low-literacy population may not be well received and are difficult to understand. Asthma plans that utilize pictures may communicate the severity of asthma in a more understandable method, leading to better asthma control and reducing visits to the emergency room. In Alachua County, Florida, the number of emergency room visits for children age 0-17 years with asthma has increased from 293 in 2005 up to 488 in 2014, and hospitalizations have increased from 82 to 164 during the same period (Florida Public Health Tracking System, 2016). Improved health literacy approaches have been linked to improved patient outcomes but have not been well studied in childhood asthma outcomes (Yin et al., 2016).  Asthmatic children of parents with low health literacy are at risk for worse asthma-related outcomes, more severe asthma exacerbations and increased use of emergency rooms. The development of a low-literacy asthma plan can be used as part of counseling that can offer providers a framework with which to educate parents and families on specific asthma issues. Asthma affects all Americans but the burden is especially high for children of low-income, lesser educated and racial and ethnic minority populations.

Ongoing Studies

Interactive Informed Consent Study
Dr. Ray Moseley and Dr. Arch G. Mainous III (UF Department of Health Services Research, Management, and Policy) in collaboration with Dr. Christopher Harle from Indiana University (Department of Health Policy & Management), Dr. Janice Krieger (UF College of Journalism), and Dr. Babette Brumback (UF Department of Biostatistics) are collaborating with the goal of developing and evaluating a novel, electronic informed consent application for research involving electronic health record (EHR) data. In response to NIH RFA-OD-15-002, this study addresses research using clinical records and data, including the issues of the appropriate content and duration of informed consent and patient preferences about research use of clinical information. This study will design an electronic consent application intended to improve patients’ satisfaction with and understanding of consent for research using their EHR data. The electronic application will provide interactive functionality that creates a virtual, patient-centered discussion with patients about research that uses EHR data. Also, to correct potential misconceptions and increase informedness, the application will present trust-enhancing messages that highlight facts about research regulations, researcher training and data protections. This study (Specific Aim 1 of the linked grant proposal) will improve understanding of how to best give patients information about research that uses their health records and data. With this understanding, this study will develop a new computer application that patients can use in their doctors’ offices. This application will allow patients to learn more about clinical research and make informed choices about whether or not they want their health records and data to be used for research. This project is innovative because it will create a virtual, patient-centered discussion about research using HER data. Moreover, this project will produce a consent application that clinicians and researchers can use as an ethically sound and practical tool for consenting patients, in a clinical setting, for research involving EHRs.

Pain Management Program Study
Dr. Siegfried O.F. Schmidt, in collaboration with Lesa Gilbert, FNP-BC, Dr. George Samraj, Dr. David Feller and Dr. Ku-Lang Chang are nearing the fourth year of the UF Pain Management Program at Main (PMPM) within the UF Family Medicine Residency Program. Through this study, researchers are continuing to monitor the care received by patients with chronic pain conditions who are being seen at the location with the goal to analyze patient data to better understand these patients’ experiences and understand how their treatment and diagnoses changed after being referred to this program. Alongside the patient care aspect, the research team intends to evaluate resident education and knowledge gained from their one-month rotation with PMPM.

Otic Barotruama Study
Dr. Millan and her research team at the UF Health Wound Care and Hyperbaric Center at Magnolia Parke have begun their project to evaluate the causes of barotrauma during hyperbaric oxygen therapy (HBOT) and what treatments can be used to prevent otic barotrauma (OB). They have begun by analyzing historical data from 2/1/2014 through 12/31/2015, and specifically otic barotrauma adverse events that have occurred at the UF Health Wound Care and Hyperbaric Center. They plan to analyze diagnoses, depth of treatments, chamber operators, number of treatments received, gender, day of week and TEED otic barotrauma scores. The aim of this project is to determine whether there are significant factors that affect otic barotrauma while patients are undergoing hyperbaric oxygen therapy. The results of this study will help aid clinicians to not only assist in decreasing the number of OB adverse events in HBOT, but it may also inform scuba divers with comorbidities of otic barotrauma. Available literature does not address comorbidities on the incidence of otic barotrauma in HBOT or of pre-hyperbaric oxygen therapy evaluation and treatment by Otolaryngology.

Heartmath Study
The research team led by Dr. Orlando and Dr. Lupi launched the HeartMath study in both the Haile Plantation and Hampton Oaks clinics with a total of 18 healthcare providers (Physicians, Nurse Practitioners, Physician Assistants, and Nurses) being monitored throughout the duration of the 12-week study. HeartMath uses biofeedback to teach the recipient emotional self-regulation techniques that can benefit them both immediately and over a sustained period of time. EmWave Pro is a HeartMath product that helps one achieve coherence through various standardized, interactive mindfulness techniques, such as guided meditations focusing on positive emotions, breathing, and imagery. The HeartMath emWave Pro uses an ear sensor that measures the user's pulse. The sensor uses a minute amount of infrared light to measure the speed of blood flow in the ear. The sensor sends this signal to the emWave Pro USB module where the inter-beat interval is calculated in milliseconds and then heart rate variability is plotted. This study will help determine whether using the HeartMath’s biofeedback system with emWave Pro daily mindfulness practice is a practical way to (1) improve job satisfaction and performance of physicians, advance practice clinicians, and nurses; (2) improve patient satisfaction; and (3) positively impact resting blood pressure and heart rate when comparing baseline to follow-up measures.

Compare Study
Eric Dietrich, PharmD, BCPS, a Clinical Assistant Professor in the Department of Community Health and Family Medicine and a Clinical Assistant Professor in the Department of Pharmacotherapy and Translational Research, in collaboration with Dr. David Feller and Dr. Peter Carek, has been working on a study aiming to identify and compare factors that patients and providers pinpoint as reasons for their hospital readmission. Hospital readmissions have been a recurring and costly problem for the healthcare system. Identifying key underlying problems could help drive a viable solution to this problem. This study seeks to find common underlying causes for hospital readmissions by obtaining the patient’s perspective, in addition to the healthcare provider’s perspective, on the possible causes for the patient’s return to the hospital within 30 days or less of their previous discharge. The study will collect data via two separate interviews conducted by research staff that ask the patient and the provider (separately) to identify potential reasons for readmission. The results will then be analyzed to determine the main reasons that cause patients to have hospital readmissions and whether there is a discrepancy in what patients perceive and what providers perceive to be the cause.

Population Health Study
Dr. Lisa Chacko, along with Dr. Karen Hall, is working on a project looking to identify barriers and best practices for implementing population health curriculums within primary care residency programs. The research team will conduct in-depth interviews with Family Medicine Residency Program Directors (PDs) in Florida. The interviews will explore Program Directors’ perceptions of ACGME milestones, the utility of EMRs, the role of leadership, the need for faculty development and resident buy-in. The data collected from Program Director responses will be coded and analyzed to identify recurrent themes across interviews. The specific aim of the project is to identify barriers to incorporating population health curriculums into residency training as means to identify opportunities for supporting curriculum development and sharing of best practices.


Quality projects in the department continue to go forward with measureable success.  Highlights over the past quarter include:

• Readmission Trends in Family Medicine – The weekly readmission rate has dipped as low as
       6.75% and as high as 30.0% with the majority of the quarter hovering around the 15%
       national average. The weekly inpatient Family Medicine team meeting continues to look for
       interventions to lower the weekly rate while achieving outstanding patient care.  Weekly
       meetings include providers from Family and Emergency Medicine, Case Managers,
       Respiratory, Nursing, Home Health and Quality.

• Eastside Health Coach - The Eastside Health Coach, Reathea Felder, RN, MHA, continues
       to make improvements with the patients who frequent the ED and patients who are admitted
       to the hospital. During the week of November 7, no patients identified as frequent ED
       utilizers presented to the ED. This patient population has Reathea’s direct office number and
       call her prior to presenting to the ED.

• Referrals – Outpatient referral trends are being submitted for publication to various journals.
       Inpatient referrals will continue to be analyzed to identify trends. 

Resident-Led Quality Improvement Projects
For the 2016-2017 academic year, the resident QI projects are designed to increase compliance rates of the following preventative health measures:

• Tobacco cessation and counseling

• Colorectal screening

• Influenza vaccinations

• Pneumococcal vaccinations

In addition, smaller groups of residents are collaborating on scholarly projects to improve understanding of quality initiatives.  Topics include:

• Increasing Advanced Directives on file

• Increasing home exercise programs for patients

• Anticoagulation uncontrolled on Coumadin

• Improving outcomes for patients with Diabetes Mellitus

• Improving provider well-being

• Increasing HPV vaccines

• PPI Usage vs. Anticoagulation Outcomes (thrombosis vs. bleeding) pre/post resident
       integration  into Coumadin Clinic


Amratia P, Millar J,Psychas P, Abuaku B, Ahorlu C, Koram K, Oppong S, Valle D. Using a Bayesian Geostatistical Model to understand local-scale heterogeneity in malaria risk: The example of Bunkpurugu-Yunyoo district in Northern Ghana. Poster presented at: American Society of Tropical Medicine and Hygiene Annual Conference; November 2016; Atlanta, GA. 

Chacko LR. The patient’s voice: Primary care in the ED. Poster presentation at: American Academy of Family Practice FMX Annual Meeting; September 2016; Orlando, FL.

Dadzie S, Coleman S, Mumba P, Seyoum A, Ricks P, Szumlas D, Psychas P, Williams J, Appawu M, Boakye D. Evolution of insecticide resistance in An. Gambiae S.S. population after six years of indoor residual spraying in Northern Ghana. Poster presented at: American Society of Tropical Medicine and Hygiene Annual Conference; November 2016; Atlanta, GA.

Clugston JR. Concussion diagnosis and management. Poster presented at: 2016 Practical Advances in MusculoSkeletal and Sports Medicine National Live Course. American Academy of Family Practice; July 20, 2016; Clearwater, FL.

Clugston JR. Concussion sideline evaluation - SMART Workshop. Poster presented at: 2016 Practical Advances in MusculoSkeletal and Sports Medicine National Live Course. American Academy of Family Practice; July 21, 2016; Clearwater, FL. 

Clugston JR. Elbow evaluation and examination. Poster presented at: 2016 Practical Advances in MusculoSkeletal and Sports Medicine National Live Course. American Academy of Family Practice; July 21, 2016; Clearwater, FL.

Clugston JR. Physical therapy prescriptions. Poster presented at: 2016 Practical Advances in MusculoSkeletal and Sports Medicine National Live Course. American Academy of Family Practice; July 21, 2016; Clearwater, FL.

Edenfield K. Female athlete triad. Poster presented at: 2016 Practical Advances in MusculoSkeletal and Sports Medicine National Live Course, American Academy of Family Practice; July 19-22, 2016; Clearwater, FL.

Millar J, Amratia P, Psychas P, Abuaku B, Ahorlu C, Koram K, Oppong S, Valle D. Identifying malaria risk factors in a hyperendemic setting using Bayesian Model Selection. Poster presented at: American Society of Tropical Medicine and Hygiene Annual Conference; November 2016; Atlanta, GA.


Houck Z, Clugston J. The role of SES and effects of exposure to collision sports on baseline neurocognitive testing.  Presented at: NCAA-DoD Concussion Awareness Research & Education (CARE) Consortium Investigators Meeting; November 9, 2016; Arlington, VA.

Malaty J. Coding/billing and documentation in the outpatient setting: How to teach it in a practical fashion.  Presented at: The Society of Teachers of Family Medicine Conference for Practice Improvement; December 1-4, 2016, Newport Beach, CA.

Malaty J, Carek PJ, Porter M, Samraj G. Hotspotting: Using GIS for population health management. Pesented at: i3 Value Collaborative; September 17, 2016: Chapel Hill, NC.

Clugston J. Concussion, the injury you can’t see. Presented at: Naples North Rotary Club; October 20, 2016; Naples, FL.

Clugston J. Concussions and concussion research. Presented at:  Six O’clock Scholars Program. University Women’s Club; October 18, 2016; Gainesville, FL.


Asken BM, Clugston JR, Snyder AR, Bauer RM. Baseline neurocognitive performance and clearance for athletes to return to contact. J Athl Train. 2016 Dec 1. PMID: 27905859 DOI: 10.4085/1062-6050-51.12.27 [Epub ahead of print].

Carek PJ, Malaty J, Dietrich E, Lombardi J, Porter M, Blanc P, Samraj G. Addressing hospital readmissions: Impact of weekly review. Fam Med. 2016 Sept;48(8): 638-41.

Carris NW, Hwang AY, Smith SM, Taylor JR, Sando K, Powell J, Rosenberg EI, Zumberg M, Gums JG, Dietrich EA, Anderson KV. Patient satisfaction with extended-interval warfarin monitoring. J Thromb Thrombolysis. 2016 Nov;42(4): 486-93. doi: 10.1007/s11239-016-1385-9.

Collins MW, Kontos AP, Okonkwo DO, Almquist J, Bailes J, Barisa M, Bazarian J, Bloom OJ, Brody D, Cantu R, Cardenas J, Clugston J, Cohen R, Echemendia R, Elbin RJ, Ellenbogen R, Fonseca J, Gioia G, Guskiewicz K, Heyer R, Hotz G, Iverson GL, Jordan B, Manley G, Maroon J, McAllister T, McCrea M, Mucha A, Pieroth E, Podell K, Pombo M, Shetty T, Sills A, Solomon G, Thomas DG, Valovich McLeod TC, Yates T, Zafonte R.  Statements of agreement from the targeted evaluation and active management (TEAM) approaches to treating concussion meeting held in Pittsburgh, October 15-16, 2015.  Neurosurgery. 2016 Dec;79(6): 912-929.

Eichner ER, Schnebel B, Anderson S, Clugston JR, Hale H, Michaudet C, Small JM. Acute lumbar paraspinal myonecrosis in football players with sickle cell trait: A case series. Med Sci Sports Exerc. 2016 Nov 21. PMID: 27875493 DOI: 10.1249/MSS.0000000000001167 [Epub ahead of print].

Hwang AY, Dave C, Smith SM. Trends in antihypertensive medication use among US patients with resistant hypertension, 2008 to 2014. Hypertension. 2016 Oct;68: 1349-1354.

Hwang AY, Smith SM, Gums JG. Cushing Syndrome. In: Schwinghamer TL, Koehler JM eds. Pharmacotherapy Case Book: A Patient-Focused Approach, 10th ed. (Chapter 88) New York, New York, McGraw-Hill 2017 (in press).

Mainous AG III, Tanner RJ, Scuderi C, Porter M, Carek PJ. Prediabetes screening and treatment in diabetes prevention: The impact of physician attitudes. JABFM. 2016 Oct;29(2): 283-85.

Shniderman AB, Solberg LB. The slippery slope of reasons-responsiveness for the criminal justice system. American Journal of Bioethics Neuroscience. 2016;7(4): 220-221.

Shahin MH, Gong Y, McDonough CW, Rotroff  DM, Beitelshees AL, Garrett T, Gums JG, Motsinger-Reif A, Chapman AB, Turner ST, Boerwinkle E, Frye RF, Fiehn O, Cooper-DeHoff RM, Kaddvrah-Daouk R, Johnson JA. A genetic response score for hydrochlorothiazide use: Insights from genomics and metabolomics integration. Hypertension. 2016 Sep;68(3): 621-9.

Smith SM, Huo T, Gong Y, Handberg E, Gulati M, Merz CN, Pepine CJ, Cooper-DeHoff RM. Mortality risk associated with resistant hypertension among women: Analysis from three prospective cohorts encompassing the spectrum of women's heart disease. J Womens Health (Larchmt). 2016 Oct;25(10): 996-1003.




January 2017 Grand Rounds has been cancelled; however, February Grand Rounds is in the planning stage.


Dr. Carek is hosting a 2nd Look Party for residency candidates at his home on January 28. The time has yet to be determined. 

Presenter:  Brian Berryman, College of Medicine, Benefits Coordinator
Topic:  CoM Benefits

This won't be your typical conference. Sessions will be interactive and centered around the sharing of ideas. This conference is for anyone and everyone working to improve primary care - medical assistants, nurses, nurse practitioners, pharmacists, administrators, students, residents, fellows, IT specialists, receptionists, physical and occupational therapists, physician assistants, and physicians.

The aim is to create a collaborative space in which the primary care community can share and learn from other's innovative practices and ideas.

With your participation we strive to:

• Share primary care innovations which improve access, quality and coordination of care.

• Think beyond our current traditional medical culture and framework to push the status quo in
      primary care forward.

• Bring together all members of the interdisciplinary primary care team to innovate.

• Build a community of innovators in primary care who will have the opportunity to continue to  
       collaborate into the future.

Schedule of Conference:
9:15 am KEYNOTE:  Dr. Andrew Morris-Singer, founder of Primary Care Progress.
10:30 am BREAK-OUT SESSION:  Attendees will present innovations in progress.
12:00 pm PROBLEM-SOLVING LUNCH:  Collaborate with others during lunch and brainstorm
solutions to common problems encountered in primary care.
1:30 pm BREAK-OUT SESSION:  Attendees will present innovations in progress.
3:30 pm WORKSHOPS:  Attendees will walk participants through an innovation in their practice with the goal of sharing lessons learned.
5:00 pm ADJOURN

To learn more and to register, visit the website for details:


On Friday, September 16, the annual State of the Department address was conducted for all CHFM faculty, staff and special guests, including Dean Michael Good, MD. Presentations provided an overview of the activities and accomplishments of our department and faculty members. In particular, the medical and program directors presented some of the accomplishments of their clinics and programs.

The CHFM Annual Administrative Retreat was held on September 30, and it was a great success! Themed “Taking Charge of Change,” the retreat was held at  the indoor Cypress Lodge and outdoor ropes course areas of Lake Wauburg. The morning session included a valuable “Taking Charge of Change” presentation where Courtney Moon, from UF Training and Development, helped participants look at why change is difficult, what can be expected and how to work through change. The afternoon activities were held outdoors on the warm, September day. The outdoor courses are designed to be a challenge with a purpose. The physical challenges were paired with mental challenges so that participants would be able to put teamwork, leadership and applying what was learned during the morning session into action. Planning is already underway for next year’s event, dated October 5, 2017. Hopefully, the later date will provide slightly cooler weather and fewer bugs, allowing for more comfort outdoors.

The University of Florida kicked off this year’s Campaign for Charities on October 3 and the campaign ended on October 21. CHFM clinics and the administrative office participated in the campaign kickoff and raised $110.87 in a change challenge. Thank you to those who donated their spare change. It just goes to show…every penny counts!  This month, the UF Campaigns for Charities spotlight is shining on the Alachua County Humane Society and St. Francis Pet Care.  To learn more about opportunities for giving, visit:

The Gainesville Chapter of the American Academy of Professional Coders hosted the 19th Annual Coding Fiesta on Saturday, October 22 at the Harrell Medical Education Building. The event involved educating healthcare professionals who are involved with medical billing, coding and utilization management. More than 149 individuals registered to learn about anatomy and physiology; Ethics; Modifiers; ICD-10 Updates; Making a Killer Presentation; Patient Safety; Heart Disease in Women; Mastering the Complexities of E&M and more. With so many excellent speakers and topics, the Coding Fiesta continues to grow as a premier annual educational and networking event attracting attendees from across the southeast region.

A great big Thank You goes out to Juan Garcia-Morell, MD; Michael Massoomi, MD ; Azra Bihorac, MD, MS, FCCM, FASN; Irene Estores, MD; Elin Baklid-Kunz, CPC; Scott Blades, BA, MEd;  Jenan Custer, CCS, CPC, CDIP; Donn Smith, CPC, CPC-I; Maryann Palmeter, CPC, CENT, CPCO, CHC; Francys C. Martin, ESQ, PA; Dana Leach, DNP, ARNP-C, CCRC;  Marsha S. Diamond, CPC, COC, CCS, CPMA; Rose M. Garcia ,COC; and Cynthia Richardson, CCS.

The event organizers would also like to thank the Dean’s Office in the College of Medicine for sponsoring the cost of the meeting space. This event would not have been a success without Art (the Magnificent) Watson. The organizers are truly thankful for his support for more than 10 years.

Communication and Change were the topics discussed at the recent Strategic Planning Retreat that was held on October 28. The retreat was attended by medical and program directors, clinic managers and administrative staff, and the afternoon event was held at Lake Wauburg.  Ground rules for communication were:  honesty, respect, participate, listen, stay open-minded, ask questions, trust and confidentiality. Effective communication between clinicians and administration is imperative and feedback is not meant to micro-manage or criticize. With the understanding that change is happening throughout medicine, we need to embrace it to become leaders in our field.  

Dr. and Mrs. Carek graciously hosted the department’s annual holiday party at their home on December 3. It was a festive evening with lots of good music, food and spirits, along with great company. Thank you, Dr. and Mrs. Carek, for a fabulous evening!

The Mind, Body, and Sole 5K was held on December 4 this year with 161 registered participants. After fundraising activity expenses, we had a profit of $6,783.47. A big THANK YOU to the generous sponsors and donors and to the excellent group of volunteers who made the race run smoothly!



Ideanna Acosta, PA-C
Physician Assistant
UF Health Family Medicine – Old Town
Hire Date: 09/12/16

Ideanna Acosta is a physician assistant at the UF Health Family Medicine clinic in Old Town. She is originally from Orlando, Florida and attended the University of Florida as an undergraduate student in August 2009. In December 2012, she graduated with her Bachelor’s degree in Microbiology and Cell Science. She completed many hours of service in underserved communities in the Gainesville, area including the Minority AIDS program at the Alachua County Health Department, “Let’s Talk About It” Women’s group, and St. Francis House. She worked at UF Health as a Patient Care Assistant on Unit 54 (Cardiac MedSurg) for two years before attending the University of Florida Physician Assistant Program in June 2014. She was rewarded with the National Health Service Corp scholarship in September 2015 and is completing her service at UF Health Family Medicine - Old Town. Her areas of interest include preventative medicine and pediatrics. When she is not at work, she likes to teach Zumba or go to Disney World with her two baby nieces. 

Lisa Chacko, MD, MPH
Assistant Professor and Medical Director for Acorn Clinic
UF Health Family Medicine – 

Eastside and Main

Hire Date: 09/01/16

Dr. Lisa Chacko’s activities in the department are diverse, including patient care and scholarly activities. What she likes best about her current position is the chance to work in teams, and the opportunity to be involved in a wide range of projects that involve clinical care, education and research. At the Eastside clinic, she is helping to develop a team-based approach to care for high-risk patients and is creating a database of patient outcomes, utilization and social determinants of health for these patients. Outside of CHFM, she serves as Medical Director of ACORN Clinic, a non-profit rural clinic for the underserved. She also recently joined a HRSA grant at Archer Clinic, a rural clinic run by the College of Nursing, to study the impact of interdisciplinary team-based care. Other current activities include participation in the planning committee for the James Free Center’s 1st Annual Conference on Primary Care Innovation, as well as co-directing an advanced undergraduate course this Spring as part of UF’s Health Disparities Minor. Outside of work, Dr. Chacko’s life revolves around friends, family, delicious food, the great outdoors and traveling the world.

Macy Gordon
Administrative Support Assistant I
Administrative Office
Hire Date: 11/18/16

A native of Belleview, FL, Macy Gordon graduated with a Bachelor of Arts in Sociology from the University of Florida. Located in Suite N1-02 of the Stetson Medical Sciences Building, Macy currently serves as an Administrative Support Assistant for the department. Macy’s primary responsibilities center around facilitating correspondence and supporting faculty, duties which encompass virtually every aspect of her work. Prior to her November promotion, Macy served as an OPS Office Assistant in the CHFM Administrative Office. Macy’s hobbies include leisurely playing Pokémon Go and cosplaying as Daenerys Targaryen at the nearest anime convention.

Asim Merchant, MD
Assistant Professor
UF Health Family Medicine –

Haile Plantation
Hire Date: 09/05/16

Dr. Asim Merchant is a board certified primary care and sports medicine physician who joined UF Health Family Medicine – Haile Plantation in September 2016. He practices a full spectrum of family medicine with a special interest in sports medicine and concussion management.

Dr. Merchant received his Bachelor of Science in Biology from Southern Methodist University and continued on to receive his medical degree from St. Matthew’s University School of Medicine. He fulfilled his primary care residency at University of Medicine and Dentistry at New Jersey (UMDNJ) and further completed a sports medicine fellowship at University of Buffalo.

During his fellowship, Dr. Merchant served as a team physician for the University of Buffalo Division I football team, the Bulls. He then worked as a sports medicine physician for several years in a private orthopedic office in NY prior to moving to Gainesville, FL. During his time in NY, he served as a director of a concussion clinic, BUMP (Before U May Play).

Dr. Merchant enjoys teaching medical students and residents. At UF Health, he appreciates the opportunity to work closely with medical students and residents. What he loves most about his job is the “sense of family around the work place.” He is very thankful for the opportunity to work with intelligent people doing extraordinary work at the university. In his spare time, he enjoys swimming, cycling and spending time with his family. 

Danielle Nelson, MD, MPH
Assistant Professor and Assistant Medical Director
UF Health Family Medicine – Main
Family Medicine Residency Program
Hire Date: 09/19/16

Dr. Danielle Nelson is a new faculty member and Assistant Medical Director at UF Health Family Medicine - Main.  She practices full-spectrum family medicine and is especially interested in underserved medicine, women's health and group visits. She recently moved to Gainesville from northern California where she worked at the Santa Clara Valley Medical System as Medical Director of a family medicine medical home clinic and later as interim Chair of Family Medicine. Dr. Nelson attended Tufts University Medical School in Boston and completed her residency with the first residency program in the country started by a community health center located in Lawrence, MA.  She is excited to be working with family medicine residents every day and to be able to bike to work. When not in clinic or the hospital, she enjoys hiking, camping and canoeing around Gainesville. 

Emilee Rice
HR Assistant
Administrative Office
Hire Date: 11/23/16

Emilee Rice is the new HR Assistant for the department. She recently joined CHFM in August 2016 as the OPS HR Assistant.  Emilee has worked for the College of Medicine for six years in the areas of Educational Affairs, Admissions and Medical Education. As an HR Assistant, Emilee is responsible for assisting faculty and staff with payroll-related inquiries, assisting with interviews and preparing new employee orientation materials. Emilee works closely with Sheila Diuguid and Sherri Swilley in the Human Resources area.  What she enjoys most about her job is the opportunity to work with such a wonderful team.  “I am engaged to come to work every day because of the leadership and comradery of the team. Having great leadership is one of the important keys to success. I am so thankful to be a part of the CHFM family.”



The 2014-2015 Annual Report has been published and added to the CHFM webpage.  Here is the link to the report: 2014-15 Annual Report



In case you missed any of the latest sessions:

October 4, 2016
Peter Carek, MD, MS
Residency Training in Family Medicine: Looking at Our History and into Our Future   
October 2016 Grand Rounds Presentation - Mediasite

November 1, 2016
Marvin Dewar, MD, JD
We’re modern, but are we contemporary?  
November 2016 Grand Rounds Presentation - Mediasite



In case you missed any of the latest sessions:

PCP Live #31
September 21, 2016
Siddhartha A. Wayangankar, MD, MPH
Demystifying the Screening and Diagnosis of Peripheral Arterial Disease
September 2016 PCP Live Presentation - Mediasite

PCP Live #32
October 19, 2016
Alice Rhoton-Vlasak, MD
Oncofertility and Infertility – What is the Difference and Why does it Matter?
October 2016 PCP Live Presentation - Mediasite

PCP Live #33
November 16, 2016
Ki Park, MD
Cardiovascular Risk Stratification in Women- Where are we in 2016?
November 2016 PCP Live Presentation - Mediasite


If you missed any of the latest issues of The Pulse, here's where you can find them!

(Clicking on the picture will take you to the website)


If you would like to add something to this newsletter or have any suggestions, questions, comments or concerns, please email Sherri Swilley at with subject “CHFM Newsletter”.