Dr. Clifford Chin
Pediatric Cardiology
Cincinnati Children's Hospital
Director, Pediatric Heart Transplant Services

It's a life or death decision no one would want to make. Which child gets a new heart?

It's a decision Dr. Clifford Chin has been involved with a couple of dozen times since coming to town 16 months ago as the Medical Director of Pediatric Heart Transplant Services at Cincinnati Children's Hospital Medical Center.

He is well aware that for every heart transplant, others in need won't get one. Heart donors remain low because of the traumatic decisions that need to be made when a child dies.

"It is difficult. But you have to divorce yourselves from the emotions even though it is a very emotional thing," says Chin. "As a transplant community, we have to be good stewards of this process. And we are. We have a vigorous selection process."

Chin says the decision is based on a number of standards that ultimately evaluates which patient has the best chance for a lengthy survival.

In a short time Chin has put Children's on the map as one of the country's premiere pediatric heart transplant facilities.

The New York native (SUNY Medical School) spent 20 years as a fellow at the prestigious Stanford University Lucile Packard Children's Hospital, home to Dr. Norman Shumway, regarded as the father of the heart transplant.

When offered the chance to come to Cincinnati he jumped at the chance, impressed by the leadership Dr. Jeffrey Towbin, executive co-director of Children's Heart Institute.

"Dr. Towbin's vision was to grow a world-class, advanced care heart institute in a way that really hasn't been done anywhere in the world," says Chin. "I was overwhelmed by the energy, the facilities, the infrastructure and the way people work together."

In 2006, two heart transplants were performed at Children's. So far this year, 12 have been performed. About 450 transplants in children are done each year worldwide.

"We aren't just trying to build numbers," Chin says. "We need to transplant people that need it and we really need to be able to get 30-40 years out of this heart. We don't want to just prolong someone's life for a couple of months or a couple of years." Chin says the Children's team is also focused on working with new drugs, researching antibodies and developing procedures that can delay a transplant, hopeful that with swift advances in medicine and other devices even more options will be available to a patient in 5-10 years.

"Our team is growing, bringing in various experts, exploring these alternative procedures," Chin says. "At Children's, we are pushing the envelope, but doing it in a very thoughtful manner to advance the care of children and adults with heart disease."

Kellie Flood-Shaffer
Obstetrics and Gynecology
UC Health
Division Director OB/GYN

The Rewards of Her Work "” Beautiful Babies

After 25 years in the field of obstetrics/gynecology, Dr. Kellie Flood-Shaffer says she is still moved by the amazing doctor-patient bond, which may be unique to this field of medicine.

"You develop these relations in very intimate settings," she says. "Delivering a baby with a husband and wife is just so intimate it really creates a bond. And they come back every year for their care."

Flood-Shaffer says her interest in the field was first triggered by a paper she did as a sophomore in high school in El Paso, Texas.

"I did a biology class project on a brand new procedure called amniocentesis. Ever since that high school term paper, I was fascinated with OB/GYN. I never changed my mind all through med school."

Flood-Shaffer came to Cincinnati in 2009 as part of an effort by UC Health to expand patient care in OB/GYN beyond teaching and research. She had been interim chairman of OB/GYN at Texas Tech University in Lubbock, where she had received her medical education.

Besides seeing patients, Flood-Shaffer is an assistant professor in charge of UC's OB/GYN residency program. She is also engaged in research in a joint National Institutes of Health-funded venture with the Department of Neurology studying epilepsy medications and pregnancy.

While she loves keeping a foot in academia, Flood-Shaffer says what makes her job most rewarding is that patient bond.

"You watch them go through a pregnancy and you get a reward at the end. You are able to hand them a beautiful baby," she says. "But that's a short-term reward. It results in a long-term relationship where women come back year after year."

And there is another facet of her practice where she is, in a sense, delivering "babies" of a different kind "” watching students become doctors.

"You see these medical students who are like the deer in the headlights. You watch them as residents and you are able to teach them skills and create this foundation of learning and expertise. Then you watch them walk out the door at graduation.

"It is such a good feeling to be able to say, "¢I trained that guy; I taught her, and they are a successful physician.' That's a big reward for me and why I stayed in an academic setting."

Dr. Paul Keck, Jr., MD
Lindner Center of HOPE, President and CEO,
University of Cincinnati College of Medicine, The Craig and Frances Lindner Professor of Psychiatry and Neuroscience, and Executive Vice Chairman of the Department of Psychiatry

Dr. Paul Keck may be the chief administrator for one of the area's leading mental health facilities, but he says his most satisfying time is that spent with his patients.

"My best days of the week are the days I have my clinic hours," says Keck. "The most rewarding thing for me has always been working with people and their families. It's a balancing act I try to strike. I very much enjoy my work as a clinician. I try to use half my time to see patients."

That's probably no small goal for the president and CEO of the Lindner Center of HOPE, the state-of-science mental health facility in Mason that opened in 2008 thanks to the backing of Craig and Frances Lindner, who felt the mental health needs in Greater Cincinnati were not being met.

Keck, one of the world's leading researchers in bipolar disorder and psychopharmacology and the author of 525 scientific papers and textbooks on psychiatry, was picked to help establish and administer the facility.

"It was a once in a lifetime opportunity to build something from a blank slate and capitalize on the best knowledge in the field," says Keck.

The lodge-like building breaks from the institutional feel, with amenities for families to stay over in an individual's room, which is unusual in a mental health facility. Serving patients age 12 and older, the facility treats all types of psychiatric and mood disorders and addictions, with a special treatment team for adolescents.

In just four years the center and its staff has made it on Best Doctor and Best Hospital lists locally and nationally. Keck says part of the quick success was having the backing to build a world-class staff.

"We were able to recruit some of the best and the brightest clinicians and scientists from around the country. That's what makes the place truly special."

The center also does research into the causes and treatments of mental illness, including genetic research and brain imaging.

Keck, a western Pennsylvania native with medical training in New York and Boston, says early in his career he was fascinated by bipolar disorder and arrived at a time when amazing new drugs were being developed in the field.

"I was fortunate to be involved in that early research, truly help people and learn more about the biology of the illness and its genetic tendencies."

Dr. Matthew McLaughlin
Physical Medicine and Rehabilitation
Wellington Orthopaedic & Sports Medicine

When people talk about doctors, it's rare that physiatry is part of the conversation.

That could be changing, however.

Dr. Matthew McLaughlin is a physiatrist with Wellington Orthopaedic & Sports Medicine. According to the American Academy of Physical Medicine and Rehabilitation, physiatrists are medical doctors who are nerve, muscle and bone experts who treat injuries or illnesses that affect how people move.

Specifically, physiatrists diagnose and treat pain with non-surgical treatments. They restore function by treating the whole person, not just the problem area.

"The value of physiatry has become more recognized over the past decade, especially the role of physiatry in the treatment of spine disorders," McLaughlin says. "Here at Wellington, I work closely with my orthopaedic colleagues to provide integrated, coordinated care."

Physiatrists add value to a medical group by the breadth of their training. Take back problems, one of the most common, painful and frustrating conditions for people.

"The vast majority of spine problems are best managed without surgery. However, many patients don't get appropriate conservative treatment prior to considering surgery," McLaughlin says. "There are a variety of highly effective, nonsurgical options for most spine problems. As a physiatrist, I coordinate the patient's care by diagnosing the problem, prescribing effective physical therapy and performing spine injections when needed to control pain. I also spend a lot of time educating the patient about their condition, treatment and the recovery process.

"I understand the indications for surgery for select patients and for those who fail to respond to appropriate conservative management. I work closely with spine surgeons and often help postoperatively manage and rehabilitate patients. The focus of physiatry is on restoring and maximizing function."

McLaughlin, who is from Kettering and graduated from the Ohio State College of Medicine, joined Wellington in 2001.

"Since coming to Wellington, my focus has been on comprehensive spine care," he says. "I still occasionally see and treat other things, and I often treat a spine patient's other musculoskeletal issues in a coordinated fashion."

That focus will pay off when McLaughlin will become team leader of a new program.

"Mercy Health is going to open a coordinated spine center in Anderson HealthPlex in January and I'm going to be the medical director," he says. "It's going to provide coordinated, integrated care with physiatry being the gatekeeper, but having pain management, surgeons, and therapists ... all in the same place. With this approach, we will be able to provide the best, most timely and most cost effective care for spine problems."
Sri S. Murthy
Family Medicine
UC Health Physicians at University Point, West Chester

The family medicine practitioner is said to be in short supply these days because so many medical students are opting for the more lucrative specialty fields. But Dr. Sri Murthy says she was always drawn to family practice.

"I am rewarded just to be able to be there and serve people, to see a smile on their faces and the happiness to know they are getting better," she says. "I enjoy having the first contact with patients.

"I wanted the challenge of diagnosing a problem when someone walks in your door."

Murthy sees patients of all ages "” infants to the elderly. (About the only thing she doesn't do: "I don't deliver babies," she says with a laugh.)

Murthy, raised in Mumbai, India, says she knew from the age of 7 she wanted to be a doctor. She fondly recalls long conversations with her father, a pharmaceutical rep, about advances in medicine.

"My dad was my biggest inspiration. We would always be talking about different drugs and different diseases. It just made me even more curious about being a doctor."

After graduating from medical school in Mumbai, Murthy did her residency at Clinton Memorial Hospital in Wilmington,Ohio. She quickly embarked on a career path of family medicine, opening a family health center in Butler County, geared to people with limited means and no health insurance. In 2007, she entered a family practice group with UC Health.

In her practice, she tries to emphasize preventive health care. Ultimately, she says, there is no mystery as to what it takes to be a good family practitioner: It's pretty much the Golden Rule.

"A good doctor is one who actually feels the pain and the happiness of the patient," she says. "A good doctor is one that does exactly what they would want any other doctor to do for them.

"I always try to put myself in the shoes of patients, whether it's a normal health check, or a problem like terminal cancer. I just think, How would I want to be comforted?'"
Dr. Ronald Warnick
Neurological Surgery
Mayfield Clinic
UC Brain Tumor Center

Providing Hope Through Research, Innovation

Dr. Ronald Warnick's resume is impressive. No surprise there, he is a brain surgeon.

More precisely, he's a brain tumor expert who specializes in radiosurgery (a focused radiation technique). He is also chairman of board and president of the Mayfield Clinic, an independent neurosurgical practice, and the director of the UC Brain Tumor Center.

What you won't find listed, however, is what Warnick calls his most important role.

"I think my job is about providing hope," he says. "I provide hope through physician expertise and training and knowledge, and I provide hope through patient education. That's really important because if I can educate patients in my interactions with them in my office "¢ (they can) become more comfortable with their disease and the pathway that they're choosing.

"(Also) hope through innovation. That's why I'm involved so heavily in clinical trials and research. But sometimes I see patients and that's all I do. I may not operate on them, I may just give them an opinion, but I'm providing them with some hope. I think that's the essence of what I do."

Warnick sees hope on many fronts, including treatment tailored to the "genetic fingerprint" of a person's brain tumor.

"In the past, once we knew the name of the tumor from the biopsy we would treat each patient pretty much the exact same way," Warnick says. "(It) was successful to some degree, but it became apparent that the tumors are very heterogeneous "¢ So basically what we do is take a cue from a show like CSI: Miami where they use physical evidence to solve a crime. We're here to solve a crime that is brain tumors."

From the genetic fingerprint obtained from the biopsy, doctors can decide if one drug would work better than another and also tell how well the treatment is working.

That's progress. But the next step excites Warnick even more.

"(Researchers) at the UC Brain Tumor Center and other institutions are looking at how a specialized form of imaging "¢ can be used to detect the genetic fingerprint of a tumor without the need for a biopsy," Warnick says.

"I envision a point in which a patient comes in with an apparent brain tumor on an MRI, we get this specialized imaging that gives us the genetic fingerprint, and from that we choose the appropriate therapy.

"My goal is to be put out of business as a surgeon "¢ if we could cure these tumors without surgery, I would consider that a grand slam."