Q&A with Dr. Michael Silber

Dr. Michael Silber grew to become the co-founder of Western NY’s largest and most successful radiology practice through smarts, grit, and a willingness to take calculated risks. In 2003, Dr. Silber recognized an opportunity to build a world-class radiology practice in the growing Buffalo market. With five partners, he arranged to acquire an existing practice, which would serve as the foundation for their growth plans. Over the ensuing 13 years, Dr. Silber and his partners have grown Great Lakes Medical Imaging (GLMI) to assume the leadership position in expertise and market share in the western NY region. GLMI now boasts 40 physicians, including 19 partners, and five PA’s. With total employment at 87, GLMI is still growing in size and dominance.

Dr. Silber is no stranger to hard work — his typical day is 12-16 hours long. The work ethic and discipline for which he is known today are consistent with his former life as a high school football player and wrestler. Prior to medicine, Dr. Silber recalls fondly the odd jobs he worked to fund his education, including busting suds as a dishwasher in a local restaurant. But he is most proud of his work in a tuxedo rental shop. “My job was to measure our clients for tuxedo fittings. No, it wasn’t glamorous – but I never had a single client return because of a mismeasurement…!” His intolerance for mistakes and his discipline, characteristics he honed early in his life, are the Q&A with Dr. Michael Silber hallmarks of his approach to radiology. We recently sat with Dr. Silber to learn more about what this goal-oriented radiologist does outside of medicine.

WNYP: We understand that you are an avid golfer – our inside sources report that you have an entirely un-coachable and unorthodox, but effective, swing and that you play about as fast as most people can power walk. What are you working on outside of medicine and golf?
MS: [Laughs] Yes, golf is a great diversion — a completely maddening game that can abuse you for 80 shots and grants you one perfect shot that brings you back again the next time. But I can’t tolerate a slow pace of play – if my group can’t walk 18 holes in less than 2 . hours, then I start to crawl out of my skin! I have always been entrepreneurially inclined, but for the first chapter of my career in medicine, I was totally focused on growing our practice. More recently, AfterHours Photo: Stephen Rosenbloom, MD 18 I VOLUME 2 I 2016 WNYPHYSICIAN.COM I have been able to dedicate more time and energy to finding opportunities for managing my investible assets more intelligently.

WNYP: What is the conventional wisdom and what are your concerns with that advice?
MS: Investment and financial planning professionals advise that income (from investments) in retirement be derived from some mix of bonds, dividend-yielding stocks, and perhaps annuities. But dividend yields on stocks are only 2.5 – 2.8%. This means that if I need, say, $250,000/yr to support my lifestyle in retirement, I would need to invest $10,000,000 to achieve the income goal. Not every physician has saved that much by retirement, and of those who have, very few are likely to be comfortable with that degree of exposure to equities and their attendant volatility during retirement.

WNYP: What about Bonds?
MS: Bonds present their own challenges. First, they’ve just enjoyed a 40-yr run, so you are acquiring them at the highest prices in decades. Second, interest rates are at historical lows, which means that they will be rising at some point in the future. Rising interest rates push bond prices down. Finally, and more to my point, coupons on high-grade corporates are less than 3.5%. Even if you weren’t concerned about the downside risk in bonds in a rising interest rate environment and you needed to generate $250,000/yr in income during retirement from bonds, then you would need to have over $7,100,000 invested in bonds alone.

Even for a doctor who has been successful in his/ her career and been a fairly diligent saver – not all accumulate $10,000,000 to $20,000,000. So, I’m wondering how they will accommodate their lifestyles without finding asset classes that generate more income per dollar invested.

WNYP: So, what types of opportunities have you been researching?
MS : I have begun working with a group that’s been investing in other asset classes — outside of stocks and bonds to find comparable stability as bonds with 2-3 times the income-producing power. This group has been investing in various real estate categories for many years, especially commercial and multi-family assets. Investing in these asset classes requires incredible commitments of time and expertise to undertake adequate due diligence as well as the discipline to walk away from deals that don’t fit your model. I’m fortunate to be partnered with them because I have neither the time nor the expertise. It is proving to be very successful – we’ve been generating income up to three times what we would be generating with bonds, with several times the growth potential. So instead of needing $7-10 million to achieve my income goal< I only need $2-3 million – a huge difference!

WNYP : So, what’s next?

MS: Continue to grow both my practice and investments. While my goal is not necessarily to produce all of my retirement income from these asset classes, I would like to diversify my income sources substantially from stocks and bonds, maintain a comparable or lower degree of risk, and commit less capital in the process. The entire process very much appeals to the analytical side of my brain and my competitiveness. So, when the time comes for me to begin to reduce my time in medicine, I could envision taking a deeper role in this. Without access to these types of investment alternatives, I honestly don’t know how most doctors are going to support their retirement lifestyles. I’m fortunate to have met the right people who have helped educate me on how to achieve greater income and capital appreciation with less risk, while diversifying both my assets and income-producing sources. It is truly transforming my future for me and my family. Several of my partners have participated and been very happy with the income-generating power of these asset classes.

Photo: Stephen Rosenbloom, MD

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GLMI Breast Care Center Offers Patients a Holistic Approach to Comprehensive Care

By Julie Nusbaum

Dr. Jason Pericak is passionate about women’s health. As Director of the GLMI Breast Care Center for the past six years, he has helmed the Center’s multidisciplinary approach to women’s health and breast cancer detection and treatment. As a board certified Diagnostic Radiologist with fellowship training in Breast Imaging, Dr. Pericak has seen the prevalence of breast cancer and the positive effects of early and annual screening studies. Dr. Pericak took the lead developing an innovative practice program for assessing lifetime breast cancer risk and offering those patients with hereditary cancer red flags genetic testing.

From the moment you make an appointment at the GLMI Breast Care Center on Park Club Lane in Williamsville, it is immediately apparent how different the breast imaging experience will be. New and returning patients download and fill out a risk assessment form, a key element of GLMI’s new Breast Care Risk Assessment and Genetic Testing program, a revolutionary program and the only of its kind in Western New York. Once patients fill out the form, which asks simple questionslike age, hormone usage, and BMI to specific ones about personal and family history of rare or multiple cancers, the doctors use the Tyrer-Cuzick computer model to determine a woman’s percentage lifetime risk for developing breast cancer. “Based on the Tyrer-Cuzick score, we determine the appropriate screening for each individual. Our patients will know whether they are having the correct screening studies such as mammography and breast sonography and/or breast MRI,” says Dr. Pericak. “Further, we will be able to guide our patients for how to proceed in the upcoming years.”

According to GLMI Breast Care Center’s newest addition, Dr. Marie Quinn, “the genetic screening uses a woman’s health and family history to identify patients that may fall through the cracks.” Dr. Quinn, a Board certified Diagnostic Radiologist and Breast Imaging Specialist, says, “My goal is to improve access to this type of testing for all women and identify patients with the risk of developing breast cancer.” The risk assessment questionnaire explores hereditary cancer red flags, including Ashkenazi Jewish ancestry with HBOC (Hereditary Breast and Ovarian Cancer) associated cancers, as well as personal and family history of rare, young or multiple cancers, and the resulting Tyrer-Cuzick score is used best determine the appropriate breast imaging studies for each individual patient. For example, every patient with an elevated Tyrer-Cuzick score will have a screening ultrasound in addition to the standard digital mammography. Depending on their Tyrer-Cuzick score, some patients will also receive a breastMRI. “Because we are a full-service radiology practice, we have the capability to add on additional tests if needed,” offersDr. Quinn. In some cases, doctors make a recommendation on  whether that patient would benefit from genetic testing. GLMI offers the genetic testing, a simple saliva test which examines 28 different genes, right on site. “We add the genetic testing because it is the right thing to do. Abnormal results can be linked to increased risk for up to eight kinds of cancer,” adds Dr. Pericak. “Nothing like this is currently happening in our community.”

Most importantly, every patient that comes into the Breast Care Center for any diagnostic breast imaging will consult with and receive results from either Dr. Pericak or Dr. Quinn explains Dr. Pericak, “ Following the studies, we interpret the results of all exams and get the best feel for what is going on with the patient. Then we consult with each patient about the risk assessment, the Tyrer-Cuzick score, and the breast imaging results to be sure that each patient understands what it all means and how it should be used.” Dr. Quinn notes, “Most patients don’t realize that we only have dedicated breast imagers reading mammograms and consulting with patients. This lowers the call back rate and empowers our patients to know risk factors and results.” In addition to delivering immediate results on-site, GLMI provides referring physicians an immediate, same-day, comprehensive dictation with results, recommendations for next steps, and referrals if warranted.

Dr. Quinn emphasizes that the Center’s “main goal is to improve access for patients to this type of testing and to be an advocate for women and be present for them,” as they navigate the breast cancer screening and diagnostic imaging process. “We are trying to do our best for women to get the appropriate screening. We offer a full range of services, including baseline screening mammograms, breast ultrasound, breast MRI, MRIguided biopsies, and stereotactic biopsies,” continues Dr. Quinn. “Breast cancer is a very treatable disease when caught early.”

Citing several examples of the ripple effect of the genetic testing among family members, Dr. Pericak recounts how the risk assessment questionnaire has led to subsequent genetic testing and discovery of a BRCA gene. He recalls a particular patient with HBOC but no prior history. She found that she had the BRCA gene and referred other members of her family for genetic testing as well. “Because sometimes cancer risk runs in families, we take care of multiple family members here, and they ultimately have procedures that can save their lives,” explains Dr. Pericak.

The three-pronged approach of risk assessment, genetic testing and state-of-the-art imaging provides a comprehensive, patient-centered, personalized approach to women’s health care. “Here at GLMI’s Breast Care Center, we make testing, which sometimes can be anxiety-provoking, as pleasant, expedient and relaxing as possible,” says Dr. Quinn.

Society of Breast Imaging and American College of Radiology Recommendations for Mammography Screening for Breast Cancer

Women at average risk for breast cancer 

Annual screening from age 40

Women at increased risk for breast cancer
Women with certain BRCA1 or BRCA2 mutations or who are untested but have first-degree relatives (mothers, sisters, or daughters) who are proved to have BRCA mutations

Yearly starting by age 30 (but not before age 25)

• Breast MRI typically added

Women with 20% lifetime risk for breast cancer on the basis of family history (both maternal and paternal)

Yearly starting by age 30 (but not before age 25), or 10 years earlier than the age of diagnosis of the youngest affected relative, whichever is later

• Breast MRI typically added

Women with mothers or sisters with pre-menopausal breast cancer

Yearly starting by age 30 (but not before age 25), or 10 years earlier than the age of diagnosis of the youngest affected relative, whichever is later

Women with histories of mantle radiation (usually for Hodgkin’s disease) received between the ages of 10 and 30

Yearly starting 8 years after the radiation therapy, but not before age 25

Women with biopsy-proven lobular neoplasia (lobular carcinoma in situ and atypical lobular hyperplasia), atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS), invasive breast cancer or ovarian cancer

Yearly from time of diagnosis, regardless of age

• Breast MRI typically added

(excerpted from Journal of the College of American Radiology, Breast Cancer Screening With Imaging: Recommendations from the Society of Breast Imaging and the ACR on the Use of Mammography, Breast MRI, Breast Ultrasound, and Other Technologies for the Detection of Clinically Occult Breast Cancer, January 2010)

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Stars align behind new residency program in Buffalo

By Brian Casey, AuntMinnie.com staff writer

September 19, 2016 — It’s not every day that a new radiology residency program starts up in the U.S. In fact, you’re excused if you can’t name the last time it happened. But the stars are aligning in western New York, where the local healthcare community is coming to together to start training future radiologists again at the University at Buffalo.

Dr. Kenneth Pearsen
Dr. Kenneth Pearsen, chair of the radiology department at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences.

On September 9, the university announced that it was restarting its radiology residency program at the Jacobs School of Medicine and Biomedical Sciences. The program had closed more than 10 years ago after operating under an accreditation cloud for several years.

And in an intriguing twist, the university disclosed that the program would be staffed and led by radiologists from a local radiology group, Great Lakes Medical Imaging, which agreed to step in and help fill out the ranks of academic faculty.

“I don’t think there is a better example of how a community comes together to fill a need,” said Dr. Kenneth Pearsen, president of Great Lakes Medical Imaging and chair of the new radiology department. “There was a huge need for radiology residency education in this community that had to be filled, and we got it done.”

Hitting rock bottom

The university’s radiology program hit rock bottom in 2006, when the school voluntarily withdrew from the accreditation program maintained by the Accreditation Council for Graduate Medical Education (ACGME), which is required for all U.S. residency programs. That move capped years of decline at the program, which suffered from a lack of resources, funding, and qualified faculty.

Great Lakes Medical Imaging had been brought in two years before the program shut down, first to read film and then to help teach residents at the program, Pearsen said. For the next two years, seven out of eight residents passed their boards, but university officials went ahead with plans to shut the program down in 2006.

Although the program was moribund, there was talk of reviving it some day. There was still an acute need for radiology residency education in western New York; other medical residency departments at the university needed to offer their residents instruction in radiology, for example. While informal talks were held, nothing concrete came of it, Pearsen said.

Momentum began to build in 2011, as western New York saw major changes in how healthcare delivery was set up in the region. At least one hospital was shut down, and two of the area’s major healthcare providers — Kaleida Health and Erie County Medical Center — were nudged into a partnership called Great Lakes Health System, designed to deliver a more integrated healthcare network. The partnership also includes the University at Buffalo.

Dr. Roseanne Berger
Dr. Roseanne Berger, senior associate dean for graduate medical education at the University at Buffalo.

The university also still had an urgent need for radiologist training, according to Dr. Roseanne Berger, senior associate dean for graduate medical education at the university. After the program’s shutdown, the university had retained three academic radiologists and two medical physicists who participated in training medical residents in other programs in imaging, but there are major advantages to providing a radiology residency program on its own, she said.

“Radiology and imaging in general is an important part of the practice of medicine in multiple specialties,” Berger told AuntMinnie.com. “We train residents in 63 different specialties. I think their training would be enhanced by the availability of academic radiologists who would not only teach residents in radiology but also residents in other specialties that use imaging.”

For example, the Buffalo area has become a center of excellence in endovascular neurosurgery, but the university can’t offer fellowship training programs in the discipline without a radiology residency program. Radiology in the area is the missing leg in a troika that includes neurology and neurosurgery; once it is in place, the university will be able to apply for ACGME accreditation of an endovascular surgery program, Berger said.

Starting with a blank slate

With the stars beginning to align, the university again approached Great Lakes Medical Imaging about reviving the radiology program, with Pearsen at its helm and the group’s radiologists serving as faculty. This time, the group picked up the task, after receiving assurances by the university that they could maintain much of their independence.

“We were taking a large private group and adapting it to a university practice plan,” Pearsen told AuntMinnie.com. “Members of our group had a vested interest in making sure they weren’t going to be swallowed up by the university. They wanted the efficiency of a private practice while providing the research, education, and teaching that the university needed.”

Great Lakes Medical Imaging has begun working with the University at Buffalo to build a new program from the ground up in collaboration with all the stakeholders in the region, a list that includes Kaleida Health and Great Lakes Health. The opportunity to start a new program from scratch is invigorating, Pearsen believes.

“Rather than everyone sticking to a decades-old template, everyone sat in a room with a blank slate and said, ‘OK, how do we do this?’ ” Pearsen said.

In addition to faculty provided by Great Lakes Medical Imaging’s roster of 35 radiologists, the University at Buffalo has committed to provide eight to nine staff members at the assistant or associate professor level whose positions are funded by the state. Funds will also be provided for research, Pearsen said.

The new program will also receive dedicated space, an entire area of Buffalo General Medical Center that will accommodate 16 residents and 10 new staff members, as well as associated medical library, lounges, and call room necessary for a vibrant residency program, according to Pearsen.

Pearsen credits the administration of the University at Buffalo for crafting an arrangement that makes it desirable for radiologists from a private group to engage in teaching without experiencing onerous burdens.

“In the past, if you were volunteer faculty, you’d have to come in on your own and get nothing,” he said. “The university is giving us value in return for the time we are devoting to teaching.”

Pearsen, his colleagues, and the university are currently engaged in the nitty-gritty of setting up the new program, which includes finding instructors for all nine major areas of radiology, from bone imaging to neuroradiology. He believes that the program will be ready to apply for ACGME accreditation by the spring of 2017, have accreditation secured by that summer, and start interviewing medical students for the academic year that begins in July 2018.

The program will start with a class of four residents, adding another four each year to a full complement of 16.

Strengthening job market?

The relaunch of the radiology residency at the University at Buffalo comes at a time when the job market for radiologists is showing signs of returning to health. This follows nearly a decade in which radiologist jobs were scarce, and when many industry observers felt that things would be improved if a few residency programs were shut down.

Pearsen believes that supply and demand for radiologist has always waxed and waned, but in the immediate future there will be demand. And long-term trends such as value-based care will only help.

“The future medical environment is going to move from fee for service to managed care. There will be a lot fewer specialties competing in the imaging space, and we are already seeing that,” he said. “People will be quite content to let radiology handle imaging in that environment, and we see the demand for imaging growing.”

Univ. at Buffalo revives radiology residency program
The University at Buffalo is reviving its radiology residency program, which has been shuttered since closing in 2006.
SUNY Buffalo residency program closes doors
The radiology residency program at the State University of New York at Buffalo will shut down by the end of 2008, according to school officials.


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UBMD growing through partnership with Great Lakes Medical Imaging

Sep 9, 2016, 1:56pm

One of the region’s largest private radiology groups is coming together with a University at Buffalo physician practice.

The partnership will make the 35 providers at Great Lakes Medical Imaging part of the radiology faculty within the Jacobs School of Medicine & Biomedical Sciences while growing the size and depth of the UBMD Radiology practice group. They’ll also provide care to the community through UB’s hospital partners in the Great Lakes Health System.

GLMI will continue to operate its own six outpatient centers and provide services to the community while gaining the ability to conduct clinical research and help build a pipeline of radiologists in the region, said Dr. Kenneth Pearsen, co-founder and president of GLMI and now chairman of UB’s department of radiology and president of the UBMD Radiology practice plan.

“Assimilating ourselves into the UBMD infrastructure allows us to expand our clinical service as well as to do research and education,” he said. “An ulterior motivation is to see if our affiliation with UBMD can make us stronger in collaborating with other specialties and to bring much greater care to the community.”

For UB, the relationship will strengthen its faculty ranks and support the reestablishment of a radiology residency program, said Dr. Michael Cain, dean of the school of medicine and UB’s vice president for health sciences.

“The part that made all of this work was the fact the entire group of Great Lakes Medical Imaging elected to join the university and become part of the UBMD brand, helping us transform and expand a core department for any school of medicine,” he said.

The deal follows two years of talks.

UBMD Radiology is one of 18 practice groups that make up the UBMD Physicians Group, which together count more than 500 physicians affiliated with UB.

Before, UB’s radiology department was relatively small, with about 10 fulland part-time faculty who provided radiology training for medical students. Cain said it was clear the program needed more full-time faculty and more clinical radiologists, and they also needed to love teaching and contribute to clinical research.

“That’s what we wanted the radiology department to evolve to, and when we looked at how we achieve that goal and at several possibilities, truly the best one was to take advantage of the expertise that was here in Buffalo through Great Lakes Medical Imaging,” Cain said.

Both Cain and Pearsen said the need to re-establish a medical residency training program in Western New York was a key motivation for the new arrangement. UB voluntarily withdrew its program in 2006 partly as a response to the departure of several faculty members from the practice. Plans call for beginning the application process this year to pursue national accreditation through the Accreditation Council on Graduate Medical Education, with a goal of enrolling its first class of residents in 2018.

“The program has been dormant for over a decade,” Pearsen said. “The greatest future source of well-trained radiologists for our community is a training program, so without a doubt we were losing out on great, qualified candidates.”

GLMI has provided radiology services at Kaleida Health’s hospitals for many years and will continue to do so under the UBMD Radiology moniker, while also becoming the sole provider of radiology services to Erie County Medical Center. It will continue to operate its outpatient clinics under the GLMI name.

Officials called the move “an important step forward” for the Great Lakes Health System, the planning entity that includes UB, Kaleida Health and ECMC, a state public benefit corporation. In April, state legislators approved amendments that expand ECMC’s ability to work with its partners.

Jody Lomeo, president and chief executive officer of Great Lakes Health and Kaleida Health said the partnership will help advance UB’s teaching mission and fill the pipelines of radiologists in the region.

His thoughts were echoed by Thomas Quatroche Jr., president and CEO at ECMC.

“This important initiative reinforces precisely what was envisioned by the partner organizations that came together as the Great Lakes Health System, fostering strong collaborative efforts that ultimately provide the highest quality health care options for the residents of Western New York,” he said.

Tracey Drury covers health/medical and nonprofits

Pearsen is appointed chair of the Department of Radiology

By Ellen Goldbaum
Release Date: September 9, 2016

BUFFALO, N.Y. – Kenneth D. Pearsen, MD, co‐founder and former president of Great Lakes Medical Imaging (GLMI), has been appointed chair of the Department of Radiology at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo.

Michael Cain, MD, vice president for health sciences and dean of the Jacobs School of Medicine and Biomedical Sciences at UB, said that Pearsen has the administrative, scientific, clinical, leadership and visionary skills needed to move the Department of Radiology forward, expand its translational and clinical research programs, re‐establish its graduate medical education and mentored research training programs, and develop and align a comprehensive clinical program at Great Lakes Health and in the community.

Pearsen is board‐certified by the American Board of Radiology and the American Board of Neuroradiology, with added qualification in vascular and interventional radiology and neuroradiology.

He currently serves as radiology chief of service for Kaleida Health and chief of radiology at Buffalo General Medical Center.

Since 2003, he has been president and, until 2014, chief executive officer of GLMI. Before founding GLMI, he was president of Ide Radiology Group in Rochester, where he also was clinical assistant professor of radiology at the University of Rochester Medical Center and chief of radiology at Highland Hospital.

Pearsen earned his undergraduate degree from the University of Pennsylvania and his medical degree from the Columbia University College of Physicians and Surgeons. After serving as an intern in internal medicine at New England Deaconess Hospital in Boston, he did his medical residency in diagnostic radiology at Massachusetts General Hospital, where he also completed a fellowship in neuroradiology.

He lives in Clarence.

Media Contact Information
Ellen Goldbaum
News Content Manager

Medicine
Tel: 716‐645‐4605

goldbaum@buffalo.edu
Twitter: @UBmednews 

Great Lakes Medical Imaging joins the Department of Radiology in the Jacobs School of Medicine and Biomedical Sciences at UB A key goal is re-establishing UB’s medical residency program in radiology

By Ellen Goldbaum
Release Date: September 9, 2016

“This transition takes advantage of the very talented pool of radiologists at Great Lakes Medical Imaging and complements the strong collaborations between the Jacobs School of Medicine and Biomedical Sciences and our hospital partners.”

Michael Cain, MD, Vice president for health sciences and dean
Jacobs School of Medicine and Biomedical Sciences

BUFFALO, N.Y. – The University at Buffalo announced today that the 35 practicing radiologists employed by Great Lakes Medical Imaging (GLMI) are joining the Jacobs School of Medicine and Biomedical Sciences as full‐time faculty members in the Department of Radiology. They also will provide care to the community as clinicians with UBMD Radiology and UB’s hospital partners in the Great Lakes Health System.

Kenneth D. Pearsen MD, the co‐founder and former president of GLMI, has been appointed chair of the Department of Radiology in the Jacobs School of Medicine and Biomedical Sciences; he has also been named president of the UBMD Radiology practice plan. Angelo DelBalso, MD, DDS, who served as chair of the UB Department of Radiology, has returned to the faculty full‐time.

The UBMD Radiology practice plan will provide radiology services to Buffalo General Medical Center as GLMI has done for years. The new agreement also makes UBMD Radiology the sole provider of radiology services at Erie County Medical Center.

The move is an important step forward for the Great Lakes Health System, the planning entity comprised of UB, Kaleida Health and ECMC, created in 2006 by the Berger Commission, whose mission was to restructure and streamline the hospital and nursing home industries in New York State.

The new arrangement could not have happened without the strong collaborative relationships among the three partners, according to Michael E. Cain, MD, vice president for health sciences at UB and dean of the Jacobs School of Medicine and Biomedical Sciences. Legislative amendments passed by the New York State Senate in April that allow ECMC to further integrate health care delivery among the Great Lakes Health partners also played a role.

“This is a major success story for Great Lakes Health,” Cain said. “This transition takes advantage of the very talented pool of radiologists at Great Lakes Medical Imaging and complements the strong collaborations between the Jacobs School of Medicine and Biomedical Sciences and our hospital partners at Kaleida Health, ECMC and elsewhere on the Buffalo Niagara Medical Campus.

“The transitioning of the radiologists from Great Lakes Medical Imaging into the UB Department of Radiology and UBMD Radiology will re‐energize radiological care, education and science in Western New York, providing UB medical students with a solid foundation in the science of imaging and how it applies to patient care.”

Toward reestablishing a radiology residency

Cain explained that a critical benefit of the new arrangement is that it allows the Jacobs School of Medicine and Biomedical Sciences to re‐establish a residency program in radiology. In 2006, the school voluntarily withdrew the program from the national accreditation process conducted by the Accreditation Council on Graduate Medical Education, partly as a response to the departure of several faculty members.

The need to re‐establish a medical residency training program in Western New York was a key motivation for the new arrangement, according to Pearsen. Medical residency programs provide training in a medical or surgical specialty for medical school graduates; they typically last three to seven years.

“Residency education is the primary pathway to securing the future of our specialty,” Pearsen said, “assuring that Buffalo has a steady supply of expertly‐trained radiology specialists to service our community for the foreseeable future and beyond.”

The school begins the residency application process this year with the goal of enrolling its first class of radiology residents in 2018.

Improving research and patient care

In addition to filling the pipeline of local radiologists, the new UB radiology faculty members will help bolster the provision of radiological services to Western New Yorkers through outpatient facilities with UBMD Radiology and at Buffalo General Medical Center and ECMC.

Cain added that the new faculty also will advance clinical research in the field, complementing the highly‐acclaimed basic science and radiation physics research performed by Stephen Rudin, PhD, SUNY Distinguished Professor and Daniel R. Bednarek, PhD, professor, both in the Department of Radiology.

Jody Lomeo, president and chief executive officer of Great Lakes Health and Kaleida Health said, “This is another step forward for Kaleida Health, ECMC, UB ‐‐ and now Great Lakes Medical Imaging. We are working together every day to better serve our patients as well as this community. This type of collaboration is another example of this. Just as important, the partnership will help advance the teaching mission and fill the pipelines of radiologists here in Western New York.”

“This important initiative reinforces precisely what was envisioned by the partner organizations that came together as the Great Lakes Health System, fostering strong collaborative efforts that ultimately provide the highest quality health care options for the residents of Western New York,” said Thomas J. Quatroche Jr., PhD, president and chief executive officer, Erie County Medical Center Corporation.

“The addition of GLMI radiologists to UB’s Department of Radiology will educate future radiologists to care for patients in our region and will add an even higher level of medical service capability for ECMC, Kaleida and UB, which will ultimately benefit the patients we serve,” he added.

Pearsen explained how the new initiative would benefit the provision of radiological services in the community.

“UBMD Radiology will create an unprecedented, integrated imaging network serving the Great Lakes Health System, including Buffalo General Medical Center and Erie County Medical Center, as well as the numerous specialty services under the umbrella of UBMD,” he said. “In addition, UBMD Radiology will provide radiologic expertise at our multiple GLMI outpatient sites canvassing Western New York. This transition will provide imaging expertise from the most rural locations to the bedside at our most specialized hospital locations

“As UBMD Radiology, we will now be able to strengthen our collaboration with other UBMD specialty practices throughout Western New York, including neurosurgery, orthopaedics, neurology, general surgery and internal medicine, to name a few,” Pearsen continued. “This will ensure the highest educational standards and most comprehensive collaborative health care service in the region.”

Pearsen noted that he has been a hospital‐based radiologist and educator throughout his career, dating back to his training in Boston at the Massachusetts General Hospital, and that he is anxious to give back to the Western New York community, where he has lived and worked for the past 25 years. He is quick to note that it will be a true team effort.

“I am privileged to have as my partners among the best‐trained physicians in the country from programs including Harvard, Georgetown, University of Rochester and Stanford,” he said. “Collectively, we are up to the task of unequivocally placing radiology training and education back on the map in Buffalo to stay.”

 

Media Contact Information Ellen Goldbaum
News Content Manager
Medicine Tel: 716‐645‐4605 goldbaum@buffalo.edu
Twitter: @UBmednews
http://www.buffalo.edu/news/releases/2016/09/013.html 

UB adds 35 radiologists from Great Lakes Medical Imaging

35 radiologists to join Jacobs School faculty
on September 9, 2016 – 10:44 AM

Thirty-five radiologists from Great Lakes Medical Imaging are joining the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences, a first step toward reviving the school’s medical residency program in radiology that ended 10 years ago.

The move provides a major boost to both the school’s radiology department, which had just a handful of full-time faculty, and the university’s UBMD Radiology practice plan, which had just one radiologist, UB officials said. The Great Lakes Medical Imaging radiologists will treat patients through UBMD Radiology.

The new arrangement eventually will bring more radiologists into the local pool of doctors and will give area patients better access to radiology services at outpatient clinics, at Buffalo General Medical Center and at Erie County Medical Center, according to the university.

“This is a transformation and a renaissance for the department of radiology, to have a new chair and 35 radiologists that will engage in the education of our students and allow us to re-establish a residency program and to be excellent caregivers as part of the larger UBMD physician workforce,” Dr. Michael E. Cain, vice president for health sciences at UB and dean of the Medical School, said in an interview.

UB officials said the move wasn’t possible without the cooperation of the members of the Great Lakes Health System – the university, the Kaleida Health hospital network and ECMC – a body created by a state commission in 2006 to encourage regional health care planning.

The 35 practicing radiologists from Great Lakes Medical Imaging join the Medical School’s radiology department, which previously had about five full-time faculty, Cain said. Two are Ph.D.s who conducted research, two practiced at the Veterans Affairs Medical Center and one practiced through UBMD Radiology, he said.

The 35 new faculty members will practice through UBMD Radiology. The practice plan will provide radiology services to Kaleida Health’s Buffalo General, as Great Lakes has done for a number of years. And the new agreement makes UBMD Radiology the sole provider of those services at ECMC, where Great Lakes Medical Imaging had been named the official diagnostic imaging provider in September 2015.

Great Lakes Medical Imaging sites will remain open under that company’s name, Cain said. There are seven outpatient locations, including five in Buffalo Niagara, according to the company’s website.

“You add all these sites together, if you go there you will have your X-ray interpreted, and you will be cared for, by a UBMD Radiology physician,” Cain said.

A key goal of the move is to restart the school’s training program in radiology. UB said it voluntarily withdrew the program from the national accreditation process conducted by the Accreditation Council on Graduate Medical Education in 2006, following the departure of several faculty members.

Residency programs provide training in a medical or surgical specialty for graduates of a medical school. The programs usually run from three to seven years, according to the university.

UB officials said they plan to start the residency application process this year with a goal of enrolling the department’s first class of radiology residents in summer 2018. Once the program is up and running, the program would bring in classes of between seven and nine residents each year, Cain said.

The addition of the 35 new faculty also will boost the clinical research performed in the department, Cain said.

UB has appointed Dr. Kenneth D. Pearsen, the co-founder and former president of Great Lakes Medical Imaging, chair of the Medical School’s radiology department and president of the UBMD Radiology practice plan. Dr. Angelo DelBalso, who served as chair of the department, has returned to the faculty full time.

Cain said UB will invest $1 million in its expanded radiology department, primarily for salaries of some of the new members and support for research and education. The money will come from the UB Foundation, the State University of New York Research Foundation, revenue from the practice plan and operating funds.

Great Lakes Medical Imaging Offers the Most Advanced Open MR Technology to Improve the Patient Experience

By Julie Nusbaum

While watching the Buffalo Bills play on any given Sunday during football season, you might notice the team staff on the sidelines on their phones. What you might not expect is that the team doctors are consulting with their radiologists from Great Lakes Medical Imaging, who are reading and interpreting images between plays, as well as before, during and after the games, to provide up–to-the minute information and diagnoses on the Bills’ players.

Dr. Gregory Shields, a Board-certified and fellowship-trained musculoskeletal radiologist who has been with the practice for 11 years, recounts, “At times when I have read images during games, the doctors on the sidelines will ask me to wait until the cheering stops so that they can hear my medical opinion.”

Established in 2003, Great Lakes Medical Imaging (GLMI) has served as the official MRI and imaging service providers for the Buffalo Bills for the past 10 years, as well as for the Buffalo Sabres,for nearly as long. According to Dr. Shields, “We have done it all [for the athletes]- pain injections, arthrograms, spine and brain imaging, all of their joints, as well as CT scans, X-Rays and MRIs. We have a great professional relationship with trust on both sides.” There is constant communication between the practice’s doctors and the teams, sometimes multiple times each week and sometimes multiple times in one night, and GLMI “provides immediate turnaround times and follow-up on every single case.”

GLMI’s long-standing relationship with Buffalo’s two beloved professional sports teams is just one of the many reasons that this practice has positioned itself as Buffalo’s sports medicine imaging expert. Dr. James Rinaldi, GLMI’s Director of Sports Imaging is one of GLMI’s Board-certified Muscular-skeletal radiologists and is fellowship-trained in Cross Sectional Imaging, says, “Our longevity speaks for itself. If we are qualified to provide imaging for the only two local elite professional sports teams, then we are well-positioned to image and diagnose the weekend warriors and anyone else with routine sports injuries who might come our way.” A large portion of the group’s outpatient practice is musculoskeletal imaging and sports medicine and athletic injuries. Dr. Rinaldi adds, “We also provide interpretations and care for all of the local college athletes, including soccer, baseball and basketball players from University of Buffalo and high school athletes as well.”

GLMI is able to service its professional athletes so effectively in part because of the OASIS, or 1.2 Tesla Open High Field MRI, which has the highest strength open magnet configuration on the market and is the only machine of its kind in the Buffalo area. As a non-invasive procedure which enables physicians to examine internal organs, tissues and skeletal systems without surgery or radiation,the MRI produces high-resolution images through powerful magnets and radio waves. The 1.2 T allows for more effective imaging and diagnosis for all patients, but is particularly effective for those  who are of larger body mass who may not fit or be comfortable on the higher strength 1.5 Tesla, which is a closed platform.

“Approximately 40% of the pro athletes need to go on the 1.2 Tesla. Tackles, linemen, tight ends, and any

of the bigger guys are much better accommodated in an open magnet,” explains Dr. Shields. “With an over 660-pound weight limit and an 82- inch wide table, the 1.2 T is open all around and side-to-side. When a patient lays down on the table, there is over 18 inches of clearance above their body, unlike the tube-like 1.5 Tesla, making it ideal not only for larger individuals, but for anxious or claustrophobic patients, patients suffering from acute pain, children, and the elderly. It is even possible for a family member to sit next to the patient and hold their hand for comfort and support.

While the higher resolution 1.5 T High Field MRI scanners are the practice’s workhorses, the 1.2 T enables high resolution imaging and diagnosis for a population that may not otherwise be able to be imaged. “Medicine is not one size fits all. We have to make sure that the patient is comfortable, and if they are not comfortable in a particular machine, they won’t get a good diagnostic study,” says Dr. Shields.

Dr. Rinaldi calls the 1.2 T “a very good tool in the arsenal to image everyone adequately and the gold standard for open magnet technologies.” Diagnostic pictures from the 1.2 T are markedly improved from the previously available .7 T open magnet. “It does better body imaging so we can see the solid organs  and abdomen better, offers better neurological imaging because we can get thinner slices, and works faster and decreases the amount of time spent imaging,” says Dr. Shields.

With nearly 100 employees, GLMI is the largest radiology group in the greater Buffalo area that provides all aspects of imaging with subspecialty expertise. In striving to offer the best possible service to the broadest cross section of patients, this highly regarded practice has been on a path of continuous growth since its inception. All GLMI radiologists are Board-certified by the American Board of Radiology. In addition, GLMI has a broad range of specialized expertise, with fellowship-trained radiologists in breast imaging and in radiology subspecialties of musculoskeletal imaging, neuroradiology and nuclear medicine. “We can image and accept anyone, and do it well, from sports medicine, to abdominal imaging to neurologic and spine imaging,” says Dr. Rinaldi. When pressed about whether they are the best in town, Dr. Shields modestly offers, “We have a good track record.” In addition to the 1.2 High Field Open MRI and the 1.5 T, PET CT, low-dose CT, nuclear medicine, mammography, bone densitometry, fluoroscopy, ultrasound and X-ray are available at their state-of-the-art Park Club Lane flagship in Williamsville. With four other centers located in Cheektowaga, Orchard Park and Cambria, GLMI is well-positioned to offer convenient imaging expertise serving patients and referring physicians throughout the Buffalo region. Whether treating weekend warriors or high level professional athletes, Great Lakes Medical Imaging is western New York’s trusted imaging expert and an exceptional asset to the community. Buffalo is fortunate to have them in our midst.

WHY 1.2T

GLMI’s 1.2 Tesla Open High Field MRI, the Hitachi OASIS, is Western NY’s highest field open magnet. Its advanced technology allows for imaging of even the most challenging patients. The open 82 cm (the widest possible) bed enables bariatric, pediatric, geriatric, anxious or claustrophobic patients to be imaged comfortably and quickly.

Special features of the 1.2T include

• Open architecture, so patients can see left to right

• Assymetric table, making it easy to transition on and off

• Rapid scanning mechanisms, which decrease study time

• Superior motion compensation, which reduces the need for rescans

• 660-pound weight limit

• Unobstructed viewing angle

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