Dr. Jay Berkelhamer
A medical executive focused on growing healthcare for children in Georgia
by Jennifer A. Morrell
Photography by Johnny Spring
Although Jay E. Berkelhamer, M.D., has southern roots in Tuscaloosa, Ala., he was raised in Chicago. Today, he is senior VP of medical affairs at Children's Healthcare of Atlanta (Children's), clinical professor of pediatrics at Emory University School of Medicine and an adjunct professor at Morehouse School of Medicine. In addition to these responsibilities, Berkelhamer is the newly elected leader of the American Academy of Pediatrics (AAP).
Georgia Physician sat down with Berkelhamer to learn more about him and what he is doing to grow and improve healthcare for Georgia's children.
Georgia Physician: What is your background, and what inspired you to practice medicine, particularly with children?
Dr. Jay Berkelhamer: After receiving my medical degree from the University of Michigan, I trained in pediatrics at the University of Chicago. Following residency and United States Public Health Service Hospital in Norfolk, Va., I joined the University of Chicago faculty and practiced general pediatrics. At the University of Chicago, I started the academic general pediatric division, directed the residency training program, served as associate chair of the department and performed clinical research.
After 20 years, I became chair of pediatrics at the Henry Ford Health System (Detroit). Collaborating with Children's Hospital of Michigan, I established The Child Health Network and worked with the University of Michigan to start a managed care program for special-needs children. Following legislative experience as a Robert Wood Johnson Health Policy Fellow for the Institute of Medicine/National Academy of Sciences and the American Political Science Association, I advocated for children's issues, serving as a national spokesperson for the AAP. I was president of the Illinois chapter and served at the chapter and national levels on numerous committees, including chairing national committees (State Government Affairs and Quality Improvement and Management). My section activities include community pediatrics, international child health and administration and practice management.
Family has always played an important role in my life. While some of my favorite classes in school were biology and other science courses, my father's interest in science was an influence on my decision to become a physician. I also had an uncle who was a physician and died in World War II. He was a family hero whom I always admired. My personal pediatrician was also a positive influence on me throughout my childhood. I have always loved working with children, and I was active in the YMCA working with children as a summer camp counselor when I was a teen. My decision to practice pediatric medicine was the coming together of these many different influences. I can't think of anything I could have done with my life that would have been more fulfilling.
I have also been married for nearly 40 years to my lovely wife, Jackie. We have three children and two grandchildren.
GP: Has being a key executive had an impact on the way you view or practice medicine and regard healthcare issues?
JB: My patient care responsibilities have been minimized, but I've been able to build on my experience as a physician in my administrative roles. The skills I learned working with parents and children help me daily in my work.
Working in an administrative role, I feel like I have the ability to affect even more children. I am seeing things from a bigger picture and helping make decisions that can affect groups or populations of children. I also enjoy working closely with my physician colleagues, collaborating on best practices and offering support for their practices of medicine.
GP: As a Georgia physician, what healthcare issues do you see affecting children in Georgia?
JB: In Georgia, we are below most other states in many health indicators relating to children's health, such as low birth weights, teen pregnancy rates and children living in single-parent households. Chronic illnesses, such as obesity and asthma, affect thousands of Georgia children. For example, about 11 percent (about 210,000) of all Georgia children have asthma, higher than the national average.
More children in Georgia are living in disadvantaged circumstances, making them more dependent on the safety net of Medicaid and Peachcare to provide a means for them to obtain healthcare services. As a state, we are struggling with funding Medicaid and expanding the Peachcare program. Our children are extraordinarily dependent on those programs. Although other states are challenged with similar problems, it seems that these problems abound even more in Georgia.
GP: Obesity has been a scare nationwide in children. What are your views on obesity as it affects children in Georgia?
JB: According to the Centers for Disease Control and Prevention, about 16 percent of boys and 14.5 percent of girls aged 6 to 11 were obese between 1999 and 2000. That compares to 4.3 percent of boys and 3.6 percent of girls between 1971 and 1974. A sedentary lifestyle and poor nutrition are often big contributors to the problem. Some common health consequences of childhood obesity include Type II diabetes, high blood pressure, asthma, sleep apnea, poor mental health and adult obesity.
At Children's, we recognized the need to address the rising rates of childhood obesity, and in 1996 established the FIT KIDS program, which empowers children and their families to take control of their health. Since the program's inception, obesity prevention experts with the program have worked with hundreds of family members to develop realistic and permanent changes to their nutritional goals and physical activity habits. A key component of the six-week program encourages better communication between parents and children about meal choices and portions. In addition, each family gradually develops a personalized plan for fun physical activities. Although childhood obesity is a major concern, the families are encouraged that weight loss and appearance should not be the main motivating factors toward making change. Rather, solid improvements in overall health and wellness are the key goals to work toward.
GP: Talk about the importance of technology in medicine today. How much new technology comes from Children's?
JB: Electronic records are an industry-wide initiative, driven by the desire for higher quality and more efficient healthcare. Children's is committed to implementing an electronic medical record system, for both inpatients and outpatients, that enhances medical documentation and improves the care we provide to children.
There is a national pursuit to improve patient safety using information technology. At Children's, our complete clinical information system, Epic, will create a seamless electronic medical record for each patient we see. Epic will become a single place to combine and store information, such as census reports and clinical information, on all our patients. It also will improve patient safety in many ways including, reducing transcription errors by transitioning to electronic entries; built-in mechanisms that check medication orders for dosage, drug interactions, food allergies, etc.; and ensuring record availability for the next care provider. As the world of medicine has become more complex, managing that world has become more complicated. By eliminating the need to manage redundant paperwork and search for missing files, Epic will free many of us to spend more time with our patients and to take on new responsibilities that add value to patient care. This technology will also position us as a hospital system on the leading edge of this national effort.
Children's is also one of the only hospitals, pediatric or adult, in the nation to have implemented voice-over-Internet-protocol technology, which helps streamline communications from multiple sites into one “virtual campus” and link 20 satellite facilities, two hospitals and the corporate office into one phone and e-mail system.
This technology has also improved our call center for families, (404) 250-KIDS. Our call center answers about 400,000 calls per year and has answered over 3.5 million calls since it opened 11 years ago. The nurses in the call center triage issues over the phone and provide healthcare advice. This number has become so well known in our community that Children's Healthcare of Atlanta adopted it as our main number.
At Children's, we continuously strive to use technological advances such as these to improve the way we care for our patients.
GP: What are your thoughts regarding medical malpractice reform?
JB: The law SB 3, signed into law by Gov. Perdue in February, is good business and good for business. It would not have passed without the support of Georgia's business leaders, who realized that a malpractice system out of control was contributing to higher healthcare costs for everyone and limiting access for their employees. This new law will reduce malpractice premiums by reducing costs, which is accomplished by placing caps on non-economic damages and minimizing frivolous lawsuits.
The new law's non-economic damage caps may have the most immediate effect. From a previous unlimited amount, the new law caps physician exposure at $350,000 for pain and suffering. MAG Mutual has committed to reduce physician premiums by 10 percent if this withstands any constitutional challenges in court, none of which have been filed as of yet.
Expert witnesses must now demonstrate familiarity and competency in the field that they offer testimony in. For the first time, statements of apology or mistake cannot be used in a malpractice action. Previously, any statement of apology by a physician could be used as an admission of liability in a malpractice action, so it is not hard to see that it did not happen often. Oftentimes, statements offering condolence or compassion can go a long way toward avoiding litigation.
This new law will ultimately help protect physicians and will help create an open communicative environment between physicians and patients. An environment where physicians are not practicing defensive medicine will improve the overall quality of care we're able to deliver. Making the environment less litigious will ultimately help patients.
GP: What do you hope will come from your election as leader of the American Academy of Pediatrics? What will your responsibilities be in that position, and how long will you hold it?
JB: As leader of the AAP, I will continue to be a spokesperson for the needs of children and will promote those policies and initiatives that pediatricians believe will improve the health of all children. One of my top priorities is helping ensure all children have access to high-quality healthcare.
As president of the AAP, I will serve as chair of the Executive Committee of the AAP. I will advocate for children and pediatricians throughout the country, in addition to working with other medical organizations and advocacy groups for children's health. I will take office as president-elect at the October 2005 AAP National Conference and Exhibition in Washington and will serve as the 2006-2007 AAP president.
GP: How are you growing the business of kids' healthcare in Georgia?
JB: Metro Atlanta has one of the fastest growing pediatric populations of any city in the United States. We are expecting 120,000 more children in our area between 2004 and 2009. That is more children than the entire pediatric population of Alabama or South Carolina.
So, physically, Children's is growing. Children's celebrated the groundbreaking for construction on expanded facilities and renovations at Children's at Egleston on March 8, 2005, and at Children's at Scottish Rite on March 29, 2005. The $344 million full-expansion project is the most comprehensive of its kind in the history of Georgia, with construction at both hospitals scheduled for completion in 2007. In total at both campuses, we will construct about 597,400 square feet of new space. We will increase our total number of beds from 430 to 500, with the flexibility for future growth. Each hospital will have 250 beds.
Currently, our two hospitals are more than 80 percent full, which means that during peak times, they are beyond 100 percent capacity. Clearly, Children's must grow now to meet the growing demand for our services.
With the expansion, Children's will also be creating new healthcare positions. Currently, we employ around 5,250 staff and physicians. By 2007, the expansion will have created more than 300 new healthcare positions at Children's.
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