June 2013

June 2013

Welcome to the June 2013 edition of the Round Table.

Roundtable Header

I would like to thank all who came out to on May 16 to the spring General Faculty Meeting & State of the School address. In it, we conferred medical degrees upon the 143 graduates of the Class of 2013; honored faculty accomplishments and excellence — applauding Dr. Richard Pearson with a well-deserved standing ovation for his 24 years of service and dedication to our students, as he is soon retiring as the Associate Dean of Student Affairs; discussed student accomplishments and looked at the (impressive) incoming Class of 2017; highlighted curriculum and research achievements; offered updates on funding (and funding challenges); reflected on the very successful 2013 Research Retreat; highlighted our continued reinvestment in our research facilities; provided updates on our Centers of Excellence and leadership transitions; discussed quality and metrics; provided updates on construction progress and the expansion of our network; and looked to the future of healthcare, exploring the ways in which we will best navigate the uncertain waters that lie ahead.

Near the end, we also took a few minutes to talk about accomplishments from the past five years — yours, mine, and ours. Together, we have achieved some amazing things: Constructing a new medical education building, moving medical instruction to the new building, and developing the successful NextGen curriculum. Increasing the size of our medical school to 156 students. Revamping the Biomedical Sciences curriculum. Opening the Carter-Harrison Research Building (MR-6). Installing the Titan microscope and the cyclotron. Maintaining and growing our NIH training programs. Refurbishing the clinical research unit in Barringer. Appointments, from an inaugural CMO to 11 new department Chairs, and a School of Medicine Chief Administrative Officer. Opening the Emily Couric Clinical Cancer Center and recruiting a new director, Thomas P. Loughran Jr., who will start on Aug. 15. Installing Epic. Increasing our focus on quality, safety, and access, and expanding Outreach beyond Grounds. The list goes on and on.

My apologies for accidentally overlooking Leigh Grossman, MD, Associate Dean for International Programs and Professor of Pediatrics, and her staff, in the presentation — their growth and stabilization of the international training programs has been outstanding.

These are incredible achievements, done incredibly well — for which you should all be extremely proud. Time passes quickly when we are not watching the clock, and in just five short years you have accomplished an outstanding number of amazing things. I applaud you all.

We covered a lot of ground in the State of the School and, if you were unable to attend, I encourage you to go online and view the presentation slides and listen to the audio capture at www.medicine.virginia.edu (login required).


Steven T. DeKosky, MD, FAAN, FACP, FANA


2013 Endowed Chairs Honorees

On May 15, we honored our faculty who were elected to endowed chairs during this academic year with a ceremony in the Medical Education Building’s Learning Studio. The holder of an endowed chair receives one of the most prestigious honors that can be bestowed on a University of Virginia faculty member. The highest levels of performance, and national and international recognition of that performance, are inherent guidelines for appointment of a chairholder. The institutional expectation of unquestionable excellence means that the person is deemed to have achieved the highest stature and exemplary accomplishment in a discipline or area of research, teaching, or clinical service as judged by an independent assessment of his or her peers.

Each the honorees received a captain's chair with a plaque affixed bearing their name and the name of their endowed professorship. This year's honorees include:

  • James E. Casanova, PhD, Harrison Distinguished Teaching Professorship (Department of Cell Biology)
  • Victor H. Engelhard, PhD, Harrison Distinguished Teaching Professorship (Department of Microbiology, Immunology, and Cancer Biology, Beirne Carter Center for Immunology Research)
  • Fern R. Hauck, MD, Spencer P. Bass, MD, Twenty-First Century Professorship in Family Medicine (Department of Family Medicine)
  • C.D. Anthony Herndon, MD, John E. Cole Professorship in Urology (Department of Urology)
  • Andra H. James, MD, MPH, John M. Nokes Professorship in Obstetrics and Gynecology (Department of Obstetrics and Gynecology)
  • Christopher M. Kramer, MD, Ruth C. Heede Professorship in Cardiology (Departments of Radiology and Medicine)
  • Maria-Beatriz S. Lopes, MD, PhD, Harrison Distinguished Teaching Professorship (Department of Pathology, Department of Neurological Surgery)
  • Mary Faith Marshall, PhD, Emily Davie and Joseph S. Kornfeld Foundation Professorship in Biomedical Ethics (Department of Public Health Sciences, Center for Biomedical Ethics and Humanities, School of Nursing)
  • Peter A. Netland, MD, PhD, Vernah Scott Moyston Professorship in Ophthalmology (Department of Ophthalmology)
  • M. Norman Oliver, MD, Walter M. Seward Professorship in Family Medicine (Department of Family Medicine)
  • Mitchell H. Rosner, MD, Henry B. Mulholland Professorship in Internal Medicine (Department of Medicine)
  • Lois L. Shepherd, JD, Peter A. Wallenborn, Jr. and Dolly F. Wallenborn Professorship in BioMedical Ethics (Department of Public Health Sciences, Center for Biomedical Ethics and Humanities, School of Law)
  • Robert A. Sinkin, MD, MPH, Charles I. Fuller, Jr., Professorship in Neonatology (Department of Pediatrics)
  • Stuart S. Howards, MD, Hovey S. Dabney Eminent Scholar Professorship (Department of Urology)
  • Christopher I. Shaffrey, MD, John A. Jane Professorship in Neurosurgery (Department of Neurological Surgery)
  • Francis H. Shen, MD, Warren G. Stamp Professorship in Orthopaedic Surgery (Department of Orthopaedic Surgery)

Congratulations to all on these outstanding achievements!

Upcoming Faculty Salary Adjustments

As the upcoming faculty salary increase cycle is arriving, I would like to provide you with an update. Some faculty will see a salary increase between 2.5-3.0%; however, these increases will be limited, and based upon exceptional performance as defined by your chair or other unique circumstances; many will receive a 0% increase in their base pay. Given the current funding environment, including decreases in research funding and clinical revenues, providing salary increases could add to the financial instability of some departments. Consistent with our compensation plans, faculty will continue to have the opportunity to generate additional income through incentive plans that reward productivity.

Plans for staff increases are still being finalized. We will provide more details on this when they become available. I would like to personally thank you for your hard work and diligence, and your daily commitment to excellence to our patients, students, and research during these difficult financial times.

2013 Leonard Sandridge Outstanding Contribution Award Recipients

Congratulations to the 2013 Leonard W. Sandridge Outstanding Contribution Award recipients. This award is the highest honor for staff at the University, celebrating their exemplary service and commitment to the University. This year, seven of the 11 awardees were from the Health System. They are:

  • Jamie DeVore, administrative manager, Radiation Oncology, School of Medicine
  • Wilma Lynch, administrative services manager, Claude Moore Health Sciences Library
  • Virginia "Jenny" Friend, registered nurse care coordinator, Emily Couric Clinical Cancer Center
  • William "Bill" Graves, surgery supply specialist, Central Sterile Supply
  • Stephanie Reed, physical therapist, Therapy Services
  • Linda Shifflett, patient care assistant, 5 East
  • Kelvin Tyree, patient care technician, Outpatient Surgery Center

Employee of the Month: Laura Simmons

As the Pre-awards Grant Manager for Orthopaedic Surgery, Laura Simmons received several nominations outlining her expertise. She was lauded as being responsible for recently coordinating the visit of the Virginia Secretary of Health & Human Resources on behalf of the department and the Medical Center. When the venue for dinner was canceled at the last minute, Laura spent her weekend researching new locations and securing a great spot for a productive and well-received interaction with this political leader.

Laura's supervisor, Mary-Leigh Thacker, stated that in addition to her duties as Pre-awards Grant Manager, Laura "serves as the department lead for the Dean's Matrix and coordinates promotion and tenure process each year." She willingly takes on additional responsibilities with enthusiasm, timeliness, and an incredible work ethic. Whether she's working on projects like the residency program, pulling together the Chair’s five-year review materials, or assisting peers, Laura is always willing to help out to keep the department running smoothly.

Michael Boblitz, Chief Operating Officer, Orthopaedic Surgery, says, "Mrs. Simmons' work ethic is beyond reproach." It is this work ethic that continues to move the department and the School of Medicine forward. Thank you to Laura for being a great example of integrity and dedication!

This Month: UVAHS Launches Employee Engagement Initiative

In the coming weeks, you will see and hear much about our upcoming 2013 Employee Engagement Survey. Signs and flyers will be posted, and table tents will sit atop cafeteria tables. You will notice that these reminders are labeled with the logo "Your Voice. Your UVA." This is your institution and you have a voice here at UVA — and this survey is an open line of communication, the first step in engagement and addressing issues in your area. This is a great opportunity for you to share information that can directly impact your work, your team, and our Health System. It takes all of us to drive meaningful change!

Advancing a culture of employee engagement is one of our key strategic initiatives. To this end, the School of Medicine has partnered with colleagues from the Medical Center, University Physicians Group, School of Nursing, Claude Moore Health Sciences Library, and the Gallup organization to launch a Health System-wide, comprehensive employee engagement initiative this summer. This will begin a year-round focus on improving and strengthening our workplace. The survey will be administered from June 12-26, and I encourage all to participate.

Engaged employees are not the same as satisfied employees. Engaged employees are psychologically and emotionally committed to their work, their colleagues, and organizational goals. An employee’s engagement level goes beyond their level of satisfaction with their workplace.

It has been shown that engaged individuals and workgroups are more productive, are more likely to stay with an organization, and are emotionally connected to the mission and success of an organization. Meta-analysis has found that top-quartile engagement work units have substantially better business outcomes than their bottom-quartile counterparts. This is seen in lower absenteeism and turnover, and higher patient safety, quality, productivity, profitability, and customer satisfaction.

The survey and its results are completely confidential. Individual responses will not be shared with supervisors or anyone else within the UVA Health System. To ensure anonymity, results will not be reported for groups with fewer than five respondents.

Everyone will be able to see results from the survey. Gallup will collect and process the survey data and prepare a series of reports for the Health System overall as well as for departments and workgroups. We expect to be able to share results starting in September. Then, the most important work will begin: conversations about the survey and action-planning that will ensure a positive UVA work experience.

I thank you in advance for helping us foster and develop a culture of engagement here at the School of Medicine and across the entire Health System.

For more information, please visit: www.medicine.virginia.edu/administration/office-of-the-dean/employee-engagement.

Success: "Administrative Leadership in a VUCA World"

Thank you to all who attended last month's inaugural Administrative Leadership Conference. The conference addressed the unstable and rapidly changing environment in which we live and work — one characterized by Volatility, Uncertainty, Complexity, and Ambiguity. Participants discussed leadership in academic medicine and explored ways to overcome and mitigate the complex challenges facing academic health systems.

Dr. Nancy Dunlap kicked off the conference with an inspiring keynote speech that focused on the importance of leaders providing Vision, Understanding, Clarity, and Agility in times of instability and ambiguity. Then, for the next two days, 150 administrative leaders and other participants from the School of Medicine, Medical Center, and University Physicians Group, discussed more than 40 different topics, ranging from Employee Relations and Funds Management, to External Threats to the Health System and Information Technology; from The Life Cycle of SOM Faculty and Emergency Planning, to Community/Physician Strategic Relations and Leading Positive Change. And many other items in between.

The feedback from attendees was extremely positive. It is my hope that this will be an annual conference, and that all attendees departed with new collaborations, new ways of thinking, and a renewed enthusiasm for our work. Special thanks go out to all those who led breakout sessions and the planning team who organized the event: Troy Buer, Anne Williams, Brian Gittens, Ashley Ayers, Kathleen Foster, and Alice Keys.

Deadline Approaches to Honor Your Faculty

A wonderful way to honor your faculty is by nominating them for recognition and awards. Listed below are five upcoming awards, to be given to faculty who bring excellence to our institution:

For deadlines, information on eligibility, and criteria, please follow the above links. If you have questions, please contact Ashley Ayers at ala5t@virginia.edu.

Health System-wide Calendar Offers Ease of Use

The Health System is a big place and, in an effort to help get us all on the same page and to Move As One, the School of Medicine (SOM) has recently adopted the Health System calendar onto the SOM homepage. As we encourage more widespread adoption of this single utility, it will allow us to focus our web resources on constantly improving the calendar's usability on computers, websites, and mobile devices. To access the calendar, go to www.healthsystem.virginia.edu/events/. If you have any questions about the calendar or how to use it, please contact Ray Nedzel at ran2n@virginia.edu.

Deadline Nears to Disclose Financial Interests

Thank you to those who have already submitted your annual disclosure of external financial interests — more than 70 percent of our faculty have already completed the process. If you have not yet done so, there is still time. All School of Medicine faculty are required to provide an annual disclosure of external financial interests and updates within 30 days of any material changes in those interests. Regardless of whether you have any external financial interests, you must access the reporting system at https://avillage.web.virginia.edu/uvacoi. Department coordinators will be working with the Dean’s Office to ensure 100 percent compliance in the next few weeks.

Last year, the disclosure requirements changed substantially, because of the revised Public Health Service Conflict of Interest policy. Please familiarize yourself with these before initiating the process. Information on policies and responsibilities can be found at www.medicine.virginia.edu/research/offices/research/home/compliance-training#COI.


This Month: LCME Self-Study Kickoff!

The Liaison Committee for Medical Education (LCME), the accrediting authority for medical schools in the U.S. and Canada, will arrive to conduct their survey from October 5-8, 2014. In preparation for their arrival, we are kicking off the institutional self-study on June 10, 2013.

To date, more than 150 faculty, staff, and students have been appointed to subcommittees to analyze and assess all aspects of the medical school and its programs. We have also invited University leaders and deans, faculty from across Grounds, and alumni to serve on an executive committee, which added approximately 30 participants to the self-study. The LCME Institutional Self-Study Subcommittees include: Institutional Setting, Educational Program, Medical Students, Faculty, and Educational Resources. Barnett Nathan, MD, is serving as faculty chair of the institutional self-study.

Thank you to the LCME steering committee — Chair Randolph Canterbury, MD, Senior Associate Dean for Education; Barnett Nathan, MD, Associate Professor of Neurology; Brad Haws, CEO, UVA Physicians Group, Senior Associate Dean and Chief Administrative Officer, UVA School of Medicine; and Lesley Thomas, JD, Assistant Dean for Medical Education — for keeping us focused on this important project. Additionally, I would like to thank all who are involved in preparing us for the October 2014 visit.

Brodie Resident Clinician Awardees Are …

The Anne L. Brodie Medical Fund Committee annually recognizes a single resident in each of the primary care disciplines with the Brodie Resident Clinician Award. This award recognizes resident physicians who demonstrate clinical excellence in primary care and serve as a model for peers and medical students at the University of Virginia by taking personal and primary responsibility for all of their patients’ needs.

The Brodie Committee had an exceptionally rich pool of nominees to discriminate among this year. The nomination letters were all quite inspiring. The 2013 awardees are:

  • Family Medicine: Dr. Kathleen Barry
  • Obstetrics and Gynecology: Dr. Sara Holmberg
  • Pediatrics: Dr. Ernesto "Mike" Villareal
  • Internal Medicine: Dr. Andrew Shaw

Each of the winners receives a Brodie Renaissance Physician pin, a framed certificate, and $500. Please join me in congratulating these model clinicians.

Daniel J. Burke, PhD, Receives Jefferson Scholars Foundation Award

Congratulations to Daniel J. Burke, PhD, Professor of Biochemistry and Molecular Genetics, for being the recipient of the Jefferson Scholars Foundation Award for Excellence in Teaching.

This year, the Award for Excellence in Teaching honored five full-time faculty members from across the University for having demonstrated excellence in teaching. In making this award, the Foundation also hopes to recognize those who have selflessly endeavored to instill in their students the virtues of scholarship and a love of learning. This award is made annually in the spring semester and recipients will be recognized at a banquet in their honor.

This has been a good year for Dr. Burke, who was recently honored with the "Excellence in Faculty Mentoring" award from the University. Congratulations, Dr. Burke!

Vitals: Medical Alumni's Spring Issue Now Online

The spring edition of the School of Medicine Vitals, the UVA Medical Alumni Association (MAA) and Medical School Foundation's (MSF) magazine, is now online at UVAMedAlum.org. This installment includes stories about team-based learning, a new method for identifying modifications in smooth muscle cell phenotypes, a wrap-up for the 47th Annual Meeting and Match Day, and other School of Medicine and alumni news.

When you have a moment, I urge you to check out this wonderful publication. And, to stay abreast of the latest MAA/MSF happenings, follow them on Facebook (facebook.com/UVAMedAlum) or Twitter (twitter.com/UVAMedAlum).

Barry J. Collins Appointed Chair of Group on Institutional Advancement

Congratulations to Barry J. Collins, Associate Dean for Medical Alumni Affairs, and Executive Director, UVA Medical Alumni Association & Medical School Foundation, for being appointed Chair of the Association of American Medical Colleges' (AAMC) Group on Institutional Advancement (GIA).

The GIA is one of 15 professional development groups within the AAMC and is composed of medical school and teaching hospital professionals working in alumni affairs, development, marketing, public affairs, and public relations. The GIA's goal is to enhance awareness and support for medical education, healthcare, and biomedical research. Members have the opportunity to network with colleagues on common challenges and share solutions in advancing medical schools and teaching hospitals.

Once again, congratulations to Barry Collins for being appointed to this distinguished group.


Julie Haizlip, MD, and Co-Authors Awarded ABIM Foundation Prize

Congratulations to Julie Haizlip, MD, Assistant Professor of Pediatrics, and her co-authors, Natalie May, PhD, Associate Professor of Research; John Schorling, MD, Professor of Medicine; Anne Williams, MA, Manager, Organizational Learning and Development; and Margaret Plews-Ogan, MD, MS, Associate Professor of Medicine. They were recently awarded the American Board of Internal Medicine (ABIM) Foundation Professionalism Article Prize in the Commentary/Perspective category for their article, "Perspective: The Negativity Bias, Medical Education, and the Culture of Academic medicine: Why Culture Change is Hard" published in Academic Medicine.

Now in its third year, the prize recognizes outstanding contributions to the field of medical professionalism. A selection committee of physicians, a medical student, and other leaders in the healthcare field reviewed more than 100 peer-reviewed articles published in 2012 before selecting a winner. Once again, congratulations! If you would like to view the abstract, you can see it here: www.ncbi.nlm.nih.gov/pubmed/22836850.

U.Va. Innovation Crowdfunds Research

U.Va. Innovation has launched USEED at U.Va., a pilot crowdfunding platform that allows the public to contribute to early-stage research currently underway at the University. The site, www.virginia.edu/useed, currently features two translational research projects with ties to Medicine and Nursing.

  • "Reducing Inequity in Forensic Exams Following Sexual Assault" is raising $19,000 to identify a new forensic dye that will help medical professionals visualize injuries more effectively on women of all skin tones.
  • "Clean Water by PureMadi" is raising $35,000 to make its life-saving water purification tools more widely available in rural areas of South Africa, where access to clean water is limited.

This is the first time a university has used crowdfunding to fund research philanthropically — and this research has the potential to make a big impact on people's lives.


ICAC Program Aids in Increasing Hand Hygiene Compliance

Through our Infection Control Auditing of Clinicians (ICAC) Program, UVA work-study students observed over 42,000 hand-hygiene events over the past eight months. Their auditing demonstrated a significant increase (nearly 20 percent!) in our hand hygiene compliance, in both the inpatient units and for physicians. Thank you for welcoming these students into our inpatient areas. We hope to work with them again beginning this fall when they are back on Grounds. Quality is a journey, not a destination and, while we still have yet to achieve our institutional goal of 90 percent hand hygiene compliance, this increase in an outstanding improvement. Keep up the good work!

The Department of Neurology Southwest Virginia Field Clinics

The Department of Neurology has been continuously attending clinics in rural Southwest Virginia since before 1967! The late Dr. Fritz Dreifuss, a grandfather of American epilepsy and pediatric neurology, started the clinics. Dr. Dreifuss started attending the clinics, then called the "Seizure Control Clinic," after his arrival at UVA in 1956. The late Dr. James Q. Miller — also an icon in UVA history, who discovered Miller-Dieker lissencephaly syndrome — joined him soon after.

The clinics were spread across the state but now are confined to regions that are still underserved: Abingdon, Tazewell, and Wise. The two-day, 309-mile, door-to-door Southwest Virginia field clinic trip starts on Hospital Drive next to the Rotunda and ends near the UVA College at Wise. After their founder’s passing, Robert Rust, MD, Professor of Neurology and Pediatrics; Mark Quigg, MD, Professor of Neurology; and Nathan Fountain, MD, Professor of Neurology, have sustained the clinics since 1998 with grants from the Virginia Department of Health and the UVA Medical Center.

To run the clinics, a faculty member is accompanied by a resident and fellow who see the approximately 1,200 patient visits per year. The trips have provided desperately needed services to rural Appalachia as well as unique educational experiences for residents. Not only do trainees see a variety of conditions — especially genetic and metabolic — that they might not see otherwise, but they see patients in a situation that provokes a special kind of compassionate care that creates indelible memories. The field clinics have provided rich opportunities for ongoing clinical research, from contributing to the discovery of Emery-Dreifuss muscular dystrophy up to the current National of Institutes of Health-funded epilepsy phenome-genome project. These unique aspects have raised their notoriety to reach across the Neurology world.

Epilepsy Program Receives National Designation

The National Association of Epilepsy Centers (NAEC) has recognized the F.E. Dreifuss Comprehensive Epilepsy Program at University of Virginia Health System as a Level 4 Epilepsy Center, the association’s highest rating.

“Level 4 epilepsy centers have the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for patients,” according to a letter from NAEC recognizing UVA’s program.

Our comprehensive epilepsy team includes epileptologists — neurologists who specialize in epilepsy care — along with neurosurgeons, neuropsychologists, nurse case managers and social workers who can monitor and treat patients in a dedicated inpatient epilepsy unit or at an outpatient clinic.

We has established a special team in its epilepsy unit — led by psychiatrists, psychologists and social workers — to treat patients with nonepileptic spells, a psychiatric condition that resembles epileptic seizures but is not actually caused by epilepsy.

UVA also has an extensive clinical research and clinical trials program in epilepsy. For example, neurologist Mark Quigg, MD, is the principal investigator of an international clinical trial evaluating the use of Gamma Knife radiosurgery to treat patients with mesial temporal lobe epilepsy.

Congratulations to all involved on this tremendous achievement!

AHA Recognizes UVA Stroke Program for Quality Care

Congratulations to all involved in the stroke program here at UVA. For consistent efforts to improve stroke care and patient outcomes, the American Heart Association (AHA) has recognized UVA Health System with two awards: the AHA’s Get With The Guidelines – Stroke Gold Plus Quality Achievement award and the Target: Stroke award.

UVA received the Gold Plus Quality Achievement award for 85 percent or better compliance for at least two years with all of the AHA’s stroke quality achievement guidelines and 75 percent compliance for at least 12 consecutive months, with five or more additional stroke quality measures.

UVA reached 95 percent or better compliance on all stroke quality achievement measures and exceeded 93 percent compliance on the five additional stroke quality measures it submitted to AHA, including:

  • Providing intravenous tPA (a drug designed to break up clots that cause strokes) within four-and-a-half hours of a stroke
  • Educating patients about strokes
  • Screening patients for dysphagia (difficulty swallowing), a common condition in stroke patients
  • Assessing patients for rehabilitation needs
  • Documenting LDL ("bad cholesterol") levels

UVA earned the Target: Stroke award for providing intravenous tPA to at least 50 percent of patients within 60 minutes of their arrival at the hospital. For calendar year 2012, more than 73 percent of patients at UVA received tPA within 60 minutes, compared with 43 percent nationally; the median time for stroke patients at UVA to receive intravenous tPA was 57.6 minutes after their arrival at the hospital.

Congratulations to all involved. This is an outstanding national recognition for your efforts!

UVA Health System Acquires Albemarle Arthritis Associates

Another step toward achieving our goal of expanding our network, University of Virginia Health System has acquired Albemarle Arthritis Associates, which provides rheumatology care to patients in Central Virginia.

Beginning June 4, the practice plans to enhance its services at a new, relocated facility at 650 Peter Jefferson Place, Suite 190, on Pantops Mountain in Charlottesville. These changes will include an additional rheumatologist and an expanded infusion center, where intravenous treatments will provide state-of-the-art therapy for arthritis, lupus, and osteoporosis.

“We believe this partnership with UVA will help patients have improved access to rheumatology and a wider array of rheumatologic care,” said Keith Frick, MD, a partner at Albemarle Arthritis Associates. “Of course, we will continue to provide the personalized, patient-first care for our entire community, as we have for more than 20 years.”

Albemarle Arthritis Associates will be a strong addition to UVA Health System, said Ray Costabile, MD, Senior Associate Dean for Clinical Strategy. “UVA Health System, the Department of Medicine and the Division of Rheumatology look forward to partnering with Albemarle Arthritis Associates to make it easier for patients to receive high-quality care for arthritis and other conditions,” Costabile said. “We’re pleased to partner with community physicians to enhance care for patients across Virginia.”