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How does Milwaukee stand out?
Renowned physicians and state-of-the-art facilities put Milwaukee on the ‘A’ list when it comes to health care

By KIRSTEN KOROSEC

 

Dr. Doug Evans


Milwaukee is chock-full of treasures — those tiny theaters, museums, public art sculptures and parks that are tucked away within the urban landscape and are so often overlooked by the folks who live here. It’s no different with the area’s health care services, which contain all sorts of hidden gems: Cutting-edge research studies, specialty centers and doctors who are often better known on the national scene than in their own backyard.

Greater Milwaukee’s hospital building boom has received much of the attention in recent years — and for good reason. Last year, Wheaton Franciscan Healthcare and physician investors opened a $30 million Midwest Orthopedic Specialty Hospital in Franklin; Columbia St. Mary’s will open its $417 million, 513-bed hospital in Milwaukee in October; and Aurora Health Care, which opened its 223,000-square-foot Aurora Medical Center in Summit earlier this year, will follow its expansion plans with a new $184 million medical center in Grafton in November.

And many of the area’s hospitals — most notably Children’s Hospital of Wisconsin, where six of its pediatric specialties were ranked in the 2010 edition of best children’s hospitals by U.S. News & World Report — enjoy loads of well-deserved local and national recognition.

But even inside some of these well-known facilities, there are doctors, basic and clinical research studies and community initiatives that have gone unnoticed, at least locally. Here are some of the few folks — and the programs and research they manage — that deserve a little extra attention.

The Feds’ Go-to Guy

It’s not exactly a surprise that Dr. Michael McCrea, head of neuropsychological services at Waukesha Memorial Hospital and executive director of the Neuroscience Center at ProHealth Care Inc. in Waukesha, is frequently called on for his expertise. It’s who asks for advice that’s so noteworthy.

McCrea’s research of traumatic brain injuries over the past 16 years has made him one of a small handful of civilian doctors the United States Department of Defense turns to for advice.

"Traumatic brain injury is occurring at really unprecedented rates in the war in Iraq and Afghanistan, relative to earlier wars," says McCrea. "And it’s posed a whole new military medical challenge for the Department of Defense. "

Dr. Michael McCrea


McCrea began working with the DOD in 2006 and nearly three years ago joined a special panel of civilian doctors that advise the military agency on the assessment and management of traumatic brain injury. McCrea’s team at Waukesha Memorial established itself internationally years ago as a leader in research on sports-related concussions. The team took its findings and developed a clinical assessment now used by paramedics, EMTs and emergency medical doctors to determine whether someone has a traumatic brain injury. This clinical tool, a basic 10-minute examination that allows someone to assess mental status and acute injury characteristics, has now been repackaged for use by the military.

While McCrea enjoyed a certain amount of street credentials at the national level for his clinical research, it wasn’t until seven years ago when the neuroscience center, which also houses a traumatic brain injury clinic, opened that the team received any local attention.

"It’s been a full loop," McCrea says. "We’re the recognized academic experts, we’ve led the clinical science and now we can bring all that to the patient in the clinical setting, and thereby they come to us because of our recognized expertise."

A Better Path to Cancer Treatment

Dr. Doug Evans, chairman of the department of surgery at the Medical College of Wisconsin and a superstar in pancreatic cancer treatment, speaks with a rather matter-of-fact tone as he describes his move to Milwaukee after nearly 20 years at University of Texas M.D. Anderson Cancer Center in Houston, widely viewed as the top cancer hospital in the country. That is, until talk turns to a new clinical trial he is overseeing on pancreatic cancer.

"In spite of patients looking the same and us treating them the exact same way, some people are cured and some people have the cancer come back very quickly and unfortunately die from the disease. Why is that?" asks Evans, before immediately answering his own question. "That reason isn’t just the patient’s immune system, but the different makeup of the individual tumor."

The clinical trial aims to take a needle biopsy of a pancreatic tumor to help doctors find the molecular difference so they can change the treatment and ultimately save the patient. Typically, Evans explains, a biopsy of a tumor is taken when a patient is first seen. The biopsy is performed under endoscopic ultrasound, which means a scope is put through a patient’s mouth while they’re sedated. In the case of pancreatic cancer, the scope is guided down through the stomach and through the first part of the small intestine, right next to the pancreas. An ultrasound probe at the end of the scope allows doctors to do a needle biopsy of the pancreas.

Under the clinical trial and with the patient’s consent, a portion of the needle biopsy is sent for molecular analysis to determine the genetic profile of a pancreas tumor. Why does that matter? It turns out not all pancreatic tumors are created the same.

"Right now, the major way to classify cancer is by the organ of origin," Evans says. "So someone has breast cancer, someone has lung cancer, someone has prostate cancer. But that may in fact not be totally correct at a molecular level, which determines sensitivity to treatment. There may be some pancreas cancers that actually are biologically more similar to a brain tumor or colon cancer than pancreas cancer."

Why Milwaukee?

So what exactly attracts some of the country’s top doctors like Evans, McCrea and other recent additions to the medical community?

Dr. Mark Malkin, a neuro-oncologist who spent 18 years as a faculty member and fellow at Memorial Sloan-Kettering Cancer Center in New York — a hospital consistently ranked in the top five cancer facilities in the country — could have gone anywhere. The same holds true for Evans and some of Froedtert/Medical College of Wisconsin’s most recent hires, including Clark Gamblin, a renowned liver surgeon from the University of Pittsburgh’s School of Medicine.

Dr. Mark Malkin


For Malkin, who came to Froedtert/Medical College of Wisconsin in 2004, the move was a chance to rebalance his interests in patient care, research and education. The Midwestern lifestyle was appealing, and for the first time his son would live in a city with extended family, Malkin says. Both Evans and Malkin acknowledged a sort of domino effect that’s created once a hospital gains a few, well-known physicians.

So how does "friendliness" factor in? The country’s best physicians typically weigh opportunity and resources, not gentility. Evans was wooed in large part because of the newly built clinical cancer center at Froedtert/Medical College of Wisconsin. But friendliness and a collaborative spirit has been a big reason Evans and Malkin stayed.

"It’s amazing," Malkin says, as he recalled a surgeon thanking him in his first several weeks on the job. "I can’t remember in 18 years at Memorial Sloan-Kettering anyone saying thank you."

Evans says from a surgical perspective, Milwaukee is unique. "The physicians have a level of collaboration that is really something special. I don’t think this exists anywhere in the U.S."

"Even though we have separate hospital systems, the cross collaboration at the doctor level is really incredible. That intangible quality of the people at MCW, Froedtert and Children’s, as well as the physicians from throughout the city, is what kind of cemented the deal for me," says Evans.

Other Notable Notables

Special programs, research and institutions in Milwaukee are too numerous to mention. Among some of the more notable developments in health care services in the past two years:

BloodCenter of Wisconsin expanded this year into tissue and organ donation, the first blood center in the country to do so. In February 2010, the BloodCenter announced it would bring the Wisconsin Donor Network Organ Procurement Organization and the Wisconsin Tissue Bank — formerly operated by Froedtert Memorial Lutheran Hospital and Aurora Health Care, respectively — into its facility.

Froedtert and the Medical College of Wisconsin opened in spring 2008 its 173,000-square-foot clinical cancer center, which houses some 500 physicians, scientists and nurses. In April 2010, construction began on a 20,000-square-foot "healing" garden plaza on the eastern side of Froedtert’s campus in Milwaukee.

Oconomowoc Memorial Hospital is the only hospital in southeastern Wisconsin using MAKOplasty technology, a minimally invasive procedure that uses robotics to perform partial knee resurfacing surgery. The procedure, which combines three-dimensional images of the patient’s knee with global positioning-like technology, is used on people suffering from arthritis.

Aurora St. Luke’s Medical Center installed in 2008 the second-largest hyperbaric chamber in the nation, which can accommodate up to 24 patients at a time. Hyperbaric oxygen therapy is used to fight infection, promote new skin growth and stimulate small blood vessel growth in patients suffering from severe wounds, burns, radiation tissue damage and carbon monoxide poisoning. m