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Dr. Robert J. White of Neurological Associates Inc. is the highest vote-getter in the neurology category. Isaac Harrell photo
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Chrissy and Grayson Walters are grateful for the care they received from Dr. R. Scott Lucidi and Dr. Cecelia Boardman (shown with the couple below). Jay Paul photo
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Madison Nickerson holds a picture she drew for her pediatrician, Dr. Tamara Sutherland (right). Madison’s mother, Adina, is behind her. Jay Paul photo
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Dr. John G. Barnes with patients Jackie and Charles Hargrave (right); their daughter, Michelle Cummings (center); and granddaughter, Alexis. Jay Paul photo
In planning this year's Top Doctors issue, we asked Richmond magazine readers to share their stories about physicians they think are exceptional. Five of their experiences are featured in the next few pages. It generally wasn't heroics, but rather the personal touch that impressed patients the most. As one reader put it, "having a doctor who spends the time to discuss what is going on, who explains changes and medical options, and who never makes you feel like he is rushing out to see the next patient, is a real gift."
For our 2012 survey, we asked local physicians to tell us whom they would recommend in 78 categories. We also asked for nominations to recognize health-care workers in five special-honors categories: chaplain, medical social worker, certified nurse-midwife, occupational therapist and pharmacist. We sent letters to more than 4,300 doctors, alerting them to our online survey. From that list of licensed practitioners obtained from the Virginia Department of Health Professions, 540 responded to the survey, for a response rate of 12.5 percent.
Keeping Hope Alive
Cancer treatment doesn't have to mean giving up the dream of childbirth
Chrissy Walters and her husband, Grayson, found out on their 15th wedding anniversary, three days before Christmas in 2009, that she had uterine cancer. She was 34, and they'd been trying to have a baby. The doctor she had been seeing told her she likely would have to have a hysterectomy, but wanted Dr. Cecelia Boardman, a gynecological oncologist at VCU Medical Center, to review Chrissy's case.
At the Chesterfield County couple's first appointment with Boardman, Chrissy says, "I was crying hysterically. We were expecting the worst." Boardman ordered an MRI and some lab work, which showed that the cancer was in an early stage, contained to Chrissy's uterus. That meant there could be other treatment options.
"With her case, but also in general, fertility preservation in the face of a cancer diagnosis is possible," Boardman says, noting an increasing body of literature in this area. "Women who are not offered that need to seek a second opinion."
Chrissy and Grayson then met with both Boardman and Dr. R. Scott Lucidi, a fertility specialist at the VCU Women's Health Center at Stony Point, to talk about options, which could have included harvesting Chrissy's eggs and freezing them so that if she did lose her uterus, she could conceive a child using a surrogate mother.
They decided to try hormone therapy, using progesterone to reverse the growth of cancer cells. By September 2010, a biopsy showed only a minute trace of cancer, and Walters underwent a dilation and curettage (D and C) to scrape the uterine wall and remove any additional cancer cells. A month later, the cancer was gone, and Chrissy began fertility treatments. She became pregnant but had a miscarriage, then continued fertility treatments until July, when Boardman suggested she take a break to let her body recover. In January, she began in vitro fertilization treatments, and she's currently awaiting results of those.
Chrissy's treatment requires careful oversight, Boardman says. Because she hasn't been ovulating on her own, she doesn't have the hormonal changes that bring about the normal maturation and shedding of the uterus, making her more at risk for developing uterine cancer again. "If estrogen is not opposed by progesterone, continued stimulation of growth can lead to endometrial cancer," Lucidi says.
The physicians have to balance the desire to preserve Chrissy's prospects for giving birth with the need to protect her from a recurrence of the cancer.
Chrissy calls Boardman "an amazing woman," adding, "She's compassionate. She's very smart. … She wants to give a woman the ability to have a family if she wants. I feel she went out of her way to give me that chance." She says of Lucidi, "He can joke with me when I need him to, but when I'm sitting in his office breaking down, he can comfort me with no problem. It's hard for a woman in this situation not to blame herself. He knows that."
A member of Gayton Road Christian Church, Chrissy emphasizes the importance of her faith in her treatment. "One thing I am sure of is that God puts people in place to make his plans come to fruition and for me — that is definitely Dr. Boardman and Dr. Lucidi." —TE
Forming a Bond
McGuire physician feels a strong connection to the veterans she treats
As Harriet Foster considered residencies after attending medical school in South Carolina, she decided she wanted to provide high-quality primary health care to military veterans. After a residency at McGuire Veterans Affairs Medical Center in Richmond, the desire remained, and so did she.
Foster joined the hospital's medical staff in 1985. "In 25 years, you get to know people very well," she says of her patients. "You become part of their lives and they come into yours." Foster adds, "My father was a World War II veteran who parachuted in at D-Day, which gives me a connection particularly with the older vets."
One of the lives she has touched is Navy Seabees veteran Jan Walker of Richmond ( pictured ; photo by Ash Daniel), who became a patient of hers more than a decade ago. Since being injured and disabled during a second tour of duty in Vietnam, Walker has seen his share of operations and medical treatments. He appreciates Foster's after-hours calls related to his care.
"After I was in an automobile accident and hurt my shoulder, I had every test in the book, and she coordinated everything," he says.
Walker's praise extends to specialists and others at the medical center that last year served more than 42,000 veterans and active-duty service members. Several years ago, McGuire adopted a team clinic approach to provide a more intimate experience for the veterans it serves. Foster leads one of the teams, which includes a registered nurse, a licensed practical nurse and a pharmacist. She also has floor duty, performs rotations in the emergency room and, because McGuire also is a teaching hospital, supervises Virginia Commonwealth University students learning to become doctors.
"Private doctors just have outpatients," Foster says. "I have outpatients, inpatients and teaching. It really keeps you on your toes." Walker says his doctor "has a pretty hard job because she's got to know everything." Foster counters that much of primary care is ongoing care and treating common ailments. But Walker thinks she stands out. "She's everything to me where health is concerned." —MJS
A Matter of Trust
‘It's an honor to help improve children's lives,' pediatrician says
A picture that 9-year-old Madison Nickerson drew of Mount Rushmore has four faces on it: One is a depiction of God, then there's her dad, Douglas; her mother, Adina; and Dr. Tamara Sutherland. "So that tells you how highly she thinks of her," Adina Nickerson says.
The warm, confident patient-doctor relationship allows Madison to talk openly with Sutherland, something that became especially important when Madison was diagnosed two years ago with attention deficit hyperactivity disorder (ADHD). Madison, then a first-grader, had trouble sitting still and focusing on her work, and would become angry or disgruntled. She was behind her peers in reading and math.
In cooperation with Sutherland and Madison's teacher, the Nickersons first tried altering their daughter's diet and routine. But, Adina says, "That didn't make a change for her." They then worked with Sutherland to find the type and dosage of medicine that would help Madison to regulate her moods and concentrate.
"Dr. Sutherland was very patient and took her time," Adina says. The pediatrician assured Madison that there wasn't anything wrong with her, and that her medicine "was not going to be a magic pill to get straight As, but it was going to help her do her best," Adina recalls.
During the first quarter of this school year, Madison made the honor roll, her mother adds.
Sutherland, a marathon runner who grew up in New Jersey, has practiced with Associates in Pediatrics since 2003. To build trust and help her young patients relax, Sutherland talks to them about school and sometimes sits on the table with them during an examination. For children like Madison, she says, it's important to offer reassurance that they're not alone in struggling with schoolwork. "It's an honor to help improve children's lives," she says. "That's why I chose pediatrics. I love the interactions with the families." —TE
The Whole Family's Doctor
Dr. John G. Barnes has treated generations of Hargraves
For the past 27 years, since finishing his residency after attending the VCU School of Medicine, Dr. John G. Barnes has been in family practice in Midlothian. To the Hargrave family, that means four generations.
"The thing I like about Dr. Barnes is [that] if he can treat you, he will do so immediately. If it's out of his realm, he'll refer you to a specialist," says Jackie Hargrave of Chesterfield County. "He has cared for my family since the 1980s and we could not be more pleased."
Hargrave says Barnes not only agreed to take on as patients her and her husband's older relatives, but one time when her husband, Charles, brought his ill mother to Richmond from Wakefield, Barnes came to the hospital around midnight to examine her. Jackie says the doctor also delayed discharging elderly relatives from the hospital at times until arrangements for long-term care could be worked out.
Barnes, a primary care physician at Midlothian Family Practice, says his philosophy of health care is simple. "It's a service business. That doesn't always mean patients get what they want, but they get what they need." The way he mines information is through good listening. "It's an art to extract information quickly and efficiently," he says. "It requires confidence on the physician's part. And it's important that the patient feels the physician has their best interest at heart."
Even when Barnes is writing notes while his patients talk, they "have my eye and my attention," he says. Otherwise, rapport and acceptance between doctor and patient can't be established. He relates a story Hargrave told, that when her mother came to him for appointments, her aging parent always felt reassured and comforted just to see him.
"I had the responsibility of looking after my father, mother and aunt in their later years," Hargrave notes. "I could not have survived all this responsibility without [Barnes'] help and cooperation." —MJS
The Power of Communication
Urologist arms prostate cancer patients with knowledge
A diagnosis of prostate cancer can strike at the core of a man's psyche. The caring disposition of a Virginia Urology physician impressed Tom Ogden ( pictured right ), who admits to being "a little frightened out of the chute" when he learned in 2010 that he had the illness.
His doctor, Robert T. Nelson Jr. ( pictured left ), contributes to the growing number of survivors of this disease, the most common form of abnormal cellular growth in men's organs. Nelson not only specializes in cancers affecting the urinary tract, but he is experienced in the increasingly popular use of robotics for surgical removal of the prostate gland.
"I've done more than 800 of these surgeries since 2005 and perform more than 100 a year," says Nelson, a pioneer in the urologic realm of robotic prostatectomies in Central Virginia. "It's easier, gentler and more precise, and less traumatic" for the patient.
But before a patient decides to pursue a surgical route, robust counseling on all options occurs. Nelson invites patients to a brief consultation after the diagnosis and then encourages them and their spouse or significant other to return once they've wrapped their mind around it. One of the benefits Nelson saw 14 years ago in joining a practice the size of Virginia Urology is that he can put patients in touch with others who have had different procedures, recommend that they meet with a radiation specialist, connect them with support groups and offer classes.
"I feel that clear, understandable communication is very important when you have been diagnosed with prostate cancer," says Ogden, now 68. His wife, Claire Martin, is very impressed with Nelson, too, he says. "Dr. Nelson has exceptional communications skills with his patients. He was diligent in explaining all of the options and provided excellent pros and cons for each option."
For the one in six men who develop prostate cancer, that's a powerful advantage. —MJS