Category: Hot Topics

The latest news and trends in medicine.

Prior Authorizations – One More Reason To Be Angry At Health Insurance Companies?

by Heath Mackley, MD, FACRO

Don’t you get upset at health insurance companies?

To that frequently asked question, my short answer is, “No.”

I have no love for health insurance companies either, but the anger that physicians and patients feel about them should probably be more evenly distributed between the insurance companies, the health care providers, the lawyers, the government, and anyone that receives the benefits. Like most of our modern “messes,” it started with a mixture of theory, good intentions, self-interest, and lack of appreciation of the consequences of government policy decisions. From that point, it evolved in directions that reflected the competing interests of the parties involved. But this is not going to be a historical treatise about how we arrived to where we are, instead it’s a description of where we are, so we can best move forward with our eyes open.

A Salute to those who Served to Save Lives

by Lucy J. Cairns, MD, and introduction by Timothy J. (T.J.) Huckleberry, MPA

There is a great quote from the movie Gladiator that says “What we do in life echoes an eternity.”

My grandfather served in World War 2. He was a Combat Engineer. In the Mountains of Central Italy he took shrapnel at the base of his neck, his spine, parts of his arm, and near his heart. He was carried by pack mule to the closest field hospital where his life was saved by a faceless physician who struggled to perform miracles every hour on the hour. Pieces of shrapnel remained in his spine and near his heart throughout his life, a constant reminder of the carnage of war and the incredible work of the men and woman who labored to keep him alive.

You hear of the heroics and sacrifices of those who served on the front lines in our nation’s wars and campaigns, and rightfully so, but much is forgotten about those who served to fix those broken by the horrors of battle. The actions of these brave men and woman certainly will echo for an eternity, for if it wasn’t for them…and a sturdy pack mule, I would not be here today writing this salute.

With great pride, in this article we celebrate a few of the many Berks County physicians who have served our country and, in one case, our colonies. We also will highlight the new Berks Military History Museum, a long needed tribute to our neighbors, friends and family members who served in our Armed Forces.

On behalf of the Berks County Medical Society, a heartfelt “THANK YOU” to all those who gave so much to make our nation what it is today.

— Timothy J. (T.J.) Huckleberry, MPA

On August 12th of this year, the Berks County Military History Museum is slated to open its doors to the public in Phase 1 of its opening. Established in 2015, this project has been the collective result of tireless work by a number of volunteers who have remodeled the building, furnished the museum, and donated the displays. Already on historic grounds, the Mohnton-based museum was originally purposed for manufacturing in the early 1870s. Despite having yet to be completed, the museum is already becoming a presence in the community, hosting several notable events and community organizations such as a 75th Annual Anniversary of Pearl Harbor Dinner, the Shillington Lion’s Club, and the Women Veterans of Berks County. In September of 2016, the museum also became home to a 9/11 Memorial containing a section of damaged rail line recovered from beneath Ground Zero. Founding member State Representative Mark Gillen has expressed his great pride in this project and hopes that it will become a monument to Berks County’s rich and fascinating military history.

The role of battlefield medicine is an important one to the history of our United States Armed Forces. Preserving its memory and cataloguing its advancements is a difficult but important task. Therefore, the Berks County Medical Society would like to encourage community members to consider donating or contributing any military medical equipment they possess that might be of historical value.

Information about the museum as well as how to volunteer or donate can be found at http://berksmilitary.weebly.com/.

Cedric C. Jimerson, MD

Editor’s note: the passages in quotes are taken from Dr. Jimerson’s memoirs.

Dr. Jimerson had recently completed the first year of his surgical training in 1943 when he received his draft notice. For the next 2 ½ years he served in the U.S. Army, first as a Battalion Surgeon and then as Captain and Surgeon in the 663rd Medical Clearing Company in the European Theater. The 663rd saw combat in two battles in Germany. During combat, the Clearing Company is positioned to the rear of the Battalion Surgeon and the Collecting Company, and forward of the Field Hospital.

“The 663rd Medical Clearing Company had a headquarters section of twenty-two men, and two platoons with forty soldiers (medics) in each platoon. … We had our own motor pool, generator, portable kitchen, and operating room and equipment under tents. The 663rd Medical Clearing Company was similar to a ‘Mash Unit’, but it was smaller. … As Captain I received $200.00 per month plus $10 for being in a combat zone.”

Dr. Jimerson with his staff at Typhus

In addition to caring for sick and wounded soldiers, Dr. Jimerson was responsible for teaching first aid to the medics, stocking the dispensary and dispensing medication, inspecting the toilets and latrines, and giving regular lectures about venereal diseases to the troops. The most common injury requiring emergency surgery was a gunshot to the chest resulting in a sucking wound, which would cause collapse of the involved lung followed by shift of the mediastinum to the opposite side of the thorax, with collapse of the contralateral lung and death.

“We performed emergency closure of the soft tissue wound, did a closed thoracostomy with trocar and cannula, inserted a short, hard rubber tube into the pleural cavity and secured a condom over the open end of the tube, with the closed end of the condom closed off. This ball valve contraption permitted air to escape from the chest during expiration, re-expansion of the collapsed lung, and re-shifting of the mediastinum and heart back to normal position. This operation enabled the patient to be transported back to a station or general hospital for definitive surgery.”

Dr. Jimerson and
one of Hitler’s Elite
SS Troopers, 1945,
Dusseldorf, Germany

At one point, Dr. Jimerson and his company crossed the Belgium-German border into Aachen, Germany. “There was almost complete destruction of the city. We were billeted in one of the remaining houses, where we found many books about Hitler and his activities. We found an underground hospital, and I liberated a few surgical instruments and two primitive tubular stethoscopes. As we drove through the country we passed the famous Maginot Line. In the fields were many destroyed tanks, cannons, and military vehicles, and many dead farm animals. In the forests the trees looked like telephone poles, with their leaves and limbs shot off. We stayed a few days in Cologne, where two huge bridges were destroyed and lying in the Rhine River. The famous Cathedral of Cologne was pockmarked from gunfire. There were many snipers in the buildings.”

Immediately after V.E. Day, Dr. Jimerson was placed in charge of medical care at a large camp for displaced persons near Aachen. In the camp were 9,000 residents, 7,000 Russians, 2,000 Poles, and 1,000 homeless persons from other countries in Europe. A Russian nurse was treating all her patients using cupping. “A small detachment from our famous Pennsylvania 28th Division – known by the German soldiers as the ‘Bloody Bucket’ and recognized by the Pennsylvania emblem on the front of their helmets – were known for their fierce fighting in the Battle of the Bulge. These soldiers protected us and they regularly inspected the displaced persons living in quarters to get rid of hidden guns in order to decrease the shootings and riots.”

For his battle service, Dr. Jimerson was awarded two Bronze Star Medals. Thanks to the efforts of Pennsylvania Representative Mark Gillen, Dr. Jimerson’s wartime service was recognized again very recently, on the House floor, in conjunction with Rep. Gillen’s Resolution #323 recognizing all the medical professionals who serve our country.

Bodo Otto, MD

Around 1772, Berks County welcomed its fourth and most renowned doctor, Bodo Otto. He was born in 1709 in the Kingdom of Hanover, Germany, to a distinguished family in the service of Privy Counselor Baron Bodo von Oberg (who was both young Bodo’s namesake and godfather). His education in surgery was received at the University of Gottingen, where he also studied anatomy, physiology, botany, and physics. He served as a physician in German military hospitals before coming to America in 1755. Like many of the immigrants from his country, Otto settled in Germantown, where he gained recognition for his medical and surgical skills. After nearly 20 years of medical experience, Bodo Otto relocated to Reading in the 1772-73 period, where he took over Dr. Kuhn’s Apothecary, which had been in Reading since 1753.

At Reading, Otto joined with Dr. Potts in the organization of Revolutionary forces. Although America was his adopted country, and he was nearly 70 years old, he volunteered his services to General Washington. Otto and his two sons, John A. and Bodo, Jr., both doctors, served at Valley Forge, in charge of the field hospital at Yellow Springs during the terrible winter of 1777-78. Otto resigned his position in 1781 at age 72, when the hospital was closed by the Army command. Following the war, Otto returned to practice in Philadelphia and Baltimore. Then, in 1785, he returned to his son, John, and to a practice in Reading, where he died in 1787. He is buried at Trinity Lutheran Church, where he was an honored member. His other son, Bodo, Jr., a Colonel of New Jersey troops, died of consumption, contracted while he was in the Army.

Harry Ramsey, MD

Capt. Harry Ramsey served as Battalion Surgeon for the 31st Combat Engineers in support of the 1st Air Cavalry in Phouc Vinh, Republic of Vietnam, from February 1970 to February 1971. Doc was known as “The Wizard of Gauze” (see above picture with his Jeep) during his service. He ran the battalion aid station and commanded approximately 40 medics providing medical care for our military personnel and South Vietnamese troops. In addition, he was responsible for monitoring and providing potable drinking water stations for the troops. When time allowed, he and his medics provided care for local Vietnamese civilians through the military MedCap (Medical Civic Action Program), which was a good will program initiated by the US military to “win the hearts and minds” of the local people and provide humanitarian assistance to the beleaguered nation caught in the conflict. A favorite site for Capt. Ramsey and his medics was the Catholic orphanage in Phouc Vinh. During his year in RVN, Capt. Ramsey had the benefit of treating numerous illnesses he had never seen before nor would ever see again in the USA.

For his service he was awarded the Bronze Star. Upon returning to the U.S. he was assigned to Aberdeen Proving Ground in Maryland before resuming his formal medical training at the Reading Hospital and Medical Center and later Hahnemann University. Upon finishing his training, Dr. Ramsey returned to the Berks County area as a Hematology/Oncology specialist.

Larry A. Rotenberg, MD

Dr. Rotenberg, Scott Peck, and the man in the center, who was chief of psychiatry US Army (name unknown).

Dr. Rotenberg served as Major in the US Army from 1969-1971. During his service he was made Chief of Psychiatry at the US Army Medical Center in Okinawa, Japan. About half of the population treated at this center was from Vietnam, and the other half came from the large military and DOD civilian presence in Okinawa. For his service he was awarded the Meritorious Service Medal, with the following narrative:

“Major Larry A. Rotenberg, Medical Corps, United States Army, distinguished himself by performance of exceptionally meritorious service while serving as Chief, Inpatient Services, Department of Psychiatry, United States Army Medical Center, Ryukyu Islands, during the period May 1969 to October 1971. Major Rotenberg’s outstanding leadership, professional competence and vast background contributed immeasurably to the successful accomplishment of his unit’s mission. Major Rotenberg served successively as Chief of the Inpatient Service of the Department of Psychiatry and Chief of the Department of Psychiatry, manifesting at all times the tradition of humane, original and effective work. He reorganized the Department of Psychiatry, often creating programs and new facilities where none existed before by imaginative utilization of the resources at hand. Major Rotenberg demonstrated a remarkable depth of knowledge and outstanding judgment in dealing with situations that required rapid analysis and timely, effective decisions. Above all, he inspired others with his tremendous sense of compassion in dealing with patients. Major Rotenberg’s outstanding performance of duty and meritorious service are in keeping with the highest traditions of the military service and reflect great credit upon himself, this command and the United States Army.”

Dr. Rotenberg, who had married while still a medical student, was drafted just after finishing a fellowship in Forensic Psychiatry. He comments: “Although I was very unhappy to be drafted, our time in the Army was some of the best times in our life. And, as I was made Chief of the Department of Psychiatry in Okinawa, I learned about administration and was then hired in 1971, upon discharge from the Army, as Chief of Psychiatry at the Reading Hospital – a position I held until 2006.”

The Department of Psychiatry when Dr. Rotenberg first came to Okinawa; the fellow at the center is Scott Peck, MD, who preceded Dr. Rotenberg as Chief of Psychiatry at the US Army Medical Center, Ryukyu Islands.

Organ Donation Transforms Lives

by D. Michael Baxter, MD
Chair, Department of Family and Community Medicine
Reading Health System

As physicians know, organ donations improve people’s health and save lives. One organ, tissue and eye donor may save up to eight lives and enhance the lives of up to 75 others. Nationally, 118,000 people are waiting for an organ transplant, and 22 people die each day because an appropriate match was not found in time. As physicians know, organ donations improve people’s health and save lives. One organ, tissue and eye donor may save up to eight lives and enhance the lives of up to 75 others. Nationally, 118,000 people are waiting for an organ transplant, and 22 people die each day because an appropriate match was not found in time.