When Ibrahim Eid, MD, founded the Prima CARE Center for Vascular Diseases in 2002, he did so with two overriding philosophies. One was a passion for providing south coast residents with access to cutting-edge vascular medicine right in their own community. The other was the firm belief that educating and empowering patients leads to better compliance and superior outcomes.
Trained in internal medicine, general and vascular surgery as well as a Fellow of the American College of Surgeons, Dr. Eid has been an innovative force advocating patient education and shared decision-making for over a decade. Dr. Eid and fellow Prima CARE surgeons Rajendra Patel, MD, and Elias Arbid, MD, are board-certified in general and vascular surgery and have years of experience treating patients with vascular diseases, using both surgical and nonsurgical interventions. The center’s team also includes physician assistants, nurse practitioners and intensive care-level nursing, along with specialized staff in radiology and noninvasive vascular testing.
The team at Prima CARE Center for Vascular Diseases includes (L–R) Kate Szal, NP, Ibrahim Eid, MD, Elias Arbid, MD, Sarah Rogers, RT, and Rajendra Patel, MD.
Now, with the first office-based endovascular suite in the area, patients requiring advanced surgical interventions can choose to have their procedures performed in a non-hospital setting specifically designed with the latest technology and patient safety, comfort and convenience in mind.
“The endovascular suite lets us deliver care in a more personalized manner,” Dr. Patel says. “This is something outside of the hospital, which in my opinion has the same level of care as a hospital. It allows us to deliver care the way we want to deliver it.
“As physicians, I like to say we are for patients first, and we go into medicine to help people. So everything we do is centered around this. We have hired the best people, and we have the equipment we need to provide the best possible care. We have created an environment where we have everything we need to do procedures with the highest quality and safety standards. We are able to shape the experience and the equipment for individual patients’ needs.”
Accredited by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), one of the gold standards in ambulatory accreditation, the endovascular suite meets stringent requirements covering a wide array of patient safety guidelines and protocols. These include ensuring that surgeons have hospital privileges for all procedures; having intensive-care level professionals on hand; setting stringent guidelines for the surgical suite (equipment, drugs, and other details); holding the center to hospital standards; and requiring peer review, oversight and tracking of data.
Because accreditation is not yet mandated, Dr. Eid says theirs is one of only a small percentage of ambulatory suites nationwide that has undergone the rigorous accreditation process.
“The numbers are shockingly low, and I’m proud to say we have the highest accreditation for quality in terms of contingency plans,” he says. “What if we have a power outage or an earthquake? It’s all in our policy manual, and we had to show what to do in every situation. We have the same level of quality and attention to detail as the hospitals.”
Drs. Eid, Patel and Arbid perform a number of office-based diagnostic procedures, including angiography and dialysis access and maintenance.
“When someone has a dialysis fistula or a graft that needs to be maintained, that maintenance can be performed here,” Dr. Arbid says. “We place ports for chemotherapy so that, instead of sending patients who are diagnosed with cancer to the hospital, they can come here. The person who checks patients in is the same person who brings them to the endovascular suite, and it’s the same person who walks them back to recovery. They see one or two faces and don’t have to be transported through endless hospital hallways, going from one area to the next without having continuity of the people involved in their care. Our center allows for more personable service. It’s more efficient so patients are able to come in, leave faster and resume their lives.”
While most procedures can be done in the office, Dr. Eid says some patients may require a hospital level of care, found at Saint Anne’s Hospital, located across the street from the vascular center.
Being a part of Prima CARE with over 150 primary care physicians and specialists enables the team at the vascular center to provide the kind of integrated and coordinated care that is essential for optimal outcomes. Dr. Arbid says that Prima CARE’s integrated care delivery system allows patients to get the best help with smoking cessation, cholesterol management and dietary changes, all important for the future of any patient with vascular disease.
“A multispecialty group such as Prima CARE allows a surgeon like me to be the best surgeon possible because the primary care doctor and myself are linked to the same electronic medical records,” Dr. Eid explains. “We can communicate very easily. We all share the testing, so after the patients undergo the test, all the doctors can see them. As things progress, we will be able to take care of patients without their having to go somewhere else for care.”
Drs. Eid, Arbid and Patel are also quick to point out that managing the broad umbrella of vascular diseases does not always include surgical intervention, even though many patients believe that referral to a vascular surgeon means they need surgery.
“I think the term surgeon is actually a misnomer,” says Dr. Patel, who views himself and his colleagues more as patient advocates. Instead, I like to think of us as the ultimate end-level specialists for any vascular disease problem outside of the heart. One of the first things I always say to a patient when I come in is ‘I know I’m a surgeon, but that doesn’t necessarily mean that you need surgery.’”
Education and Advocacy
In the three years that the endovascular suite has been open, the team has worked on hundreds of cases with excellent results. But world-class care is only part of the story.
“We are equipped to take patients who have just been diagnosed with a vascular problem and start educating them,” Dr. Eid says. “This is so important because studies have shown that when you empower patients, they choose more wisely, and often make the less-invasive and less- expensive choice.
“We start by telling them, ‘Now that you’ve identified that you have this problem, we are going to try to prevent it from progressing,’ We monitor the disease and provide intensive medical care. We recommend exercise and help patients stop smoking. We also recommend weight loss and management of cholesterol. We try not to operate, but if and when the time comes, we can do procedures in the office. We pride ourselves on the fact that, in this practice, we try to avoid every surgery. Then, if we are going to do surgery, we pick the least-invasive and the least costly setting to perform it.”
In fact, Dr. Eid’s commitment to empowering patients through education has led him to develop Santovia, a user-friendly patient software platform that offers third-party educational tools and feedback opportunities with the goal of increasing engagement and improving the decision-making process, which should involve both the patient and the doctor. (See “Patient Education and Physician Feedback Via Santovia.”)
Dr. Eid believes shared decision-making ensures patients have a voice in their treatment plans, which ultimately leads to better outcomes.
“Instead of me picking out one of the valid choices and telling the patients what they need to do, I tell them, ‘There are actually choices in your situation, and I’m going to give you the tools to make the decision. I’m going to educate you, and I’m going to have you make the decision. I’m here as a counselor. I’m here as an advocate for you.’
“There is a link between educated, empowered patients and cost reduction. And it is a mandate, part of the healthcare reform act, for doctors to show that they are educating their patients.”
For more information about the Prima CARE Center for Vascular Diseases, please call 508-673-4329 or visit www.prima-care.com.