Michael A. Chizner, M.D.

Broward Health is proud to announce that Michael A. Chizner, M.D., noted cardiologist and Chief Medical Director of the Heart Center of Excellence, has been selected by his peers for inclusion in America’s Top Doctors, published by Castle Connelly Medical Ltd.

Dr. Chizner graduated with highest honors from Cornell University Medical College. He completed his internship and residency in internal medicine at the New York Hospital – Cornell Medical Center, and his cardiology fellowship with the legendary cardiologist W. Proctor Harvey, M.D. at Georgetown University, where he later received the distinguished alumnus award.

Dr. Chizner has been a practicing cardiologist in Fort Lauderdale since 1979. He is a Diplomat of the American Board of Internal Medicine and the Sub-specialty Board of Cardiovascular Disease. Dr. Chizner is currently a Clinical Professor of Medicine at the University of Florida College of Medicine, the University of Miami Miller School of Medicine, Nova Southeastern University College of Osteopathic Medicine and Barry University. He also served as team cardiologist to the Florida Marlins and the Miami Dolphins.

Throughout his career, Dr. Chizner has been the director and keynote speaker at medical education conferences, and has served on the editorial advisory boards of national cardiology journals. Dr. Chizner has authored and edited many articles, monographs, and textbooks that have become standards in cardiovascular education. His most recent best-selling book entitled, Clinical Cardiology Made Ridiculously Simple, is now being used in medical schools throughout the United States and abroad.

In addition to the practice and teaching of cardiology, Dr. Chizner has spearheaded the establishment of the Heart Center of Excellence at Broward General Medical Center.

In recognition of his outstanding achievements, Dr. Chizner was appointed by Governor Charlie Crist to the Florida Board of Medicine, where he currently serves as Chairman of the Credentials Committee.



Gabriela Cora, M.D., MBA

Gabriela Cora, M.D., MBA, is the President of the Executive Health and Wealth Institute and the Managing Partner for the Florida Neuroscience Center. She is a medical doctor with a master’s in business administration, board-certified psychiatrist, wellness doctor and coach, best-selling author, and keynote speaker. Her areas of expertise include leading in critical times, strategic planning, and individual and organizational health and wellness.

As President of Executive Health and Wealth Institute, Dr. Cora works with groups and organizations to develop corporate wellness programs, wellness coaching services, and wellbeing keynotes. Her unique expertise blends her knowledge as a medical doctor with her business knowledge and expertise. She developed the executive wellness niche as she worked with many successful corporate warriors and entrepreneurs who were working 16-hour days to produce more with less. Most of these high achievers experienced stress-related problems that affected their health and their ability to produce at their peak performance level.

As a board-certified psychiatrist, Dr. Cora offers individual mental health assessments and counseling services for stress management and mood and anxiety disorders at Florida Neuroscience Center. She offers integrated services including psychotherapy, psychopharmacology, and health lifestyle strategies.

“Stress is the buzzword of the twenty-first century, and stressful times always take a toll on our psyche,” says Dr. Cora. “Our intellectual abilities may become less sharp, our emotions may be all over the place, and our physical stamina may suffer. To stay competitive, avoid illness and poor productivity, people must prioritize their health, implement a plan to set goals, and practice healthy lifestyle strategies daily.”

Dr. Cora strives to bring together every learning experience into action as she assists others to achieve their maximum potential and ultimate well-being. She serves on the Board of Directors of the American Psychiatric Foundation.



Summer brings an increased number of international travelers, and physicians are often asked about travel immunizations. Travel Medicine is a specialty dealing with the prevention and management of health issues facing international voyagers. Good health is obviously important for everyone, but it becomes even more relevant when people travel outside our borders.

Increased international travel to Asia, Africa, South America and to areas which were formerly considered inaccessible has increased the need for travel consultations and immunizations throughout the nation. One company has taken the lead: Passport Health (www.passporthealthusa.com) is the largest private provider of immunizations in the U.S. Hundreds of thousands of doctors throughout the United States refer their patients to Passport Health for specialized pre-departure counseling, travel & safety advice and immunizations prior to their international excursion.

In South Florida, Passport Health has a well-represented network of travel clinics that provide all types of vaccinations; and, this is becoming more and more attractive to primary care physicians, ObGyn’s and pediatricians alike. “We have known for a while that the reimbursement schedule for vaccines never benefits the doctor,” said Fran Lessans, Passport Health’s founder and CEO. “You have to consider the time explaining the need for a specific vaccine as well as its side effects, administration, documentation, record keeping and monitored storage. Insurance typically does not cover travel immunizations. Even if insurance does cover a vaccine it is often at or below the actual cost of the vaccine. By the time you are done you lost money,” she added.

In a 2008 survey of pediatricians and primary care physicians, nearly 50% of the 800 doctors who responded said they had delayed buying at least one vaccine because of the cost. About one in five said they felt strongly that reimbursement for the purchase and administration of vaccines was not adequate. ABC News reported on June 16, 2009 of another survey which reveals that one in ten doctors who vaccinate privately insured children are considering dropping that service largely because they are losing money.

“We do not treat or diagnose,” continued Karen Kluge, R.N., Executive Director at Passport Health Boca Raton. “We provide destination-specific counseling and immunizations to travelers and general wellness vaccinations like Hepatitis A & B, Pneumococcal, TDaP and HPV.” After each consultation with the traveler’s permission, Passport Health sends a letter to the patient’s primary care physician advising of all immunizations received. “We do not compete with primary care physicians. We concentrate on immunizations,” she concluded.

Although Passport Health provides a wide array of immunizations, the company focuses on providing education, counseling, vaccinations and medications to international travelers. Kluge stated that even seasoned travelers risk illness if they enter endemic areas where diseases such as Yellow Fever, Malaria and Japanese Encephalitis, thrive.

Travel Medicine, like any other medical specialty, is practiced by medical professionals who have undergone rigorous training and must keep up with ever changing recommendations, outbreaks and pathogen resistance to medications.

Those in practice are trained in global epidemiology of health risks to the traveler. These include tropical diseases, pathology, altitude medicine, and malaria prevention. Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and referral.

“In the United States, there are about 33 million international travelers every year; and this does not include those who are traveling to Mexico or Canada. Most of them unfortunately travel unprepared; some do not even have insurance or emergency evacuation means,” said Claudie Boulay, RN, Executive Director at Passport Health Miami in closing.



As the economy has tightened, patients’ discharge needs have become increasingly complex. At the same time, Medicaid guidelines for home health care have changed and private insurance companies continue to focus on timely discharge. While this environment is stressing case management staff at most hospitals, Memorial Hospital Pembroke’s Clinical Case Management (CCM) team has risen to the challenge.

“We start by doing very in-depth assessments with patients and their caregivers,” explained Susan Levine, R.N., and Director, Clinical Case Management, who heads a six-person team with a total of 77 years of service in the field. “Experience really makes a difference here because some of our sickest patients have very limited means. So, we have to determine exactly what their needs will be at the time of discharge.”

The Memorial Hospital Pembroke Clinical Case Management Team includes (front row l-r) Linda Kirkeberg, R.N.; Jennifer Groves, R.N.; Debbie Hand, LCSW; Marise Christophe, R.N.; Carolyn Timmons, R.N.; Louise McLune R.N., Sandra Jaime, Secretary; (back row l-r) Susan Levine, R.N.; and Deloris Thompson, R.N.

The team feels that its shared expertise makes a difference every day on the job. “We’re working from something we’ve already done but now we have to be very creative with the limited resources available in the community,” said Delores Thompson, R.N., and Clinical Case Manager. Also on the Memorial Hospital Pembroke CCM team are Carolyn Timmons, R.N.; Marise Christophe, R.N.; Linda Kirkeberg, R.N.; Louise McLune; and Jennifer Groves, R.N.

Thompson pointed out that daily rounding with staff hospitalists has helped the team better understand patients’ needs. “Teamwork within the hospital staff and among ourselves enables us to provide better service to our patients,” she said. Work often continues over lunch as the CCMs share strategies for assisting patients and securing much needed services.

Patient satisfaction scores for the case management team are excellent, demonstrating that the group is achieving its goals. Thompson explained, “Our ultimate goal is a safe discharge for every patient—one where he or she is getting exactly the care needed to recover properly following hospitalization.”



Somewhere in the back of my mind I recall a Florida Governor who used that statement as a marketing slogan. Come to Florida. We will make it easier for you to do business. Come live and work where fun and sun are part of the both physical and social climate with which to work.

The rules are different here!

Now that mantra haunts me like an “ear bug.” It seems to be used as the excuse, rationale, defense for all the myriad of differences in data that represent Southeast Florida’s distinctions in health status, insurance penetration, poverty levels, health services supply and utilization, more pain clinics than hospitals, higher healthcare costs per capita or per any other measure. It’s the excuse, rationale and defense for Miami-Dade County’s health system fraud and abuse, excessive testing, physicians without malpractice insurance (i.e. self-insured), more MRI machines than the country of Canada, more Medicare Advantage programs than entire states, and literally hundreds of “home care” agencies billing half of all claims in the nation.

The rules are different here!

Those of you who work hard every day in every way to do the right things for patients, payers, tax payers, personnel and fellow professionals know that you don’t have to serve on the MEDPAC board or be a professor at Dartmouth to know the rules are different here. From municipal elected officials to county commissioners to state legislators to Congressional Representatives to Statewide office holders, the way to get and stay in office is to promise and promote lower taxes. Never mind that the quality of our educational institutions and the funding of health and human services are dependent on tax dollars to survive. Even in the area of citizenship and philanthropy Florida ranks 46th and 44th respectively. “In fact the Miami-Ft. Lauderdale MSA ranked 50th among the nation’s 50 largest metropolitan areas on 3 key civic indicators: volunteering, public meeting attendance and collaboration with others on local issues,” according to the Florida Joint Center for Citizenship’s most recent study. Of course it’s not easy or popular to find revenue during a recession, but I haven’t heard many legislators say they are going to Tallahassee looking for creative ways to secure resources instead of ways to “cut funding.”

The rules are different here!

Now we actually have elected officials that think we should apply for a Medicaid waiver that allows the state to receive its share of Federal funds, but not actually run a Medicaid program. There are also folks who think the state should pass legislations that would create a ballot measure to amend Florida’s constitution in a way that would exempt us from implementing national healthcare reform once Congress and the President finish with the process. This article is supposed to be a prediction of the year ahead. Well my prediction is that the rules here aren’t that different. And if we, the hospital and healthcare system, don’t embrace and creatively implement healthcare reform, it will be done to us. If our managed care companies can’t find a way to serve our seniors at a per member per month amount closer to the cost of other communities, they won’t have Medicare contracts. If our physicians can’t figure out a way to diagnose and treat our patients without using every machine in their arsenal, then some of those services will stop being paid for. If hospitals and doctors can’t do a better job with the first admission, lowering the readmission rates, then reimbursement rates for an entire range of DRGs will be less. And finally, if we don’t as succeed in marketing whatever new health insurance options are available through the new exchange, the numbers of uninsured won’t get lower.

The rules are different here!

So this is the moment in time when we should use this to our advantage. We should fix our system as rapidly as we can. Hospitals ought to sign up with PSOFlorida to provide safer more consistent care. Doctors, hospitals and legitimate home care agencies ought to align their incentives and prepare for bundled payments. The uninsured ought to start taking responsibility for their health by participating in Cover Florida, Miami-Dade Blue, or the other lower premium, reasonable benefit health plans and/or by using the constellation of available federally qualified community health centers instead of hospital emergency rooms for non-emergent needs. If the rules are different here then we need to create a set of rules that work a lot better. It will be nice to be distinctive for being the best, for leading the way at reform, and for a reputation of lower cost, higher quality, accessible care.