Birmingham Medical News April 2026

HLA of Alabama Holds Winter Conference

50 Year Anniversary

By steVe sPencer

When the Healthcare Leaders Association of Alabama, formerly the Alabama MGMA, held their first conference, Gerald Ford was president and Love Machine by The Miracles (who?) was the number one song on the charts. In the following 50 years, the HLA of Alabama has grown from a handful of administrators to an organization of over 700 members, serving as a premier resource of information for practice administrators.

The HLA Alabama semi-annual conferences have been a wonderful place

for administrators to meet and learn, and this year’s winter conference at the Hyatt Regency was no exception.

“This event reminds us how important it is for physician leaders to come together, share best practices and support one another,” said Howard Bogard, who spoke at the conference.

“It’s a great opportunity to connect with peers, exchange ideas, and stay ahead of where the industry is going,” Kyle Church of Lightpoint said.

The group of speakers consisted of experts from across the field of healthcare including Howard Bogard with

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Expanded Access to Functional Neurological Disorder Care Through Telehealth

By ansLey Franco

For many patients living with Functional Neurological Disorder (FND), the path to diagnosis and treatment can take years. Symptoms may resemble serious neurological conditions such as seizure-like episodes, weakness, paralysis, speech problems and gait disorders, but the root cause lies elsewhere.

“Functional neurological disorder consists of neurological symptoms that are not due to a neurological pain condition or another medical condition,” Aaron Fobian, founder of ReACT FND Health, said. “Instead of it having a structural issue

that’s causing the problem, it’s the result of the communication between the brain and the body.”

Despite being one of the most common diagnoses seen in outpatient neurology clinics, FND has long been misunderstood. To address the gap, Fobian helped create a telehealth-based program designed to expand access to specialized treatment.

Historically, the condition carried heavy stigma. “It used to be called hysteria, and it was believed to be a woman’s uterus moving around in the body. During the Salem witch trials, a lot of people who had FND were believed to be witches,” Fobian said.

For decades, theories surrounding FND focused primarily on psychological explanations. Sigmund Freud coined the term “conversion disorder.” It was theorized to be a psychological conflict resulting in a communication problem between the brain and body caused by unresolved trauma.

Research conducted in the past several decades has reshaped that late-1800s understanding of FND. Fobian said that while psychological factors can interact with and trigger FND symptoms, that’s not the main underlying cause for the disorder, as studies have found that a lot of patients don’t have

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At the heart of one of the most highly regulated industries in the nation, health care facilities and providers face challenges that draw attention and resources away from their mission to provide quality patient care.

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Rising Medical Malpractice Payouts Drive Push for Tort Reform

By Lauren Johnson

Medical professionals, insurance companies and government representatives are calling for tort reform, and warning that without it, Alabama is going to struggle economically.

Claim severity has increased significantly in the past few years, especially for medical malpractice. According to the Alabama Department of Insurance, total payouts from insurers rose by 140 percent from $9.6 million in 2020 to $23.5 million in 2024.

Margaret Nekic, CEO of Inspirien, and William McGowin, general counsel for Inspirien, described the current state of the medical malpractice legal field as an uphill battle.

With venue shopping, no caps on damages, and an increase in plaintiff ads, everything seems to be stacked against the medical professional defendants. These lawsuits increase malpractice insurance costs, and the fear of lawsuits leads physicians to practice defensive medicine. It’s becoming harder to recruit doctors when surrounding states have caps on damages, and other tort reform legislation already in place.

“We’re not trying to block plaintiffs from getting what they deserve– reasonable compensation for damages. We’re against the nuclear verdicts,” McGowin said.

The Medical Liability Act of 1987 put a $1 million cap on damages in medical malpractice cases in Alabama. However, this bill was ruled unconstitutional in the 1995 Smith v Schulte case. In that trial, the jury awarded $4.5 million to the plaintiff, and the supreme court reduced the amount to $2.5 million.

Since this decision, medical malpractice damages have skyrocketed. In the Mobile County Circuit Court last month, a jury awarded $50 million for a wrongful death medical malpractice case. That’s up from a $35 million judgement in a similar case in the same venue four years earlier.

“If the cap had held, we would be around $2.5 million now, but they raised it to $2.5 million in 1995,” Nekic said. “If you look at consumer price index, that amount would be about $5 million

in today’s world, but the supreme court has raised it significantly in recent years. These escalating jury awards are unsustainable.”

Before trial, plaintiff lawyers get to select a venue, which plays a huge role in the case according to McGowin.

“The plaintiff lawyers are always trying to shop venue,” he said. “Venue is probably the number one thing they look at when they file a lawsuit. Our big metropolitan areas have become very plaintiff friendly – Mobile, Montgomery and Jefferson County.

“Some of our biggest settlements have been in cases where our hospital and doctors didn’t even practice in that county, but they’re sued there. We’ve got to change the venue statute in medical malpractice.”

McGowin and Nekic have also seen the negative effects the global pandemic has had on the medical field, malpractice cases and lawsuits in general. “Since Covid, you can’t turn on the television without seeing a plaintiff lawyer ad, ” McGowin said.

The pandemic put a halt to most lawsuits, causing a backlog of court pro-

Ambient listener AI Transforms Patient Visits

By Lauren Johnson

Ambient clinical AI is now assisting doctors before, during, and after patient visits. Using the newest artificial intelligence, Cullman-based Systemedx has created a program that can summarize patient information, listen to doctor-patient conversations and complete medical documentation.

Before the doctor enters the examination room, AI will use the patient chart and provide a summary of information, including the patient’s reason for the visit, their medications, allergies, previous treatments, things for the doctor to watch out for and recommended solutions. Then the ambient listener will record, listen and document conversation in real time.

“When you go into the room, you can just push the record button on your tablet or smartphone, and it will listen to the conversation. When it hears certain pieces of the conversation, it can start an order for the provider, ordering medication or getting you in for an x-ray,” said Systemedx President Kevin Bonner.

The AI program will remember the doctor’s preferences for things like referrals or labs. The doctor can review, edit and change the information before approving anything. All of this saves the

doctor time and allows her to focus on the patient during the visit instead of worrying about typing information on a keyboard.

“I’ve heard some doctors that do dictation coming out of the room say, ‘I have to sit there and make a mental note when I say my dictation that I need to talk about this.’ So, they’re focusing on what they have to dictate later, rather than the patient,” Bonner said.

AI engineers at Systemedx work with physicians to modify the technology to their needs, putting in the questions the doctor wants to ask or updating the exam template the doctor wants to use. The AI program will follow the template provided instead of developing its own or answering other questions that aren’t on the template.

“It will actually fill out the template

for you with the exact wording that you want it to say, so you fix a lot by creating good templates and good forms,” Bonner said. “Then our system lets you send that ambient to a human for review. If the doctor doesn’t have the time to review it, they can route it for human review.”

Systemedx is currently expanding their facility to create more room for the AI department. The company is building offices for these reviewers who will check the AI and make sure it listened and recorded correctly. Doctors have the options to review the information themselves, have someone from their medical practice review it or send it to the reviewers at Systemedx. This way a human is always in the loop.

“We build all the technology here in-house,” Bonner said. “It helps us build our AI prompt engineers, and we can adjust it fast too. Because every doctor practices a little bit differently, it’s nice to be able to adjust the AI to prescribe and do things their way.”

The ambient listening system can also listen, understand and translate Spanish. A doctor can talk to their patient in Spanish, and the AI technology can print out a summary or chart in Spanish or translate it into English.

“We’re at the tip of the iceberg with this technology. We’re just now getting it

where it’s actually very practical to use every day,” Bonner said.

This ambient listener technology was introduced about a year ago and is now being adopted nationwide by medical professionals in various fields including orthopedics, primary care, neurology, pulmonology and others. Bonner expects to see more physicians implementing this technology at their facilities in the near future.

“That’s our next thing, rolling this stuff out, getting best practices in place and building standard operating procedures for providers so these tools can go in easily at minimum cost. We want to get it where it’s easy to deploy and very costeffective,” Bonner said.

The basic AI is $100 a month. If the physician needs to use a prompt engineer more or use Systemedx reviewers, the price will go up from there. The AI software can be loaded onto a device or a window surface, and there are buttons to switch to different modes that allow for dictation or ambient listening. The doctor can also talk to the chart, requesting it to pull up something like the patient’s blood pressure records or an x-ray image.

“AI is becoming more practical now,” Bonner said. “It’s transitioning from the cool, dreamy state to real world, and doctors are asking how they can use it.”

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The Wait Is Over: Information Blocking Enforcement Is Officially Here

By Beth neaL Pitman and miranda a. Franco

We were told it would arrive, heard it was on the brink, and now it is here. U.S. Department of Health and Human Services (HHS) Assistant Secretary for Technology Policy (ATSP) Thomas Keane recently announced that ASTP has issued notices of investigation of potential nonconformity to one category of information blocking actors, health IT developers.

Information Blocking Enforcement Is Active

The 21st Century Cures Act (Cures Act), enacted in 2016, established provisions to promote interoperability and patient access to electronic health information (EHI). A critical component of the Cures Act is the prohibition of information blocking, which refers to practices that interfere with the access, exchange or use of EHI. Effective April 5, 2021, and amended beginning in December 2023 through the Health Data, Technology and Interoperability (HTI) Rules, the Office of the National Coordinator for Health Information Technology (ONC)

issued regulations defining information blocking and establishing permissible exceptions.

An enforcement structure for health IT developers and health information exchanges was finalized June 27, 2023, with enforcement against these information blocking actors effective since September 1, 2023. Penalties for healthcare providers were effective July 1, 2024. The Office of Inspector General (OIG) is authorized to investigate information blocking claims, and in September 2025, HHS Secretary Robert F. Kennedy Jr. directed HHS resources toward active enforcement.

Information Blocking Complaints Will Continue to Increase

Since 2021, there has been no enforcement; however, the Information Blocking Complaint Portal has been open and actively used, with nearly 1,600 complaints submitted as of February 2026.

Penalties Are Likely

Information blocking actors can be assured of potential penalties. Health IT developers, entities “offering certified

Banking for what’s

health IT” and health information exchanges or networks are facing potential fines of up to $1 million per violation, with potential for stacking of violations. Health IT developers face potential loss of ONC Health IT certification and being banned from the ONC program. This can have a significant economic impact on health IT developers and potential for indirect negative impact on their customers who rely on the certification for Centers for Medicare & Medicaid Services (CMS) payment program reporting.

Healthcare providers reporting to CMS under the Merit-Based Incentive Payment System and Promoting Interoperability, as well as those participating in accountable care organizations (ACOs) may experience loss of reimbursement and savings revenue. In addition, healthcare providers should be cognizant of the potential for related False Claim Act enforcement activity.

How to Prepare

• Incorporate Information Sharing and Privacy and Security in Health IT Design and Development: Although this is currently prioritized through

the Health Information Technology for Economic and Clinical Health (HITECH)/Cures Act Certification regulations and process, the HTI-5 Rule proposes the removal of 34 of 60 certification criteria and revision of seven others, altering nearly 70 percent of existing requirements. In addition, as seen in prior whistleblower actions against health IT developers, claims of certification failures may still arise.

• Assess Actor Status: Although an organization may not be a health IT developer, the organization may meet the definition of an entity “offering certified health IT” or as a health information exchange or network. The modified definition of “offering certified health IT” may apply to healthcare providers and support organizations that do not satisfy one of the definition exceptions and increase exposure to financial civil money penalties.

• Review and Update Policies and Pr ocesses: Steps to take include ensuring that organizational policies and procedures align with information blocking regulations and

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HLA of Alabama Holds Winter

Burr Forman; Cameron Cox with e3c3 consulting; Maddox Casey with Warren Averett; Stephen Dickens with State Volunteer Mutual Insurance; Janet Day with Kassouf & Co; Scott Harris with the Alabama Department of Public Health (ADHP); Gary Parker with the Alabama Medicaid Society; Philip Hemphill with LSU Health Sciences Department of Psychiatry; Mary Smith with Doctor Directory Services; Zed Williamson with TrackableMed, and many more.

The conference opened on Wednesday, March 4th with specialty breakout sessions. Meetings were held for 12 different specialties, including orthopedics, cardiology, and oncology. After lunch, there was a general session on the next frontier in healthcare.

On Thursday, Scott Harris, MD, State Health Officer with ADPH spoke about the state of public health in Alabama. This was followed by morning breakout sessions on using AI in healthcare, managing workplace culture, and a new practice manager’s guide to excellence. The afternoon sessions focused on the future of value based care, a guide to obtaining the best contracting results,

and tips on evaluating talent. There were also sessions on managing your brand with social media, and how to rally your team to achieve goals. Gary Parker, Chief Data Office with the Alabama Medicaid Agency gave a talk on Alabama’s health information Exchange to end the day.

The conference ended on Friday with two general sessions. Over 200 medical practice administrators attended the meeting, and almost 70 vendors. “From a vendor perspective, we have the opportunity to gain insight and provide solutions to our medical practice clients. It’s not just about exhibiting, it’s about building relationships, sharing ideas, and working alongside healthcare professionals who are committed to improving patient care,” said Tiana Benitez with Systemedx Healthcare Technology.

“I’ve been attending this conference for 15 years and look forward to it each year,” said Georgina Perry, CPA, CMPE with Carr, Riggs & Ingram. “I enjoy connecting with clients and other vendors, and I love to see the first-time attendees realize they can connect with peers and vendors here. It’s so much more than just the lectures.”

The Wait Is Over: Information Blocking

Enforcement, continued from page 6 promote seamless EHI exchange and confirming that implemented processes align with policy statements and do not contribute to practices of information blocking.

• Establish a Formal Documentation Process for Exceptions: Meeting an exception may provide relief from enforcement. Documentation and supporting records should be created and maintained. HTI-5 proposes removal of the prior Trusted Exchange Framework and Common Agreement (TEFCA) exception adopted in HTI3, and this exception, if finalized, may create the need to expand documentation when transmission has been through TEFCA.

• Privacy Compliance Integration: Monitor changes in privacy laws and integrate compliance with privacy laws, such as Part 2 Substance Use Disorder privacy law and the various state medical record laws, with processes to mitigate and prevent information blocking while continuing to meet required privacy restrictions. Establishing a process for prompt response to patient requests for electronic access outside of the patient portal and implementing requirements for release of information (ROI) vendors are imperative. State law privacy requirements, particularly in

California, complicate the interaction between information sharing and privacy requirements.

• Training: Provide comprehensive training to staff members on information blocking, including the definition, exceptions and potential consequences of noncompliance. Particular attention to staff responsible for health IT, health information management and privacy is important.

• Monitor Compliance: Implement mechanisms to monitor and audit information sharing practices to identify and address any potential issues proactively. Address specific processes for navigating privacy laws prohibiting or delaying disclosures.

• Health IT Coordination and Contracting: Investigate technology processes that can enable compliance with the Cures Act and assist in flagging and restricting disclosure of sensitive information that is either prohibited from disclosure or requires additional consents or other actions prior to disclosure. Appropriate contract provisions may provide protections on all sides of the transaction.

Expanded Access to Functional Neurological Disorde,

a history of trauma.

Even with improved understanding, people often spend years searching for answers. Some studies show it can take an average of seven years for adults with functional seizures to receive an accurate diagnosis. In her pediatric research, Fobian said most patients have experienced symptoms for more than a year before they reach her for treatment.

Diagnosis itself can be complex. For functional seizures, the gold standard involves capturing an episode during an EEG, which can take time to arrange. Patients may also be given medication that they don’t need, causing other side effects. But even after diagnosis, treatment access can remain limited.

By using ReACT FND Health, Fobian hopes to address that gap. A key factor enabling this approach is PSYPACT, a reciprocal licensing system that allows psychologists authorized in participating states to practice telehealth across state lines.

“Telehealth is particularly beneficial for patients outside major academic medical centers,” Fobian said. “Psychologists have a unique opportunity to be able to treat in most of the U.S. Most of the access is in larger cities around academic medical centers, and it’s often hard for people in Birmingham to get downtown. Pediatric patients get taken out of school for treatment and adults have to miss work.

“Telehealth removes many of those barriers, and being able to use it increases the patient’s ability to maintain the treatment. Since launching, the program has already expanded nationwide and continues to grow.”

ReACT has treated patients across dozens of states and recently expanded

continued from page 1

care to New York and California by hiring psychologists licensed in those states. Delivering care nationwide has also expanded other opportunities for specialized medicine in medical deserts.

Someone is described as living in a healthcare desert if they “have insufficient access to healthcare due to a low number of providers of services, long waiting times to have access to a health professional, and long travel distances to facilities,” according to a 2023 study published by the National Library of Medicine. Data collected by GoodRX in 2025 revealed that 80 percent of U.S. counties are considered healthcare deserts, impacting one in three Americans.

“I think this can be the future of healthcare, where you don’t have to rely on a specialist somewhere close to you, but where you can get someone very specialized,” Fobian said.

Technology is also helping improve treatment delivery. The ReACT Precision Treatment Tool, a digital adaptive manual for clinicians, helps tailor therapy sessions to a patient’s evolving symptoms.

“One of the biggest challenges in mental health treatment in general is disseminating the treatment with fidelity,” Fobian said. “Most mental health treatments are linear, and it’s incredibly hard to treat someone with FND in a linear fashion.”

Interest in the program continues to surge. More than 500 providers are currently waiting to train in the ReACT method, with clinicians from around the world seeking education on FND treatment.

“I think even just on an international level, there’s more awareness and excitement in trying to gain more knowledge and resources,” Fobian said.

Rising Medical Malpractice Payouts,

continued from page 3

ceedings. Since the courts reopened, the cost of settlements and awarded damages drastically increased.

“You’re faced with jurors who are not knowledgeable about healthcare, and you don’t have judges who are trying to manage expectations,” Nekic said. “Plaintiff’s attorneys are advertising everywhere and saying they’re getting multi millions. It’s a jackpot justice.”

Some hospitals and healthcare providers have insurance to cover the cost of damages while others do not. Either way, their rates will increase.

“That’s the misconception that the general public doesn’t understand. This money has got to come from somewhere,” McGowin said. “It costs the average family in Alabama about $3,000 a year in litigation cost, so somebody’s paying for it

and it’s the consumer. Something’s got to be done, or we’re going to lose business to the adjacent states, especially in healthcare but in other industries as well.”

To implement caps again, the supreme court could simply rule that the court back in 1995 was wrong and caps are constitutional. Then the cap of about $2.5 million would be effective again.

“Medical professionals are being very cautious with patients because they don’t want to get sued. They’re practicing defensive medicine instead of what they really wanted to do, which was to help people,” Nekic said.

Alabamians for Legal Reform (ALR) is working to get this message out, and it’s expected that tort reform will be a big topic in next year’s legislative session.

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Financial And Retirement Planning For Health Professionals

By Laura Freeman

Choosing a career in healthcare often means starting your professional life with a load of student debt. Getting from there to a retirement takes strategy and planning, starting as early as possible.

The magnifying effects of time on money can be surprising, either negatively as debt or positively as investment. That’s why it’s important to get good advice from someone who understands money so you can build a financial plan as soon as possible.

“The conversation begins by listening to our client’s concerns, goals and needs,” Andrew H. Mears, Senior Vice President and Financial Consultant for SouthState Investment Services, said. “We ask questions about their family, their current financial situation and priorities and look for opportunities to help them develop a strategy that meets their goals. Some of the things we think about are age, savings, cash flow, liquidity needs, insurance and what type of legacy they would like to leave.

“We approach each of our client’s goals differently depending on the time horizon, financial situation and specific

needs. All of these goals can be incorporated into a comprehensive financial plan that addresses their risk tolerance and takes into account market fluctuations and income needs.

“After we prioritize your goals, we can analyze your current holdings and talk about whether your current plan is on track to meet those goals. We can also look at things like savings, debt, insurance coverage, retirement, income and long-term care plan. Do you have children or grandchildren you want to pass money to? Are you recently divorced or concerned about selling a practice?

“There are many things that may have kept a person from starting to invest, like educational debt, but getting started

as soon as possible to take advantage of compound interest over time helps clients in the long run.”

How much money will you need to save and invest to achieve your goals and live the life you want to live thirty years from now? That can be a difficult question to answer, given the many factors involved and the possibilities for changes over time. However, a financial planner can give you a sense of how different scenarios could work.

“Your Financial Consultant can run a full financial plan that can give different projections based on how much you make, spend and what goals you have. Do you want to travel frequently, buy a second home or just cover your basic expenses? All of these things impact your overall savings goals,” Mears said.

The core principle is balance. You’ll typically want to work your way out of debt as soon as possible and move into asset building. However, that doesn’t mean sacrificing interim goals and quality of life to shift everything toward a nest egg at the end of life. One of your interim goals may be buying a comfortable home. You may want to travel along the way. Good financial stewardship is what

gives you the means to live your best life over time and still build the resources to live comfortably in retirement and leave a legacy.

A key element in protecting that legacy is estate planning. Ideally, you’ll set up a will as early as possible, check it regularly for needed updates and make changes as your life changes.

“It’s important to update documents as events such as the birth of children, divorce, death of a spouse, second marriages, liquidity events and other changes occur,” Mears said.

For some healthcare professionals, one of the changes to manage at retirement may be the sale of a practice.

“It’s important to have a timeline in which you intend to sell your practice and consider who your potential buyers are” Mears said. “In a practice with multiple owners you could put a buy-sell agreement in place. Money will be needed to complete the transaction, which may come from cash, a loan, savings, an installment sale or insurance.”

There are other aspects of financial management that are more likely to be associated with a career in healthcare.

Potential Legal Risks Associated with Peptides

By Angie Cameron Smith

Introduction

Peptides have emerged as one of the most rapidly evolving areas in modern medicine. According to those that promote the benefits of peptides, these short chains of amino acids can play critical roles in numerous biological processes and have become increasingly prominent in therapeutic applications. As the use of peptide-based therapies expands across medical specialties ranging from endocrinology to dermatology and anti-aging medicine, practitioners must understand the legal risks that may accompany their clinical use. This article provides an overview of some of the litigation-related issues that physicians, nurse practitioners, and other prescribers should consider when incorporating peptide therapies into their practices.

Regulatory Status of Peptides

In the United States, the Food and Drug Administration (FDA) categorizes peptides along a spectrum. There are some FDA-approved peptide drugs, such as semaglutide, tirzepatide, and certain formulations of growth hormone, which have obtained approval by undergoing clinical trials that demonstrate safety and efficacy for specific uses. Compounded peptides occupy a more complex regula-

tory space; these are peptides prepared by compounding pharmacies under either Section 503A or Section 503B of the Federal Food, Drug, and Cosmetic Act. The FDA has taken an increasingly active role in regulating compounded peptides, and in recent years has placed several formerly available peptides on its “difficult to compound” list or has otherwise restricted their availability through compounding. Research-use-only peptides represent yet another category and are not intended for human use, though they have at times been diverted into clinical or consumer channels through gray-market suppliers.

Changes to the Regulatory Landscape

The regulatory environment surrounding peptides has shifted considerably in recent years and continues to evolve. The FDA’s increased scrutiny of compounding pharmacies, particularly those producing peptide therapies such as BPC-157 (body protection compound-157) and thymosin alpha-1, has created a landscape in which the legal permissibility of prescribing certain peptides can change rapidly. In 2023 and 2024, the FDA added several popular peptides to its list of Category 2 substances, effectively restricting their avail-

ability from compounding pharmacies. However, as recently as February 2026, United States Secretary of Health and Human Services Robert F. Kennedy promised more access to compounded peptides.

Additionally, practitioners must keep in mind whether state medical boards and state pharmacy boards may impose additional restrictions or requirements beyond those established at the federal level.

Litigation Risks Associated with Prescribing Peptides

The prescription of peptide therapies exposes practitioners to several distinct categories of litigation risk, and an understanding of those risks is an essential component of responsible clinical practice.

Medical Malpractice Claims

The most straightforward litigation risk associated with peptide prescribing is medical malpractice. Malpractice claims in this area may arise from several factual scenarios. A practitioner who prescribes a peptide for an off-label indication without adequately informing the patient of the off-label nature of the use, the limited evidence supporting it, or the potential risks involved may face claims

grounded in failure to obtain informed consent. Similarly, adverse reactions to peptide therapies, including injection-site reactions or more serious systemic effects, may give rise to negligence claims if the prescribing practitioner failed to conduct appropriate baseline assessments, failed to monitor the patient during treatment, or failed to recognize and respond to warning signs of adverse effects.

The standard of care for prescribing peptide therapies remains somewhat unsettled because many peptide uses are relatively novel and lack the depth of clinical trial data that supports more established therapies. This ambiguity can cut both ways in litigation: plaintiffs may argue that the absence of robust evidence should have deterred the practitioner from prescribing the peptide at all, while defendants may argue that the emerging nature of the field makes it inappropriate to judge their clinical decisions by standards that have not yet been firmly established.

Regulatory and Licensing Violations

Prescribing peptides that are not FDA-approved, or that are obtained from non-compliant sources, may expose practitioners to regulatory enforcement

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Financial And Retirement,

from page 10

Ideas, Support & Solutions

That is why some firms offering financial advice have counselors who specialize in the field.

“My father was an anesthesiologist and my grandfather was a surgeon, so building on that perspective and years of experience in the field have helped me understand how building a healthy financial future may differ for clients working in different areas of health care. For example, in addition to malpractice insurance, a surgeon may need disability insurance written to cover anything that could affect the strength and steadiness of their hands or acuity of their vision,” Mears said.

On the plus side, working in health care may make client eligible for programs that could be financially beneficial.

“There are programs available to help medical professionals repay educational debt, such as the National Health Services Corp Loan Repayment Program, Nurse Corp Loan Repayment

Potential

Program and the Indian Health Service Loan Repayment Program. There are great resources online regarding each program, eligibility and potential benefits,” Mears said.

A financial counselor is part of your overall team and will likely be working with you along with specialists in insurance, taxes, legal issues and your CPA. The specific combination of investment tools your counselor recommends will vary depending on your season of life, changes in the marketplace and your specific circumstances.

“In general, investments in early years may tend to be more aggressive as there is potential for more growth and losses are able to be absorbed along the way,” Mears said. “Gradually, risk is dialed down to a more conservative investment allocation nearing retirement. However every investor’s risk tolerance differs.”

Legal Risks Associated with Peptides,

continued from page 11 actions by state medical boards. These regulatory actions may, in turn, give rise to civil litigation. For example, a finding by a state medical board that a practitioner engaged in unprofessional conduct by prescribing an unapproved peptide could be used as evidence in a subsequent malpractice action.

Fraud and Misrepresentation Claims

The marketing and promotion of peptide therapies is another area of concern. Practitioners who make unsupported claims about the efficacy of peptide therapies, whether in direct patient communications, on practice websites, or through social media, may face claims of fraud or misrepresentation. These claims may be brought by individual patients or, in some cases, by state attorneys general or the Federal Trade Commission.

Risk Mitigation Strategies for Practitioners

Given the litigation risks associated with peptide prescribing, practitioners should adopt comprehensive risk mitigation strategies. Thorough informed consent processes are paramount and should include clear documentation that the patient understands the regulatory status of the prescribed peptide, the level of evidence supporting its use, the known and potential risks, and any alternative treatments that may be available. Practitioners should source peptides exclusively from appropriately licensed and accredited pharmacies and should maintain documentation verifying the credentials of any compounding pharmacy from which they obtain peptide products.

Ongoing patient monitoring is essential, including baseline laboratory assessments and periodic follow-up testing appropriate to the specific peptide being prescribed. Practitioners should maintain detailed clinical records documenting the medical indication for the peptide therapy, the clinical rationale supporting its use, and the patient’s response to treatment over time. Continuing education in both the clinical science of peptide therapies and the evolving regulatory landscape is advisable, as is consultation with legal counsel experienced in healthcare regulatory matters when questions arise regarding the permissibility of a particular peptide therapy.

Conclusion

The rapid expansion of peptide prescribing has outpaced the development of clear regulatory frameworks and established standards of care, creating a legal environment characterized by uncertainty and evolving risk. Practitioners who choose to incorporate peptide therapies into their clinical practice must do so with a clear-eyed understanding of the classification of these compounds, the regulatory requirements governing their use, and the litigation risks that may follow from their prescription.

The information provided in this article is for educational purposes only and does not constitute legal advice. Practitioners with specific questions regarding the legality of prescribing particular peptide therapies should consult qualified legal counsel in their jurisdiction.

Angie Cameron Smith is a partner in the Health Care Practice Group at Burr & Forman.

East Alabama Health Creates Blueprint for Solving Workforce Shortages

As workforce shortages challenge health systems, East Alabama Health (EAH) is using innovative strategies to recruit, train, and retain professionals. The initiatives prepare employees for roles in nursing, medical coding, radiology, emergency services and more.

In 2024, EAH partnered with Chattahoochee Valley Community College (CVCC) to launch an on-site LPN school to address the need for more nurses. Students enrolled in the program get paid while attending class, lab and clinicals and maintain employment during school. After finishing their degree and achieving licensure, the students step into their new jobs at East Alabama Health as LPNs.

To provide employees with additional opportunities to obtain a nursing degree, EAH sponsors 10 spots each semester for employees to enroll in Southern Union State Community College’s (SUSCC) nursing program.

The partnerships with local schools also extend into the organization’s nurse apprenticeship program. Students pursuing a nursing degree at Auburn University, Central Alabama Community College, CVCC, SUSCC, or Troy University at Montgomery are eligible to apply for East Alabama Health’s Registered Apprenticeship Program, approved by the U.S. Department of Labor.

For selected applicants, East Alabama Health covers tuition, books and fees in exchange for a work commitment

following degree completion. Apprentices are paired with a nurse mentor for their rotations and receive payment as they complete the clinicals for their degree. In addition to payment for required clinical hours, apprentices are also guaranteed 24 additional hours of work per month, providing financial security and even more exposure to hands-on training.

Through a partnership with Wallace State Community College, employees receive on-the-job training and coursework over a one-year apprenticeship.

Beyond expanding opportunities for nursing careers, East Alabama Health’s apprenticeship programs extend to training employees for roles such as medical coders, scrub techs and certified nursing assistants (CNA).

Through a partnership with Wallace State Community College, employees receive on-the-job training and coursework over a one-year apprenticeship.

“Through the Workforce Development program, two employees earned their Certified Coding Specialists (CCS) credentials on their first attempt and have transitioned into full-time coding specialist positions,” said Claire Payne, director of Medical Records.

The journey doesn’t have to end with the CCS credential. Employees can further pursue a follow-up apprenticeship aimed at preparing for the Certified Professional Coder exam.

Another high-demand, low-supply

(CONTINUED ON PAGE 15)

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Researchers Identify Inflammatory Bacteria in Crohn’s

The human intestine is home to trillions of microscopic organisms, including hundreds of species of bacteria. In most people, these bacteria coexist and contribute to a mutually beneficial relationship. In certain individuals, specific bacteria are believed to provoke inflammation that characterize diseases like Crohn’s disease.

“A very diverse set of gut bacteria can swim through the layer of mucus that lines the intestines using specialized thread-like structures called flagella, the assembly and function of which involves a complex array of motility proteins,” said Craig Maynard, PhD, an associate professor in the UAB Department of Pathology’s Division of Molecular and Cellular Pathology.

mice, the bacteria induced immune responses that favored their survival in the intestines. When the gut mucus barrier was breached, the G2 bacteria induced intestinal inflammation whereas the G1 bacteria did not.

Maynard explained that flagellins may be at least partially responsible for the pro-inflammatory capabilities of G2 bacteria.

“We identified a specific region of the flagellin proteins of select G1 and G2 bacteria that regulate their respective ability to stimulate the immune system,” he said. “More broadly, we’ve identified multiple bacteria that are potentially capable of inducing intestinal inflammation, along with one flagellin-related mechanism that could underpin this function.”

Children’s of Alabama Responds to Statewide Critical Care Needs

Among these motility proteins, flagellins, which are the basic building blocks of the flagella, are believed to be capable of inducing the inflammatory responses seen in Crohn’s. It is still unclear which flagellated bacteria drive gut inflammation, and whether there are specific features of their flagellins that underlie this potential.

Maynard recently published work that investigated the distinct immune stimulatory functions of flagellated gut commensal bacteria. In this study, analysis of more than 100 motile gut bacteria identified at least two highly distinct groups, which the authors refer to as G1 and G2 bacteria, based on the arrangement and diversity of specific motility genes.

The researchers examined mice in which the only bacteria in their intestines were three species of either G1 or G2 bacteria. In both sets of

Maynard is corresponding author on this study in collaboration with his group and that of Charles Elson, MD, a professor in the UAB Division of Gastroenterology and Hepatology. Other authors of the study include first author Lennard Duck, Katie Alexander and Qing Zhao, Division of Gastroenterology and Hepatology; Melissa Jennings, Jung-Shan Hsu, Covenant Adeboboye, Leighann Morgan, Kiarra Coger, Barbara Klocke and Goo Lee, Division of Molecular and Cellular Pathology; and Dave Hill and Alexander Rosenberg, Department of Biomedical Informatics and Data Science.

This work was supported by grants from the National Institutes of Health and the Crohn’s and Colitis Foundation and funding from the UAB Heersink School of Medicine Pittman Scholars Program.

Children’s of Alabama has opened a newly designed Pediatric Intensive Care Unit (PICU).

“This new unit addresses the increasing demand for pediatric critical care, particularly for children with complex medical needs,” said Tom Shufflebarger, President and CEO of Children’s of Alabama. “It features leadingedge design and technology.”

This new unit combines the PICU and Special Care Units into a single critical care space, providing flexibility for both

high- and low-acuity patients. It is the result of a multidisciplinary effort involving nurses, physicians, respiratory therapists, pharmacists, IT professionals, facilities, and other partners. This project was made possible through support from the community, including a $3 million gift from Quarterbacking Children’s Health Foundation. Hoar Construction served as the construction manager, and Poole and Company Architects served as the design firm.

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East Alabama Health Creates Blueprint

Solving Workforce

for

Shortages, continued from page 13

career are surgical techs, also known as scrub techs. In 2022, EAH began a year-long Scrub Tech Apprenticeship Program. Since starting, more than 20 employees have become certified as scrub techs through the program.

For those pursuing formal education, scholarship loans and tuition reimbursement programs provide financial support. The workforce development programs at East Alabama Health not only cover educational costs, but also pay employees as they participate.

Between October 2024 and September 2025, EAH provided nearly $700,000 in educational funding for existing employees through scholarship loan programs and tuition reimbursement.

The organization's Nurse Residency Program is designed to support the transition from student to professional nurse. Recognizing that the first year of practice can be challenging, the program creates a supportive cohort community where new nurses are paired with experienced mentors and gradually integrated into clinical work.

East Alabama Health’s Earn and Learn program allows high school students an opportunity to work in areas of

TCAR, and EVAR procedures

the organization that fit their career goals. Earn and Learn students can be found in nursing units, radiology, ambulances, the maintenance department, and nearly every other department that keeps East Alabama Health running.

Together, these workforce training programs create a continuum of opportunity—welcoming learners at all levels of education and experience, nurturing their growth, and helping to build a stronger healthcare workforce for the region.

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