Shriners Hospitals
For Children
Pediatric Specialty Hospitals
• Mayo Clinic Initiative Update • Puerto Rico Initiative Update
• New “Epilepsy” Research in Honolulu
• Status of our Financial Position…John McCabe
• Shriners Research and Diabetes…Dr. Raymond Novak • Mexico City activity
Douglas E. Maxwell President and CEO
My Dear Fellow Representatives and Nobles,
This is such a beautiful time of the yearto be with family and friends in a very festive spirit. Patricia and Iwould like to wish you and your family a very Merry Christmas and a Happy Hanukah. I would like to update you on some thoughts from the Chairman’s “Fall Message”.
Shriners Hospitals and Mayo Clinics proceed to a closer relationship.
For the last two years, your Joint Boards have been working with the Twin Cities Board of Governors and Staff to find an improved relationship between these two organizations. At this
past November Board meeting, the National Boards approved moving forward with an expanded affiliation agreement with the Mayo Clinic Care Network…”System Wide”.
This new program will give Shriners Hospitals physicians the ability to work with the Mayo Clinic’s physicians through a variety of paths such as e-consults, ask-a-Mayo expert, archived grand rounds and knowledge sharing collaborative efforts in research and medical education.
But most importantly, Mayo will help us to develop a meaningful Shriners Hospitals “Outcomes Studies” using the Mayo proven guidelines. Outcome Studies are the specific data relating to a Shrine medical procedure. It will allow a parent looking for specific care for their child, to know if one of our doctors has done this before and how successful he or she was in the care they provided. You might ask…”What is Shriners Hospitals contribution to this partnership”? Shriners bring 92 years of great “Pediatric Expertise”in orthopedics, cerebral palsy, spina bifida, scoliosis, cleft lip and palate, and acute burns care.
We also bring a care presence from coast to coast in the United States, plus Canada and Mexico. Shriners is also a very healthy financial organization. Neither of these two great organizations are looking for a financial solution as part of this affiliation. Each organization has a great foundation and have been pillars of healthcare in America with combined experience of more than 180 years. This is a great association for both Organizations.
An interesting thought was brought to our attention during these meetings. In the early part of the 20th century when our Ancient Arabic Order of Nobles of the Mystic Shrine was beginning its path to take care of children with polio…two brothers with the last name of Mayo, who were Shriners in
Minnesota, began treating adults in Rochester Minnesota with their medical issues.
To now have the great Mayo Clinics, coming together with the great Shriners Hospitals for Children, 92 years later, and beginning to perform some of the “worlds” greatest medicine, is bringing this story full circle.
• Puerto Rico Initiative
As was mentioned in the last message, our Shriners Hospitals in Philadelphia has been providing Orthopedic “outreach clinics” in Puerto Rico for the last 40 Years. Twice a year, families would bring their children to a clinic run by the Philadelphia medical staff, in hopes that Shriners would be able to help their child. Many hundreds of children would show up for each of these semi-annual events. If the doctor’s examination determined Shriners could help, the child and a parent would be flown north to Philadelphia. Because of the long distance and the expense of the air travel, that parent and child would often be required to stay in Philadelphia forquite some time. Compare this to families who live close enough that they could be driven home after each procedure by one of our Shrine vans. We have been working with the Government of Puerto Rico, our Philadelphia hospital leadership and the University of Puerto Rico to develop a plan to expand the Care provided on the island.
Using our new Tijuana model of taking our “Great Medical Capabilities” closer to where the patient lives… we talked with the Governor of Puerto Rico for over an hour on September 9th
about some new possibilities. We indicated that with the support and backing from the local government, the
Philadelphia hospital could perhaps increase what it accomplishes here on the island. That meeting with the Governor has brought forth a wonderful new direction in orthopedic care for the children of Puerto Rico and the Caribbean basin. The Government of Puerto Rico has stated that it will
participate in a very substantial and meaningful way, to help Shriners Hospitals/Philadelphia develop a more regular presence in San Juan. Currently, on the island of Puerto Rico, we have identified 6 Pediatric Orthopedic surgeons, who are willing to become credentialed “Shrine Doctors” for at least one day a week to provide a regular care on the island for the children. Some of the physicians have already received their training at a Shriners Hospital. This increased care presence will be in
collaboration with our Philadelphia surgeons and will provide our great expertise in care without the burden of extensive travel. As Tijuana relates to our Los Angeles Hospital, The less complicated cases would be done locally with both Medical staffs working together. The complex cases will continue to be accomplished in Philadelphia.
(A side note; the Governor reminded us that all children in Puerto Rico are covered by insurance)
These new Puerto Rican doctors will also participate in an ongoing educational exchange with the SHC Philadelphia medical staff to keep their skills up to date.
• Executive Vice President, John McCabe
I have asked our Executive Vice President, John McCabe, to update us on the financial position of our philanthropy as we approach the mid-point between our Annual Meeting Updates.
John McCabe…
Doug has asked me to give you a mid-session update on our finances. As you are aware, we have been working very hard at getting our spending under control without adversely affecting the patient care we provide at our hospitals worldwide. We are doing just that.
We are continuing to spend smart. As a result, our current spend rate on the endowment is less than 4.9%. This is down from a high of almost 9%.
We are continuing to strive for new revenues. Our fundraising efforts
continue to pay off. This year is shaping up to be the highest donation level yet. We continue our efforts with third party pay and look forward to another good
year.
Finally, we are working hard to continue to increase the yield on the endowment fund. You may recall that in 2008 our endowment fund ranked in the 77 percentile among other like sized endowments. In 2013, we got that ranking up to the 13th percentile.
This year SHC's endowment fund was selected by CIO Magazine as a finalist in the healthcare organization category for industry innovation. We also rank 7th in fundraising among all healthcare organizations by Chronicles of Philanthropy. But the work is not over yet. There still continues to be volatility in the markets. We need to be able to adjust as needed -- being defensive or opportunistic as the circumstances dictate. I am confident that our team can do just that and continue the success. It's important that we stay the course during this volatility and these short term market shifts. We need to stay the course under our Strategic Plan to balance the budget by 2018 and secure the long term financial security of SHC. There is light at the end of the tunnel. The Federal Reserve is keeping interest rates low, the 10 year bond is approximately 2%. Historically the 10 year bond yields were approximately 5%. Once the markets are allowed to recover to historic levels, the additional 3% yield will go a long way to achieving our goal of having a balanced budget by 2018. In the mean time we need to continue to spend smart, and seek out other
sources of revenue. We need to focus on fundraising and increasing our donor base. These are things we can all do to help.
Thank you for all you do for Shriners Hospitals for Children. John McCabe
And now an update from our Director of Research, Dr. Raymond Novak, about our Shrine Research in Cincinnati regarding…
• Diabetes, Insulin Resistance, and Nutritional Supplements
Dr. Novak
In order to metabolize glucose within our body, the pancreas, which is located close to the liver, must secrete a hormone known as insulin. When there is a malfunction in the ability of the pancreas to produce insulin, or the body's inability to use the insulin secreted by the pancreas, there is a loss of the body's ability to lower glucose levels in the blood and other bodily tissues. This results in high
glucose levels which damages tissues and causes numerous adverse effects, including loss of muscle mass, severe pain in the extremities, kidneyfailure, poor vision/blindness, and if unchecked,
amputation of extremities, like toes, fingers and feet. There are two types of Diabetes:
Type 1 Diabetes results from an autoimmune disease in which the insulin-producing cells of the pancreas are destroyed.
Type 2 Diabetes is associated with obesity, high cholesterol and other metabolic alterations associated with "metabolic syndrome".
The condition which develops prior to Type 2 diabetes is referred to as insulin resistance. This means the pancreas is producing plenty of insulin, but the tissues are unable to effectively use it.
“Insulin resistance” can also result from severe trauma such as Burns. This can and does happen to some of our severely burned children.
overall recovery. Investigators at our Cincinnati hospital are working on a nutritional supplement that may alleviate the condition of "insulin resistance" and restore the use of insulin to tissues within the body. They are currently working with food chemists to improve the taste of the supplement and are planning to use this in initial studies on adult patients prior to using it on pediatric patients. This will “not only help our burn patients”, but others, including adults, who have insulin resistance.
• New Honolulu Research to help epilepsy
Our Honolulu researchers have been given a grant of $58,000 by the Hawaiian Medical Service Association to study how to help young people with epilepsyhave fewer seizures. The
Neurodevelopmental Clinic at our hospital headed by SHC neurologist Dr. Ryan Lee with the
assistance of our clinical dietician Miki Wong are launching a new Ketogenic Diet program to do the study. This diet gives the brain an alternate source of fuel. The best candidates for this study are patients with epilepsy whose normal medications are not working for them.
This ketogenic diet is high in fat, adequate in protein and low in carbohydrates. This diet changes the way the body uses energyand leads to elevated levels of ketone bodies in the blood, which is called ketosis. Studies have shown that this diet helps decrease the severity and frequency of seizures, though it might not be safe for every patient. Our doctors will work with each patient individually to come up with a diet plan and then closely supervise the child while they are on it. The diet is strict but can be modified to allow the parents some flexibility for their life conditions. Shriners Hospitals continue to make a difference in many children’s lives,
through both our great clinical care and our equally aggressive research. And finally…
• Mexico City Hospital
In late November, I had the opportunity to be at our Mexico City hospital. As we entered the hospital
at 7:00am that morning, our lobby was already filled with families waiting to be seen that day. For the second year, this Shrine hospital is doing clinical operations from 7:00am in the morning till
8:30pm in the evening, 5 days a week, to improve our children’s lives, They are again on a pace to see over 60,000 children this year.
My fellow Nobles and Ladies…
We can all take Great Pride in what our forefathers began and that all of us are continuing in a most magnificent way…
As we proceeded past this group in the “entry lobby” and entered the multiple “inner waiting rooms”, each of these areas were also completely filled with families.
When one looks into the eyes of these family members, you can see how hopeful they are that this place called “Los Hospitales Shriners Para Ninos”
• will make their child better….
• to walk for the first time in an upright position… • to smile again…
"Strong supporters of our Shriner's Hospitals, Mexican Presidente Vicente' Fox and his wife, visited our children when he was in office. He is being introduced to one of "our kids" by Chief of Staff, Dr. Felipe Haces".
A sincere heart felt “Thank You” to all of you for the difference you help us make in so many lives everyday of the year in so many places….
“God Bless You” and “God Bless Shriners Hospitals for Children” at this joyous time of the year…
Yours in the Faith,
Douglas E. Maxwell
Chairman of the Board of Trustees COBT@shrinenet.org
