By Mary Alice Murphy

Gila Regional Medical Center Chief Executive Officer Taffy Arias introduced the hospital's newest surgeon.

"There are lots of things I do every day," Arias said, "but the most enjoyable is bringing top-level physicians to your hospital. You deserve the best. I am pleased to introduce Dr. James 'Butch' Rosser."

"I'm here because I want to be here," Rosser said. "I'm here for a long run, maybe to retire here. My wife and family have been behind me on this getting out of the chaos that has been my life for the past 30 years."

He described his strategic initiatives for his role at the hospital. "I want to create at Gila Regional an Advanced Heartburn Diagnostic and Treatment Center, with new procedures, including Transnasal Esophagogastroscopy, a 48-hour Bravo ph capsule, esophageal manometry; and chaperone heartburn centers.

Rosser uses minimally invasive surgical procedures, including incisionless hemorrhoidectomy, laparoscopic inguinal hernia and ventral hernia repair and anti-heartburn procedures.

He also wants to increase the Gila Regional telemedicine network, with a primary care telemedicine support network and mobile endoscopy.

"It's job creation," Rosser said. "One of the themes that are the cornerstone for the reason why the chamber exists. I am a surgeon. I wanted to be a doctor my whole life, but never a surgeon. The first to perform a heart transplant in this country was Dr. Hardy. He was my professor. He called me into his office when I was a fourth-year medical student. I was scared to death. But he was smiling and said; 'We've heard you have great hands and great compassion for patients. Did you ever think about going into surgery? I replied: 'No, sir,' and he said: 'Why not?'"

Rosser said he asked permission to speak freely and "Dr. Hardy said: 'By all means.' And I said: 'Don't you have to be a horse's ass to be a surgeon?' He laughed with the biggest laugh and leaned back in his chair. Once he gathered himself, he replied: 'Did you ever think that being a horse's ass is a personal decision?' And a lightbulb went off for me that I could decide if I wanted to be a horse's ass and I didn't have to. And that's why I became a surgeon."

He noted that Taffy Arias has the "tenacity of a wolverine. She infected me with her enthusiasm about this community and this hospital. When she said the hospital believes that a person should not have to leave Silver City to get world-class health care, she convinced me. I want you all to embrace that. We're gonna get T-shirts and I want you to wear it. She said that's our mantra. That's what Taffy and (Chief Executive Officer) Richard (Stokes) are trying to do here."

"I've gone on record against big corporations taking over small hospitals and then leaving the communities high and dry," Rosser continued. "You, as a community, rallied around Gila Regional. You rallied around Dr. (Brian) Robinson after his accident. The way I look at it is if you cannot save Silver City's hospital, you cannot save this nation. I absolutely believe we will save this nation."

He introduced his wife, Dana, and his office manager, Jennifer. "Richard and I speak the same language, southernese." He also introduced Jerome from IT, who got Rosser's new technology and equipment to work this week.

"I'm coming at this from the hospital side and the community side," Rosser said. "I want to see a sustaining vibrant commercial operation at the hospital. I want to bring the Advanced Heartburn Diagnostic and Treatment Center here. There are 400,000 people within the 1.2 million people in the 150-mile radius that have heartburn. Heartburn brings dangers of esophageal cancer, which is one of the fastest growing cancers in the country. It's personal for me. I lost my uncle, a Korean War veteran, to esophageal cancer due to heartburn. You have a nationally recognized, internationally recognized expert on heartburn and esophageal cancer. Dr. Oz and I did a show on it. He has recognized me as an expert on heartburn since 2010. We could be a special center in a special place."

He showed a map of 7 places in west Texas and Arizona that have heartburn centers. "We can be the center in this large blank space in the middle in a special location. On top of that, 50 percent of you who are taking heartburn medicine, you don't even have a diagnosis. You got something else wrong. One of the things that makes us special is that we have a nationally recognized system that gets the diagnosis right the first time. We have the technology to determine your diagnosis. Data dominates instead of 'I think this is what's wrong.' We're all about getting you treated the right way. Homeopathic, over-the-counter medicines can work, but we take the time with you to determine the cause."

Rosser also does two-hour heartburn "fireside" chats.

"We have appointments spaced so that we have time to figure out what's wrong," he said. "The transnasal esophagogastroscopy can determine the cause. It may be yeast, which can be treated. All these procedures are really cost-effective stuff. We often find it's not heartburn. In fact, some of the remedies you may have been taking have been taken off the market because they are cancer-causing. The ranitidines should have been removed long ago. The esophageal manometry is another method we use to determine if it's really heartburn."

He said the proposed center can be expanded to scale. "How do we create an enterprise to hire more people? We are looking to start chaperone heartburn centers in small to medium hospitals to treat more people. And how do we do that? We have to go out and train the people. We're creating the enterprise system. If we create two more centers, what does Gila Regional get out of it? Well, out of every 100 heartburn cases, about 15 need advanced heartburn surgery, which we will do here at Gila Regional. We are creating new jobs that are sustainable."

Since July 15, Rosser has 42 people lined up for the transnasal esophagogastroscopy procedure, 56 for endoscopies, 56 for the 48-hour Bravo pH capsule and 46 for the esophageal manometry. "And we haven't even advertised."

"When I was at Yale, when in New York, Atlanta and Orlando, we had people coming from around the world for me to take care of them," Rosser said. "It's called a medical destination. We already have a medical destination here for your pets. Did you know that? Dr. Bradberry has created a medical destination here for pets that need special surgery. So, if we can do it for pets, we ought to be able to do this here.

"I'm happy to announce we have all our equipment, as of about 10 days ago, thanks to the efforts of Miss Taffy and Richard, we got them about two months earlier than expected." he continued. "So, we’re starting on the backlog on Nov. 13. That's the day we start the new procedures. On Nov. 22, I will do the first incisionless hemorrhoidectomy. We did the first two hernia repairs two weeks ago, And we will be starting the anti-reflux procedures for when the homeopathic treatment fails."

An attendee asked if these procedures were covered by insurance, and Rosser said they were.

"Now I want to show you part of my past and how it connects to the future," he said. "Fee for service is done. What's going to happen is they will tell us 'you have to take care of X number of people, get X amount of satisfactory results, and it's up to you to make a profit. That's what's coming. The only way you can do that is with telemedicine, which is the remote care of people, without the provider actually being there."

He showed a short video of him talking to a doctor and his patient and his diagnosis over the computer. "Imagine you didn't have to travel 100 miles or from Deming. Imagine, Curtis (Clough, Silver Schools associate superintendent), if you had all the schools covered with coverage like this. This is how you can have patients seen sooner and with a high level of patient satisfaction. Think about this. I'm going to strip the boundaries of your imagination. I was in Japan and this van pulls up to a company. They have mobile endoscopy units with gastroenterologists inside coming to the job site to do endoscopies, because they have such a high rate of gastric cancer. The only way to attack it is to scope it early. I didn't see how it could work here because we only have so many gastroenterologists. So, my thing is how do we bring a force multiplier into this. So, I got NASA and Karl Stortz to trust me to do the academic research on how to train nurse practitioners and physician assistants to do the magic scope you saw earlier." He showed another video. "This person was trained by me and our team and now this person has become an extender." He explained the diagnosis.

"There is public money available for this," Rosser said. "Tony Trujillo is working on this. There is public and private money we can access. Joe Shepard at Western New Mexico University is a visionary. His next project is the expansion of medical education at Western. He knows we need the lower level. He wants to train medical assistants. When I talked to the World Bank in 2000, I said we need telemedicine assistants. These assistants are trained in the medicine, but also in the technology and the protocols of how to be under remote guidance, like what I've done with NASA getting astronauts ready for space travel and with the military. Imagine:" he showed photos of the Rosser Global Command Center, a cost-effective command center, which is a drop in at $53,000. "Having the trained assistants that Joe is working on, this is workforce readiness. This is commerce. By 2010, we are short 46,000 proceduralists and 83,000 primary physicians. So how are we going to make it up? This is how we do it. This is where Curtis comes in. He has the same enthusiasm I do. He's a terminal 12-year old like I am. He wants the science, technology, engineering, medicine and mathematics programs. We have to get students to ready to fill these positions. We have to start young. I presented this to him. We have to get them excited about the 21st-Century jobs and we have to get increased scores on their standardized tests. I have a problem with teaching to tests, but we have to give Caesar what Caesar wants. We have to show the data. So, we want to take the most disadvantaged kids. We took a program in Florida and converted it to music, video games and workforce readiness, and it worked. It can be done. The kids that went through the program scored significantly higher on the tests."

He showed a video of students playing with drones. "We call it stealth learning, teaching them to learn while they are having fun, and not knowing they are learning. They learned it through activity. The students had to keep data points. I believe if students are trained in the right way, they can do anything."

Rosser said he gets emotional when he sees this film. "That student, when we began, never said a word. And he got up that day and articulated."

Rosser is a NASA-certified drone pilot. "New Mexico has one of the best drone testing sites."

"We need regional centers for this sort of activity," Rosser said. "It will be centered here. We have to have all the training to support. I believe Silver City can be one of the six regional training centers, with others in New Jersey and Florida. I talked to Joe again about how to go after funding for the WNMU Center for Innovative Educational Pedagogies to study how video games and modern technology can help and train the teachers to teach the students using these methods.

"Finally, I want to talk about something close to my wife's heart and mine," he said. "She was raised by a single mother, a bank teller who raised three great kids. It was hard. So, in recognition of her, we started a non-profit, the Single and Strong Program. We got Starbucks and Mary Kay to work with us. We have people nominated. We're starting with hospital employees and will announce our first winner at the hospital Christmas party."

He said, to laughs, that he has learned a lot at the geographical epicenter of Silver City, Daylight Donuts. There he heard about grandparents that are taking care of their grandkids.

"I understand, but this is part of the giving back," Rosser said. "Miss Taffy and her teammates understand that in order to win for the hospital they have to not only take care of the medical side, but also take care of the community. I want to thank you for your support."

In closing, he said the groundwork has been done and is not a figment of his imagination. "Go to the library or Google and look for my research. This is not the cornerstone of a pipe dream. It is the foundation of a reality that has been forged from the nebulousness of my dream tested by the crucible of academic validation. You may not want to see things change, but they will. My research stands as the support of the keys to the future. What do we need? We need an educated work force. We need a skilled work force. This community will not thrive if you don't have a great health care system that is population-based. It's all about maximum work force readiness. The best ability is availability. It's what has separated our nation from others. Our people were healthier and could work more frequently and consistently. Health care has to come to the people. We have to empower people to take care of themselves, and we have to have the availability of cutting-edge services locally. The regionalization of health care is the rationing of health care. We don't want to be like the person who chopped off his finger. He took four helicopter rides over 700 miles and when he got there the finger was dead. That's what regionalization of health care means. We do not have the luxury of complacency. We must move forward."

Strong applause accompanied his closing comment: "Thank you for tolerating me and my ideas."