Department of Oral & Maxillofacial Surgery

In comparing the value of individual patient stories with the evidence obtained from randomized clinical trials, it is often said that “the plural of anecdote is not data.” In general, I agree with that statement.

One of the meaningful ways I have measured our progress at UF Health, however, is in reading the letters I receive about the care our faculty and staff provide. At first, the number of complaints far outstripped the letters of appreciation. Over the years, the situation slowly improved. Now, I am pleased to report that the volume of letters in the two categories has completely reversed. Measuring the height of the piles of letters across time does not constitute a publishable longitudinal study, but I must confess that reading the many letters of appreciation for your work in helping our patients is enormously gratifying and heartwarming. It’s why we do what we do.

Here’s a recent letter from Debbie and Dean Heaton of Jacksonville:

Dear Dr. Guzick,

I am a parent of a precious 6 year old boy, named Tyger. He is a normal, active young boy in many ways with the exception that he does not have a lower jaw. He was born with a birth defect named Treacher Collins Syndrome.

Now let me tell you about a wonderful man, a physician, that puts his heart, soul and love of medicine in practice! His name is Dr. Barry Steinberg. He cares for my son as if he was his own. He has given 110% in surgically helping my son to be able to “grow” a lower jaw, striving to allow Tyger to breath, eat and function like his peers. Dr. Steinberg is a caring and compassionate man with a strong love for children who is helping to enhance their lives through his gift of surgical expertise.

My husband and I are so grateful to Dr. Steinberg for the sensitive, caring, exemplary treatment he has given to Tyger. We are so lucky that he is here in Jacksonville! Tyger is so blessed to be under his care. We could not ask for anything more!

The Department of Oral and Maxillofacial Surgery at UF Health Jacksonville is a signature program that has become well-known for its wide-ranging expertise in the care of patients with facial trauma, head and neck cancer, correction of hereditary facial malformations, and other conditions, as well as for aesthetic surgery. The growth of this department, in size and reputation, has been striking, and it is a wonderful story to tell. It is the story of how talented and dedicated faculty can build a stellar clinical program that attracts patients far and wide to a location in Jacksonville that is viewed locally as challenging as a site for care, and it is a story that bridges two colleges of UF Health – Medicine and Dentistry – embodying the interdisciplinary nature of our academic health center.

The department of Oral Surgery at Duval County Medical Center was established in 1967. This was done to support a residency program for general dentists who wanted to specialize in oral surgical procedures. The residency program was 24 months and included rotations through the anesthesia and surgery departments. As time went on, the specialty of oral and maxillofacial surgery (OMS) was established in the United States. This specialty, with a more comprehensive scope of practice, initially concentrated on the management of facial trauma, corrective jaw surgery and surgery of the temporomandibular joint. During the 1980s and 1990s, the oral and maxillofacial surgery service in Jacksonville was a component of the department of oral and maxillofacial surgery at the College of Dentistry in Gainesville, and the scope of practice was limited to office-based oral surgery as well as facial trauma.

During this period of time, however, the specialty of OMS was changing in the United States. Many program directors and faculty members realized formal medical school training was an integral part of the scope of practice of the specialty, especially for programs such as the one in Jacksonville that were actively involved in cancer surgery, microvascular surgery and other head and neck surgery. A model based on the European OMS training curriculum was developed, which required a formal medical degree after obtaining a dental degree. This movement led to the creation of M.D./OMS residency programs across the country.

In 2001, under the direction of Barry Steinberg, M.D., D.D.S., Ph.D., OMS faculty at UF College of Medicine-Jacksonville became a division within the Department of Surgery. Over the next five years, after recruiting several young fellowship-trained faculty members, and with support from UF Health Jacksonville, the Division of OMS created an M.D./OMS residency program. This is designed for graduates of dental school who enter an integrated, six-year program in which they obtain an M.D. degree (two years) and expertise in oral and maxillofacial surgery (four years). The division quickly became known nationally and internationally for its state-of-the-art head and neck surgery and microvascular reconstruction, as well as pediatric craniofacial surgery, performed in conjunction with UF pediatric neurosurgeons. In 2012, after a yearlong process, the division became the newest department at the UF College of Medicine–Jacksonville, under the leadership of Tirbod Fattahi, M.D., D.D.S., as chair.

Today, the Department of Oral and Maxillofacial Surgery has seven full-time faculty members, 19 residents, and two fellows in microvascular and head and neck surgery. The Section of Head and Neck Cancer resides in the department of OMS. The scope of practice is unlike most other OMS programs in the country. In addition to traditional office-based oral surgical procedures, residents and fellows participate in a robust head and neck oncology and reconstructive practice as well as facial plastic surgery and pediatric craniofacial surgery. The department has a private practice office outside of the medical center with emphasis on facial plastic surgery as well as endocrine surgery (thyroid and parathyroid disease).

Most of the faculty is fellowship trained in various subspecialties such as head and neck surgery, facial plastic surgery or craniofacial surgery. The department is also among the top-ranking OMS residency programs in the country. Many of the faculty have reached national and international recognition for expertise in their specific field of practice. Recent alumni from the department are now full-time or part-time academic OMS faculty at various academic health centers, including Indiana University, Loma Linda University and the MetroHealth System at Case Western University. Patients seeking advanced head and neck reconstruction and cancer surgery routinely travel from several regions of the world (Central and South America, Africa) to UF Health Jacksonville for their surgery.

Closer to home, Glenn Sisler, M.D., a retired thoracic surgeon, writes that he was operated on by Rui Fernandes, M.D., D.M.D., associate chair of OMS and chief of the Section of Head and Neck Cancer, for carcinoma of the tongue, explaining that the operation and postoperative course went well, and that he is now a five-year survivor.

“I have a professional background which allows me to make judgments regarding physicians and surgeons,” states Dr. Sisler. “Dr. Fernandes has my highest respect as a surgeon and as a kind and competent physician. I was very fortunate to have his services, and you are fortunate to have someone of his quality on your staff.”

In the broad spectrum of services provided by the department there is expertise in plastic surgery as well as reconstructive surgery for inherited malformations and cancer. Listen to this woman from Jacksonville who wanted to pursue a new career but lacked confidence, in part because of her perception about her aging appearance. After researching potential plastic surgeons, she consulted Dr. Fattahi because of his reputation in the community and that of the department. “Having that face lift surgery was one of the best decisions I ever made,” she wrote. “It gave me all the confidence in the world”

The future looks very bright for the department of Oral and Maxillofacial Surgery. Expansion of clinical practice into the UF Health Jacksonville North campus and the creation of a new craniofacial fellowship are two more exciting projects on the horizon. Moreover, the remarkable growth of the department in its clinical and training programs is complemented by academic recognition. For example, in FY13, there were 16 national and international presentations by our OMS faculty members, as well as eight publications of peer-reviewed manuscripts. In addition, four OMS faculty members received the Exemplary Teaching Award from the College of Medicine. For more information regarding the department, please go to: http://hscj.ufl.edu/oral-maxillofacial/.

Forward Together,

David S. Guzick, M.D., Ph.D. Senior Vice President, Health Affairs President, UF Health