MMC blog header

When you think about eyeglasses, what do you think? Most likely you will think of your own pair or those of a loved one. If you like fashion, you may think of some you have seen in a magazine or on your favorite celebrity. You definitely do not think of old age.

But what do you think of hearing aids? It is probably a different story.

In the United States, 14 million people 12 years or older have a vision impairment. 30 million people 12 years or older have hearing loss – that’s one out of every eight people. Both eyeglasses and hearing aids correct a sense impairment, so why are eyeglasses a fashion statement, but it takes, on average, seven years for someone to get their hearing tested after noticing a change in their hearing?

The idea of hearing loss affecting you when you are older is simply not true. Here are some statistics to prove our point:

  • 2 to 3 of every 1,000 U.S. babies are born with a detectable hearing loss.
  • According to the World Health Organization, millennials risk hearing loss because of damaging volumes via personal audio devices.
  • About 1 in 7 U.S. adults ages 20 to 69 has hearing loss.

Clearly, hearing loss leaves no age group untouched. But the stigma of hearing aids remains, and only 1 in 5 people who could benefit from hearing aids actually use them. The technology today is a far cry than the hearing aids 20 years ago. The digital age of today is sleek and discreet, minimizes background noise, improves speech clarity and focuses on your conversation partner rather than the noise behind you. If you have noticed any changes in your hearing in the last few years, regardless of your age, it’s important to have your hearing checked by a hearing professional. Contact us today to learn more!

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

3 Myths about Tinnitus

November 19th, 2019

Tinnitus is described as the ringing or buzzing inside your ears. Tinnitus is a condition that is annoying at best, and debilitating at its worst – but there are ways to make it better. Here are some of the misconceptions about tinnitus, and the facts you need to know.

MYTH: There is nothing that can be done about my tinnitus.
FACT: Many people come to see us about their tinnitus. Here are some proven ways to help your symptoms:

  • Tinnitus Sound Therapy: An important element in tinnitus management is sound therapy. Amplified sound from hearing aids, environmental influences, or noise generators can help minimize the contrast of the ringing in your ears to the sound of your therapy.
  • Tinnitus Counseling: Assessment and counseling with a licensed Audiologist trained in managing tinnitus can help determine the cause of your tinnitus and minimize the impact it has on your life. The effects of tinnitus can be minimized with counseling and sound therapy.
  • Relaxation Exercises: Stress can make tinnitus worse. Easier said than done, try limiting stressors in your life. Read a book, go for a walk, or practice breathing exercises.

MYTH: There are pills that will cure my tinnitus.
FACT: Some companies will try to point you to a miraculous cure for your tinnitus, but very little research has proven this to be true.

MYTH: Tinnitus and hearing loss are not linked.
FACT: Many people with tinnitus will also have hearing loss. In fact, a recent study revealed out of 123 people with tinnitus surveyed, only one participant did not have hearing loss!

Although common in our profession, tinnitus is a topic that cannot be addressed with a simple solution. Rather, as your hearing care professional, we are tasked with investigating our patients’ conditions and making educated decisions on the best treatment plan for you.

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

How does hearing work?

November 5th, 2019

Whether a friend whispers into your ear or a jet is flying in the sky, sound is all around us. Our ears enclose the three smallest bones in our body, change sound waves in the air to electrical signals in the brain, and help us communicate and connect with our loved ones. So, how exactly does this happen?

Our ears have three parts: the outer, middle, and inner ear. The first step in hearing is collecting sounds. Our outer ear, or Pinna, collects the sound to travel inside your ear canal. Our Pinna is also responsible for locating sounds. The sound waves travel into the ear canal until they reach the eardrum. The eardrum is at the end of the ear canal. This is where your middle ear starts.

The eardrum passes vibrations through the three middle ear bones called the Ossicles (Malleus, Incus, Stapes or sometimes commonly referred to as the “hammer, anvil, and stirrup”). These three bones form a chain from the eardrum to the inner ear. The eardrum moves back and forth when sounds hit it. The eardrum will move faster or slower depending on how loud, or what pitch, the sound is. This sends the chain into motion and then sends a signal to the inner ear.

The inner ear, or Cochlea, is shaped like a snail and filled with fluid and hair cells. There are thousands of tiny hair cells (not to be confused with the hair on top of your head) housed inside the Cochlea. The hair cells change the vibrations into electrical signals that are sent to the brain through the hearing nerve. The brain then tells you that you are hearing a sound and what that sound is. Your inner ear also helps you control your balance. The parts of your inner ear that help with balance share the same space and fluid as the cochlea.

The human body is a network of pairs: two eyes, ears, nostrils, arms, hands, feet, and legs. The brain uses these pairs to coordinate and maximize how the body works. Our ears work as a duo. We have two ears to locate sound, discriminate volume, as well as enjoy a better quality of sound like hearing in “stereo”. Being able to hear with both ears makes it easier to enjoy the sounds of life.

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

If you have a sinus operation scheduled, then sinus relief is on the horizon. But you may be wondering what to expect from your upcoming surgery. You will most likely need to be away from work or school for several days. Be sure to talk with your doctor about your surgery and ask any questions you may have so that you know how best to care for yourself after surgery.

Although there are several different kinds of sinus surgery, what happens following your operation will be similar. It can take several weeks to fully heal, and you’ll have some swelling and tenderness in your nose after the surgery. To help your nose and sinuses return to normal, your doctor may recommend nasal irrigation or saline sprays and antibiotic lubricants.

Dr. Mangus, one of MMC’s ENT Specialists, helps patients navigate their recovery process after sinus surgery.

“As I counsel my patients before sinus surgery, they are often surprised when I tell them that most of their pain after sinus surgery will be controlled with Advil and Tylenol. A recent study of patients who underwent sinus surgery reported that 70% of patients took less than 5 pain pills,” Dr. Mangus said. 

“I have seen this in my patient population as well. This is due to recent advances in sinus surgery that allow us to do the entire surgery with cameras inside the nose as well as avoid putting packing or splints inside the nose at the end of the surgery.”

Here are a few tips for making your recovery go more smoothly after your sinus operation:

  • Keep your head elevated to help reduce bleeding and swelling after your surgery. The first night following your operation, elevate your head with extra pillows or sleep in a recliner.
  • Some bleeding is normal following a sinus operation, but if you are bleeding a lot, be sure to call your doctor.
  • Don’t blow your nose for at least a week after your operation. Avoid heavy lifting, straining, or strenuous exercise in order to decrease the likelihood of bleeding in your nose.
  • If you have to sneeze, try keeping your mouth open.
  • Avoid taking aspirin following your surgery. This slows clotting and increases bleeding.
Once your sinuses fully heal, you should be able to resume your normal activity. However, remember that sinus surgery results are never guaranteed. Your symptoms may improve, or you still may need some kind of medical therapy to manage your symptoms after surgery. It’s important to keep up constant communication with your doctor in order to make sure you are receiving the best possible care.

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT

From its inception in 1949, the physicians and staff of Murfreesboro Medical Clinic have created a true healthcare community in Rutherford County, providing all patients with a holistic,multidisciplinary approach to everyday wellness. Drs. Carl Adams and S.C.Garrison founded Murfreesboro Medical Clinic with the lofty goal of providing convenient, quality care to all Rutherford County residents. Though the clinic has experienced a variety of changes and expansions throughout its 70 years of care, the physicians and staff of MMC have continued to pursue Adam’sand Garrison’s core values of care, compassion and community in every endeavor.

Now in 2019, MMC remains a multispecialty, physician-owned medical group with over 80 physicians and 20 different departments who are still committed to offering patients both primary and specialty care within their community. Today, MMC has over 700 employees and five locations across Murfreesboro.

“As our community continues to grow, it is imperative that its medical community grows as well to ensure that we have access to quality healthcare provided by excellent physicians instate-of-the-art medical facilities,” shares Joey Peay, Chief Executive Officer.“At Murfreesboro Medical Clinic, we remain committed to meeting those goals. It is my belief that Drs. Adams and Garrison would beam with a strong smile and a well-deserved sense of pride if they could see what MMC has become and how it continues to provide quality medical care to this community,” Peay continues.

MMC is proud to celebrate its 70 years of caring for its patients and community.

Posted by Murfreesboro Medical Clinic | Topic: News  | Category: Recognition & Awards

Renee Yarbrough

Article via VIP Murfreesboro

By Sadie Fowler

Renee Yarbrough is a sweet, kind and gentle person with a tenacious spirit — especially when it comes to sharing her story and struggles she faces daily with her battle against cervical cancer — and it’s an important topic to discuss this month.


Yarbrough, a stay-at-home mom to two teenage boys, Dalton and Gavin, has been married to her wonderful husband James for 23 years. She is a typical happy mom: She loves spending time with her mom and friends, beach vacations, and enjoys reading, writing and making bracelets. She is also a seven-year survivor of cervical cancer.


“I was diagnosed in 2011 with an abnormal pap smear,” she said, adding her very first doctor at

MMC was Dr. Colleen Bratsch. “I had had a few of those in the past so it didn’t come as a big surprise.”


Dr. Bratsch decided, based on Yarbrough’s previous history, to take some biopsy samples of her

cervix and to follow up in four months as opposed to the typical six months. Yarbrough went back to see her doctor in December of 2011 and that pap came back abnormal as well, which led to more biopsy samples.


“A couple of weeks later I was called into Dr.Bratsch’s office and told that I had cervical cancer and would be referred to a gynecological oncologist in Nashville for a surgery consult,” she said. “I was scheduled for a radical hysterectomy in February of 2012.”


Yarbrough underwent the surgery and it was thought they had gotten all of the cancer but pathology reports six weeks later showed cancer cells were very well in her bloodstream. She learned then that she would have to undergo both chemotherapy and radiation — seven and 35 rounds, respectively. 


“I had 17 partial bowel obstructions from the radiation aftereffects,” she said. “I underwent 40 treatments in the hyperbaric oxygen chamber to try and correct the intestinal issues because I wasn’t a surgical candidate because of the amount of damage. I developed lymphedema in my legs due to the lymph node dissection during my cancer surgery.”


It was a tough journey to say the least. To date, she’s had two surgeries to try to help with the issues from that disease as well and she is scheduled for a third surgery consult.


“Things are better now as far as my quality of life,” she said. “I remain positive that only good things are on the horizon for me. All of my post op pap smears have been clear and I wake up each day just happy to be cancer  free!”


Yarbrough continues to be under the care of her gyno-oncologist and her primary care giver from Murfreesboro Medical Clinic, Dr. Nicholas Cote.


“He is my hero and my biggest advocate for a happy healthy life,” she said, finding comfort in his loyalties as a provider. “He is never more than a phone call or email away for help! He truly cares about the well-being of his patients. Whenever I have had infections that could have very well sent me to the ER, he has been there to assess me and take care of the issues in his office. He is so awesome!”


There are so many misconceptions when it comes to cervical cancer, such as how you get it or what can be done once you’ve been told you have a disease caused by a virus that you can get a vaccine to prevent. In reality, cervical cancer is 100 percent curable if it’s caught early enough.


“I am a big advocate about women getting yearly pap exams. It only takes a few minutes to see your gynecologist and save your own life,” she said. “The HPV virus is the main culprit in about 80 percent of cervical cancers. I always advise people to research the HPV virus, the ways it is transmitted and how ridiculous the stigma is behind the virus itself.”


Most importantly, Yarbrough encourages everyone she possibly can to get the vaccine if at all possible.


“Our children, whether male or female, can be protected from ever having to experience the horrible effects of cervical, oral, anal, and or penile cancers typically caused by certain strains of the human papillomavirus (HPV). It is very common for anyone from the ages of 14 and up to have some strain of the HPV virus and not even know it.”


A lot of the strains of HPV will clear on their own but there are some that will not. Yearly exams and vaccinating is key, she believes. 


“The vaccine, Gardasil, can help protect you or your children before you are ever exposed to the virus,” she said. “The vaccine is available up to the age of 26 but can be given up to the age of 45 though the benefits after a certain age go down because most have already been exposed to the virus.”


Like all vaccines, there are side effects; most are mild and definitely not life threatening. Both of Yarbrough’s sons have received the vaccine and neither experienced any side effects at all. The benefits of the HPV Gardasil vaccine far outweigh any potential risk of side effects.


“I will be the first to tell you, the emotional, mental and physical trauma that your family and loved ones suffer watching you go through fighting this disease has everlasting effects and the worry never goes away,” she said.


Please talk to your doctor and your children’s pediatrician about the Gardasil vaccine and the benefits of it. 


“Please ladies, get your yearly exams!” she encouraged, showing her passionate spirit. “There are people in your life that love you, need you and depend on you. We need you happy and healthy!”


Yarbrough loves spreading the message and considers herself the lucky one. In fact, her final quote for this piece was ‘Peace out and much love to all! … #iamtheluckyone!”

Posted by Murfreesboro Medical Clinic | Topic: News  | Category: OBGYN

Article via VIP Murfreesboro


Being tossed into the category of “breast cancer patient” is on no woman’s wish list. Breast cancer is really something that all women hope to be spared of in their lifetime, because they’ve seen the tough battle that their friends, moms, sisters, and daughters have fought. The journey of a breast cancer patient is difficult, and it not only affects the individual, but every member of the family as well. In honor of those families being affected by breast cancer, Murfreesboro Medical Clinic (MMC) has established the Crystal Scholarship to assist the children of MMC breast cancer patients in continuing their education beyond high school.

“As a new mom myself, I know that the one person I would worry about most, should I ever develop a life threatening condition, is my daughter,” said Dr. Lisa White, a provider at MMC’s Comprehensive Breast Center. “This new scholarship is our way of showing our patients that we care about not only them, but those people who are dearest to them.”

Crystal Brown, the MMC Comprehensive Breast Center patient after whom the scholarship was named, was diagnosed with a very unusual and aggressive breast cancer that has required care far beyond that of a typical patient. Of course, this diagnosis was difficult on the Brown family, but they always held out hope. Crystal remembered her son, Michael, now a freshman at Murray State, would always encourage her with words of strength.

“When he found out I was sick, he took it like a champ,” Crystal said. “He told me I was strong and that we could beat this.”

Like Crystal, Amanda Sterner was diagnosed with breast cancer at MMC. After considering all of her options, Amanda decided to delay her own surgery so that she could be a part of a special clinical trial to help other breast cancer patients. This selfless move ended up being successful, but she did not get through it alone. Throughout the fight, Amanda’s daughter was by her side.

“Erin was there with me every step of the way,” Amanda said. “She always had a brave face. I couldn’t have done it without her.”

Erin had always planned on going to school to study marketing. Her experience with the clinical side of the diagnosis of her mom changed those plans. She is now attending University of Tennessee at Chattanooga in pursuit of a degree in nursing.

Breast cancer not only affects the individual, it affects the whole family.

 The Browns and the Sterners are fighting their battles as families, and it was for families like these that the Crystal Scholarship was established. Deservedly, both Michael and Erin have each been awarded MMC’s inaugural Crystal Scholarship.

The Brown Family The Sterner Family

She may not be from the area, but Tennessee has called Dr. Caplin and her family back 'home!' Murfreesboro Medical Clinic is proud to welcome Board Certified, Otolaryngologist, Britni Caplin, M.D. to its skilled physician group and to the Murfreesboro Community.

Dr. Caplin spent her early life in West Virginia, prior to attending medical school and completing residency at Vanderbilt University in Nashville. From there, she worked in private practice in Massachusetts before returning to what felt like home: Nashville, Tennessee. Since 2017 Dr. Caplin and her husband have lived in Nashville with their almost two-year-old daughter, two dogs, and a cat. Most recently, in Nashville, she has served as the Chief of Otolaryngology within the Tennessee Valley Healthcare System, while also holding an appointment as an Assistant Professor at Vanderbilt University Medical Center in the Department of Otolaryngology – Head & Neck Surgery.

Dr. Caplin was introduced to Murfreesboro by current MMC Otolaryngologist, Brannon Mangus, M.D. They completed their residency together at Vanderbilt and kept in touch over the years. "I'd heard Dr. Mangus talk about the Murfreesboro community and how happy he was here and at Murfreesboro Medical Clinic," Caplin said, "when the opportunity arose, I jumped on it right away."

While Dr. Caplin is a general Otolaryngologist and enjoys all aspects of the specialty, she is especially drawn to surgeries that impact the overall quality of life for the patient. Specifically, she is passionate and well versed in ear surgery, functional nasal surgery, thyroid/parathyroid surgery, sinus surgery, and other adult and pediatric surgeries in the head and neck.

When asked what led her to surgery and Otolaryngology she said, "having a mother and father who were both in the medical field. My dad is a dentist and my mom a nurse practitioner. I knew from a young age I would one day follow in their footsteps into healthcare." Caplin continued, "I always knew I was a surgeon. I worked with my dad as a dental assistant and was fascinated by surgery and the difference it would make for people." Going into medical school she knew she was passionate about surgery, but after being introduced to Otolaryngology she knew that was the specialty for her. "In Otolaryngology we specialize in everything above the collar bone. We focus on a patient's senses, from their sense of smell, to their voice, to hearing and how it all connects to who they are. We can make a true impact in our patients' lives," Dr. Caplin said.

To learn more about Dr. Britini Caplin or MMC's ENT department, please visit mmclinic.com or call 615-867-8110

Posted by Murfreesboro Medical Clinic | Topic: ENT  | Category: ENT


Leadership at Murfreesboro Medical Clinic and SurgiCenter realized several years ago that genomics and precision medicine were the future of healthcare and would be invaluable in helping provide better, safer therapies

By Nicholas Cote, D.O.

Article via Healthcare Innovation


As healthcare leaders look toward the future, most envision a clinical environment where providers are equipped and empowered to deliver personalized and precise care to their patients. Advances in genomic science over the past decade have provided insights that will enable organizations to transform the way they diagnose and treat both common and rare conditions.

Yet this progress has been slow to arrive at the point of care. Hospitals, health systems and medical groups are striving to develop strategies that allow their clinicians to leverage this critical information to improve quality of care and patient satisfaction.

Interestingly, ambulatory groups are among the leaders in adopting precision medicine, overtaking many larger organizations and academic centers, especially in pharmacogenomics (PGx). Because it delivers information about how well patients will metabolize specific medications based on their genetic profile, PGx has practical (and highly valuable) application across virtually all specialties. Impacting prescribing decisions in real time, PGx results help clinicians identify the most effective medication first, rather than relying on the traditional trial-and-error approach. In addition, these tests can flag if a drug might cause side effects (which impact how closely a patient follows the care plan) and even if it could prove unsafe or toxic.

Leadership at Murfreesboro Medical Clinic and SurgiCenter (MMC) realized several years ago that genomics and precision medicine were the future of healthcare and would be invaluable in helping provide better, safer therapies. Providers began to order PGx tests when they felt the information would benefit their treatment decisions (and thereby their patients). Initial efforts centered on psychiatric and behavioral health medications (e.g., antidepressants and anti-anxiety drugs) and common cardiovascular treatments (e.g., statins, clopidogrel). Both providers and patients saw immediate value and were excited about the potential for expanded usage.

Three barriers impeded MMC’s ability to scale its precision program, however:

1.      The cost of testing. Payer policies around reimbursement are lagging and patients often are required the cover the cost. This proved to be an obstacle. While most patients intuitively recognized how valuable PGx information could be, they understandably balked at the added expense. Although prices have dropped dramatically in the past year or two, it was not so long ago that they ran into the thousands – well out of reach for the average patient.

2.       Lack of understanding about how PGx factors into clinical decision making. Again, while the concept of PGx testing is easy to grasp, operational questions remained. Although most medical schools now include coursework on genomics, providers practicing today have varying degree of familiarity with this area of science. And they have a lot of questions such as: When should I order a PGx test? Does every patient need to have one? What happens if a patient’s PGx test indicates that she should change medications – but the alternative is not fully covered by insurance?

3.       Lack of convenient – and understandable – access to PGx test results. To date, PGx test results are returned as a paper document or a scanned attachment in the medical record. Since results could not be saved as discreet data or integrated with other patient information, providers had to A) realize/remember the data was available somewhere in the record; B) leave their workflow and find it; and C) figure out what the test results meant in context of their patient’s condition.

It was important to MMC’s leadership and care teams to achieve success with precision medicine, and so MMC proactively addressed each of these barriers.

First, we reached out to a lab partner that specializes in PGx testing and asked if we could negotiate a pricing model to help our patients. The partner was accommodating and agreed on a cap for patients qualifying for financial assistance. Previously, we learned patients seemed to have a $100 threshold for out-of-pocket expenses and were able to stay within that price point.

Next, we began to investigate technology partners that could help MMC bring the PGx results directly into the clinical workflow. Ultimately, we adopted a solution that ingests genomic data from the lab (and can handle additional labs as we expand) and integrates it with clinical information so providers see the complete picture within the patient context. Providers can access the PGx information with one click from their EHR, and from there can dive deeper into test results or link out to evidence-based materials if they want more information.

And, of course, we are training providers and addressing operational issues on an ongoing basis. As the organization becomes more familiar with PGx, we are working out the processes, procedures, workflows and decision support to guide day-by-day precision medicine practices.

Bringing the power of pharmacogenomics to the point of care has produced a multitude of benefits.

·         Patients are receiving better care. MMC has had patients diagnosed with depression, for instance, who have spent months working with their physician trying to come up with the best medication at the most appropriate dose. With ready access to genomic insights, providers can prescribe a more effective therapy much earlier in the treatment cycle. Less time is lost and the quality of the patient’s life is better. One patient messaged his physician through the portal saying MMC had “changed his life” through the simple PGx test.

·         Providers feel empowered. I like to say that having genomic data available makes us feel more “doctor-y.” Clinicians have been frustrated by having to practice trial-and-error medicine for so long. PGx test results, available within the patient context and connected to current knowledgebases, mean providers have a more complete picture. They can bring all their training and skills to bear when making clinical decisions.

·         MMC has differentiated itself within its service area. Patients in our region have many choices for healthcare: Nashville is just minutes away and other urban centers, like Atlanta, are within easy driving distance. Because there are many healthcare providers nearby, MMC is dedicated to leveraging all the talent and technology available to ensure our patients receive superior care. I like to say that, with precision medicine, we are on the bleeding edge, not just the cutting edge. We have had one patient tell us that the reason they chose us as their provider was our PGx program.

It is not often that an innovation of this magnitude comes along. Placing critical genomic information directly into the hands of providers, right at the point of clinical decision making, represents one such breakthrough. MMC and its patients will continue to explore the value PGx can deliver – and look beyond to additional utilization of genomic insights in areas like disease risk identification (e.g., cardiovascular) and targeted therapies for select conditions (e.g., cancer).

A primary care provider, Nicolas Cote, D.O., also serves as Chief Medical Information Officer and President of the Murfreesboro Medical Clinic and SurgiCenter in Tennessee.

Dr. Lauren Blackwell

Murfreesboro Medical Clinic & SurgiCenter is proud to announce the addition of Lauren Blackwell, D.O., to its Pediatrics Department.

Lauren Blackwell, D.O. is a board-certified Pediatrician. She attended undergrad at the University of Tennessee at Chattanooga before receiving her medical degree from Lincoln Memorial University-DeBusk College of Osteopathic Medicine.  She went on to complete her Residency at University of Kentucky in Lexington, KY. 

Dr. Blackwell is excited to join MMC’s Pediatric department and to be back serving the patients of Tennessee.

When she isn’t working, Dr. Blackwell enjoys reading, crafting and spending time with her family.

For more information about Dr. LaurenBlackwell or to make an appointment, visit mmclinic.com or call 615-867-8020.

Posted by Murfreesboro Medical Clinic | Topic: New Physicians  | Category: New Physicians

Murfreesboro Medical Clinic | 615-893-4480 | see all locations