The Journal
of the
Oklahoma Osteopathic Association
Oklahoma D.O. January2013 2013 January
Volume 77, No. 7
Featured in this Issue: q Registration for the Winter CME q OMECO Update q Tribute to OEFOM Board Member- Mary Shaw Steve Whitfill Oklahoma Educational Foundation for Osteopathic Medicine 2012-2013 President
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Oklahoma D.O. | January 2013
The Journal
of the
Oklahoma Osteopathic Association
Oklahoma D.O. May/June 2012 January 2012 January 2013
Volume 77, No. 6
November 2012
Lynette C. McLain, Editor Lany Milner, Associate Editor
OOA Officers: Layne E. Subera, DO, FACOFP, President (Tulsa District) Bret S. Langerman, DO, President-Elect (South Central District) Michael K. Cooper, DO, FACOFP, Vice President (Northeastern District) LeRoy E. Young, DO, FAOCOPM, Immediate Past President (South Central District)
OOA Trustees: Kenneth E. Calabrese, DO, FACOI (Tulsa District) Dale Derby, DO (Tulsa District) C. Michael Ogle, DO (Northwest District) Gabriel M. Pitman, DO (South Central District) Richard W. Schafer, DO, FACOFP (Tulsa District) Christopher A. Shearer, DO, FACOI (Northwest District) Kayse M. Shrum, DO, FACOP (Tulsa District) Ronald S. Stevens, DO (Eastern District) OOA Central Office Staff: Lynette C. McLain, Executive Director Lany Milner, Director of Operations and Education Rachel Prince, Director of Communications Allison Rathgeber, Director of Member Services & Foundation Administrator
The Oklahoma D.O. is published monthly from the Oklahoma Osteopathic Association Central Office: 4848 N. Lincoln Blvd., Oklahoma City, OK 73105-3335. Lany Milner, Graphic Designer and Associate Editor Copy deadline is the 10th of the month preceding publication. Advertising copy deadline is the 15th of the month preceding publication. For more information: 405.528.4848 or 800.522.8379 Fax: 405.528.6102 E-mail: ooa@okosteo.org
4
President’s Message provided by Layne E. Subera, DO, FACOFP, 2012-2013 President
6
OOPAC Challenge
7
2012 OOPAC Contributors List
8
Foundation Update
10
“Graduate Medical Education Update” provided by Jeffrey J. LeBoeuf, CAE, Executive Director,
13
OOA Directory Order Form
14
“Let’s Talk” provided by Val Schott, MPH, Chief Executive Offiver
18
Winter CME Seminar Program: Ravages of Obesity APPROVED FOR 18 1-A AOA CREDITS
19
Winter CME Seminar Registration Form
21
“Technology Corner: New Year’s Resolution” provided by the OOA Bureau on Information Technology
22
What DO’s Need To Know
24
“Advocates to the OOA Recap” provided by Walli Daniel, 2012-2013 AOOA President
25
By the Way
26
Health for the Whole Family: “The Real Harm in High Heels” Provided by the American Osteopathic Association
27
Classifieds & Calendar of Events
O
OMECOOMEC
The OOA Website is located at www.okosteo.org Oklahoma D.O. | January 2013
3
President’s Message: Three things we can do now about pain issues by Layne E. Subera, DO, FACOFP, 2012 - 2013 OOA President
Pain care is fast becoming a politically and emotionally charged issue in our state. We have allegations of excessive abuse amongst our citizenry. Allegations of excessive prescribing. Allegations of under prescribing. Other states elected representatives have heckled us nationally. We have reports of increases in over dose mortality tied especially to mixing alcohol with medications and medications with medications. Because of all of this, various agencies feel the need to get tough with somebody. Why is this? Does it have to do with our commodities based economy and injuries caused by the physical demands of those jobs? Our skyrocketing obesity rates? Our aging population? Workforce education? Our doctors increasing willingness to treat pain with opioids? The increasingly concerning side effect profiles of non-opioid pain drugs? Patient’s increasing dissatisfaction with living in pain? Is there something changing about our character? Are we no longer willing to just tough things out? Maybe, it is all of those factors and more. One thing is sure, the legislature is going to be asked “to do something” again this session. So, what can we do as physicians and what policy issues can we support to enhance opioid safety without creating an access to care issue for those in need? The Oklahoma Osteopathic Association supports the responsible use, prescribing and regulation of opioid pain medications. To that end we are supportive of legislation or rules changes that will help meet our mission statement of advocating for the profession and enhancing the health and well-being of all Oklahomans. Here are a couple of ideas. First, we need to be allowed better communication amongst ourselves. I was shocked to learn that my own hospital is barred by the state mental health law from reporting back to me if my own patient presents to the emergency room with an overdose situation. Currently, they can only tell you the patient was there if your established patient gives consent. Recently, a patient of ours presented to a local emergency room three times in one week for acute alcohol toxicity and no one called us to let us know. Luckily, we eventually found out and the patient got the help needed. It seems to me that the onus of legal requirement should be to inform not to bar reporting of problems back to a patient's own established physician.
ered proprietary information and cannot be shared. It is accessible only by physicians who register an account with the program and they may only access their own patient’s information. Though frequently flawed, the information can be an invaluable tool when used to screen for doctor shoppers and drug diverters. Yet, it is illegal to share this information directly with the patient, to place physical copies of the patient’s own information in the patient's chart and to call other treating physicians to let them know what you have discovered by accessing the information. I don't think we should be required to call other physicians. But, it is certainly not in the patient's or the state's best interest to forbid it. Third, we need to make prescription forgery more difficult. The requirement for tamperproof paper sounded like a good start. Unfortunately, prescription paper is cheaply available online to anyone. That makes it too easy to make duplicate prescriptions using photocopiers and cheap editing software. Eventually, the answer has to be online prescribing. Unfortunately, the current requirements for online prescribing of controlled drugs are too onerous. The security rule of something you are, something you have and something you know makes the prescription transmission process far too complicated. If it is legal to literally write your information on a popsicle wrapper and fax it to a pharmacy. It should be legal to send a controlled drug prescription from a certified electronic medical record. But it is not. That needs to change. So, let’s use this session as an opportunity to improve communication and care. Let’s stay away from setting arbitrary limits on doctors that have caused access to care issues in other states. Let’s avoid one size fits all legislative solutions and focus on improved patient care. Let's preserve our practice freedom to individualize treatments and practice safe osteopathic mediokDO cine. Let's be reasonable.
Second, we need to use the information we have more efficiently. The state maintains an extensive database on patients, their medications and prescribers. This information is consid4
Oklahoma D.O. | January 2013
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To discuss referring your patients, please call
800-261-1255 | cancercenter.com Scan to learn more about IORT Novac™7 ©2012 Rising Tide | January 2013 Oklahoma D.O.
5
Plan to Take the OOPAC Challenge in 2013! Give Back to OOPAC...
A P
Political Ac t i o n
O
Osteopathic
O
C
Oklahoma
Committee
Pledge annually and pay monthly with the OOPAC automatic credit card plan!
Take the OOPAC Challenge in 2013 and you will be helping with legislative efforts to preserve the osteopathic profession in Oklahoma! _____ OOPAC AUTOMATIC CREDIT CARD PLAN:
I choose to pledge annually & pay monthly with my credit card.
Please charge my contribution monthly to my:
o Visa
o $504 ($42 per month) o $1,008 ($84 per month)
o MasterCard
o American Express
o Discover o $1,200 ($100 per month)
_____ My personal check made payable to “OOPAC� is enclosed.
o $100
o $250-$500 (PAC Partner)
o $1,001-$2,499 (Executive PAC Partner)
o $501-$1,000 (Premier PAC Partner) o $2,500 + (Platinum PAC Partner)
______ Please charge my contribution of $________ to my: o Visa
or
o MasterCard
Account Number __________________________________ Exp. Date __________________
Name as it appears on Card ___________________________________ CID# ____________
Address_____________________________________________________________________
City, State, Zip _______________________________________________________________
Signature ___________________________________________________________________
Please mail to: OOPAC, 4848 N. Lincoln Blvd., Oklahoma City, OK 73105-3335. This personal contribution is not deductible as a donation or business expense.
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Oklahoma D.O. | January 2013
Sp ur
k ac Tr
r
TH SA V E E D A T h e t S n p w e o cia E D l g t y in 113th OOA Annual Convention
Individualizing a Program for Your Specialty Needs Saddle up April 18-21, 2013 Embassy Suites-Norman
Bret S. Langerman, DO General Convention chair
Michael K. Cooper, DO, FACOFP Convention Program Chair
WBe on the lookout for the online convention module E N Oklahoma D.O. | January 2013
7
Foundation Update ... The Oklahoma Educational Foundation for Osteopathic Medicine (OEFOM) would like to take a moment to wish everyone a happy new year with many blessings and opportunities. For this month’s OEFOM update, we would like to share with you an article of gratitude and thanks to Steven E. Whitfill, Executive Director of Northwest Oklahoma Osteopathic Foundation and Past President of the OEFOM. Mr. Whitfill was first welcomed to the OEFOM Board in 1992, and remained on the board until 2012, when the OEFOM term limits required that he step down. During his time, he served two terms as Foundation President. His first term as president was September 1996 to August 1997 and the second was September 2007 to August 2008. He was the recipient of the Oklahoma Osteopathic Association’s Award of Appreciation for distinguished leadership in 1995. In his years before service to the OEFOM Board of Trustees, Mr. Whitfill was the Director of Alumni Affairs and Annual Giving at Phillips University in Enid, OK; Director of Retired Senior Volunteer Program of Enid and North Central Oklahoma; and Director of Senior Care Services at Enid Memorial Hospital. Mr. Whitfill has held the position of Executive Director of Northwest Oklahoma Osteopathic Foundation since December 1987.
Steve E. Whitfill OEFOM Board Member 1992-2012 Another prestigious title held by Mr. Whitfill is that of an Eagle Scout, the highest rank one can receive through the Boy Scouts of America. He devotes time to the Boy Scouts as he is a Board Member of the Great Salt Plains Boy Scouts of America as well as council Vice President. In short, Steven Whitfill has been an asset to the Osteopathic Community as well as the rural health community in Oklahoma.
We are incredibly grateful for his hard work and dedication to the OEF OM Board of Trustees and wish to thank him for his 20 years of tireless service.
Mr. Whitfill began his outstanding career in service during his years spent at Phillips University where he received his Bachelor of Science degree in 1973. He was a member of the Student Senate as well as made the distinguished listing of Who’s Who in American Colleges and Universities in 1973. He is a dedicated member of many organizations including Habitat for Humanity, the National Association for Osteopathic Foundations, the Enid Community Foundation Board of Trustees and was appointed to the State of Oklahoma Long Term Care Quality of Care Task Force by Governor Frank Keating.
8
n OEFOM Memorials n Contributing
Dr. Thomas and Glenda Carlile Dr. Thomas and Glenda Carlile Dr. Paul and Bonnie Benien Dr. Paul and Bonnie Benien Dr. Paul and Bonnie Benien
In Memory of
Delene Dare Freda Webster John A. Marouk, DO Richard C. Staab, DO Maurice W. Payne, DO Oklahoma D.O. | January 2013
During the holiday season more than ever, our thoughts turn gratefully to those who have made our progress possible. It’s in this spirit we say simply, but sincerely, Thank You and Best Wishes For a Joyful Holiday Season and a Happy New Year.
Oklahoma State University Medical Center Diane Rafferty, CEO | Ethan Norris, CFO | Jerry L. Hudson, TRUST CHAIRMAN
In 2012, OSU Medical Center invested in capital infrastructure and equipment. 2013 will bring more improvements and growth to the facility. These include renovations in the department of Maternal Child Health to enhance the patient experience in this area. Also, improvements to the exterior grounds of the OSUMC campus are underway. These include a complete parking garage rebuild and entrance enhancements to blend in with the bustling growth of downtown Tulsa. The coming year will bring more enhancements impacting patient care, residency training as well as physician and employee satisfaction. We look forward to continued growth and opportunities in 2013. Oklahoma D.O. | January 2013
9
GRADUATE MEDICAL EDUCATION UPDATE Provided by Jeffrey J. LeBoeuf, CAE, Executive Director, OMECO
CENTER FOR HEALTH SCIENCES
The Osteopathic Medical Education Consortium of Oklahoma, Inc. (OMECO) is pleased to welcome a new partner to our consortium, McAlester Regional Health Center (MRHC). MRHC was recently approved for new residency training programs in internal medicine and family medicine. Ronald Tanner, DO, PhD, a long-time osteopathic medical educator has recently joined MRHC and will serve as the Director of Medical Education and Program Director of the Family Medicine residency program. Misty Branam, DO, an Oklahoma State University College of Osteopathic Medicine (OSUCOM) alumnus will serve as the Internal Medicine Program Director. America’s physician shortage is anticipated to grow to 91,000 by 2020(1). In response to this shortage, medical schools,
Oklahoma, has acted in a prudent and responsible manner. With the addition of the McAlester residency programs, the total number of graduate medical education positions sponsored by OMECO is 446, of which, 390 are in Oklahoma. It is the goal of Oklahoma State University to have as many GME positions as graduates from our College of Osteopathic Medicine. These 390 Oklahoma osteopathic residency and fellowship positions include 96 First Year positions. There are also 172 ACGME (allopathic) first-year positions in Oklahoma, for a total of 262 (six first-year positions are in a dually accredited program). Because of funding issues and programmatic changes, these amounts vary somewhat from year to year. So is this enough? In 2012 the University of Oklahoma School of
both allopathic (MD) and osteopathic (DO) are increasing their class sizes. Many new schools are also being founded. These efforts, while noble, will fall short of creating residencytrained physicians if we are unable to grow graduate medical education (GME), i.e., residency positions at the same pace as the growth of graduating medical students. This is very important for Oklahoma, which has about 179 physicians per 100,000 population, ranking 43rd among the states.(2)
Medicine graduated 165 MDs and the Oklahoma State University College of Osteopathic Medicine graduated 87 DOs. So, are we in danger of creating too many Graduate Medical Education positions in Oklahoma? Not by a long-shot! New campuses, increased class sizes, and extreme GME shortages in neighboring states will add to the demand for additional available GME positions.
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Oklahoma D.O. | January 2013
Figure 2: First Year CME slots vs. Medical School Graduating Classes Dually Accredited PGY1 Slots
AOA First-year Positions (3)
ACGME First-year Positions (4)
Total First-year Positions
Annual MD Grad’s(5)
Annual DO Grad’s
GME Position Surplus (Shortage)
Texas
7
60
1472
Oklahoma
6
96
172
4
4
167
Missouri
2
61
556
Colorado
3
27
290
Kansas
10
10
152
Regional Totals
32
258
2809
1471 170 161 536 173 185 2697
182 90
Arkansas
1525 262 167 615 315 152 3036
809
-128 2 6 -343 26 -33 -470
Dually Accredited PGY1 Slots
AOA First-year Positions (3)
ACGME First-year Positions (4)
Total First-year Positions
Annual MD Grad’s(5)
Annual DO Grad’s
GME Position Surplus (Shortage)
Mississippi
2
8
124
0
0
305
Georgia
10
14
435
Gulf Coast Totals
12
22
874
122 263 499 884
100
Alabama
130 305 439 874
-92 42 -146 -196
421 116
Gulf Coast States
86 186
An analysis of the contiguous states reveals a GME shortage of 470 positions in our region. In addition, the Gulf Coast states have a shortage of 196 slots. This number will rise exponentially when the new schools in Mississippi and Alabama begin graduating students. See Figure 2.
Medicare funding amount and the GME caps are being established. “The new Oklahoma-appropriated funding plugs a needed gap", says William Pettit, DO, Associate Dean for Rural Health at the Oklahoma State University Center for Health Sciences College of Osteopathic Medicine.
OMECO will continue to explore creative ways to address our region’s and nation’s GME shortage. The development of new graduate medical education programs is an involved process, which includes assurances of adequate hospital funding and accreditation standards that must be met. The primary funding source for GME programs is Medicare, administered by the Centers for Medicare and Medicaid Services (CMS). The Balanced Budget Act of 1997 placed a limit on the number of CMS-funded GME positions in each existing teaching hospital. This limit is commonly referred to as the teaching hospital’s GME “cap”. With the exception of occasional adjustments and reallocations, existing teaching hospitals cannot increase their number of CMS-funded GME positions. This means that new CMS-funded hospital-based programs can only be added in hospitals that have not had previous accredited programs. New teaching hospitals, until recently, have been given three years to establish their GME cap, but that regulation has been increased to 5 years. McAlester is our first teaching hospital that will have five years to establish its CMS GME cap.
OMECO will continue to apply for other funding sources, as we did with the Teaching Health Center grants for clinic-based residencies funded through the Health Resources Services Administration (HRSA). Partnerships with other facilities and agencies, such as the Veterans Administration are developed to add non-CMS funded positions at hospitals already capped. Regarding the accreditation issues, OMECO has been successful in navigating the AOA approval processes. If the new proposed merger between ACGME, AOA and AACOM goes through(6), we must become equally proficient guiding new program applications through the ACGME initial approval process. We must also be diligent in assisting our existing training programs to meet the new accreditation standards once ACGME inspections are implemented after July, 2015.
The recent passage of the Oklahoma Hospital Residency Training Program Act will make it easier for hospitals to develop new primary care residency programs. The legislation provides funding to new programs during the first three years, when the Oklahoma D.O. | January 2013
REFERENCES:
1.) American Medical News, Carolyn Krupa, October 11, 2010, http:// www.ama-assn.org/amednews/2010/10/11/prsb1011.htm 2.) Association of Medical Colleges, 2011 State Physician Workforce Data Book, Table 2. Active Patient Care Physicians per 100,000 Population by Degree Type, 2010. 3.) www.opportunities.osteopathic.org; Detailed analysis program by program, selected states. 4.) NRMP.org 2012 Match Results by State, Specialty and Applicant type. Data extracted from PGY-1 match slots offered. 5.) Association of Medical Colleges, 2011 State Physician Workforce Data Book, Table 8. Medical and Osteopathic School Enrollment. 6.) M.D.s and D.O.s Moving toward a Single, Unified Accreditation System for Graduate Medical Education, press release, 10/24/2012 http://www.acgme.org/acgmeweb/Portals/0/PDFs/10-24-2012Press Release.pdf
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INTEREST FEES COLLEGE COSTS $$$$$
L A I C N A N I F D LOANS E E N CREDIT ? TUITION E C N A T REPAYMENT S I ASS
%
visit www.okosteo.org/Scholarship & apply for the OEFOM Scholarship (Must be an osteopathic student)
The
Ok
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.O.
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Do you need more copies of the 2012-2013 OOA Annual Directory?
aTion
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e 77, No
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roe e h r e p u S
2 0 1 2 -2
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Oklahoma D.O. | January 2013
2012-2013 Directory Order Form I would like to order______ copies of the 2012-2013 directory @ $55 per directory. Shipping and Handling is not included in the price, please call for pricing (405) 528-4848 or (800) 522-8379 PAYMENT INFORMATION:
I have enclosed a check in amount of $__________. Please bill my credit card Check card type: ______VISA ______MC ______AMX ______ DSC Card Number:_________________________________________________________ Name on Credit Card: __________________________________________________
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PLEASE RETURN FORM BY MAIL OR FAX MAIL: FAX TO: 4848 N. Lincoln Blvd. (405) 528-6102 Oklahoma City, OK 73105-3335 Oklahoma D.O. | January 2013
13
Let’s Talk Provided by Val Schott, MPH, Chief Executive Officer Oklahoma Health Information Exchange Trust
Let’s look at what the Oklahoma Health Information Exchange Trust (OHIET) is supposed to do and what it has accomplished. In a long and sometimes contentious discussion process, the Oklahoma provider community determined that the entity selected to advocate for and promote the use of electronic health records and electronic exchange of health data should be a public trust. This was a compromise. State agency representatives generally wanted the entity to be a state agency. Some in the provider community pushed for an independent not-for-profit. The provider community foresaw significant problems with entrusting this responsibility to a state agency. Concerns expressed included protecting patient data and loss of provider control of decisions regarding data use. There were also concerns about an independent not-for-profit including the lack of input and control from the state perspective for such a board and the lack of any ability for tort liability protection for such an organization. The compromise was the public beneficiary trust. While the legislation creating the trust specified the type of skills required for board of trustee positions heavily related to the medical professions, the decision for board of trustee positions rests with the Governor (three) and the Speaker of the House and President Pro-Temp of the State Senate (two each).1 This arrangement seemed to satisfy both the provider community and state agency representatives. Also, the trust document establishing the trust by legislation specified the trust was eligible for state tort liability protection. Thus, the trust was born with the obligation to manage, as the State Designated Agency, the funding made available under the American Recovery and Reinvestment Act (ARRA).
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reform our fragmented system, there is little agreement on how that should happen. Even though there is general agreement that the United States is the very best place to come to have some things fixed, we generally agree we simply cannot sustain a system that sends more than any other country, almost nineteen percent of gross domestic production while ranking in the thirties as the best system for prevention. There is also general agreement among physicians that EHR is more productive, more effective and more efficient. As with any technology application there will always be some disagreement; most physicians that
The initial charge to establish an electronic health record for every American came from President George W. Bush in his 2004 State-of-the-Union address. At the same time, he established the Office of the National Coordinator for Health Information Technology (ONC) and set aside one hundred million dollars for research and development. President Bush established the goal of every American having an electronic health record (EHR) by 2014.2 There has been lots of discussion and debate regarding health care reform. While most reasonable people agree we need to
The following tables showing a variety of information regarding the progress of electronic health records and the federal incentives offered to Oklahoma providers. The Oklahoma Health Care Authority provides all information.3 EHR Stats by Program
SoonerCare (Medicaid) EHR Program Total Total Registered Attested
Eligible Professionals
2,014
Eligible Hospital Total
1,609
Medicare EHR Program (Ending October 2012)1
Total Paid
Total Total Paid Amount Registered
Total Paid
Total Paid Amount
1,474
$32,216,417
826
$14,318,019
2,080
96
87
82
$55,491,872
100
28
$40,395,142
2,110
1,696
1,556
$87,708,289
2,180
854
$54,713,161
SoonerCare EHR
AIU2
MU3
Stats by Attestation Type
Total Attested
Total Paid
Total Paid Amount
Total Attested
Total Paid
Total Paid Amount
Eligible Professionals
1,602
1,470
$31,060,417
153
130
$1,156,000
87
82
$53,762,635
14
7
$1,729,236
1,689
1,552
$84,823,052
167
137
$2,885,236
Eligible Hospital Total SoonerCare EHR
AIU2
MU3
Stats by EligibilityType
Eligible
Pending Review
Not Eligible
Eligible
Eligible Professionals
1,482
61
59
133
19
1
83
1
3
9
5
0
1,565
62
62
142
24
1
Eligible Hospital Total
Pending Not Review Eligible
Oklahoma D.O. | January 2013
For additional information on the EHR Incentive Programs please visit www.okhca.org/EHR-Incentive or 1www.cms.gov/EHRIncentivePrograms. 2 AIU = Adopt, Implement, or Upgrade an EHR system (began January 2011). 3 MU = Meaningful Use (began January 2012). Data is valid as of the report date and is subject to change.
have converted to an EHR would not go back to the old paper system. What has OHIET accomplished? Has it met the goal of being provider oriented? Let’s look. OHIET has certified three Health Information Organizations (HIOs). Among other requirements, to be certified HIOs applicants have to have a documented privacy and security policy to protect patient data and have demonstrated participation in policy and procedure development from the providers they serve. These two requirements form the basis for service to Oklahoma providers. Those HIOs are MyHealth, OPHX (Oklahoma Physicians Health Exchange) and SMRTNET. All three programs have the capacity to work statewide. OHIET has developed and implemented three voucher programs. The Eligible Hospital Voucher, the Eligible Provider Voucher and the Eligible Behavioral Health Provider Voucher. All three programs provide vouchers or ‘coupons’ that can only redeemed through an OHIET certified HIO. The first Voucher program is designed for Eligible Hospitals. To be eligible for this
Oklahoma D.O. | January 2013
voucher program, the applicant must be licensed, as a hospital by the Centers for Medicare and Medicaid Services (CMS), be eligible to participate in government programs, and be located in an area described as rural in Oklahoma. That is, to be located in any county other than Oklahoma, Tulsa, Cleveland or Comanche counties. OHIET used this definition in conjunction with the Oklahoma State University Center for Rural Health in describing rural, urban and mixed counties in Oklahoma where the four counties listed are all defined as urban counties. Vouchers for hospitals are described in two Levels. The requirements for Level 1 and Level 2 are described below:
HIO. This could include Level 1-specific fees, including ini tiation fees and subscription service/support.
Hospital Level 2 Interoperability: Connect directly with a certi- fied HIO and send structured clinical data using HL-7 proto cols for transmission of CCDs or other clinical data. In partic- ular, EH’s will be expected to exchange hospital and ED dis- charge summaries to the Certi- fied HIO. Voucher value for funding “Level 2” will be ap- plied toward the cost of con tractual agreements made with participant’s Certified HIO. Hospital Level 1 Interoperability: This could include Level 2-spe- Send and receive CCDs via cific fees such as interface fees, DIRECT standard messaging initiation fees, and subscription or equivalent, and query for service/support and will be and view data on individual pa- based on the contractual tients via the web-based portal arrangement with participants from the chosen HIO. Voucher Certified HIO.4 value for funding “Level 1” will be applied toward the cost of The second program is the Eligible Procontractual agreements made vider Voucher Program. This program with participants Certified targets physicians, nurse practitioners,
15
and physician assistants (PA) in physician assistant directed practices. Again, the practice site for these practitioners to be eligible for vouchers must be in the counties in Oklahoma designated as rural as described above. These vouchers are also designed in two levels with certain milestones required to move from Level 1 to Level 2. The requirements for both levels are described below:
Provider Level 1 Interoperability: Send and receive CCDs via DIRECT standard messaging or equivalent, and query for and view Data on individual patients via the web-based portal from the chosen HIO. Voucher value for fund ing “Level 1” will be applied toward the cost of con- tractual agreements made with participant’s Certified HIO. This could include Level 1-spe- cific fees including initiation/ credentialing fees and subscrip- tion service/support.
Provider Level 2 Interoperability: Connect directly with a certified HIO and send structured clinical data using HL-7 protocols for transmission of CCDs as well as other structured clinical data and potentially unstructured text data in the form of reports and dictations. Voucher value for funding “Level 2” will be applied toward the cost of contractual agreements made with participants Certified HIO. This could include Level 2-specific fees, including Interface fees, initiation fees, and subscription service/support and will be based on the contractual arrangement with participants Certified HIO.5
The third OHIET voucher program is the Behavioral Health Voucher Program. This is a specialized program designed as a result of a grant from the Substance
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Abuse and Mental Health Services Administration (SAMHSA) through the National Council for Behavioral Health. Oklahoma is one of five states to receive this grant. It is designed to integrate behavioral health with physical health into a more comprehensive system of care. As a result of this grant, OHIET has funded selected behavioral health professionals that contract with the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) to provide care to Medicaid eligible populations. This program is funded at two tiers with the requirements described below:6
Provider Agency Tier 2 Interoperability: Create an electronic connec- tion between the provider or ganization’s chosen electronic health record and a chosen cer- tified HIO to send structured clinical data for transmission of continuity of care documents (CCDs) as well as any other structured clinical data and un- structured data such as reports or other documents which the chosen HIO is capable of receiving/rendering for view ing. Voucher value for funding “Tier 2” will be applied toward the cost of contractual agree- ments made among voucher re- cipients, their EHR vendor and chosen HIO. This could in clude Tier 2-specific fees, including Interface fees, ini- tiation fees, and subscription service/support fees and will be based on the contractual ar- rangement with participants Certified HIO. In addition to the interface funds, provider agencies may request Direct secure messaging licenses for up to 11 staff. The Direct secure messaging, allows individual clinicians to exchange informa- tion directly with other cli- nicians involved in the patient’s care.
Provider Agency Tier 1 Interoperability: Using DIRECT secure messag- ing, send and receive secure email with the option to attach documents that may include protected health information (PHI), as well as the ability to query for and view data on individual patients via the web based portal from the chosen HIO. Due to federal privacy regulations (42 CFR Part 2), substance abuse treatment in formation can only be submit ted through the Tier 1 meth- odology. Voucher value for funding “Tier 1” will be ap plied toward the cost of con tractual agreements made with participant’s Certified HIO. This could include Tier 1-speOHIET has funded forty-one rural hoscific fees including initiation/ pitals with a potential voucher value of credentialing fees and sub- $1,000,400.00; fifty-eight rural proscription service/support. Tier viders with a potential voucher value 1 funding is on an individual of $133,748.00; and fifteen behavioral clinician basis. Provider agenhealth centers with a potential voucher cies must specify how many Di- value of $307,800 for a grand total porect connections they are apply tential value to Oklahoma providers of ing for. The number of connec- $1,441,948.00. OHIET also provides tions approved will be based on up to $3,000.00 for an EHR connecavailability. Funding is for a tion to a unique database and there are one-year period, but may be ex- approximately another fifty providers in tended based on funding avail- the approval pipeline. And there is more ability. to come. So, let’s talk about vouchers.
Oklahoma D.O. | January 2013
Have you applied for your vouchers yet? If not, why not? This is something that you are going to do to keep your practice modern and competitive. If so, why not make the application and get some help in the process. The application is simple. Just go online to the OHIET.org website. Look for the Eligible Provider Voucher link on the Main Menu on the upper right side of the website. Fill out the simple application form, read the disclosures and push ‘Submit Application.’ It really is that simple. If you are in a rural county, are a physician, a nurse practitioner, or a PA in a PA directed clinic, your application will be approved. Also, ask you hospital administrator if he or she has made application. If they have not, please have them contact me at val.schott@ okstate.edu for a simple paper application. OHIET will review your application. If you are applying for the Eligible Provider Voucher and meet the qualifications listed above, we will approve your application and send you an attestation letter for your signature. Again, this is a simple letter showing that you meet the criteria for this grant. Once we get that letter back, we will send you your voucher. But time is running out. Our original grant requires that we have all money obligated soon. Don’t be left out. Make you application today and let’s okDO all get started improving Oklahoma’s health performance.
REFERENCES: 1.) 2.) 3.) 4.) 5.) 6.)
Oklahoma Health Information Exchange Trust, Trust Indenture, September 22, 2010, pg. 4 President Bush continues EHR push, sets national goals, Healthcare IT News, April 26, 2004. EHR Stats Report 11_2012, Chad Sickler, HIE Program Coordinator, Oklahoma Health Care Authority, December 6, 2012. Eligible Hospitals and Eligible Providers, Voucher Funding Announcement No. 2012-02, Oklahoma Health Information Exchange Trust, November 2012-02 Ibid Eligible Behavioral Health Provider Agencies, Voucher Funding Announcement No. 2012-02, OHIET, November, 2012
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Oklahoma D.O. | January 2013
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Hard Rock Hotel & Casino Catoosa, OK Kenneth E. Calabrese, DO, Program Chair Melinda R. Allen, DO, Program Co-Chair Program Approved for 18 Category 1A Credits from the AOA Program granted for 16 Prescribed Credits from the AAFP
12:00 – 6:00 pm
Registration
2:00 – 6:00 pm
Exhibits Open
*1:00 – 2:00 pm
“Oklahoma and Obesity: The Health of Our State Address” Teri Bourdeau, PhD (Tulsa, OK) www.ok.gov/strongandhealthy/Obesity/index.html
*2:00 – 3:00 pm
“The Spread of Obesity” Duane G. Koehler, DO, FACOFP (certified family practice, Tulsa, OK) www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004552
*3:00 – 4:00 pm
“Childhood Obesity” Colony S. Fugate, DO, ACOP (certified pediatrician, Tulsa, OK) www.cdc.gov/obesity/childhood/
*4:00 – 5:00 pm
“Metabolic Syndrome and Cardiovascular Risk” Sharolyn D. Cook, DO (cardiology, Tulsa, OK) www.nhlbi.nih.gov/health/health-topics/topics/ms/
*5:00 – 6:00 pm
“Endocrinopathies and Obesity” Sean R. Hamlett, DO, FACOI (certified internal medicine, Joplin, MO) www.yourhormones.info/endocrine_conditions/obesity.aspx
6:00 –7:00 pm
OOA Past Presidents & District Presidents Meeting
6:00 – 7:00 pm
OOA New Physicians Meeting
7:00 – 8:00 pm
AOA House of Delegates Meeting
Saturday, January 19, 2013 7:00 am
Registration
7:00 am
Continental Breakfast
8:00 – 9:30 am
Bureau on CME Meeting
8:00 am – Noon
Exhibits Open
*8:00 – 9:00 am
“GI Consequences of Obesity” Jeffrey M. Hunt, DO (certified internal medicine, Tulsa, OK) http://jn.nutrition.org/content/130/2/280S.full
*9:00 – 10:00 am
“Obesity Related Hypoventilation Syndrome & Sleep Apnea” Kendal L. Mitchell, DO (internal medicine, Tulsa, OK) www.nlm.nih.gov/medlineplus/ency/article/000085.htm
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*10:00 – 11:00 am
“Choosing Change From Over 500 Pounds-A Personal Journey” Sean Anderson (Ponca City, OK) www.transformationroad.com
*11:00 am – Noon
“Gastric Bypass for Obesity: Personal Reflection” Randall S. Reust, DO, FACOI (certified internal medicine, Tulsa, OK) www.ncbi.nlm.nih.gov/pmc/articles/PMC1421184/
*Noon – 2:00 pm “Shape Your Future”-Physician Luncheon Julie Cox-Kain, Deputy Commissioner of Disease & Prevention Services bing Prescri Properre - Sign - dInit! www.ok.gov/health/ tu c re e c L ed for Requir *2:00 – 3:00 pm “Improper Prescribing- You Can’t Afford It” Proper Prescribing Lecture – Sign-In Required for Credit Sean D. Boone, DO (family practice, Hugo, OK) www.ok.gov/osboe/
a
Friday, January 18, 2013
*3:00 – 5:00 pm
“Risk Concerns & Strategies in Treating the Obese Patient” Risk Management Course – Sign-In Required for Credit Gail Harris, Sr. Risk Consultant (Las Vegas, NV) Risk Management Program Sponsored by a Risk L Re ectu Man Medical Protective qu re ag ire - S em d f ig en www.medpro.com or n t
5:00 – 6:30 pm
President’s Mentor/Mentee Reception Hosted by President Layne E. Subera, DO & First Lady Amy Subera
cre - In dit !
Sunday, January 20, 2013
7:00 am
Registration & Continental Breakfast – Sequoyah Foyer
*8:00 – 9:00 am “Physicians Prescription for Nutrition (Rx)” Michele L. Neil, DO, ACOI (certified internal medicine, Tulsa, OK) www.mayoclinic.com/health/obesity/DS00314/ DSECTION=treatments-and-drugs *9:00 – 10:00 am “Drugs in the Treatment of Obesity” Lora D. Cotton, DO (certified family practice, Tulsa, OK) www.emedicinehealth.com/medication_in_the_treatment_ of_obesity/article_em.htm *10:00 – 11:00 am
“Bariatric Surgery: What the Primary Care Physician Needs to Know” Kevin T. Fisher, DO, FACOS (certified surgeon, Tulsa, OK) www.nlm.nih.gov/medlineplus/weightlosssurgery.html
*11:00 am – Noon
“An Internist’s Perspective” Melinda R. Allen, DO, ACOI (certified internal medicine, Blackwell, OK) www.webmd.com/cholesterol-management/obesity-health-risks
Oklahoma D.O. | January 2013
OOA Winter CME Seminar “Ravages of Obesity” q *DO Member Registration q DO Registration for Saturday afternoon “Proper Prescribing” & “Risk Management” Courses only (3 Credit Hours) q*Retired DO Member Registration q*DO Nonmember Registration q Nonmember Saturday Only Registration q *MD/Non-Physician Clinician Registration q Student, Intern, Resident, Spouse, Guest Registration
On or Before 1/11/13 $340 $180 $80 $840 $680 $340 $0
After 1/11/13 $365
$205 $105 $865 $705 $365 $0
Mail Registration Form & Payment to: OOA, 4848 North Lincoln Boulevard, Oklahoma City, OK 73105-3335 or Fax to 405.528.6102.
Payment: q Check Enclosed q VISA/MASTERCARD q DISCOVER
q AMERICAN EXPRESS (card holder’s zip code: ___________________)
Credit Card No.: _____________________________________ Card Exp. Date: ________ 3 Digit CID Number: ___________ Signature: _______________________________________________________________________________________________ Name (as it appears on card - please print): ____________________________________________________________________ DO Name (please print): ____________________________________________________________________________________ Other Professional/Guest: ___________________________________________________________________________________ Resident/Intern: ___________________________________________________________________________________________ Student: _________________________________________________________________________________________________ q OMS-I q OMS-II q OMS-III q OMS-IV Spouse: __________________________________________________________________________________________________ Office Address: ___________________________________________________________________________________________ City: _______________________________________________ State: _____________ Zip: ____________________________ Office Telephone: (_______)_____________________________ E-Mail address: _____________________________________ Please indicate:
q Printed syllabus OR
q DVD syllabus
*Includes: Proper Prescribing Course, 2 Continental Breakfasts, Saturday Luncheon, & Evening Reception.
Requests for Refunds Must Be Received Before January 11, 2013 and a $25 Service Fee Will Be Charged.
SEMINAR LOCATION:
Hard Rock Hotel & Casino- 777 West Cherokee, Catoosa, OK 74015 For room reservations, please go online to www.hardrockcasinotulsa.com or call 1.800.760.6700. Be sure to mention you are with the OOA. Room Rate: $134 a night. Cut-off date: December 28, 2012. Hard Rock Hotel & Casino features:Hard Rock Store; Variety of dining options including Toby Keith’s “I Love This Bar & Grill”; Vegas style buffet; bistro-style grills; & 24-hour casino with 2,300 slot machines. All Hard Rock Hotel Rooms include:iPod docking stations; refrigerators; complimentary wired & wireless high-speed internet; complimentary airport transportation; complimentary covered & uncovered self-parking; complimentary fitness center; and complimentary USA Today.
Oklahoma D.O. | January 2013
19
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3/28/11 Oklahoma D.O. | January 2013
11:05 AM
TECHNOLOGY CORNER: New Year’s Resolution Provided by the OOA Bureau on Information Technology
The Bureau on Information Technology (IT) would like to propose to you a challenge and a possible resolution in this New Year, become savvy about your cyber security. As more and more information moves to online it is imperative that users follow the necessary steps and precautions to protect their sensitive materials.
The Bureau on IT has compiled five recommendations and friendly reminders to help keep you safe in this mobile world. 1. When setting a password never use “password”, your username, a word that can be found in the diction ary or a password you currently have in place for another account. Many antivirus software applicat ions include a password generator. These generators will produce random characters, user names and logins that you may utilize. It is important that you do not store these passwords on your computer or on a sticky note attached to your computer. If you need to write it down keep the two separate with no indi- cation to what accounts they may be associated.
2. Security questions are often overlooked. Many of the answers to these questions can be found through a series of Google searches or your social media profile. It is recommended to add a unique piece of information that only you will remember. For exam- ple, “What is your hometown”, may be answered with Oklahoma City 1981. Google and many other platforms offer a 2-step verification process for logging into e-mail accounts. While setting up this process the user saves what devices and computers they trust to login to their account. When your account is accessed from a device that is not saved it will text or call you with a code. Only you will know the code that is required to login from a new device or computer. This is a simple and free way to ensure that you control what types of devices and who is truly entering your account.
3. When choosing a browser to download onto your computer it may seem to be a decision just based on personal opinion. However, a study last year by Accucant Labs of Web browsers1 — including Mozilla Firefox, Google Chrome and Microsoft Internet Explorer — found that Chrome was the least susceptible to attacks. When browsing it is recommended to use a secure browser for logging into your bank accounts and other sensitive sites and open a
Oklahoma D.O. | January 2013
new browser when participating in activities such as an online forum or social media. 4. Locking your device is more important than one might think. By setting up a login password on your mobile device, tablet or computer it could be possible to save yourself a lawsuit in the future if these devices contain work related materials. There are numerous recovery software’s available to aid you in the instance it gets lost or stolen. Apple provides the “find my device” service that will allow users to locate the exact location of the device, display a message on the screen or make a noise to help the user locate it. 5. And finally stay savvy – aWhen you receive an e-mail from the so claimed “tech support” asking for your credentials because your account was hacked know that the actual tech support would never request this information through an e-mail. Make a quick phone call to confirm if this request is valid or not.
aWhile you are not using your wifi card or Bluetooth turn it off, this will prevent attacks on your device.
aAfter receiving an unwarranted subscribing e-mail, never reply or click “unsubscribe”, this will often lead to signing you up for further spamming.
aPay attention to your webcam! If the camera is ever activated while you are not using it this could mean an individual has hacked into the camera. Many recommend simply closing your laptop or placing a piece of tape over the camera while not in use.
The most important tip to remember is to stay proactive. By being in control and aware of possible threats you are the biggest resource for protecting your personal information. The Bureau on IT wishes you a happy New Year and hopes that this information will aid you in the coming year. If you have any questions regarding this article or the Bureau on Information Technology please contact Rachel Prince, CommunicaokDO tions Director, at Rachel@okosteo.org. Resources: 1.) Accuvant Browser Security Comparison: A Quantitative Approach http://www.accuvant.com/capability/accuvant-labs/security-research/ browser-security-comparison-quantitative-approach
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What DO’s Need To
KNOW
Prescription Monitoring Program (PMP) The goal of the State of Oklahoma is to reduce prescription fraud, substance abuse, "doctor shopping", and other illegal activity related to pharmaceutical drug diversion. The Bureau works in partnership with pharmacies, practitioners and other health care professionals throughout Oklahoma to reduce prescription drug abuse. The Oklahoma Prescription Monitoring Program (PMP) was enacted into law by the Oklahoma Anti-Drug Diversion Act (63 O.S. Section: 2-309). Designed to deter the abuse of prescription drugs, the statute requires all dispensers of Schedule II, III, IV, and V controlled substances to submit prescription dispensing information to OBNDDC using the ASAP 2007, Version 4, Release 1 standard within 24 hours of dispensing a scheduled narcotic. PMP System The PMP system provides secure access to OBN registrants, including pharmacies and practitioners who are in good standing. Regulatory and law enforcement agencies may also access the system. The PMP application provides continuity between practitioners, pharmacies, and state law enforcement to help prevent prescription fraud in Oklahoma. Access to PMP 2010 will be granted in accordance with state law 63 O.S. Section: 2-309D. Dispensers are required to submit controlled substance prescription information directly to OBNDDC in ASAP 2007 format every 24 hours. For access to the PMP, please refer to the Access Forms, Rules and Manuals section on this page. PMP Data Submission Most dispensers are already familiar with the reporting standard for submitting dispensing data to OBNDDC. However, it is important to note that PMP 2010 includes extensive "data-integrity" checking. Improperly formatted data or missing information could cause the data submission to be rejected by the system and returned to the originator for corrections. The dispensing report data can be submitted in one of the following ways: 1. Upload via the OBNDDC PMP Web Portal interface 2. Direct upload via SFTP 3. Manually entered using the Web portal manual entry form. 4. Using the PMP 2010 Web Service. For access to the PMP, please refer to the Access Forms, Rules and Manuals section on this page. Help Desk and Support Any questions, problems, or concerns regarding the PMP reporting procedures, PMP Web Center application, dispensing data format, or other related issues can be submitted directly to OBNDDC via email or by calling the PMP Help Line 1-877-627-2674 or pmpadmin@obn. state.ok.us.
Want more information about the EHR Incentive Programs? Make sure to visit the EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.
January 2013 Average Sales Price Files Now Available CMS has posted the January 2013 Average Sales Price (ASP) and Not Otherwise Classified (NOC) pricing files and crosswalks. All are available for download on the2013 ASP Drug Pricing Files web page.
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Oklahoma D.O. | January 2013
CMS to Release a Comparative Billing Report on Home Health Services — Target Release January 23 On January 23, 2013, CMS will release a national provider Comparative Billing Report (CBR) addressing Home Health Services. CBRs produced by SafeGuard Services under contract with CMS, contain actual data-driven tables and graphs with an explanation of findings that compare provider's billing and payment patterns to those of their peers located in the state and across the nation. These reports are not available to anyone except the providers who receive them. To ensure privacy, CMS presents only summary billing information. No patient or case-specific data is included. These reports are an example of a tool that helps providers better understand applicable Medicare billing rules and improve the level of care they furnish to their Medicare patients. CMS has received feedback from a number of providers that this kind of data is very helpful to them and encouraged us to produce more CBRs and make them available to providers. For more information and to review a sample of the Home Health Services CBR, please visit the CBR Services website or call the SafeGuard Services’ Provider Help Desk, CBR Support Team at 530-896-7080.
Review the Changes to the EHR Incentive Programs for Hospitals Included in New Interim Final Rule with Comment CMS and ONC have released an Interim Final Rule with Comment (IFC) that makes several changes to the Medicare and Medicaid EHR Incentive Programs and 2014 Edition EHR Certification Criteria that will affect hospitals. The rule also provides notice of CMS’s intention to issue technical corrections to the electronic specifications for clinical quality measures (CQMs) released on October 25, 2012. The IFC’s major changes include: • Revising the regulation text for the hospital measures for the objective of making patient information available online. The mea sure will now base the denominator not on all patients, but all unique patients. • Expanding the denominator options for the objective of sending electronic lab results to ambulatory providers. It now allows hospitals to choose between a denominator of all lab orders received from ambulatory providers or all lab orders received electroni cally from ambulatory providers. • Moving the CQM minimum denominator threshold effective date from 2014 to 2013, so hospitals can begin taking advantage of this flexibility right away. More information about the comment period will be included in an upcoming listserv. Want more information about the EHR Incentive Programs? Make sure to visit the EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.
MOL Update The Federation of State Medical Boards has developed an email newsletter intended to keep physicians apprised of developments in the FSMB’s Maintenance of Licensure (MOL) initiative. In 2010, the FSMB’s House of Delegates adopted a model policy for MOL recommending that physicians participate in continuous professional development as a part of the license renewal process. This policy is now being considered by state medical boards, some of which are engaged in pilot projects to evaluate the process, structure and resource requirements necessary to develop an effective MOL system. While implementation of MOL is still years away, the FSMB believes physicians, health care organizations and other stakeholders should be kept informed as a new system is developed. We also encourage you to visit the MOL Information Center online at www.fsmb.org.
CMS Distributes Free Hand in Hand Toolkit to Every Nursing Home in the Nation Nursing Homes, CMS Regional Offices, and State Survey Agencies will receive a free toolkit from CMS by January 31, 2013. Hand in Hand is a high quality training series for nursing homes that emphasizes person-centered care for persons with dementia, as well as the prevention of abuse. These tool kits are being mailed free to every nursing home in the country by IPC Systems, a CMS contractor. Section 6121 of the Affordable Care Act requires CMS to ensure that nurse aides receive regular training on caring for residents with dementia and on preventing abuse. Hand in Hand addresses the annual requirement for nurse aide training on these important topics. While annual training for nurse aides on dementia care and abuse prevention is required in current nursing home regulations, CMS does not require nursing homes to use the Hand in Hand training specifically. Other tools and resources are also available. More information is available on the Hand in Hand website. If you have questions or comments regarding these materials, please contact cms_training_support@icpsystems.com.
Oklahoma D.O. | January 2013
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Live to Give Provided by Walli Daniel, RN, 2012-2013 AOOA President Happy New Year! Now that the holidays are behind us it is time to once again refocus and get back to work, but first a recap of the final events of 2012. The AOOA sponsored the SAA Thanksgiving Dinner served to the students at OSU-COM and their families and it was especially nice this year with the largest student attendance ever – 225! The officers and physicians who attended commented on the maturity and organizational skills that have developed within the SAA. It was beautifully decorated with music and scrumptious food! They had a professional SAA photographer with a fall theme vignette taking photos of all the young families as a gift from SAA and it was really fun! The student families loved it! We took a picture with Orpha Harnish, board members and myself surrounded by the young student spouses and called it, “The Past, the Present and the Future!” I appointed an SAA member to the AOOA Board which has facilitated constant correlation of activities, genuine friendships, mentoring and mutual strengthening of the Advocacies. On December 1st the AOOA sponsored the SAA “High English Tea” and Etiquette Course in my home. The Etiquette Course was presented by Debby Hughes and our Committee Chair, Beverly Schafer. A distinguished panel including Billie Barnett, Trudy Milner, DO, and OEFOM President Mary Shaw assisted. Forty-two guests attended including 20 student spouses as well as Past Presidents and respected leaders and officers from around the state of Oklahoma. It was elegant and educational with an optional English Hat Contest- a lot of fun!
A panel of judges led by Marni Pettit, Rita Hitzeman, Judy Schlect and Donna Reimer awarded 3 winners who made their hats at the “SAA hat-making party” the day before and did not look handcrafted at all. They were spectacular! We were amazed at the talent and creativity.
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Prizes included crystal snowman earrings and a “Miss Manners Book”, a classic to keep for a lifetime. Thirteen Christmas Books of all shapes and sizes were awarded as door prizes to encourage the young ladies to start their own Christmas collections as I’ve done for my own family. It was a beautiful day to be an Advocate for the Oklahoma Osteopathic Association. The second week in December a wonderful opportunity presented itself and the AOOA stepped up! The Salvation Army was in need of extra “bell ringers” to collect funds in the Tulsa area. It was short notice, but we came together and started with those available and rang bells around Tulsa. But most exciting is the future prospect of expanding this initiative across the state next year and making it an AOOA community service project. The Salvation Army has invited us to include all our members to serve as “bell ringers” in their hometowns. They will provide AOOA sponsorship signs at each location. This is an opportunity to demonstrate the heart and soul of the Osteopathic family - we basically “live to give.” For the first time the AOOA sent out E-cards celebrating Christmas to our physician base around the state. We are working hard to make strides and improve communications. Our first online newsletter was just completed and a hard copy will be accompanying our membership dues invoices arriving January 1st. We are collecting AOOA dues and welcome your financial support as well as your attendance at any event! Come and join us any time and we will utilize your gifts and talents – most of all we want your friendship. You are important! Look for us on Facebook: Advocates for the Oklahoma Osteopathic Association. Last week alone we received 142 hits and 92 people were talking about us! There is include:
a full schedule ahead for the AOOA. Some of our plans
March 15, 2013-Manvocate Event Oklahoma City Thunder Game! Limited tickets available. We have a block of good seats available and a bus leaving Tulsa! This is a statewide outreach and we expect a sell out!
January 18-20, 2013-OOA Winter CME Seminar Jewelry making party and a technology instructor for our electronic devices (by popular request!) We receive regu- lar requests for this service in order to utilize functions at higher levels of proficiency. This may be well attended by advocates and their spouses!
Oklahoma D.O. | January 2013
BY THE WAY... 2013 Proposed OOA Bylaw
The proposed Bylaws will be voted on during the Association’s annual business meeting at 2:00 pm, Thursday, April 18, 2013 at the Norman Embassy Suites. During the December 6, 2012 meeting, the OOA Board of Trustees approved the following dissolution clause be added to the OOA Bylaws and Constitution. According to the OOA Bylaws, Article IX. Amendments, the Bylaws may be amended by this Association at any annual session by a two-thirds vote of the accredited voting members in attendance at such session... “Upon dissolution or other termination, all remaining assets, after payment in full of all its debts, obligations, and necessary final expenses, or after the making of adequate provision therefore, shall be distributed to such tax-exempt organizations with purposes similar to those of the organization as shall be chosen by the then existing Board of Directors.”
Fifth Annual ROGME Poster Symposium (Research in Osteopathic Graduate Medical Education) Cash Prizes! $1,500 - First Place $1,000 - Second Place $500 - Third Place Abstracts Due - January 14, 2013 Posters Due - February 7, 2013 For more information, please contact Rachel Prince at Rachel@okosteo.org or visit the Student & Residents tab www.okosteo.org for complete details
Bureau on Membership
The OOA Board of Trustees welcomes the following new members to the OOA family!
Rachel Ray, DO Family Practice (Claremore) Moira A. Redcorn, DO Psychiatry (Tahlequah) Arielle Allen, DO Urogynecology (Oklahoma City) Mark Damon II, DO Emergency Medicine (Oklahoma City)
Oklahoma Doctor Featured in AOA’s The DO The AOA recently published an article over telemedicine. Oklahoma’s very own William J. Pettit, DO (Tulsa) was one of the physicians featured discussing the benefits of the telemedicine. We are so proud of the medical advancements taking place in our very own state made possible by physician’s like Dr. Pettit. To read the entire article, please visit: http://www.do-online.org/TheDO/?p=118641
Oklahoma D.O. | January 2013
From the American Osteopathic Association Communications Department
HEALTH FOR THE WHOLE FAMILY DOs and other members of the profession consider the American Osteopathic Association’s “Health for the Whole Family” series a great way to promote the profession and educate patients about a variety of health topics. To use this month’s article, you have permission to simply make copies of the article (see page 34). Please copy & share page 26 to keep your patients informed.
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The Real Harm in High Heels Your killer heels are killing much more than you think. One in 10 women wear high heels at least three days a week and a third have fallen while wearing them. Statistics show that high heels are one of the biggest factors leading to foot problems in women, with up to a third suffering permanent problems as a result of prolonged wear. Natalie A. Nevins, DO, an osteopathic physician from Hollywood, Calif. who specializes in family medicine, osteopathic manipulative medicine, and neuromusculoskeletal medicine, explains the common medical problems associated with prolonged high heel wear and provides tips to avoid them. High Heels: The Higher the Better? Those perfect pumps can create the perfect storm for permanent health problems. If you frequently wear high heels, you are setting yourself up for long-term issues. "Extended wear of high heels and continually bending your toes into an unnatural position can cause a range of ailments, from ingrown toenails to irreversible damage to leg tendons. Additionally, cramming your toes into a narrow toe box can cause nerve damage and bunions," says Dr. Nevins. "High heels have also been linked to overworked or injured leg muscles, osteoarthritis of the knee, plantar fasciitis and low back pain," she adds. According to Dr. Nevins, when you wear high heels - shoes with a heel two inches or higher - your foot slides forward in your shoe, forcing the toes into the unnatural shape of the shoe and redistributing your weight incorrectly. The increased weight on your toes causes your body to tilt forward, and to compensate, you lean backwards and overarch your back, creating a posture that can strain your knees, hips, and lower back. "The change to the position of your spine puts pressure on nerves in the back and can cause sciatica, a condition where nerves become trapped, triggering pain and numbness as far down as the feet," Dr. Nevins adds. High Heels and Chronic Pain Over time, wearing high heels can shorten the muscles in your calves and in your back, leading to pain and muscle spasms. "Any time you wear shoes that restrict the natural shape of your foot, you’re at risk for experiencing pain," Dr. Nevins points out. According to Dr. Nevins, many women who wear high heels often suffer a shortening of the Achilles tendon because once the heel is pointed upwards, it tightens up. Stretching it again or switching to flats can be very painful; it can even lead to plantar fasciitis. "This tendon is designed to be flexible, so the foot can lie flat or point. With repetitive wear, you can develop unhealthy patterns that can persist even when you’re not wearing high heels," adds Dr. Nevins. Do You Have to Give Up Your Heels? No, but to avoid the problems that develop over time, Dr. Nevins recommends the following routines: 1. Choose sensible heels. Select shoes with low heels - an inch and a half or less - and a wide heel base; a slightly thicker heel will spread the load more evenly. Narrow, stiletto-type heels provide little support and three inch or higher heels may shorten the Achilles tendon.
2. Wear soft insoles to reduce the impact on your knees.
3. Make sure your shoes are the right size so the foot doesn't slide forward, putting even more pressure on the toes. Pick a shoe with a wide enough toe box to allow you to wiggle your toes.
4. Wear heels on days that require limited walking or standing.
5. Alternate your shoe choice throughout the day or from one day to the next. Don't wear your high heels all day; and wear more com - fortable shoes, such as athletic or walking shoes for commuting to and from work. Wearing shoes that allow your body to move naturally during walking will allow your feet, legs, hips and back to stretch.
6. Stretch. Take time every day to stretch your calf muscles and feet. Dr. Nevins recommends standing on the edge of a step with your shoes off. With your weight on the balls of your feet and your heels extending off the edge, drop your heels down to stretch. You can also put a pencil on the floor and try to pick it up with your toes.
The Final Word on Foot Health Don't let your sense of style cripple your ability to stand or step pain-free. "Your feet are, quite literally, your base of support. If your feet aren’t happy, nothing above them will be," says Dr. Nevins. "Take a closer look at your shoe selection and take small steps now to prevent big foot problems later."
Preventive medicine is just one aspect of care osteopathic physicians (DOs) provide. DOs are fully licensed to prescribe medicine and practice in all specialty areas, including surgery. DOs are trained to consider the health of the whole person and use their hands to help diagnose and treat their patients.
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Oklahoma D.O. | January 2013
Classified Advertising
OFFICE BUILDING FOR SALE: 6501 S. Western, OKC, OK 73139. Over 1 1/2 acres total size, 10,000 sq ft building divided into 3 doctors offices. 1200 sq foot private office upstairs with private bathroom and shower. 2 double sided fireplaces, over a dozen chandeliers, rough wood cathedral ceilings. Alarm and phone system in place, double glass doors in entrance, back patio with separate storage building. Larger office is fully equipped with exam tables, Pap table, chairs, medical instruments, QBC (CBC) machine, autoclave, medical supplies, and much more. For information contact: Captain David Simpson at (405) 820-5360. CLINIC FOR SALE: by owner. Fully equipped: LAB, XRAY, EKG. Well established clinic, near Integris Southwest Medical Center is available for sale. Clinic is well equipped and is ideal for one or more physician practice as well as a variety of specialties. Clinic has: waiting room with refrigerated water cooler, wheelchair accessible restroom, reception and staff work stations, Nurses station, 5 - 7 exam rooms with sinks and running water, large multipurpose procedure room, 3 private offices with built-in bookcases, (One Office with 3/4 Bath), additional staff and patient restrooms, large upstairs (currently used for storage) and variety of other medical equipment. Misys Medical Software. Large Parking Lot. “Must See Inside” the all steel building located at 2716 S.W. 44th St. in OKC to appreciate the effort placed upon providing convenient and up to date medical care. Price: $425,000-PRICE IS NEGOTIABLE. Doctor prefers to sell, but would consider leasing. If interested, please call: Evelyn Francis at (405) 249-6945. OFFICE FOR LEASE: Great Location - Central to Norman Reg. Hospital & Healthplex! 2121 W. Main. Approx. 1700 s.f. available, incl. 5 rooms & 3 restrooms. Gas, Elec. & Water paid. Call (405) 321-1497 or email adoverstr@yahoo.com. Also for Sale: 2 Hamilton Exam tables. Call (405)321-1497 or email adoverstr@yahoo.com.
PHYSICIAN NEEDED: The practice of Terry L. Nickels, DO is currently seeking a part-time Family Physician with OMT Skills to help cover the office. If interested please contact Dr. Terry Nickels at (405) 301-6813. IMMEDIATE NEED: for FP & ER (and more) Physicians, PAs and NPs: PT, FT and temp jobs. Bimonthly pay. Pd Malpractice and expenses. Call Sonja @ 877-377-3627 and send CV to sgentry@oklahomaoncall.com
December 24, 2012 Christmas Eve-OOA Central Office Close
December 25, 2012 Christmas Day-OOA Central Office Closed January 1, 2013 New Years Day-OOA Central Office Closed January 18-20, 2013 Winter CME Seminar: "Ravages of Obesity" Hard Rock Hotel & Casino, Catoosa, Oklahoma March 6, 2013 Medicine Day at the State Capitol March 14, 2013 DO Day on the Hill Washington, DC
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DOCTORS WANTED: to perform physical exams for Social Security Disability. DO’s, MD’s, residents and retired. Set your own days and hours. Quality Medical Clinic-OKC, in business for 16 years. Call Jim or JoAnne at 405-632-5151.
FULL or PART-TIME OPPORTUNITY / TREATMENT OF OPIATE DEPENDENCE WITH SUBOXONE: I have been practicing addiction medicine for three years and have reached the 100-patient limit for treating opiate dependent patients with SUBOXONE. I have a waiting list of interested persons and adjoining office space is available for lease in the CITYPLEX Towers near ORU at 81st Street and S. Lewis Avenue. Whether you want to begin prescribing SUBOXONE or plan to continue treating current patients with SUBOXONE, I am interested in sharing the waiting room, office staff, phone/fax/Internet, and billing services. Contact: Constance Honeycutt, DO 918-779-5907 or e-mail suboxone-rocks@hotmail.com
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OFFICE FOR RENT: Excellent area with high traffic count. Established location. Utilities are paid. Completely remodeled, very nice. Easy access from all areas of town, 7300 S Western, OKC. $1500 per month. Please call Dr. Buddy Shadid 405.833.4684 or 405.843.1709.
113th OOA Annual Convention Individualizing a Program for Your Specialty Needs Saddle April 18-21, 2013 2013 Saddle upupApril 18-21,
GOING OUT OF BUSINESS SALE: Quitting practice at year’s end! Great deals on exam tables, Universal X-ray unit with table, wall bucky and accessories, Hope processor, darkroom equipment, and general office equipment, etc. Also braces and other supplies. Please call 918-4530023 if you are interested. Oklahoma D.O. | January 2013
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SPRINGFIELD, MO Oklahoma D.O. | January 2013