WESTERN CAROLINA MEDICAL SOCIETY
THE BULLETIN Volume XXIV * Issue I
President’s Message In this issue… President’s Message ................................. page 1 Foundation Chair Report ......................... page 2 Foundation Update................................... page 3 Calendar of Events ................................... page 5 Association Update .................................. page 6 WCMS Announces Circle of Friends...... page 8 The Physicians’ Voice................................ page 9 WNC Interpreter Services ....................page 10 2013 Annual Campaign........................page 11 2013 Marketing Options ......................page 11 Physicians’ News .....................................page 12 The Cutting Edge (New) .......................page 14 Public Health Corner ..............................page 17 Welcome New Members.......................page 18
Frank Moretz, MD Increasingly corporations, hospitals, and even government officials are speaking for physicians. Physicians are capable of speaking for and should speak for themselves. We are not widgets, we are serviceoriented providers of health care. The challenge for us is that we are a diverse group who struggle to find commonality. I feel that a medical society is an excellent venue for physician voices to be heard and can represent physicians as a whole with concerns that affect all of us.
Frank Moretz, MD
One of the most important things that a medical society can do is to advocate for the practice of medicine, particularly as it relates to patient safety and positive health outcomes. We physicians assume that the community, its hospitals, and the government know the importance of what we do for patients. They do not always fully appreciate the importance of the doctorpatient relationship and the special responsibility we hold in that regard, so we must market what we do and become involved with legislation. We must also advocate for the health and well being of the people of WNC and for access to quality healthcare.
As we move forward with accountable care, team-based health care is going to be the new norm, where non-physician medical providers work with physicians to maximize skills of various team members. While non-physician care yields efficiencies and drives down costs, some non-physician advocacy groups are introducing legislation to legalize their ability to perform services that require a higher level of training than these groups currently possess. All “doctors” are not the same: an MD or DO is very different in background and training than a DC, DPM, PhD, or most recently a DNP (Doctor of Nursing Practice). The public should be fully aware of the differences in education and skill level, and make their choices accordingly. Due to the diligent work by individual physicians and medical societies, meaningful liability reform was passed last year. More remains to be done, and the trial lawyers have made the repeal of last year’s legislation the number one issue on their agenda. Because of this legislation, several physicians who were going to retire or limit their practice because of liability are still practicing fully, and all physicians have seen a decrease in their liability premiums. To stay abreast of current legislative issues, visit our website here. The Affordable Care Act presents many challenges as well as opportunities. We physicians must be knowledgeable about the issues and take appropriate steps to see that patients’ best interests are represented and that physicians will be able to practice medicine ethically and responsibly. To stay abreast of the ACA, visit our website here. If you’ve read WCMS’ 2013 Strategic (Continued on page 2)
(Continued from page 1) Plan (http://www.mywcms.org/About), you will see that our focus is on growing physician leadership, conducting legislative advocacy, and supporting vulnerable populations. The WCMS plans to promote leadership development for physicians who are interested. Hospital administrators, corporate executives and government officials have had training to be leaders and negotiators. Most physicians have not had similar training and are at a disadvantage when negotiating with these entities. Mental health has been ignored for too long and must be addressed. Currently there is no safety net other than hospitals and jails. Another issue is that medical conversations between physicians and their patients are confidential and must not be regulated by the government. These are patient-focused advocacy issues that WCMS will be championing in the coming months. The bottom line is that physicians are ultimately about the patient. If our own practice concerns take precedence over patient care, our profession is doomed, but if we take the high road and put patient care and access to quality healthcare first and foremost with physician advocacy and legislative involvement, the practice of high-quality medicine will be secure. Frank Moretz, MD WCMS Association President
Foundation Chair Report
Winfield Word Sims, MD
Will the physicians of Buncombe County continue to provide leadership in caring for the poor? Physicians and other medical providers in Buncombe County have for 18 years provided a model of how to improve health care availability for the poor. Project Access was started by physicians here in cooperation with Mission Hospital and other medical providers. Its administrative operations, including direct services such as patient eligibility screening, Winfield Word Sims, MD enrollment, navigation and interpreter services, are sustained by the Western Carolina Medical Society through its charitable arm, the WCMS Foundation, thanks to very generous grants from Buncombe County, Mission Hospital Community Benefits, TD Bank, and HealthNet, as well as funds from individual donors. Prior to Project Access , physicians used to see uninsured, low-income patients pro bono in their practices, but if their patients needed anything outside of the practice—a referral to a specialist, a medication, crutches, blood glucose monitors, a language interpreter—physicians had to spend inordinate amounts of time trying to advocate for each patient (read: beg, ask favors, make endless phone calls) to gain access to these services. Project Access opens doors for patients in need. Project Access saves physicians time and energy and, as many long-time PA physician volunteers will tell you, allows them to “practice medicine the way it was intended.” Project Access is a coordinated network, with participation by most physicians from most specialties and with wraparound services to insure that patients can follow through on their treatment plans. Patients are able to get primary and specialty medical care, labs, x-rays, physical therapy, medications, durable medical equipment, interpreter services, and other services without having to wonder if they are going to be financially ruined, shamed in their efforts to get these services, or turned away altogether. This great effort of providing for our neediest citizens is in the deepest spirit of what brought many of us to the practice of medicine: the desire to pay attention to suffering and to relieve it when we can. What is the role for this in an era of “insurance exchanges,” budget shortfalls and a sluggish economy? (Continued on page 3)
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(Continued from page 2) In the short term, it would appear that the NC legislature’s decision not to expand Medicaid eligibility will ensure there are plenty of very poor, sick people who will continue to need urgent access to these critical services. Without Project Access , these patients will take on crushing debts, based on the Alice-in-Wonderland world of health care pricing ($20 for Tylenol, $20,000 for an appendectomy, etc), or they won’t get the care they need and get even sicker until they land in Mission’s emergency room in very bad shape. With no Medicaid expansion, those who make 100% of the federal poverty level –OR LESS – will not be eligible for federal help buying insurance through the exchanges. The expectation was that the poorest would be covered by the Medicaid expansion, and it is estimated that without that expansion, only 20% of the currently uninsured will be eligible for coverage through the insurance exchanges. Moreover, it is certain that some of those people who we think would be eligible for the health insurance exchange will end up being exempt from the mandate because the premiums will be unaffordable; they, too, will go uninsured. So, the poor of Buncombe County will still need Project Access for the foreseeable future. Will we be there for them? This requires so many moving pieces to work together!
It requires ongoing operations from the WCMS and its charitable arm, the WCMS Foundation; It requires ongoing willingness by the physicians of Buncombe County to provide charity care from individual providers and practices; It requires grant support from Buncombe County, and other funding organizations (the program’s direct services and overhead cost $650,000); It requires support from Mission Hospital, and It requires a host of volunteers, from board members to fund raisers.
As the incoming chairman of the WCMSF board, I am deeply appreciative of all the people who have made Project Access work. For the providers, it is living by ideals that we like to claim for ourselves, or that we feel are claimed upon us by our Maker. For the patients, it is in many cases a matter of avoiding financial ruin, needless suffering or even death. Let’s keep it going. Winfield Word Sims, MD WCMS Foundation Chair
Foundation Update
Sharon Lewis, Director of Foundation Programs
ACCESS TO CARE WCMS CEO Miriam Schwarz continues to arrange the very popular and welcome specialty provider-led discussions for the primary care providers at WNCCHS including Asheville Gastroenterology, Asheville Pulmonary Associates, Blue Ridge Bone and Joint, Cancer Care of Western North Carolina, and Asheville Eye Associates in 2012. Presentations in 2013 will focus on dermatology, cardiology, and urology. We are finding that specialists discussing referral issues directly with PCPs is a beneficial tool for both PCPs and specialists to work more effectively together. Specialists discuss how to diagnose and treat various illnesses in primary care, when to refer, how to prep the patient for referral and what to communicate to the specialist. If you are a specialist interested in making such a presentation, please call Miriam Schwarz at (828) 274-2267 or email her at miriam@mywcms.org. We’ve made a number of significant improvements with our Project Access® program to enhance its alignment with the original mission and enhance patient accountability: (Continued on page 4)
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Beginning December 11th, 2012 the Prescription Committee of the Foundation Board has been collaborating with Community Care of Western North Carolina to analyze 2012 medication utilization patterns by Project Access® physician volunteers, and to assist CCWNC with their consultancy dedicated to improving the treatment of chronic pain. Recommendations will be presented at the next Foundation Board meeting on May 15th, 2013. On Monday, February 11th, 2013 WCMS launched a new Project Access® Navigator co-location agreement with our biggest safety net partner, Buncombe County’s Federal Qualified Health Center, Western North Carolina Community Health Services. The arrangement features a newly hired bilingual PA Navigator and a ceiling on referrals of 96 per month, for now, which should be more than enough to meet historical needs while enabling WCMS to deliver the quality of service to which we aspire for our partners, our patients and ourselves. We are planning a May 2013 launch date with Community Care of Western North Carolina to develop a collaborative process enabling Project Access® Navigators to cross reference our system, fhases, with Medicaid databases to prevent dual enrollments. We are continuing to explore with our key partners locally, regionally and state-wide various scenarios for what Project Access® may look like in the years to come as the Affordable Care Act continues to be implemented, and will keep you apprised of the details as they become clear.
On a lighter note, HeartStrings, the Foundation’s key fundraiser of the year benefitting Project Access® and the charitable programs of the Foundation, took place on Saturday, February 22nd at the Asheville Racquet Club. The total amount raised so far is about $17,000! A great time was had by 11 corporate, non-profit and family teams, many individuals and volunteers on Saturday as everyone exercised for health and gave from the heart. Mission Sports Medicine and Mission Stroke Outreach Center did blood pressure and BMI and gave out great advice! ARC staff, including childcare and group exercise leaders donated their time and ARC graciously opened their doors to WCMS. Healthy snacks were provided by Earthfare and event promotion was provided by Clear Channel and the Asheville Radio Group. Everyone participating received a goody bag and certificate of participation. A shout out to all of our HeartStrings sponsors who supported the event:
Presenting Sponsor/Champion of Access - Mission Health System Host Sponsor - Asheville Racquet Club Downtown Gold Friend of Medicine sponsor - Wells Fargo Friend of Medicine sponsor - Asheville Anesthesia Associates Friend of Medicine sponsor - CarePartners Friend of Medicine sponsor - Mountain Sleep Friend of Medicine sponsor - Paragon Financial Society Advocate sponsor - Four Seasons CFL Gold HeartStrings Supporter sponsor - Insurance Services of Asheville HeartStrings Supporter sponsor - Great Beginnings HeartStrings Supporter sponsor - Blue Ridge Bone & Joint HeartStrings Supporter sponsor - Broker & Hamrick, P.A. HeartStrings Supporter sponsor - Asheville Breast Center HeartStrings Supporter sponsor - McGill Associates, P.A.
If you have questions, comments or concerns about Project Access®, please contact Sharon at (828) 274-2267 ext. 305 or sharon@mywcms.org. HEALTH PARITY The WNC Interpreter Network is now the WCMS Interpreter Network…but still WIN! Doctors are increasingly making WIN a part of their team. They do not hire interpreters as a mere courtesy to their Limited English Proficient (LEP) patients. They hire interpreters for many reasons including better communication and patient (Continued on page 5)
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(Continued from page 4) compliance, to provide confidentiality and protect patient privacy. However, they also do so to protect themselves from a host of liability issues and to protect patients from abuse. The following is a true story:
Over a period of a few months a patient’s husband refused interpreter services for his non-English speaking wife at two different practices. He said that he would interpret for his wife and that he did not ask for or need an interpreter. Unfortunately, not knowing what else to do, practice staff dismissed the interpreters. When a third practice called WIN to schedule a visit for the same patient, WIN staff spoke with the practice manager who asked the doctor how he wanted to handle the situation. The doctor sent a clear message to the family “I will not see the patient without my WIN interpreter present!”
Medical professionals know that even when there is no language barrier, it is not uncommon for the person who accompanies a patient to try to control their partner, parent, friend or follower (in cases of religious leaders) and filter the information shared between doctor and patient; in LEP situations, the English-speaking companion has undue control of their patient. There are routine safety net questions that medical professionals, social workers and law enforcement always ask when no one other than the patient is present. Having the partner as the interpreter in many situations is often out of the question. Interpreters insure transparency, which means that everyone in the room is hearing what is being said at all times. Remind your staff that WIN interpreters are part of your medical team and they are there to interpret for YOU and your staff! WIN EXPANSION As you may have read in the Mountain Xpress, the Western Carolina Medical Society Foundation has been awarded a Janirve Legacy grant to expand into Henderson and Transylvania Counties! The aim of the grant is to educate the medical community and the Limited English Proficient (LEP) public about professional interpreter services. Services will be donated and/or offered at a reduced rate to 24 area practices that see uninsured patients. Currently WIN is working with Henderson County’s Federally Qualified Health Center, Blue Ridge Community Health Services, to reach the LEP community with educational resources. Contact Mary-Jo Dukas at mary-jo@mywcms.org or 828-274-6627 ext. 307 for more details on how your practice can benefit from this opportunity.
Calendar of Events April 18 ............................ Women In Medicine Social, 5:30pm, Battery Park Book Exchange & Champagne Bar May 3 ................................................................................... Development Council Meeting, 12:00noon, MAHEC May 14 .......................................................... Quarterly Emeritus Luncheon, 11:30am, DoubleTree Biltmore Hotel May 15 ........................................................................................... Foundation Board Meeting, 6:00pm, MAHEC May 16 ................................................................... Early Career Physicians’ Section, 6:00pm, Highland Brewery May 27 ................................................................................................................ Memorial Day, WCMS Closed June 7 .................................................................................. Development Council Meeting, 12:00noon, MAHEC June 20 .......................................................... Women In Medicine Social, 5:30pm, Dr. Donna Burkett Residence June 24 .......................................................................................... Association Board Meeting, 6:00pm, MAHEC July TBD .....................................................................................................................................Emeritus Summer Social, TBD 5
Association Update
Donna Wiedrich, Director of Member Services
EVENTS We held our annual Newcomers’ Picnic on Sunday, October 14 at Claxton Farms and what a great event it was! We featured live music by Deep River, great food, children’s activities, fishing, and horse drawn wagon rides all of this complemented by the breathtaking beauty of Claxton Farms! Many thanks to our sponsors:
2012 Newcomer Families
Our 2012 Fall Conference was held on November 14th at MAHEC. This year’s conference theme was “KISS- Keep it Simple and Sweet: how to stay underwhelmed in an overwhelming environment. Some of the topics included an update on the Affordable Care Act by Carolyn Coward, RVUs-drilling down the numbers, Social Media (compliance and marketing), The Lighter Side of Healthcare: a comedy relief by Denise Price Thomas (aka Gladys Friday) and more. Folks were rolling in the aisles after Gladys Friday’s comedy performance! A big thank you to our Fall Conference Planning Committee: Lisa Wheeler of Pathways Medical Management, Barbara Iles of Allayant Pain Management, Dan Keller of MedOasis, Amanda Early of East Asheville Family Medicine, and Donna Wiedrich and Nancy Caine of WCMS. Many thanks to our sponsors: Gladys Friday demonstrating the importance of teamwork.
WCMS held its fourth Women In Medicine social on October 18th at the home of Dr. Shannon Hunter in Haywood County. The focus of the discussion was Growing Women Leaders in Medicine in WNC. Approximately 15 women physicians came out for this event, representing a wide range of ages and specialties. The February Women In Medicine social was hosted by Dr. Lorena Wade at her home with over 20 women attending. The next WIM will be our one-year anniversary of the program and is scheduled for the evening of April 18th at the Battery Park Book Exchange. We are also excited to announce that we will be launching our newest affinity group, “Early Career Physicians” in the next few months! For more information contact Nancy Caine, Member Services Coordinator, at 828-274-2267 ext. 310 or email nancy@mywcms.org (Continued on page 7)
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(Continued from page 6) The WCMS 2013 Annual Celebration was hosted by BMW of Asheville on January 26. Attendees enjoyed great food catered by Frankie Bones and relaxing music by local musician Chris Rhodes. 2013 WCMS Association and Foundation Board members were approved (click here for the lists). We also had some great prizes (compliments of BMW) including a trip for 2 to the BMW Performance Center in SC. Many thanks to Steve Gordon and BMW for hosting and sponsoring our 2013 Annual Celebration! ADVOCACY Mental Health Focus WCMS is focusing its attention on mental health this year. Mental health has been an area of concern for many physicians throughout WNC for many years. We are in the process of developing an initiative to help expand access to mental health services in WNC. We will be sharing our plans with you as we move forward so please stay tuned. White Coat Wednesdays Each year NCMS organizes Legislative Advocacy Days (aka White Coat Wednesdays) for physicians to travel to Raleigh and spend the day talking with their legislators. WCMS would like to organize a team of WNC physicians to travel to Raleigh on May 29th. You can travel together (road trip!) or separate, and meet at the NCMS office in the morning for a briefing on the current legislative issues and talking points. Then, you will head to the legislative buildings to spend the afternoon with legislators and head home by 4pm. For more information please visit the NCMS website here. VALUE ADDED BENEFITS Special Pricing on Group Purchasing In collaboration with WCMS, the WNC Health Network is pleased to offer its Group Purchasing program to all WNC physicians. The program is in conjunction with the Premier Purchasing Partners national contracting group and McKesson Medical Distribution. The contract portfolio covers items from cotton balls to office supplies to copiers. The sign-up process is simple and the savings potential for small to large practices can be significant. For more information, please contact Tim Bugg, VP of Group Purchasing Member Services for the WNC Health Network, at 828.667.8220 or tim.bugg@wnchn.org.
To learn more about Provider Select MD Group Purchasing program, click here (Word document). To learn more about clinically-related supplies, click here (Excel document). To learn more about non-clinically related supplies, click here (Excel document). To learn more about high risk medical malpractice coverage, click here (PDF file).
Special Pricing on EHR/PM Systems WNC Health Network in conjunction with WCMS is pleased to offer your practice special pricing on your EHR/PM system. Each practice's needs are different and we encourage your practice to diligently survey the marketplace for an appropriate fit. We have obtained special pricing with: Allscripts Greenway eClinicalWorks
Please contact Tim Bugg and WNC Health Network for pricing terms at 828-771-4223 or tim.bugg@wnchn.org.
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(Continued from page 7) Endorsed Vendors Check out our Endorsed Vendor program! Member practices can save money using our endorsed vendors and WCMS receives a revenue stream in return to help fund our physician-focused activities and programs. For more information contact Donna Wiedrich at 828-274-2267 ext. 313 or email donna@mywcms.org or visit our website at http://www.mywcms.org/About/Partner -with-us/Vendors. ADN (Advanced Data and Network Solutions) (IT Management) OneWhoServes, Inc. (IT Management) Charter Communications (T1, WAN, Fiber Internet, Fiber Circuits to data centers) The Technology Services Group of JPS (Accounting, Consulting & Technology Services) Management Services on Call EMR Partners Consulting (EHR selection/implementation, Meaningful Use), Pathways Medical Management (Practice Management) Carolyn Coward, Van Winkle Law Firm (Healthcare Law) Evolution Healthcare Consulting (Practice Management) REGIONALIZATION As part of our new strategic plan WCMS will be visiting practices out in the region to reach out to WNC physicians and identify the challenges they are facing within their practices, then determine how WCMS can assist. We will have some exciting new features to share with physicians and hope that we can build new relationships throughout the region and continue to provide excellent services to our members. This is an exciting time of growth for our organization and we look forward to serving all WNC physicians. If you are interested in having WCMS staff visit your practice please email Donna Wiedrich, Director of Member Services, at donna@mywcms.org.
Welcome WCMS Circle of Friends
For more information about The Van Winkle Law Firm go to www.mywcms.org Click here to learn more about the WCMS Circle of Friends program and how you can participate. Miriam Schwarz, CEO and Donna Wiedrich, Director of Member Services are pleased to announce that The Van Winkle Law Firm is an inaugural member of the WCMS Circle of Friends Program. A by-invitation-only opportunity from the WCMS members and approved by the WCMS Association Board, participation has many advantages, including numerous opportunities to spend time with physicians. If, as a WCMS member physician, you’d like to recommend a company to join the Circle of Friends Program or have comments about companies in this program, please contact Miriam Schwarz, CEO/Executive Director of the Western Carolina Medical Society at Miriam@mywcms.org.
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"The Physician's Voice" Media Series Highlights WCMS Physicians The Physicians’ Voice is a media-based educational resource comprised of information provided by WCMS members, and disseminated to media outlets throughout western North Carolina, on healthcare, medical and community topics that are relevant and important to our general community. Print articles and web posts are published in various media outlets, including: Asheville Citizen-Times, Mountain Xpress, The Mountaineer, Hendersonville Times-News, Mitchell News Journal, Yancy Common Times Journal, The Yancey County News and Smokey Mountain News, La Voz Independiate, WLOS, Asheville Radio Group and Clear Channel. In 2012 and to date in 2013, the following WCMS physicians contributed to The Physician Voice. Listed are the doctors, their practice and their topics:
Dr. Brent Jeffries, Asheville Gastroenterology Associates - Colon Cancer Dr. Robin Matthews, Haywood Women’s Center - Cervical Cancer Dr. Sesalie Smathers, Mountain Radiation Oncology - Breast Cancer Awareness Dr. Kate Queen, Mountain Medical Associates/ Haywood Osteoporosis Center at MedWest - Osteoporosis Dr. David Clements, Carolina Internal Medicine Associates - Cholesterol Dr. Jon Morris, Palliative Coordinator, Four Seasons - Palliative Care Dr. Todd Walenius, WNC Community Health Services - Infectious Diseases/HIV/Aids Dr. Elise Rackoff, Advanced Dermatology and Skin Surgery - UV Safety Dr. Lydia Jeffries, Asheville Women’s Medical Center - Menopause Awareness Dr. Shannon Dowler, Family Physician and Chief Medical Officer , Blue Ridge Community Health Services – Minority Health Awareness Dr. Melissa Thingholl, Olson Huff Center for Child Development/Mission - Vaccines Dr. Jim Cumming, Blue Ridge Premier Medicine - Nutrition Dr. Rhoda B. Brosnan, Asheville Cardiology Associates - Women’s Heart Health Dr. Susan Mims, VP for Women’s and Children’s at Mission Hospital/Medical Director for Mission Children’s Hospital - Nutrition for Children Dr. Kenneth Leetz, Biltmore Associates in Psychiatry and Psychology - Post Traumatic Stress
We thank our WCMS physicians for their participation!
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It’s win-win-win
WIN!
The WCMS Interpreter Network (WIN) WIN provides professional interpretive services in over 20 foreign languages and ASL to WNC health care providers, government agencies and businesses. WIN helps patients communicate with their health care providers, while providing medical professionals with low-cost, stress-free access to interpretive services.
Don’t let a language barrier come between you and providing quality care to your patients!
Professional WIN Interpreters complete your medical team. WIN provides interpretive services in over 20 foreign languages, ASL, ASL Tactile (for blind and deaf ), Albanian, Arabic, Chinese, Farsi, French, Greek, Gujarati, Hindi, Hungarian, Japanese, Korean, Moldovan, Portuguese, Romanian, Russian, Spanish, Tagalog, Ukrainian, Vietnamese, Visaya.
Call us today at 828.274.0950 WCMS Interpreter Network (WIN) 304 Summit Street • Asheville, NC 28803 Mary Jo Dukas, WIN Coordinator, maryjo@mywcms.org
WWW.MYWCMS.ORG
WIN: makes it easy for your staff. empowers your patients. takes your interests to heart. provides interpreters you can trust.
2013 ANNUAL CAMPAIGN HELPING OUR COMMUNITY NAVIGATE HEALTHCARE CHANGE The Western Carolina Medical Society serves our vulnerable populations and is helping our community navigate the changing healthcare environment. Our community’s needs during these uncertain times include: Project Access® in Buncombe County. Can we continue to offer free health care in 2013 in order to serve those in greatest need? WCMS Interpreter Network. Can we help more of our low-income, limited English proficient community in WNC communicate with their providers? Charles Blair Health Parity Scholarship Fund. Can we grow the scholarship fund for minorities who want to go to medical school? 2013-2015 WCMS Strategic Plan business and physician initiatives. Can we bring physicians, businesses, and community members together to connect patients to wellness, prevention and health promotion offerings? The WCMS Foundation - Helping our Community Navigate Healthcare Change Learn More / Log in now http://mywcms.org/wecare Watch for our mailing to your home this month. We urge you to Care About Our Healthcare Future and give generously to the WCMS Foundation Annual Campaign when it arrives or go to http://mywcms.org/wecare donate. Help us help our community navigate the changes in healthcare - now and in the future!
Take Advantage of Marketing Opportunities with WCMS and the Community Preferred Position Advertisers for the Bulletin Advertiser receives 1/8 page (vertical or horizontal) promotional ad space located in our most popular sections of the Bulletin: President’s Message, Foundation Chair Report, Foundation Update, Association Update, Physicians’ News or Welcome to New WCMS Members. Distributed to 1,500 WNC physicians, practice managers, health care leaders, business leaders, legislators, and more!
*WCMS Member Special- receive 20% discount Vital Signs E-Newsletter—ONLY A FEW ISSUES LEFT! Community Pulse E-Newsletter — SOLD OUT! Provides timely information about the Western Carolina Medical Society, its Foundation and Association programs and critical announcements geared specifically to non-WCMS members and community members, supporters and leaders across WNC. Distributed monthly - 3000+ non- member physicians, donors & supporters, community leaders and volunteers Code Combo Package $1,500 BEST VALUE* Four (4) Vital Signs E Newsletter exclusive ad sponsorships Twelve (12) months exposure on WCMS Website Home Page Cube Two (2) Community Pulse E Newsletter exclusive ad sponsorships (we will substitute Bulletin Preferred Position advertising space) Click here to view these and all 2013 WCMS Sponsorships and Marketing Opportunities
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Physicians’ News WNCPA Holds Its William Bruce Awards Dinner for Physicians and Psychologists On Wednesday, February 27, the Western North Carolina Psychological Association hosted the “William Bruce” awardees and local physicians at a dinner honoring Dominique Huneycutt, J.D., Ph.D. and Cindy Brown, M.D. at the Grovewood Café. The dinner began in 1994 and has become an annual event to gather Western North Carolina’s psychologists and physicians interested in the art of interdisciplinary collaboration. Karen Marcus, Psy.D., WNCPA president, was emcee.
Dominique Huneycutt, JD, PhD & Cindy Brown, MD.
Drs. Huneycutt and Brown were honored with this year’s William Bruce Award, as have been others of the two disciplines and two members of the Asheville media over the 17year history of the event. In 1996, William Bruce, Ph.D. was the award’s first psychologist recipient, along with a physician colleague with whom he helped to foster interdisciplinary cooperation within the MAHEC Family Practice residency-training program in Asheville, among psychology, mental health, and behavioral medicine. The dinner and award ceremony have come to be called informally “the M.D.—Ph.D. dinner.”
Collaboration with physicians has been an extensive part of Dr. Dominique Huneycutt’s clinical practice. Additionally, she has collaborated with attorneys in the forensic aspects of her practice with children and families. WNCPA is in her debt for her unstinting leadership of the association over the past few years. Dr. Cindy Brown is a dynamic physician who performs and oversees child-abuse evaluations for Buncombe County. She helped create and grow the child-focused approach used in the County, and she values the contribution of psychologists and other mental-health providers for abused children. In addition to remarks from the two awardees, the attendees also had the treat of hearing WNCPA member, Dr. Ed Hamlin’s talk about the neuropsychology of trauma and stress resilience. Dr. Hamlin is a specialist in applied neuroscience and director of the Center for the Advancement of Human Potential in Asheville. WNCPA seeks ways of strengthening collaborative relationships with members of other professions and groups, too, whose concerns for our mutual patients or clients overlap with those of psychologists. Reprinted from The North Carolina Psychologist, with permission.
Local physician appointed to leadership roles with international organization The American Academy of Orthopaedic Surgeons, the preeminent provider of musculoskeletal education to orthopaedic surgeons and others in the world, has appointed local orthopaedic surgeon Gordon I. Groh, MD, to several leadership roles with the organization. A board-certified specialist in shoulder, elbow and hand surgery at Blue Ridge Bone & Joint in Asheville and Hendersonville for the past 18 years, Dr. Groh has been named to the AAOS Shoulder and Elbow Program Committee, an educational body of select leading national and international orthopaedic surgeons who specialize in surgery of the shoulder and elbow.
Gordon Groh, MD
He has also been reappointed to the Education Subcommittee for the 2013 AAOS annual meeting to be held in Chicago in March. In addition, he will present a course on “Reverse Shoulder Arthroplasty – Beyond the Basics,” at that meeting, the (Continued on page 13)
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(Continued from page 12) largest gathering of orthopedic surgeons in the world, with some 30,000 attendees expected. Dr. Groh is recognized nationally for his expertise, having been named one of the 65 Outstanding Shoulder Surgeons and Specialists in the country by Becker's Orthopedic, Spine & Pain Management Review. He is also one of only four orthopaedic surgeons in the nation to hold memberships in the American Shoulder and Elbow Surgeons (ASES) society as well as the American Society for Surgery of the Hand (ASSH). He is Assistant Editor for the Journal of Shoulder and Elbow Surgery, the official publication for eight leading specialty organizations focusing on medical, surgical, and physical techniques for treating injury and disease of the upper extremity, and is a reviewer for the Journal of Bone and Joint Surgery, a twice-monthly peer review journal for orthopaedic surgeons and researchers.
Karen L. Dedman, MD Asheville-based Family practitioner Retires After 28 Years of Practice Dr. Karen L. Dedman of Cannon Family Health has recently announced her retirement from private practice. After a sabbatical she will pursue other ways to serve the medical needs of our community. Dr. Dedman started her professional journey in medical school at Rush Medical College in Chicago, and then completed her residency at MAHEC. She began medical practice at the Valley Clinic in Bat Cave in 1984 through the National Health Service Corp. In 2009 she returned to Asheville and started Community Family Practice with Drs. Martha Salyers and Robert Kline. In 2009 Dr. Dedman joined Cannon Family Health. “After 28 years of practice I am stepping back from private practice to pay more attention to my own practice of good health- eat better, exercise and enjoy my Karen Dedman, MD grandchildren. The demands of a full time practice have brought me to this important decision, and it’s time for me to move into a new stage in my life,” notes Dedman. “We live in a fabulous medical community and I am so grateful to Dr. Cannon and our staff and to all of my patients over the years. I am also grateful for my husband’s support throughout my career. As bittersweet as it is to retire, I look forward to practicing what I have been advocating all these years for others.” Her medical partner, Daniel Cannon M.D. commented on her departure “Dr. Dedman will be missed by staff and patients. Her excellence in care and conscientious, personal approach, have been a boon to Cannon Family Health. I wish her well in her future endeavors.” Dr. Dedman conveyed the following. “In Family Medicine I have had the privilege of working with patients of all ages, some for decades, through pregnancy, birth, infancy, childhood, adulthood and until death. What a tremendous honor to be entrusted with the care of these families”. Dr. Dedman is married to Tennessean Scott Dedman who is the Executive Director of Mountain Housing Opportunities. They have two sons - Jesse who lives with his wife and two children in Puerto Rico (with one on the way) and Ben who resides in China. “I am happy to be able to spend more time with my grandkids and children,” added Dr. Dedman.
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Asheville Anesthesia Associates recognized for superior performance Asheville Anesthesia Associates has been recognized by the Medical Group Management Association (MGMA) for its “Superior Performance” compared with similar medical groups nationwide. The MGMA award is given to medical practices that have demonstrated superior performance in cost management, productivity, capacity and staffing, and patient satisfaction. This is the second consecutive year that Asheville Anesthesia has received this award. The MGMA’s Performance and Practices of Successful Medical Groups report has been the nationally recognized benchmarking standard among medical groups for more than a decade. “Our practice is dedicated to providing the highest quality of anesthesia services to the people of Western North Carolina,” said Dr. Rodney Pugh, President and Chair of Asheville Anesthesia Associates. “This MGMA award recognizes the efforts of our staff and our practice’s commitment to the patients, hospitals and surgical facilities that we serve.” Asheville Anesthesia has served Western North Carolina for over 40 years and provides anesthesia and perioperative management services to area hospitals and surgery centers throughout the region. MGMA member medical practices represent more than 40 percent of the physicians providing healthcare services in the United States.
The Cutting Edge (New!) WCMS’ Cutting Edge highlights WNC physicians, practices and programs that are on the cutting edge of healthcare transformation, both big and small. WCMS supports local physician members who are change agents by recognizing them and sharing among other WCMS members and the general community information about these local innovations. If you know of such a physician or practice, please contact Donna Wiedrich at or Nancy Caine WCMS and we will check it out. ________________________________
The Western Carolina Medical Society recently interviewed WCMS member Dr. S. Mark McNeill from Trillium Family Medicine as the first in a series highlighting health innovation practices in Western NC. The Perfect Practice Early in the morning before the first patient arrives and after the patient portal and emails are checked, Trillium Family Medicine starts with “the huddle.” Sole practitioner Dr. Mark McNeill, practice manager Jill LaBelle, and medical assistant Tammy Jessup gather to plan and prioritize for the day. Trillium is one of a number of independent small practices in WNC that are successfully challenging conventional thinking about the capacity of small practices to be financially stable while growing and delivering quality care in a cost-efficient manner.
Dr. McNeill’s goal was to establish a low-overhead model right here in WNC using technology as his key tool.
Why Trillium? Why Now? Dr. McNeill lives by the credo “Think out of the box and embrace change.” Dr. McNeill’s journey began when he worked in New Zealand in their healthcare system, where average overhead is significantly lower than in the United States. In the family medicine practices where Dr. McNeill worked thereafter, he “The key is to train patients to became an “electronic czar,” enjoying the EHR experience, becoming known as the “Agent of use a web-based patient Change.” These experiences evolved into the idea and model for his “perfect practice.” His portal as their primary form goal was to establish a low-overhead model right here in WNC, using technology as his key of communication instead tool. of the telephone. “ McNeill starts by saying, “The days of running a practice as in the past are long gone. I sought -S. Mark McNeill, MD to create a low overhead office using the technology available. The key is to train patients to use a web-based patient portal as their primary form of communication instead of the telephone. The patient portal is the pivotal component. It is a customized/modified version of E-Clinical Works – a product that suited my needs.” (Continued on page 15)
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(Continued from page 14) Trillium’s Mission Trillium Family Medicine is committed to providing compassionate, patient-centered, high-quality care that is available to patients from children through adulthood. Through efficient use of office staff and information technology, they believe that they are able to offer exceptionally accessible and personal care in a comfortable atmosphere. A technology-based A technology-based practice means patient-centered workflow with less staff and with greater practice means patientefficiency. Dr. McNeill finds that the accessibility created by the use of the patient portal significantly reduces patient anxiety and improves the doctor-patient relationship. Precentered workflow with appointment interviews are done via the web patient portal. The staff reviews patient less staff and with information ahead of time, which saves documentation time; since the online documents are tied greater efficiency. to the EHR, the practice achieves great time savings and efficiency. Because most of the patient’s health data is collected via the portal, during the actual patient appointment Dr. McNeill spends most of his time talking directly with the patient, making eye contact, and strengthening the physician-patient relationship, instead of entering data in the exam room. The Patient Portal- Access is the Answer Patients may login 24/7 to schedule their own appointment at their convenience. “Patients are “70% of our patients use trained on the portal at their first visit and encouraged to use it. 70% of our patients use the patient the patient portal for portal for scheduling appointments and information uploads. This number continues to grow. This scheduling appointments approach appeals to the younger generations as well as older patients so inclined to use and information uploads. “ technology,” says Dr. McNeill. Dr. McNeill and his staff at Trillium Family Medicine highly value accessibility. McNeill continues, “We have an ‘open access’ schedule which is different than -S. Mark McNeill, MD most practices in the area. This means we do not fill up the schedule weeks ahead of time like most practices. We make sure that there are same day and next day appointments available every day. Same day sick appointments will not be turned away. In addition to this you will always see your physician rather than being passed around to whichever doctor is available when you feel ill.” “Only needing to see 16 patients on average a day allows us greater flexibility in the schedule,” adds McNeill. “We encourage our patients to make their follow up appointments only a few days in advance to avoid having my scheduled booked out days or weeks. This eliminates no-shows considerably and the need for re-scheduling. With availability being one of our core values having a flexible open access schedule is crucial to what we are trying to create.” Use of the patient portal also allows patients unprecedented access 24/7 to their primary care physician. Dr. McNeill uses secured emails on the patient portal to communicate with his patients. He says that they love it because they get to hear from him directly rather than being passed through nurses and other personnel. He responds to all emails himself and finds it is not hard or time-consuming. The emails are checked early in the morning then every 2 hours throughout the day for a timely response. “By using the latest technology in the form of a secure patient portal, you can McNeill adds, “By using the latest technology in the form of a secure patient portal, get what you need quickly …” you can get what you need quickly by securely messaging me, including -S. Mark McNeill, MD prescription refill requests, lab requests and routine questions. During our business hours these messages are dealt with the same day and quickly. The portal also allows our patients to schedule their own appointments. This means no waiting for the office to open and waiting on hold.”
Others can follow such models successfully—it will be a victory for independent practices...
What does “growth” mean to Dr. McNeill? Growth occurs when 1) the Trillium mission is fulfilled for his patients 2) Trillium maintains its high-value level of service as the practice expands 3) in the future others can follow such models successfully—it will be a victory for independent practices to be able to not only survive but thrive in an era of healthcare reform. How is Trillium positioning itself to handle or manage various aspects of healthcare reform? Dr. McNeill answers by saying, “We know there will be a flood of people looking for doctors. (Continued on page 16)
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(Continued from page 15) Being able to do electronic visits through the portal will be crucial to accommodate the influx. Common issues - such as urinary tract infections, colds, and high blood pressure follow-up - can be ideal for electronic visits. Also, the type of care we give is the type of high value care that will be incentivized more in the future by both private and public payers.”
“We know there will be a flood of people looking for doctors. Being able to do electronic visits through the portal will be crucial to accommodate the influx. “
-S. Mark McNeill, MD Trillium is not a boutique practice; the practice takes Medicare and Medicaid patients. According to practice manager Jill Labelle, “All insurances that Dr. McNeill took at his previous practices he is taking now. Dr. McNeill provides care to the uninsured and participates in all of the insurances—both public and private—offered in the region. His payer mix is estimated as 35% Medicare/Medicaid, 5% uninsured and the rest private insurance.”
Who were helpful influencers in creating Trillium? McNeill credits some other national and local innovators with his success. “Dr. Steven Crane was a huge influence. Also, Dr. John Bachman at Mayo Clinic, Dr. Allen Wenner in Columbia, SC, former MAHEC colleague Dr. Betsey Sorenson, and East Asheville Family Health were extremely helpful and had good ideas.” We asked Dr. McNeill what advice he would give to other independent practices struggling to find ways not only to serve but thrive as healthcare reform takes hold. 1. Collaboration. The ideas are there. Good literature on the subject is available. “You do not need to re-invent the wheel.” 2. Use models of innovation. “I feel good knowing there are exciting options available… seek them out.” 3. Keep lean with low overhead. “This allows you more flexibility on how to run your office." 4. Embrace technology. “This is the key to maximizing efficiency, so build your processes around it.” 5. Think out of the box and embrace change. Trillium Family Medicine, PLLC S. Mark McNeill, MD 675 Biltmore Ave, Suite F Asheville, NC http://www.trilliumfamilymedicine.com 828-772-8673
Embrace technology. It is the key to maximizing efficiency.
Be sure to visit and contribute to the WCMS Cutting Edge Blog! We have launched a new strategic effort that highlights health innovations throughout the region via our new Cutting Edge blog. We will be featuring WNC physicians, practices and programs that are on the cutting edge of healthcare transformation, both big and small. WCMS supports local physician members who are change agents by recognizing them and sharing among other WCMS members and the general community information about these local innovations. Our first featured practice was Trillium Family Health, founded by Dr. Mark McNeill. Check out the Cutting Edge blog here.
S. Mark McNeill, MD
If you know of any physicians or practices that are stepping outside of the box, please contact Donna Wiedrich at donna@mywcms.org or Nancy Caine at nancy@mywcms.org and we will check it out.
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Public Health Corner
Jennifer Mullendore, MD Buncombe County Department of Public Health
Tdap Clinics for Rising 6th Graders in Buncombe County Per NC General Statute (130A-152) and Administrative Code [10A NCAC 41A .0401 (a) (1) (C)], all public school students entering the 6th grade who have had their last tetanus/diphtheria vaccine five or more years ago must have a booster dose of the Tdap vaccine before the first day of school.
At the start of the 2012-13 school year, 1373 or 59% of Buncombe County sixth-graders did not have their Tdap. Most of these students received their Tdap during the following 30 days, but this resulted in long lines and wait times at the BCHD Immunization Clinic as well as many phone calls and last minute visits to your offices.
Jennifer Mullendore, MD
Any student who has not provided written documentation of this booster dose of Tdap (or a valid medical or religious exemption to this vaccine) to their school within 30 days after enrollment in the 6th grade will be excluded from school until documentation is provided.
In an effort to make it easier for parents to meet this state requirement prior to the start of the school year, the Buncombe County Department of Health will be offering Tdap vaccines to all rising sixth-graders at each of the Asheville City and Buncombe County public schools and charter schools during April 2013. Unlike last year when these clinics were held in the evening, this year we will be administering the vaccines during the school day based on written parental consent. While we also would like to offer each of these students the recommended adolescent vaccines against meningococcal disease and human papillomavirus (HPV), issues with payment make provision of these vaccines in the school setting a bit more complicated. This year we will pilot offering the Tdap, meningococcal (Menactra) and HPV (Gardasil) vaccines in one charter school and one Asheville City school to determine whether this is something we could offer to all schools next year. The Buncombe County Department of Health strongly supports primary care and the patient-centered medical home. We know that the most important factor in a patient’s or a parent’s decision to immunize themselves or their child is a recommendation from their doctor. In our letter to parents about these clinics, we inform them that other vaccines are recommended for children at this age and that they may take their child to their private doctor for these vaccines if they prefer. However, we all know that preteens and teens often fail to see their primary care providers regularly. By providing these vaccines in the school, we are offering parents an easy way to make a healthy choice as well as meet a state requirement. If primary care providers do not want their patients to participate in these clinics, we are asking them to contact these patients in advance. If you have any questions or comments about our vaccination efforts, please contact me at Jennifer.Mullendore@buncombecounty.org or (828) 250-6308. Jennifer Mullendore, MD, MSPH Medical Director Buncombe County Department of Health
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Welcome New WCMS Members—Buncombe County Robbie Buechler, MD (Sleep Medicine) Dr. Buechler received his Medical Degree from Chicago Medical School. Dr. Buechler completed his internship and residency with Duke University Medical Center. He also completed a fellowship at The Mayo Clinic. Dr. Buechler is associated with Mountain Sleep.
Megan Daw, MD (Obstetrics/Gynecology) Dr. Daw received her Medical Degree from the University of North Carolina - Chapel Hill. Dr. Daw completed her internship and residency at University of California at San Francisco. She also completed a fellowship at Advocate Lutheran General Hospital. Dr. Daw is associated with Western Carolina Women's Specialty Center, PA.
Todd Hodges, MD (Family Medicine) Dr. Hodges received his Medical Degree from The Brody School of Medicine at East Carolina University. Dr. Hodges completed his internship at Wake Forest Baptist Medical Center Department of Family Medicine. Dr. Hodges is associated with The Family Health Centers.
Stephen Hoover, Jr., MD (Hand Surgery) Dr. Hoover received his Medical Degree from the University of North Carolina at Chapel Hill School of Medicine. Dr. Hoover completed his residency at UNC Memorial Hospital. He also completed a fellowship at Mary S. Stern Hand Fellowship. Dr. Hoover is associated with Carolina Hand & Sports Medicine.
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Renju Joseph, MD (Physical Medicine and Rehabilitation) Dr. Joseph received his Medical Degree from Ross University. Dr. Joseph completed his internship and residency at University of Cincinnati. Dr. Joseph is associated with Carolinas Center for Advanced Management of Pain.
Ellen Kaczmarek, MD (Geriatrics) Dr. Kaczmarek received her Medical Degree from SUNY Syracuse New York. Dr. Kaczmarek completed her internship and residency at Rochester General Hospital. Dr. Kaczmarek is associated with Mission Hospital Senior Services.
Nicole Groves, MD (Pediatrics) Dr. Groves received her Medical Degree from the University of Minnesota Medical School - Minneapolis. Dr. Groves completed her internship and residency with University of Minnesota. Dr. Groves is associated with Mission Children's Specialists.
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Welcome New WCMS Members—Buncombe County (Cont.) Leigh Anne Schwietz, MD (Allergy and Immunology) Dr. Schwietz received her Medical Degree from Virginia Commonwealth University School of Medicine. Dr. Schwietz completed her internship and residency at David Grant USAF Medical Center. She also completed a fellowship at Wilford Hall USAF Medical Center. Dr. Schwietz is associated with Allergy Partners.
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Emile Karl Ventre III, MD (Anesthesiology) Dr. Ventre received his Medical Degree from Louisiana State University Medical Center. Dr. Ventre completed his internship and residency at Lafayette Charity Hospital. He also completed his anesthesiology residency at Louisiana State University Hospital. Dr. Ventre is associated with Asheville Anesthesia Associates.
Welcome New WCMS Members—WNC Javid Baksh, DO (Anesthesiology) Dr. Baksh received his Medical Degree from the University of Medicine and Dentistry of New Jersey. Dr. Baksh completed his internship at Sisters of Charity and his residency at SUNY Buffalo. Dr. Baksh is associated with Swain Hospital Pain Management Clinic.
John Caldemeyer, MD (Diagnostic Radiology) Dr. Caldemeyer received his Medical Degree from Indiana University School of Medicine. Dr. Caldemeyer completed his residency at NC Baptist Hospital. Dr. Caldemeyer is associated with Hendersonville Radiological.
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Brie Folkner, MD (Family Medicine) Dr. Folkner received her Medical Degree from the University of Florida College of Medicine. Dr. Folkner completed her internship and residency at MAHEC Family Medicine. Dr. Folkner is associated with Chad Smoker, MD.
Aysha Inankur, MD (Internal Medicine - Endocrinology, Diabetes & Metabolism) Dr. Inankur received her Medical Degree from Loma Linda University School of Medicine. Dr. Inankur completed her internship and residency at Kettering Medical Center. Dr. Inankur is associated with Park Ridge Health Endocrinology.
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Zane Kalter, MD (Pediatrics) Dr. Kalter received his Medical Degree from New York University School of Medicine. Dr. Kalter completed his internship and residency at NYU - Bellevue Hospital Center. He also completed a residency at NYU - Bellevue Hospital Center. Dr. Kalter is associated with McDowell Pediatrics.
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Welcome New WCMS Members—WNC (Cont.) Photo not available
Gary Mauldin, MD (Anesthesiology) Dr. Mauldin received his Medical Degree from Medical College o Georgia. Dr. Mauldin completed his internship and residency at the University of Texas Medical Branch - Galveston. Dr. Mauldin is associated with Sylva Anesthesiology, PA.
Donna McGee, MD (Family Medicine) Dr. McGee received her Medical Degree from UNC Chapel Hill School of Medicine. Dr. McGee completed her internship at Spartanburg Regional Medical Center and residency at Family Medicine at Spartanburg Regional Medical System. Dr. McGee is associated with Park Ridge Medical Associates.
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Thomas McGee, Jr., MD (Dermatology) Dr. McGee received his Medical Degree from the University of Tennessee. Dr. McGee completed his internship and residency at Methodist Hospital, Memphis. He also completed a fellowship at Armed Forces Institute of Pathology. Dr. McGee is associated with McGee Dermatology Clinic.
Ananda Vieages, MD (Family Medicine) Dr. Vieages received her Medical Degree from The Brody School of Medicine at East Carolina University. Dr. Vieages completed her internship and residency at MAHEC Family Medicine. Dr. Vieages is associated with Family Medicine-Glenwood.
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Betsy Walker, MD (Hospice & Palliative Medicine) Dr. Walker received her Medical Degree from the Medical University of South Carolina. Dr. Walker completed her residency at Anderson Area Medical Center. Dr. Walker is associated with Four Seasons Compassion for Life.
Introducing the
Early Career Physicians’ Section of the WCMS The Early Career Physicians’ Section of the WCMS is our newest physician-led affinity group focusing on physicians within their first eight (8) years of professional practice after residency and fellowship training. The ECPS will consist of social and/or informational events giving physicians who are early in their career—many new to our region—an opportunity to meet, network, and lend support as they transition into practice.
Early Career Physicians’ Section of the
Ananda Vieages, MD, WCMS Board Member and 2011 MAHEC graduate, affiliated with Family Medicine of Glenwood will be helping to spearhead the ECP Section. If you are a WNC physician within your first eight years of practice, save the date, and come out and join your peers for a pint on May 16th at Highland Brewing Company at 6:00pm. More details and RSVP information coming soon. For questions or more information about the Early Career Physicians’ Section contact Nancy Caine, Member Services Coordinator, at 828-274-2267 ext. 310 or nancy@mywcms.org.
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Thursday, May 16th, 2013 6:00—8:00pm Highland Brewing Company Asheville, NC