ACMS June 2025 Bulletin

BULLETIN Allegheny County Medical Society

June 2025 / Vol. 115 No. 06

BULLETIN Allegheny County Medical Society

June 2025 / Vol. 115 No. 06

Opinion Editorial

• Summer Do Gooders Deval (Reshma) Paranjpe, MD, MBA, FACS

Society News ACMS News

• Nominate a Healthcare Hero for the 2025 ACMS Distinguished Awards

Articles Article

• We the Physicians...

Vint Blackburn, MD

Article

Editorial

Membership

• Q&A with Felicia Snead, MD, FASTRO

• Caffeine, Connection, and Conversation Melanie Mayer

Editorial

ACMS News

Materia medica

• Medial Malpractice 101 Richard H. Daffner, MD, FACR • Putting Physician Wellbeing First Sara Hussey, MBA, CAE

• Member Acknowledgements

ACMS News

• Call for Nominations

• Ensifentrine (OhtuvayreTM) Camryn Molnar, PharmD and Madeline Stanko, PharmD

Foundation News

• Supporting Infant Feeding Without Stigma Melanie Mayer

ACMS News

• Specialty Group Updates ACMS Staff: Nadine Popovich, Melanie Mayer and Haley Thon

Cover Photo by Terence Starz, MD Terence Starz, MD is a retired physician 2

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Bulletin Managing Editor Sara C. Hussey, MBA, CAE ACMS Executive Director shussey@acms.org Medical Editor Deval (Reshma) Paranjpe, MD reshma_paranjpe@hotmail.com

2025 Executive Committee and Board of Directors President Keith T. Kanel, MD President-elect Kirsten D. Lin, MD Secretary Richard B. Hoffmaster, MD Treasurer William F. Coppula, MD Board Chair Raymond E. Pontzer, MD

PAMED District Trustee James Latronica, DO, DFASAM

2025 Board Committees Bylaws Richard B. Hoffmaster, MD Finance William F. Coppula, MD Nominating Kirsten D. Lin, MD

Bulletin Designer Victoria Gricks

victoria@thecorcorancollective.com

2025 Bulletin Editorial Board Richard Daffner, MD, FACR Robert Howland, MD Anthony Kovatch, MD Charles E. Mount, MD, FAAD Alexandra Johnston, DO John P. Williams, MD

Women’s Committee Prerna Mewawalla, MD & Meilin Young, MD

Board of Directors Term Expires 2025 Anuradha Anand, MD Amber Elway, DO Mark A. Goodman, MD Elizabeth Ungerman, MD, MS Alexander Yu, MD Term Expires 2026 Michael M. Aziz, MD, MPH, FACOG Michael W. Best, MD Micah A. Jacobs, MD, FIDSA Kevin G. Kotar, DO Jody Leonardo, MD Term Expires 2027: David J. Deitrick, DO Sharon L. Goldstein, MD Prerna Mewawalla, MD Raymond J. Pan, MD Nicole F. Velez, MD

Administrative Staff Executive Director Sara Hussey shussey@acms.org Vice President - Member and Association Services Nadine M. Popovich npopovich@acms.org Manager - Member and Association Services Haley Thon hthon@acms.org

Operations Coordinator ACMS & ACMS Foundation Melanie Mayer mmayer@acms.org Manager - Operations and Finance Elizabeth Yurkovich eyurkovich@acms.org Bulletin Designer Victoria Gricks victoria@thecorcorancollective.com

EDITORIAL/ADVERTISING OFFICES: Bulletin of the Allegheny County Medical Society, 850 Ridge Avenue, Pittsburgh, PA 15212; (412) 321-5030; fax (412) 321-5323.

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The Bulletin of the Allegheny County Medical Society is presented as a report in accordance with ACMS Bylaws.

The Bulletin of the Allegheny County Medical Society welcomes contributions from readers, physicians, medical students, members of allied professions, spouses, etc. Items may be letters, informal clinical reports, editorials, or articles. Contributions are received with the understanding that they are not under simultaneous consideration by another publication.

Issued the third Saturday of each month. Deadline for submission of copy is the SECOND Monday preceding publication date.

Periodical postage paid at Pittsburgh, PA. Bulletin of the Allegheny County Medical Society reserves the right to edit all reader contributions for brevity, clarity and length as well as to reject any subject material submitted.

The opinions expressed in the Editorials and other opinion pieces are those of the writer and do not necessarily reflect the official policy of the Allegheny County Medical Society, the institution with which the author is affiliated, or the opinion of the Editorial Board. Advertisements do not imply sponsorship by or endorsement of the ACMS, except where noted.

Publisher reserves the right to exclude any advertisement which in its opinion does not conform to the standards of the publication. The acceptance of advertising in this publication in no way constitutes approval or endorsement of products or services by the Allegheny County Medical Society of any company or its products.

Annual subscriptions: $60 Advertising rates and information available by calling (412) 321-5030 or online at www.acms.org.

Improving Healthcare through Education, Service, and Physician Well-Being ACMS Bulletin / June 2025

COPYRIGHT 2025: ALLEGHENY COUNTY MEDICAL SOCIETY POSTMASTER—Send address changes to: Bulletin of the Allegheny County Medical Society, 850 Ridge Avenue, Pittsburgh, PA 15212.

ISSN: 0098-3772

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Editorial

Summer Do Gooders By: Deval (Reshma) Paranjpe, MD, MBA, FACS Have you been wondering what to do with your kids, tweens and teenagers now that they are home from school?

Some may be overscheduled already with summer jobs, summer camps and sports clinics, robotics and enrichment activities galore. Don’t you wish there were something fun that you could do together—character building activities that would simultaneously expose them to the wider world and its challenges, encourage their altruism and creative thinking, and allow you to feel good about giving back and being a role model to your children while doing something other than the practice of medicine?

Consider contacting one of these community service organizations which are always in need of volunteers to help with their mission. Minds and hearts are opened and shaped by learning about the struggles of others and attempting to improve the lives of others through service. Maybe it’s an afternoon; maybe a weekend. Maybe a week or an entire summer of hands-on, screen-free (or useful screen time only), purposedriven activity and good clean fun.

There’s a greater joy in helping others, and a greater gift in realizing that coming together and caring for each other can help distract you from your individual struggles.

If you are child-free, empty-nesting, semi-retired or retired, consider volunteering—it’s a great way to feel good, make friends and feel connected to your city and community.

Help support our community and get your kids involved! Here are some selected volunteer organizations which could always use more help:

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412 Food Rescue 6140 Station Street , Pittsburgh, PA 15206 https://412foodrescue.org/ 412.277.3831

Humane Animal Rescue 6926 Hamilton Avenue, Pittsburgh, PA 15208 https://humaneanimalrescue.org/ 412-345-7300

Animal Friends 562 Camp Horne Road, Pittsburgh, PA 15237 https://www.thinkingoutsidethecage.org/ 412.847.7000

Literacy Pittsburgh 411 Seventh Avenue Suite 525, Pittsburgh, PA 15219 http://literacypittsburgh.org/ 412.393.7600

Brother’s Brother Foundation 1200 Galveston Avenue, Pittsburgh, PA 15233 https://brothersbrother.org/ 412.321.3160

Little Sisters of the Poor 1028 Benton Avenue, Pittsburgh, PA https://www.littlesistersofthepoorpittsburgh.org/ 412.307.1100

Bushy Run Battlefield Historical Society 1253 Bushy Run Road, Jeannette, PA 15644 https://bushyrunbattlefield.com/ 724.527.5584

North Hills Community Outreach 1975 Ferguson Road, Pittsburgh, PA 15101 https://www.nhco.org/ 412.487.6316

Carnegie Library of Pittsburgh 4400 Forbes Avenue, Pittsburgh, PA 15213 https://www.carnegielibrary.org/ 412.622.3114

Pittsburgh Cares 1600 Marys Avenue, Pittsburgh, PA 15212 https://www.pittsburghcares.org/ 412.471.2114

Dress for Success 305 34th Street, Pittsburgh, PA 15201 https://pittsburgh.dressforsuccess.org/ 412.201.4204

PUMP 100 Ross Street, Pittsburgh, PA 15217 https://www.pump.org/ 412.338.2133

Family House 5308 Liberty Avenue, Pittsburgh, PA 15224 https://familyhouse.org/ 412.578.8650

Rainbow Kitchen 135 East 9th Avenue, Homestead, PA 15116 https://www.rainbowkitchen.org/ 412.464.1892

Girl Scouts of Western PA 503 Martindale Street, Suite 500, Pittsburgh, PA 15212 https://www.gswpa.org/ 1.800.248.3355

Reading Ready Pittsburgh 1705 Maple Street, Homestead, PA 15116 https://www.readingreadypittsburgh.org/ 412.352.7488

Global Links 700 Trumball Drive, Pittsburgh, PA 15205 https://globallinks.org/ 412.361.3424

Sojourner House 5460 Penn Avenue, Pittsburgh, PA https://www.sojournerhousepa.org/ 412.441.7783

Greater Pittsburgh Community Food Bank 1 N. Linden Street, Duquesne, PA 15110 https://pittsburghfoodbank.org/ 412.745.7600

The Blessing Board 880 Butler Street, Pittsburgh, PA 15223 https://theblessingboard.org/ 412.607.0202

Gwen’s Girls 711 West Commons, Third Floor, Pittsburgh, PA 15212 https://gwensgirls.org/ 412.904.4239

Vitalant 429 Fourth Avenue, Pittsburgh, PA 15219 https://vitalant.org/ 877.258.4825

Habitat for Humanity of Greater Pittsburgh 6435 Frankstown Avenue, Suite 100, Pittsburgh, PA 15206 https://www.habitatpittsburgh.org/ 412.450.8520

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ACMS Bulletin / June 2025

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Article

Nominate a Healthcare Hero for the 2025 ACMS Distinguished Awards After a remarkable return in 2024, the Allegheny County Medical Society (ACMS) Distinguished Awards continue in 2025 to honor outstanding contributions in the field of healthcare.

Nominations are now open and will be accepted through July 25, 2025. Honorees will be recognized at the ACMS Annual Meeting and Distinguished Awards Reception on Thursday, November 13, 2025, at the PNC Champions Club at Acrisure Stadium.

These awards celebrate excellence in both clinical practice and community impact, recognizing physicians and non-physicians alike who exemplify the highest ideals of service, leadership, and compassion in medicine. We invite ACMS members to nominate deserving colleagues, organizations, and community partners using the online nomination form at www.acms.org/ membership/distinguished-awards/.

Award Categories The ACMS Distinguished Awards are divided into two main categories: Community Awards – The Benjamin Rush Awards These honors recognize the vital role of non-physician individuals and organizations in advancing public health and supporting community well-being: • Benjamin Rush Individual Award – Celebrates a non-physician who has significantly contributed to the health of the community. 2024 Honoree: Dr. Robert Mendicino (DPM) recognized for his national leadership in wound care and surgical education.

• Benjamin Rush Community Organization Award – Recognizes

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an organization addressing critical community health issues. 2024 Honoree: Familylinks, for over 65 years of essential services in mental health, housing, substance use treatment, and senior care across Western Pennsylvania.

Physician Awards • Nathaniel Bedford Primary Care Award – Honors a primary care physician who demonstrates extraordinary commitment to holistic, patient-centered care.

2024 Honoree: Dr. Jodie Bryk, for her visionary work with the UPMC Enhanced Care Program serving Allegheny County’s most vulnerable patients.

• Ralph C. Wilde Leadership Award – Recognizes exceptional physician leadership in clinical care, education, and professional service. 2024 Honoree: Dr. Darrell Triulzi, for his national leadership in transfusion medicine and contributions to research, education, and patient safety.

• Richard E. Deitrick Humanity in Medicine Award – Celebrates physicians who embody compassion, respect, and integrity in their care for patients. 2024 Honorees: Dr. Thuy Bui and Dr. Julie Childers, for their lifelong advocacy and service to underserved, immigrant, and vulnerable patient populations in Pittsburgh and globally.

In addition, the Spirit of Service Award was presented in 2024 to Dr. Bruce MacLeod in recognition of his extraordinary dedication to public service and physician advocacy.

The Distinguished Awards honor the best in medicine—not just in clinical practice but in heart, leadership, and service. Please take a few moments to reflect on those in your professional or community circles whose contributions deserve to be recognized in 2025.

Questions? Contact Nadine Popovich at npopovich@acms.org. https://www.acms.org/acmsdistinguished-awards-program-2025/

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ACMS Bulletin / June 2025

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Article

We the Physicians...

A preview of the 2025 Delegation By: Vint Blackburn, MD One of the things that I have enjoyed the most in working as a delegate for the Allegheny County Medical Society has been the sense of camaraderie, a feeling that we are all working toward the same purpose. I was actually surprised to find out that this is not necessarily the case throughout the various county medical societies.

For the last two years, we have been meeting well in advance of the House of Delegates to discuss how we feel about upcoming resolutions, go over resolutions we might want to propose, and see if there is a consensus among our members. This has always allowed me, as a voting delegate, to feel like I was really supporting the society.

While we do not always agree at these meetings, and there is some very spirited conversation, we almost always come to a consensus, or at least a better understanding of the general mood of our community. I have felt that being a part of these meetings has been critical for my role as a delegate.

It was not until I began to see the recognition that the Allegheny County Medical Society has gotten from the delegations at large that I realized this is not the norm, and it has allowed me to appreciate how unique and powerful getting together has been.

This year is absolutely no exception, and if anything, we are even more committed to hearing the broad spectrum of voices that represent our very diverse county. On May 19, we met for the first time as a delegation and, as always, had open and interesting discussions about the proposals coming down the pike. However, beyond looking at resolutions from

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other delegates and members, we also discussed several things that we felt were important enough for our society to consider proposing ourselves.

While each individual delegate is not obligated to—or pressured to—vote as a caucusing group, it is nice to know when most everybody is on a similar page. Together, we speak with a much more powerful voice, and knowing that we are approaching topics as a group is not only reassuring but empowering.

The following resolutions are ones that we discussed at our last meeting and will likely be drafting for submission. The first was a resolution that medical professionals not be compelled to collaborate with immigration enforcement. It was discussed that, as physicians, our position is to help everyone without consideration of status. Everyone seemed to be quite passionate and committed to this autonomy. Another important concern was the disparity between gynecological and urologic surgeries. As is often the case, there seem to be unfortunate biases and impairments that tend to lead to significant differences in how male and female medical treatments are approached and reimbursed. We felt that in the 21st century, there is no place for this kind of bias, and achieving parity should be an important stance taken by medical professionals.

Another resolution would seek better discussion and approaches to screen time usage, especially among children and adolescents. This is not new to the House of Delegates, but due to a lot of complexity, there has been some struggle in coming up with

helpful advice and approaches. As a child psychiatrist, I am all too aware of the damage that we are seeing from excessive, unfiltered exposure to the Internet—not to mention the endless list of digital entertainment that can occupy valuable time. I’m also aware of how much our current digital natives (those born late enough to never have known a pre-Internet world) rely on it. This is one of the reasons why this very complicated subject should be of great interest to us as practitioners.

Much like the other proposals, it is not a problem that is going to be solved by one specialty or one doctor, and this is one of the reasons why input from members is so beneficial as we prepare these resolutions.

Another important topic that was suggested for a resolution was addressing state-imposed barriers to women’s healthcare. As we all know, this can take many forms, but we felt that it is important that, as practitioners, we have a significant voice in this medical issue. Along the same vein—especially in light of strong concerns that medical professionals are being sidelined in critical medical policy—we are proposing a resolution that would allow minors the right to receive vaccinations without parental consent, much as we already do for psychiatric medications and those involving reproductive choices.

And finally, although a perennial issue, the strong concern expressed by all of us at the meeting regarding access to healthcare has led us to believe that we need to continue to advocate for options such as expanded Medicare.

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Article As always, none of these proposals are without their complexity or controversy. This is one of the reasons why having a consensus makes it so empowering when we go to the House of Delegates. We all know that it is impossible to please all the people all the time—and that you cannot please some of the people any time—but the goal is for the majority of us to come together and fight for causes that are important to us as physicians. This is one of the reasons why I find these early meetings to be so crucial. It is also what makes me feel like we, as the Allegheny County Medical Society, are a cohesive group.

Another thing that was obvious with this group is how much we want to work together. To this end, we would really like to reach out to anyone who wants to draft a resolution but may be overwhelmed by the process, and

to let them know that there are many of us who are willing to help. I would encourage any of our members to talk to other members, including their delegates, about their passions and ideas. I plan on helping contribute to at least one of the above-mentioned resolutions, and it is comforting to know that I’m not doing it by myself.

Everybody who is a member of the Allegheny County Medical Society should remember that we are just that—a society. When I was the Assistant Medical Director of the Resolve Crisis Center, my boss, Dr. Rozel, had a saying that he was very fond of and that very well represented the ethos: “Never worry alone.” I think this is a powerful sentiment, and I also think that if you feel strongly about something, there are many others out there who agree.

Having these meetings in advance

of the General House reminds me that we are a delegation. Spirited debate and constructive criticism only make resolutions stronger and—as someone who has now been to three House of Delegates meetings—this is much more effective in advance than making last-minute arguments on the floor. I would certainly encourage everyone in the society to reach out and engage in the process. If there are any questions, I know that Dr. Michael Aziz, the 2025 Chair of the ACMS Delegation, and I are more than willing to help answer questions or just discuss the process.

Healthcare is a complicated beast— unfortunately often legislated by wellmeaning but non-medical individuals who rely on us to give them our voice.

After all, isn’t that why we are a part of the Allegheny County Medical Society in the first place?

Resolutions are due July 1, 2025.

ACMS Bulletin / June 2025

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QA Membership

Dr. Felicia Snead is a board-certified radiation oncologist with over 20 years of experience in medical practice and clinical research. She currently serves as Medical Director and Clinical Associate Professor of Radiation Oncology at Saint Clair Health, affiliated with UPMC Hillman Cancer Center in Pittsburgh, PA. In 2020, she was honored as a Fellow of the American Society for Radiation Oncology (ASTRO).

Dr. Snead is an active member of the Gateway Medical Society and has been nominated to serve as its next VicePresident. In addition to her medical career, she is a passionate advocate for the arts. She co-founded Atypical Arts, LLC, a creative production company supporting culturally diverse artistic programming, and later launched Feel Well Arts, a program

Felicia Snead, MD, FASTRO

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WITH FELICIA SNEAD, MD, FASTRO

dedicated to integrating the arts into healthcare settings to enhance healing and wellbeing for both patients and providers.

After completing a graduate certificate in Arts in Healthcare from the University of Florida in 2019, Dr. Snead began focusing her efforts on advancing arts-in-health research and programming. Her future goals include transitioning from clinical practice into arts and health administration and research, with a particular interest in music as medicine. She is actively seeking postdoctoral opportunities to further this work and elevate the role of the arts in healthcare. Her future goals include incorporating arts and health administration and research, into clinical practice.

Q: CAN YOU SHARE A LITTLE ABOUT YOUR BACKGROUND AND WHAT LED YOU TO A CAREER IN MEDICINE? A: As a New York City high school student, I enjoyed and was a strong science and math student with little insight into a future in medicine. After completing training and employment as a board-certified radiation oncology technologist at Memorial Sloan Kettering Cancer Center, I found a calling to medicine. While continuing to work as an radiation oncology technologist, I completed a BS degree in Radiological Health Physics. I then applied to and entered medical school

at Albert Einstein College of Medicine of Yeshiva University, followed by a Radiation Oncology residency at New York Presbyterian Hospital, ColumbiaPresbyterian Medical Center.

Q: WHAT INSPIRED YOU TO PURSUE YOUR CURRENT SPECIALTY? A: Radiation Oncology is unique as a medicine that treats all organ systems.

It is challenging, as it requires in-depth knowledge of many organ systems in the settings of cancer, radiation, as well as systemic therapies. This requires a lifelong learning approach, which never gets boring. Being able to care for others with high quality and compassion, as if they were my own family, is an indescribable reward.

Q: CAN YOU TELL US ABOUT YOUR CURRENT ROLE AND WHAT A TYPICAL WORKDAY OR WEEK LOOKS LIKE FOR YOU? A: My current clinical practice is community-based with active academic participation at the only National Cancer Institute (NCI)-designated comprehensive cancer center in Western PA. I work alongside one fulltime and one part-time clinical partner, managing and treating approximately 30 to 40 patients daily. Workdays begin early and are long, but they follow a Monday-to-Friday schedule with a reasonable regional on-call rotation.

Often, my weekends and evening hours

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Membership Although medical history is filled with practices that have not been ethical, fair, or respectful, seeing decades of internationally proven standards be abandoned based on unvetted resources—not data—is truly disheartening.

Dr. Snead with a linear accelerator acknowledging “Women that Curie” campaign

are spent supporting my personal passions for art, music, advocacy, and time with family and friends.

Q: HOW DID YOU FIRST GET INVOLVED WITH THE ALLEGHENY COUNTY MEDICAL SOCIETY OR WHAT HAS YOUR OVERALL ENGAGEMENT BEEN WITH THE ACMS? A: I joined PAMED/ACMS in 2022.

My involvement has been slow, but I look forward to the monthly ACMS Bulletin to learn about the interests and achievements of my regional medical colleagues. It also keeps me informed of important local trends, legislation, and practice developments.

I feel connected to my professional community. Given my personal interest and experience in art in healthcare—as a powerful tool to achieve and maintain wellbeing—the ACMS Physician Wellness Program is of particular interest to me.

Q: ARE THERE ANY ACMS INITIATIVES (OR PAMED INITIATIVES) OR EVENTS THAT YOU ARE PARTICULARLY PASSIONATE ABOUT? A: The legal resources of PAMED are very helpful. I am currently interested in the ACMS Physician Wellness Program.

Q: WHAT DO YOU THINK IS THE BIGGEST CHALLENGE FACING HEALTHCARE TODAY? A: I think the biggest challenge in healthcare today is the increased access to misinformation, which directly exacerbates medical mistrust.

ACMS Bulletin / June 2025

Q: HOW DO YOU SEE THE HEALTHCARE FIELD EVOLVING IN THE NEXT 5-10 YEARS? A: I’m not quite sure. The healthcare field must work harder than ever to dispute misinformation and mistrust.

This is more than challenging in the setting of declining resources and rising healthcare costs. This makes health advocacy and creative innovation more important than ever. I’m hopeful that art in healthcare, which has been an integral part of care in other countries, may be an effective tool.

Q: WHAT ADVICE WOULD YOU GIVE TO MEDICAL STUDENTS OR EARLYCAREER PHYSICIANS? A: I would encourage upcoming medical providers to never lose the passion for helping and working with others. Take care of yourself first to ensure the capacity to care for others.

Building and maintaining a network of colleagues, supporters, mentors, and mentees is important and will help in ways you may not see initially. Stay connected with family and friends.

my furry companion Oscar is key to my balance. Oscar is a 9-year-old, 12-pound rescue dog adopted by my family seven years ago. Having a very communicative “barker” as a companion keeps me on schedule and reminds me that I’m also needed elsewhere. I love my family and friends, giving priority to fellowship and community. To stay healthy myself, I try to do regular swimming, get good rest, and healthy dietary habits are a must.

Q: WHAT IS ONE SENTIMENT YOU'D LIKE TO SHARE WITH YOUR FELLOW ACMS MEMBERS? A: As stated, misinformation is a serious threat to quality healthcare.

Organizations like ACMS can help counteract this threat through active, effective, and robust membership participation. Strong, engaged members are needed more than ever, so please get—and stay—involved in whatever capacity you can.

Q: HOW CAN FELLOW ACMS MEMBERS CONNECT WITH YOU OR SUPPORT YOUR WORK? A: I'm available on LinkedIn and in the directories for PAMED/ACMS, the Gateway Medical Society, the American Society of Radiation Oncology (ASTRO), and UPMC Hillman Cancer Center.

Q: OUTSIDE OF MEDICINE, WHAT ARE YOUR HOBBIES OR INTERESTS? A: Outside of medicine, I’m a wellrounded artist. I am a vocalist and musician, currently studying piano. As a dedicated arts patron, I have served on multiple arts organization boards of directors, including the August Wilson African American Cultural Center and Alumni Theater. Musical theater is my favorite, along with gardening, travel, and visiting museums.

Q: HOW DO YOU MAINTAIN WORKLIFE BALANCE? A: As an empty nester with a rising senior college student out of state,

"I’m Fine” Project featured at Hillman Library and Susquehanna Art Museum 2024

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Editorial

Medical Malpractice 101: A Primer Part VI: A Time to Settle

By: Richard H. Daffner, MD, FACR “There is a time for everything, and a season for every activity under the heavens.”

Ecclesiastes 3:1 Previous articles in this series have discussed the many facets of medical malpractice suits1-5. Statistically, 60% of suits that are filed are either withdrawn or are dismissed; 35% are settled out of court through arbitration; and the remaining 5% that do go to trial end with a jury verdict in favor of the plaintiff. So, when is it prudent to settle? In my experience there are three situations that warrant consideration for settlement: 1) the injury to the plaintiff is egregious; 2) the case is winnable for the defense on facts, but the outcome is so bad, a jury will have sympathy with the plaintiff regardless of those facts; and 3) a token payment is offered to make the case go away. I have consulted as an expert witness in all three situations.

Situation 1. Egregious injury In my more than 35 years of doing medicolegal consulting I have encountered several cases where there was clear-cut failure by the defendant(s) to perform accord to the Standard of Care and the injury (or death) that resulted was egregious, In each instance I told the attorney(s), “You can’t defend this. Don’t waste your time or resources (don’t throw good money after bad).” A good example is shown in figure 1, an abdominal radiograph that shows a surgical instrument left in a patient.

Situation 2. No malpractice but bad outcome Sometimes, despite the best

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Fig. 1. Forceps left in a patient. The surgeon told the scrub nurse, “The instrument count by me is correct. End of discussion.”

intentions of medical practitioners, there is a complication resulting in a very bad outcome. The following case is illustrative: A 66-year-old man underwent a total hip replacement. Unfortunately, the incision site became infected with methicillin-resistant Staphylococcus aureus (MRSA). He underwent one month of intravenous antibiotic treatment, which successfully eradicated the pathogen from the incision and the patient’s bloodstream.

He was sent to a rehabilitation facility, where he later complained to the “house doctor” of upper back pain.

The attending physician ordered a CT examination of the patient’s thoracic spine. The requisition listed the indication as, “Back pain. R/O fracture”. The radiologist reported an osteoporotic compression fracture

of T6 and importantly, noted that the vertebral end plates were intact.

The patient was treated with pain medication and a back brace. One month later, the patient became paraplegic. A repeat CT scan showed further collapse of T6 accompanied by destruction of the body and the vertebral end plates suggesting osteomyelitis. Subsequent MRI exam showed an epidural abscess compressing the spinal cord. At surgery, the site was found to be infected with MRSA. The patient sued the hospital, the radiologist, and the orthopedic surgeon.

The defense team for all parties hired a nationally known infectious disease expert, who, in his deposition stated, “Although the infection had been clinically cleared, a few ‘bugs’ remained in the patient’s blood stream.

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The plaintiff suffered an osteoporotic compression fracture, which with the subsequent hyperemia became a ‘sump’ that attracted the few remaining bacteria still within the patient’s bloodstream.” The other defense expert witnesses found no evidence of breach of standard for any of the defendants.

However, because of the paraplegia, the defense team agreed to a settlement rather than to allow a jury to see the now paralyzed plaintiff.

Situation 3. Token payment Medical malpractice cases are expensive for both sides. The costs for court filings, document production, hiring of expert witnesses, etc average between $100,000 and $150,000 for the plaintiff’s side and between $150,000 and $200,000 for the defense to take a case through a trial. If the verdict is appealed additional costs may be as high as $50,000. The plaintiff’s attorneys work on a “Contingency System”, whereby their reimbursement is not guaranteed unless they win.

This is their justification for taking 25 – 40% of any awards. The defense attorneys have their fees “guaranteed” by the liability insurance carrier, the amount dependent on the complexity of the case. It is for these reasons that an offer to settle may be tendered by either side. The principle behind the decision to settle is to reduce the costs by not proceeding with a trial. In a way, tort litigation resembles a poker game in which the stakes are considerably higher. And so, like a poker game, if one side doesn’t have the right cards, they “fold” (not throwing good money after bad).

The following case is illustrative. A 105-year-old woman died while a patient in a nursing home. Several months before her demise she had sustained several falls, none of which resulted in any fractures, as documented by x-rays. At the time of her death, she had several bruises on her upper and lower limbs. The family brought a suit against the nursing home, alleging elder abuse. I was hired by the defense to review her radiographs and confirmed

ACMS Bulletin / June 2025

that there were no fractures present in her osteoporotic bones. I suggested to the defense attorney that he could probably settle this case with an offer of $20,000. When he asked me why, I told him that the woman had outlived the average life-expectancy, was not a wage earner, and that I thought that the cost of a funeral in this area was around $20,000. A month later, the attorney called me and said, “You were right.

We settled for $14,000, the funeral expenses”.

There may be some reluctance on the part of defendant physicians to settle because of the National Practitioner Data Bank (NPDB), a web-based repository of reports on medical malpractice payments as well as adverse actions, such as license suspensions related to health care providers. The NPDB was established by Congress in 1986 to prevent practitioners from moving from state to state without disclosure or discovery of evidence of previous substandard performance. More than 24,000 entities interact with the NPDB including hospitals, state licensing boards, and medical malpractice insurers. All states are required to notify the NPDB of any payments made stemming from a malpractice suit.

Token payments, which are generally small, usually do not adversely affect a practitioner’s reputation, because they are recognized for what they are.

Conversely, large payments ($300,000+) indicate that the suit was not frivolous.

Dr. Daffner is a retired radiologist, who was an Expert Witness legal consultant for over 35 years.

References: 1. Daffner RH. Medical Malpractice 101: A primer. ACMS Bulletin Jun 2019, pp 164 – 167.

2. Daffner RH. Medical Malpractice 101: A primer Part II: The road to the courtroom. ACMS Bulletin Jul 2019, pp 204 – 207.

3. Daffner RH. Medical Malpractice 101: A primer: Part III: Elements of a malpractice suit. ACMS Bulletin Aug 2019, pp 242 – 245.

4. Daffner RH. Medical Malpractice 101: A primer: Part IV: The expert witness.

ACMS Bulletin Sep 2019, pp 286 – 290.

5. Daffner RH. Medical Malpractice 101: A primer: Part V: Communications and incidental findings. ACMS Bulletin May 2023, pp 12 – 14.

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Article

Caffeine, Connection, and Conversation

Celebrating Mental Health Awareness Month By: Mel Mayer – Operations Coordinator, ACMS & ACMS Foundation In honor of Mental Health Awareness Month in May, the Allegheny County Medical Society (ACMS) brought a mobile dose of connection and care to physicians across the region, one cup of coffee at a time.

The ACMS Coffee Truck Tour, courtesy of Urban Trail Coffee, rolled into multiple healthcare campuses over several days, offering free coffee, friendly conversation, and wellness resources to physicians and medical staff. The initiative was designed to promote the ACMS Physician Wellness Program (PWP), a confidential counseling service tailored specifically for physicians and residents in Allegheny County.

“We know how hard it can be for physicians to pause and prioritize their own well-being,” said ACMS Executive Director Sara Hussey. “This was our way of meeting them where they are, literally, and reminding them that support is available, stigma-free.”

The coffee truck stops created a relaxed atmosphere where physicians could take a moment for themselves, chat with ACMS staff, and learn more about the PWP. As a reminder, the PWP offers up to four free counseling sessions per year with vetted mental health providers experienced in addressing issues like burnout, imposter syndrome, and depression.

Importantly, the service is completely confidential, no insurance billing, no medical records, and no employer notification.

The response was overwhelmingly positive. Physicians expressed appreciation for the thoughtful gesture and the opportunity to engage in

ACMS Bulletin / June 2025

conversations about mental health in a non-clinical setting. Many took the time to learn more about the PWP and how it could benefit them or their colleagues.

This initiative is part of ACMS’s broader commitment to supporting physician well-being. By bringing resources directly to healthcare providers, ACMS aims to foster a culture where seeking help is seen as a

strength, not a weakness.

For more information about the ACMS Physician Wellness Program, including how to schedule a confidential appointment, visit www.acms.org/ physicianwellness.

To see highlights from the Coffee Truck Tour, check out the ACMS Social Media channels!

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Society News

Congratulations to Allegheny County's 2025 PAMED Top Physicians Under 40!

We are proud to recognize several outstanding early-career physicians from Allegheny County who have been named among the Pennsylvania Medical Society’s 2025 Top Physicians Under 40. This statewide honor celebrates young physician leaders who are making a significant impact on the future of medicine through clinical excellence, advocacy, innovation, and community service.

Please join us in congratulating our local awardees on this well-deserved recognition!

Jocelyn Fitzgerald, MD

Juan Giugale, MD

Matthew Simpson, MD

Lauren Mathos, DO, FACP

Alexander Whiting, MD

Nabeeha Mohy-ud-din, MD

Andrew Williams, MD

The PAMED Top Physicians Under 40 will be acknowledged by PAMED at a ceremony on September 27 at DiSalvo’s Station in Latrobe. The ACMS will acknowledge the recipients at the ACMS Distinguished Awards Event on November 13 at the PNC Champions Club at Acrisure Stadium.

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Society News

Call For Nominations 2026 Leadership Positions www.acms.org/nominations/ Join the Board of Directors & ACMS House of Delegates! Nominations are due by: July 15, 2025.

Join the ACMS Delegation to the PA Medical Society House of Delegates on October 22 - 25, 2026.

Take Your Career to the Next Level

Why Become a Delegate?

The ACMS Nominating Committee is thrilled to announce six exciting opportunities to join the 2026 Board of Directors! We’re looking for enthusiastic, forward-thinking members to fill (5) three-year term seats.

• Make a Difference: Play a key role in shaping policies that affect the medical community.

• Grow Your Network: Meet and collaborate with peers and leaders in the field.

• Boost Your Career: Enhance your resume and gain valuable experience in governance.

Why Join the Board?

• Influence and Impact: Shape the future of healthcare and make your voice heard in crucial decisions.

• Networking: Connect with leading professionals and create invaluable relationships.

• Professional Development: Gain leadership experience and new skills that will propel your career forward.

• Personal Fulfillment: Make a difference in your community and be part of something bigger.

Key Details: • Delegates: Serve for two years (up to three consecutive terms).

• Alternate Delegates: Serve for one year with unlimited consecutive terms.

• Attendance: In-person participation is highly encouraged to make the most of this experience.

How to Nominate: Key Details: • Meetings: Four times a year (quarterly) with a preference for in-person attendance.

• Special Meetings: Occasionally, extra meetings may arise, adding a dynamic twist to your role.

• Eligibility: Open to all ACMS physician members in good standing.

ACMS Bulletin / June 2025

To nominate yourself or a colleague, use our easy online submission portal by visiting www. acms.org/nominations/. For any questions, reach out to ACMS Executive Director, Sara Hussey at shussey@acms.org or Kirsten D. Lin, MD – Nominating Committee Chair and ACMS President-Elect kdlin8@gmail.com.

Don’t miss this chance to elevate your career and contribute to the medical community in a meaningful way. Step up and make a difference.

This next seat could be yours!

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Foundation News

Supporting Infant Feeding Without Stigma

The Launch of the Infant Feeding Collaborative By: Mel Mayer – Operations Coordinator, ACMS & ACMS Foundation On May 15, I attended the launch of the Infant Feeding Collaborative, a new initiative led by Beverly’s PGH to address a critical but often overlooked piece of maternal and child health: how, and whether, families are supported in feeding their babies.

The concept is simple—make sure babies get fed, and make sure families feel supported in whatever feeding journey they choose. But in practice, that support is often fragmented or conditional.

According to the CDC, while 83% of U.S. babies begin breastfeeding, only 25% are exclusively breastfed at six months. Many parents turn to combination feeding or formula—often not by choice, but by necessity. A 2023 HHS study found that 60% of parents don’t breastfeed as long as they intended, citing barriers such as low milk supply, mental health challenges, return-to-work demands, and a lack of support or education.

Programs like WIC and services like lactation consulting play a vital role, yet participation in WIC remains underutilized, especially in Pennsylvania. At the same time, disparities in birth outcomes—such as higher preterm birth rates among Black mothers—underscore the need for equitable and nonjudgmental support.

Beverly’s PGH, which operates Pennsylvania’s first public infant formula bank, is expanding its work through the Collaborative by bringing together hospitals, health plans, and community-based organizations to take a systems-level view. The initiative looks at access, stigma, equity, and public health data to build better

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outcomes from birth onward.

The launch event featured a strong cross-sector panel: • Dr. Marcia Klein-Patel: System Chair, Women's Institute Allegheny Health Network • Amy Shannon: Director of SDOH Strategy and Operations, Highmark Health • Diana Byas: Manager, Maternity Care Management UPMC Health Plan • Dr. Patrick Tate: Pediatrician, UPMC Children's Community Pediatrics • Kate Brennan: Director of Operations, NurturePA Inc. • Renae Green: Lead Lactation Consultant, UPMC Magee-Womens Hospital • Jeaonna Hodges: Lead Doula, The Birth Circle of UPMC MageeWomens Hospital Their message was clear: parents need practical, nonjudgmental support.

“Fed is best” isn’t a fallback—it’s a comprehensive strategy to promote infant health, reduce stigma, and improve maternal well-being. The panel emphasized the need for culturally responsive care, access to lactation and formula resources, and better prenatal education.

Notably, Beverly’s PGH surveyed over 500 local families to inform this initiative. Their findings are a call to action: • Only 42% of those who planned to exclusively breastfeed were able to do so.

• Nearly 40% reported feeling judged for how they fed their baby.

• Families who accessed WIC,

formula banks, or lactation services reported greater confidence in their baby’s health and feeding choices.

As many of our ACMS members know firsthand—especially OB-GYNs, pediatricians, and maternal-child health professionals—conversations about infant feeding begin early and carry lasting emotional weight. Many of our women physicians also bring lived experience as new mothers navigating this complex space.

This is also a powerful example of community impact: Beverly’s PGH is a multi-year grantee of the ACMS Foundation. Their grassroots approach and ability to build trust within underserved populations align directly with the Foundation’s mission to support health equity and innovation.

As our medical society continues its work in advocacy, maternal mental health, and systems-level solutions, I encourage ACMS members to engage with efforts like this. Point families to resources like Beverly’s PGH. Partner with community orgs that break down stigma. And continue advocating for policies and systems that put support over shame.

The Infant Feeding Collaborative is more than a program—it’s a reminder that small, local steps can shift the culture and improve outcomes. Let’s keep connecting those dots.

To learn more about the Infant Feeding Collaborative visit: https:// www.beverlyspgh.org/ifc

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Editorial

Putting Physician Wellbeing First In Policy, Practice, and Culture

By: Sara Hussey, MBA, CAE – Executive Director of ACMS On June 10, USA Today published an op-ed by actor Noah Wyle, who played Dr. John Carter on ER and most recently appeared in The Pitt, a show that brings healthcare burnout to the forefront.

Wyle’s piece wasn’t just Hollywood storytelling, it was an emotional, unfiltered look at how real physicians suffer in silence, weighed down by the very system that once inspired them to serve. It was also a call to action: for healthcare institutions, licensing boards, and medical societies to dismantle the structures that penalize vulnerability and keep physicians from seeking help. I encourage you to take the time to read Wyle’s very poignant article.

READ THE ARTICLE

Here in Pennsylvania, we have an opportunity to answer that call.

The Allegheny County Medical Society (ACMS) joins the Pennsylvania Medical Society (PAMED) in celebrating the recent national recognition of the Pennsylvania State Boards of Medicine and Osteopathic Medicine as Wellbeing First Champions. This designation honors entities that have removed intrusive mental health questions from licensure and renewal forms; questions that, for too long, discouraged physicians from seeking care out of fear it could jeopardize their careers.

For years, physicians have faced a double bind: take care of yourself and

ACMS Bulletin / June 2025

Actor Noah Wyle plays Dr. Michael "Robby" Robinavitch in "The Pitt"

risk losing your license, or stay quiet and risk everything else. The former licensure language - ambiguous, invasive, and stigmatizing - contributed directly to burnout, moral injury, and worsening mental health across the profession.

Now, Pennsylvania is one of a growing number of states setting a new precedent: physician wellbeing is not a liability. It’s a priority.

This shift is exactly the kind of systemic change we need to support wellness in a sustainable way—and it’s deeply aligned with our work at

ACMS. In 2024, we launched the ACMS Physician Wellness Program, providing free, confidential peer support sessions and mental health referrals for physicians across Allegheny County.

Since its inception, the program has served physicians at all stages of training and practice—those navigating burnout, those struggling in silence, and those simply needing someone to talk to outside of their health system.

But wellness can't begin and end with individual resilience. It must be reinforced by policy, by organizational culture, and by removing the fear and stigma around getting help.

The Wellbeing First recognition for Pennsylvania’s medical boards is more than a commendation—it’s a commitment. And at ACMS, we are proud to continue supporting that commitment through our advocacy, our programs, and our belief that physician health is patient health.

To our members: your wellbeing matters. Your care matters. And we’re here for you.

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Materia medica

Ensifentrine (Ohtuvayre™) By: Camryn Molnar, PharmD and Madeline Stanko, PharmD Background Ensifentrine is a selective dual phosphodiesterase (PDE) 3/4 inhibitor inhalation suspension that is FDA approved for maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults.1 PDE3 primarily hydrolyzes cAMP and is capable of hydrolyzing cGMP while PDE 4 only hydrolyzes cAMP. The inhibition of PDE3 and PDE4 leads to bronchodilation as well as anti-inflammatory effects.

This dual inhibitory mechanism has been shown to have enhanced effects on both contraction of smooth airway muscles and reducing inflammation in comparison to the inhibition of PDE3 or PDE4 alone. Prior to the approval of ensifentrine, the standards of care treatment for COPDs include inhaled short and long-acting bronchodilators such as tiotropium and salmeterol and inhaled corticosteroids such as budesonide and fluticasone.3 Ensifentrine can be administered as add on therapy to these agents for additional COPD management. Unlike other treatments for COPD, ensifentrine is a nebulization suspension administered twice daily.1,4 Safety The safety evaluation of ensifentrine was similar across both clinical trials for evaluation of treatment-emergent adverse events (TEAEs). The most commonly reported TEAEs were nasopharyngitis (13 [2.7%] ensifentrine vs. 16 [5.7%] placebo) and (9 [1.8%] ensifentrine vs. 3 [1.0%] placebo), hypertension (12 [2.5%] ensifentrine vs. 4 [1.4%] placebo) and 5 [1.0%] ensifentrine vs. 1[0.3%] placebo), and back pain (10 [2.1%] ensifentrine

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vs. 1 [0.4%] placebo) and (8 [1.6%] ensifentrine vs. 5 [1.7%] placebo) for ENHANCE-1 and ENHANCE-2, respectively. In the first clinical trial (ENHANCE-1), 38.4% of patients in the ensifentrine group and 36.4% of patients in the placebo group reported TEAEs. Serious TEAEs were reported in 6.7% of both groups. There were 18 (3.8%) ensifentrine-treated and 11 (3.9%) placebo-treated patients who discontinued treatment because of an adverse event. TEAEs leading to treatment withdrawal occurred in 6.1% of ensifentrine patients and 6.4% of patients taking the placebo.

Over 24-48 weeks, the adverse effect profile was similar to that observed in the first 24 weeks.2 Overall, statistical significance is lacking in the data set provided for safety outcomes. Both confidence intervals and p-values were not provided, so statistical significance cannot be confirmed.

In the second clinical trial (ENHANCE-2), TEAEs occurred in 35.3% and 35.4% of the ensifentrine group and placebo group, respectively. There were 24 (4.8%) ensifentrine-treated and 14 (4.8%) placebo-treated patients who discontinued treatment because of an adverse event. TEAEs leading to trial withdrawal occurred in 9.0% of ensifentrine-treated patients and 10.0% of placebo-treated patients with non-COVID-19 TEAEs leading to trial withdrawal occurring in a total of 3.7% of patients overall.2 In both trials, there were no statistically significant treatment group differences in safety laboratory tests, vital signs, or ECG parameters.2

Tolerability Ensifentrine has been shown to be a well-tolerated medication in clinical trials. The most common adverse event reported in two randomized, double-blind, parallel group, placebocontrolled trials were back pain. Back pain was collectively reported for 1.8% of patients in the treatment group compared to 1% in the placebo group.

Other adverse events reported among the two trials included hypertension, urinary tract infections, and diarrhea.1 Statistical significance cannot be confirmed.

Efficacy The efficacy of ensifentrine was studied in two replicate multicenter, randomized, double-blind, parallel group, placebo-controlled clinical trials. Both studies, ENHANCE-1 and ENHANCE-2, compared the efficacy of ensifentrine 3mg twice daily versus placebo via a standard jet nebulizer over 24 weeks for the treatment of patients with symptomatic, moderate to severe COPD. Jet nebulizers use compressed air to turn liquid medication into a fine mist that can be inhaled into the lungs and can be obtained at pharmacies by either prescription or over the counter in some instances. In addition to the 24-week timeframe in both trials, ENHANCE-1 also included a 48-week subset for further efficacy evaluation. The primary endpoint of both studies was change from baseline in average Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve Over 12 Hours (AUC0-12h) at Week 12.

Secondary endpoints included change from baseline FEV1 to peak FEV1 at Day 1 and Weeks 6, 12 and 24, change from

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Materia medica baseline to mean weekly Evaluating Respiratory Symptoms (ERS) total score at weeks 6, 12, and 24, and change from baseline in the St. George’s Respiratory Questionnaire (SGQR) score at weeks 6, 12, and 24.

The ENHANCE-1 trial included 760 randomized and treated patients, with 69% of patients on concomitant long-acting muscarinic antagonists or long-acting β2-antagonists.

Ensifentrine improved average FEV 1 area under the curve at 0-12 hours versus placebo 87 mL (95% CI 55, 119; P<0.001). Ensifentrine reduced the rate of moderate or severe exacerbations compared to placebo (rate ratio, 0.64 [0.40, 1.00]; P= 0.050) and increased time to first COPD exacerbation (hazard ratio, 0.62 [0.39, 0.97]; P= 0.038).

Ensifentrine also improved symptoms based on Evaluating Respiratory Symptoms (E-RS) and quality of life based on St. George’s Respiratory Questionnaire (E-RS, 21.0 [21.7, 20.2], P = 0.011; SGRQ, 22.3 [24.3, 20.3]; P = 0.025) Out of the 789 patients studied in the ENHANCE-2 trial, 55% of patients were concomitantly receiving long-acting muscarinic antagonists or long-acting β2-antagonists. Ensifentrine improved mean FEV 1 area under the curve at 0-12 hours versus placebo 94 mL (95% CI 65, 124; P<0.001). Ensifentrine reduced the rate of moderate or severe exacerbations versus placebo (rate ratio, 0.57 [0.38, 0.87]; P= 0.009). It also took longer for the first COPD exacerbation to occur. (hazard ratio, 0.58 [0.38, 0.87]; P= 0.009).

Ensifentrine did not improve symptoms and quality of life versus placebo at 24 weeks in ENHANCE-2.

Price The only FDA approved dose for ensifentrine is 3mg/2 mL. The treatment is priced at approximately $2,950 per month ($35,400 annually).5,6 There are currently no generic equivalents to Ohtuvayre™ on the market. The manufacturer of this medication, Verona Pharma, offers a program called Verona Pathway Plus Support Program which offers care

ACMS Bulletin / June 2025

coordination, reviews insurance costs and financial assistance options, and provides specialty pharmacy coordination.4 For comparison with first-line agents, the average wholesale price for Spiriva Respimat (tiotropium) 2.5cmg, a long-acting muscarinic antagonist, is $90 per month ($1,080 annually).7 The average wholesale price for the combination inhaler, Symbicort (budesonide/formoterol) 80-4.5 mcg, is $138 per month. Because this first-inclass inhaled therapy is used in addition to other treatments, it would be an additional cost to patients.8 Simplicity Ensifentrine is currently available as a 3mg/2.5 mL nebulization suspension packaged in ampules. This medication is intended for use twice a day (once in the morning and once in the evening), with each nebulization treatment lasting approximately 5-7 minutes.1 Because compatibly of this medication has not been established, it should not be physically mixed with other drugs or combined with solutions containing other drugs. There are no dose adjustments for patients with mild to moderate renal impairment, but there is no existing data for patients with severe renal impairment. Caution should be taken in patients with moderate to severe hepatic impairment. due to the increase in systemic exposure (2.3-fold) when compared to patients without hepatic impairment.1 Bottom Line Ensifentrine is a selective dual PDE3/4 inhibitor that has been proven to be an effective maintenance treatment for COPD, as it has shown significant improvement in bronchodilation as well as improvement in symptoms and quality of life and a clinically significant reduction in moderate to severe COPD exacerbations. The exact placed in therapy for this novel medication is unclear. The ENHANCE trials were not designed to assess the impact of ensifentrine in addition to existing combination bronchodilator or bronchodilator/inhaled corticosteroid therapies, thus making it difficult to

place the medication in the GOLD guideline treatment algorithm.9 This medication has been shown to be a safe and effective addition to the current standards of care maintenance treatment for COPD. Ensifentrine’s mechanism of action is more targeted and demonstrates synergistic effects on smooth muscle and antiinflammatory response.

Dr. Camryn Molnar is a PGY1 Pharmacy resident at UPMC St. Margaret and can be reached at molnarc2@upmc. edu. Dr. Madeline Stanko is a PGY2 Ambulatory Care Pharmacy resident at UPMC St. Margaret and can be reached at stankom2@upmc.edu. Dr. Heather Sakely, PharmD, BCPS, BCGP, the Director of Clinical Pharmacy Services and Director of the PGY2 Geriatric Pharmacy Residency served as editor and mentor for this work and can be reached at sakelyh@upmc.edu.

References: 1. Ensifentrine (Ohtuvayre™) [package insert]. Verona Pharma; 2024.

2. Anzueto A, Barjaktarevic IZ, Siler TM, et al. Ensifentrine, a Novel Phosphodiesterase 3 and 4 Inhibitor for the Treatment of Chronic Obstructive Pulmonary Disease: Randomized, Double-Blind, Placebo-controlled, Multicenter Phase III Trials (the ENHANCE Trials). Am J Respir Crit Care Med. 2023;208(4):406-416. doi:10.1164/rccm.202306-0944OC. 3. Global Initiative for Chronic Obstructive Lung Disease.

Global Strategy for the Diagnosis, Management, and Prevention of COPD: 2023 Report. Available from: https://goldcopd.org/.

Accessed September 22, 2024.

4. Ohtuvayre (ensifentrine) nebulizer inhalation solution.

OHTUVAYRE (ensifentrine) Nebulizer Inhalation Solution.

Accessed September 20, 2024. https://ohtuvayre.com/.

5. Institute for Clinical and Economic Review publishes final evidence report on treatment for chronic obstructive pulmonary disease. ICER. July 16, 2024. Accessed September 19, 2024. https://icer.org/news-insights/press-releases/ institute-for-clinical-and-economic-review-publishes-finalevidence-report-on-treatment-for-chronic-obstructivepulmonary-disease/.

6. Ensifentrine. Drug Information. UpToDate. Accessed September 18, 2024.

7. https://www.uptodate.com/contents/ensifentrinedrug-information?search=ohtuvayre&source=panel_search_ result&selectedTitle=1%7E9&usage_type=panel&kp_tab=drug_ general&display_rank=1#F59616940.

8. Tiotropium. Drug Information. UpToDate. Accessed September 20, 2024. https://www.uptodate.com/contents/ tiotropium-drug-information?search=spiriva&source=panel_ search_result&selectedTitle=1%7E38&usage_type=panel&kp_ tab=drug_general&display_rank=1#F3422284 9. Budesonide/formoterol. UpToDate. Accessed November 11, 2024. Budesonide and formoterol: Drug information UpToDate 10. Global Initiative for Chronic Obstructive Lung Disease.

Global Strategy for the Diagnosis, Management, and Prevention of COPD: 2025 Report. Available from: https://goldcopd.org/.

Accessed January 23, 2025.

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Society News

Specialty Group Updates June 2025

By: Nadine Popovich, Melanie Mayer and Haley Thon Allegheny County Immunization Coalition (ACIC) — 2024-2025 Chair - Patrick Hussey, PharmD, MBA: ACIC will host its next Quarterly Membership Meeting on Wednesday, June 19, 2025, from 9:00–11:00 AM, featuring guest speaker Biyanka Patel, MSL, of Bavarian Nordic. Her presentation, “Chikungunya – An Emerging Threat,” will highlight the rising clinical and public health concerns associated with the virus.

The 20th Annual Immunization Conference, will take place Wednesday, November 5, 2025, at the Regional Learning Alliance in Cranberry Township. Conference details are now available at www.immunizeallegheny. org, with registration opening in late summer.

American College of Surgeons Southwestern Pennsylvania Chapter (ACS-SWPA) — 2025 President – Richard Fortunato, DO, FACS: The American College of Surgeons Southwestern Pennsylvania Chapter hosted its annual “Most Interesting Cases” event on Wednesday, May 28, 2025, at the Kimpton Hotel Monaco in downtown Pittsburgh. The evening brought together over 35 attendees for a dynamic program featuring challenging and unique surgical cases presented by local residents and reviewed by a panel of ACS Fellows.

This long-standing tradition once again supported surgical education, peer connection, and professional development across our region. Many thanks to our sponsors and attendees for making the 2025 program a success.

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Winners of the ACS Most Interesting Cases

Pennsylvania Geriatric Society Western Division (PAGS-WD) — 2025 President - Heather Sakely, PharmD, BCPS, BCGP: The David C. Martin Award The Awards Committee is delighted to announce that four exceptional students have been selected to receive honoraria to support their participation in the virtual AGS Annual Scientific Meeting, that took place on May 8–10, 2025. Each awardee will showcase their work by presenting a poster based on their submitted abstract. Congratulations to Anjana Mahesh, Joseph Shin, Naomi Shin, and Rutvi Chahal on this well-deserved recognition!

2025 Geriatrics Teacher of the Year Award – Nominations Now Open The Society is proud to announce that nominations are being accepted for the 2025 Geriatrics Teacher of the Year Award. This prestigious annual honor recognizes two outstanding educators, one physician and one healthcare

professional, who have shown exceptional commitment to advancing geriatrics education. Award recipients are individuals who have made a lasting impact on the training and development of future geriatric professionals and have significantly contributed to the growth of geriatrics education across the healthcare continuum. Full details, including eligibility requirements, selection criteria, and the nomination form, are available on the Society’s website at Pennsylvania Geriatrics Society - WD - Teacher of the Year.

Deadline for nominations: June 20, 2025.

Fall Program 2025 Planning is currently underway for the Fall 2025 Program. While the exact date is still to be determined, we’re excited to announce that the event will once again be held at the PNC Champions Club at Acrisure Stadium.

The planning committee is actively reviewing potential topics to ensure a timely and engaging agenda.

www.acms.org

Society News Monthly Meeting Dates: • September 4, 2025 • October 9, 2025 • November 6, 2025 • December 11, 2025 • January 22, 2026

The Pittsburgh Ophthalmology Society (POS) — 2025 President - Laurie A. Roba, MD: Pittsburgh Ophthalmology Society announces 2025-2026 Monthly Meeting and Annual Meeting Dates Laurie A. Roba, MD, President, along with the POS Board of Directors, is pleased to announce the 2025– 2026 schedule for the Pittsburgh Ophthalmology Society’s Monthly

ACMS Bulletin / June 2025

Meeting Series and Annual Meeting.

A total of six in-person meetings are scheduled, beginning in September and culminating with the 61st Annual Meeting on March 20, 2026. All monthly meetings will be held at the PNC Champions Club at Acrisure Stadium (100 Art Rooney Ave, Pittsburgh, PA 15212), conveniently located on Pittsburgh’s North Side with nearby parking options.

Note: There will be no February meeting to allow for preparation for the Annual Meeting and the 46th Ophthalmic Personnel Meeting, both scheduled for March.

Details regarding guest speakers will be shared in July via the POS Website and the July issue of the ACMS Bulletin.

The 61st Annual Meeting and 46th Ophthalmic Personnel Meeting will take place on March 20, 2026.

Planning is underway, and members are encouraged to check the POS website regularly for the latest updates.

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Allegheny County Medical Society 850 Ridge Avenue Pittsburgh, PA 15212