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Digest Arizona Osteopathic Medical Association

Volume 33, No. 3 Fall 2018

SETTING OUR SIGHTS HIGH

INSIDE

„ AOMA: The (Not So) Secret Ingredient „ 38th Annual Fall Seminar „ 2018-2019 Board of Trustees


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AOMA Digest Fall 2018

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Volume 33, No. 3 Fall 2018

2018-2019 Board of Trustees President Angela DeRosa, DO, MBA, CPE President Elect Christopher Labban, DO Immediate Past President Laurel Mueller, DO, MBA Vice President Danielle Barnett-Trapp, DO Secretary/Treasurer Richard Dobrusin, DO, MS (Ost), FACOFP Executive Director/Editor Pete Wertheim, MS Trustees Brandon Abbott, DO, MPH, FAAP Elise Barney, DO Craig Cassidy, DO, FACOO Donald Curran, DO Susan Del Sordi-Staats, DO William Devine, DO Datcha Dorvil, DO, MPH David England, MS, DO Michelle Eyler, DO Kendra Gray, DO David Leff, DO Michael Lokale, DO, MSc (Oxon), FAAFP Julie Morrison, DO Homan Mostafavi, DO, MBA George Parides, DO, FACOI Bunnie Richie, DO, FAAN Resident Trustee Marissa Jacobs, DO Student Trustees Jennifer Oster, MPH, OMS IV - SOMA Jamie Shawver, OMS IV - AZCOM Speaker of the House of Delegates Jeffrey Morgan, DO, MA, CS, FACOI

Digest

The Official Publication of the Arizona Osteopathic Medical Association

Contents COLUMNS 2 President’s Message 4 Executive Director’s Message 6 AOMA in Action 8 2018-2019 AOMA Board of Trustees FEATURES 11 Innovations and Transformations 12 Passing the Baton 14 A Look at Opioid-Related Closed Claims and Lawsuits 16 Click for Control: Help with New State Mandate 18 AOA CME Cycle Ending 12-31-2018 AOMA NEWS 20 Welcome New AOMA Members 20 In Memoriam 21 AOA House of Delegates 22 4th Annual Flagstaff Osteopathic Conference 23 AOMA 38th Annual Fall Seminar 24 Birdies for Charity 25 2019 Clinical Case Competition and Poster Forum 26 Important AOMA Events OSTEOPATHIC COMMUNITY NEWS 27 A. T. Still University School of Osteopathic Medicine in Arizona 31 Midwestern University Arizona College of Osteopathic Medicine 34 DOs in the News 36 Advertisers Index 36 Calendar of Events

Vice Speaker of the House Charles Finch, DO, FACOEP

AOMA Staff Director of Membership and Communications and Managing Editor Janet Weigel

Director of Education Teresa Roland

Office Administrator Kristen Strong © 2018

Opinions expressed in the AOMA Digest are those of the authors and do not necessarily reflect viewpoints of the editors or official policy of the AOMA, or the institutions with which the authors are affiliated, unless explicitly specified. AOMA Digest does not hold itself responsible for statements made by any contributor. We reserve the right to edit articles on the basis of content or length. Although all advertising is expected to conform to ethical medical standards, acceptance does not imply endorsement by this magazine. The appearance of advertising in the AOMA Digest is not an AOMA guarantee or endorsement of the product, service or claims made for the product or service by the advertiser.

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AOMA Digest Fall 2018


President’s Message

AOMA: The (Not So) Secret Ingredient As the fall season begins, I am reminded of the time as a child playing in piles of leaves, trick-ortreating, and my mother making delicious home-made soups and cookies. Here in Arizona we don’t have many leaves to frolic about in, or cooler weather that Angela DeRosa, DO, conjures up the desire MBA, CPE to make soups, but it 2018-2019 AOMA President certainly is a time of year that we start to think about timehonored traditions - practices that ground us and bring us together as friends, family, and a profession. Traditions are wonderful and should be cherished, but we also need to evolve and incorporate new concepts and grow as the years go on. We need to be “chefs and not cooks” in life and our profession if we want to stay relevant and not become outmoded. As chefs, we are given the opportunity to experiment with new ingredients and create wonderful recipes that can inspire the palate and push the envelope of innovation. Most chefs have a “secret ingredient” that makes their recipes so delicious. Wikipedia defines secret ingredient as: “a component of a product that is closely guarded from public disclosure for competitive advantage. Sometimes the ingredient makes a noticeable difference in the way a product performs, looks, or tastes.”

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The Arizona Osteopathic Medical Association has been your (not-so) secret ingredient for more than 97 years – protecting you from legislation detrimental to the profession; representing you in healthcare issues; supporting you with superior continuing medical education; providing you with timely business of medicine resources; helping you grow your practice with patient referrals; creating opportunities for you to network with your peers. During the Board of Trustees meeting held in June 2018, the Trustees worked tirelessly to develop a new strategic recipe for the AOMA and its future direction. High priority has been given to expanding legislative advocacy, increasing member engagement, supporting members’ ability to practice successfully, and promoting osteopathic medicine. These strategies will help position our Association to stay relevant as well as mitigate risk as changes continue to occur administratively and legislatively at the state and national levels. We have identified immediate, shortterm, and long-term goals that require funding and volunteer hours. The AOMA staff and your leaders have started the process of achieving these goals. You can be certain your membership dollars are being well-utilized to help the osteopathic physicians of Arizona have a voice, stay relevant, and function at their highest level. The chefs are in the kitchen!


President’s Message

This year’s fall seminar focuses on “Recipe for Success” in medicine and how we can best incorporate new “ingredients” into our dayto-day clinical practice. The environment of the physician patriarch is no longer effective and our communications with patients and colleagues need to reflect this new paradigm as well as how to deal with the new societal expectation of our role in healthcare. Simultaneously, with the level of physician burnout and dissatisfaction with healthcare at an all-time high, we need to remember to not take ourselves too seriously. Laughter is the best medicine and can be used to heal not only our patients but ourselves. We need to “clown around” a bit more and incorporate this very important “spice” into our life soup. The fall seminar agenda will be one you won’t want to miss!!!

Arizona Osteopathic Medical Association

As with any organization, its success is highly dependent on its leadership and membership participation. As AOMA members, there are on-going opportunities to become involved and I hope you will explore these options. Recruit new members, join a committee, attend the CME programs, mentor a student. With AOMA as your secret ingredient, create your own recipe for success and help us develop a cookbook of what can become time-honored successful recipes to share with others while creating new ones as an osteopathic chef. There is no better time than the present…. trust me you won’t regret it! Now let’s get cooking!!!

AOMA 38th Annual Fall Seminar November 10 & 11, 2018

Recipe for Success:

Innovations and Applications El Conquistador Tucson, A Hilton Resort 10000 N. Oracle Rd Tucson, Arizona 85704 Go to www.az-osteo.org/FallSeminar AOMA Member $ 370 Non-Member $ 495 Retired or Honorary Life Member $ 320

This program has been approved for: • AOMA Category 1-A Credits • AMA PRA Category 1 CreditsTM • AAFP Prescribed Credits

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Executive Director’s Message

Setting Our Sights High The escalating prevalence of burnout among physicians is a significant multifaceted problem leading to career dissatisfaction, early retirement, depression, and even suicide. According to the 2018 Medscape National Report on Physician Burnout Pete Wertheim, MS and Depression, an AOMA Executive Director astonishing two-thirds of physicians report feeling burned out, depressed, or both. Okay, we get it already! Seemingly, every day there is a news article or column about the increasing severity of the physician burnout epidemic. Do you ever wonder if the continual reminders of physician depression and career dissatisfaction are actually contributing to the problem? I digress. The causalities of physician burnout are well researched and documented. We know the symptoms and diagnosis, but there is no clear strategic intervention and treatment plan. During a conversation two years ago with a primary care physician, I learned a great deal about the onerous burdens and hassles of receiving fair reimbursement for services, timely credentialing for new contracts, and the non-existent reimbursement for invaluable time consulting with patients. This physician shared about a half dozen issues that were limiting her time and ability to provide quality care to patients. It was apparent to me one of the best ways to understand these issues was to get into the trenches alongside busy physicians and actively listen to them to find solutions to their problems. AOMA Digest Fall 2018

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The burnout problems are inexhaustible, complicated, and exceptionally challenging to solve. AOMA is your physician association. We have a critical responsibility of looking after the needs of physicians and that includes addressing burnout. So how does AOMA actually do this? In April 2017, a resolution was introduced at the AOMA House of Delegates, HOD 2017-01 Administrative Simplification, to address the most egregious contributor to physician burnout – administrative burdens. The resolution passed unanimously, adopting principles for administrative simplification and making it a priority for the 2018 legislative session. Identifying these burdens as a high priority advocacy issue was an important first step. After several months of research and preparation, AOMA and the Arizona Medical Association (ArMA) were equipped to advocate for the inclusion of more than a dozen prior authorization (PA) reforms into the Opioid Epidemic Act special session legislation. Some of the provisions included maximum timeframes for approvals, transparency of PA requirements, mandatory notification policies and timeframes, appeals processes, and minimum PA duration. This success was the result of months of preparation and a fortuitous opportunity to address administrative hassles related to the opioid epidemic. The PA reforms are a great start, but now we are setting our sights higher to address additional root causes of physician burnout.


Executive Director’s Message

SLOWING THE BURN OF PHYSICIAN BURNOUT: A MULTIDISCIPLINARY INITIATIVE TO ADDRESS ROOT CAUSES AND ADVANCE SOLUTIONS Most of the impactful solutions to address physician burnout require a significant investment of time, personnel, and resources to research and develop actionable policy solutions. It is simply not feasible for AOMA to tackle this alone and divert precious capacity from other responsibilities. The AOMA Board of Trustees recognized the need to enlist outside support to accelerate the development of policy solutions and supplement advocacy efforts. AOMA has begun an ambitious project with the College of Health Solutions at Arizona State University (ASU-CHS), led by Professor Swapna Reddy and a team of researchers, on a multidisciplinary initiative to address the root causes of physician burnout through the identification and development of strategic policy solutions. These strategic policy solutions will come from research, a state-by-state analysis of various legislative and regulatory advancements, and direct input from AOMA physicians and medical students. At the conclusion of this project, these actionable solutions will be organized and integrated into AOMA’s future policy agenda and activities. During the next five months, AOMA and ASU-CHS want to learn about your experiences and personal challenges practicing medicine. We seek to understand and document all of the clinical and nonclinical activities that detract from the meaningful practice of medicine.

Project Deliverables The project will focus on solutions that can be determined at the individual practice, institutional, organizational, state, and federal levels. The goals and deliverables include the following: •

• • •

Identify and solicit a diverse profile of physicians across the state for their participation in focus groups and surveys to contextualize perceptions and organizational management of burnout Research and develop a state-by-state legislative repository of established and innovative policies targeting physician burnout Collate findings with existing literature to create a robust, cohesive analysis Review findings and adopt an AOMA strategic plan for the advancement of policies to address physician burnout Publicize policy solutions and strategic initiatives to enable national and state medical associations to advance their own initiatives to reduce physician burnout (via national academic conference(s), published report, policy toolkit, and research manuscript)

We are setting our sights high with this ambitious project. It will only succeed with your participation. If you have a few minutes to spare and are willing to share your perspective and ideas, please contact me at the AOMA office at 602-266-6999 or email to communications@az-osteo.org and we will ensure that your feedback is captured. Members of the research team will also be onsite at the 38th Annual Fall Seminar in Tucson on November 10, 2018. The project and findings will be presented at the AOMA 97th Annual Convention in Scottsdale on April 10-14, 2019.

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AOMA in Action

AOMA in Action AOMA is the voice of osteopathic medicine in Arizona, representing the profession as a healthcare stakeholder and community partner. This activity update covers the three-month period from July 1, 2018 to October 1, 2018. Advocacy/Legislative Affairs • Developed and disseminated statewide action alert and guidance on impending mandate for electronic prescribing of opioids • Submitted comments and concerns to the Department of Insurance on proposed administrative rules for the implementation of the surprise billing law in 2019 • Disseminated action alerts for comments on the CMS Revised Payment Policies to the Physician Fee Schedule • Added Voter Voice grassroots advocacy system to activate and enhance physician engagement with elected officials • Launched a multidisciplinary initiative to address root causes and advance solutions for physician burnout project with the Arizona State University College of Health Solutions • Submitted letter to congressional delegates urging continued suspension or repeal of the ACA health insurance premium tax • Met with the Arizona Society of Interventional Pain Physicians to discuss health plan authorization and payment policies for nonopioid pain management therapies • Met with Arizona Optometric Association to discuss concerns about contact lens prescriptions American Osteopathic Association (AOA) • Sent twelve delegates, three alternates and four student delegates to the AOA House of Delegates in Chicago in July 2018 • AOMA Past President Shannon C. Scott, DO, FACOFP was elected Third Vice President to the AOA Board of Trustees • AOA and AOMA Past President Karen J. Nichols, DO, MA, MACOI, CS received AOA’s highest honor, the AOA Presidential Citation from AOA Outgoing President Mark Baker, DO; Dr. Nichols was also elected to serve as the chair of the United Federation of Osteopathic Societies • AOMA Board of Trustee member Jamie Shawver, OMS IV, and AOMA Executive Director Pete Wertheim, MS were appointed to AOA’s Bureau of Federal Health Programs AOMA Digest Fall 2018

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Political Action Committee • Contributed $650 to one candidate for office Member Services • Offered attendance to the 4th Annual Flagstaff Osteopathic Medical Conference at a discount • Approved two new AOMA Business Partners • Hosted AOMA Mix and Mingle event in Flagstaff Continuing Medical Education • Submitted proposal to the Department of Health Services for State Target Response grant funds to develop online CME on the opioid laws, prescribing guidelines, prescription drug monitoring program, healthcare facility rules, and Medication Assisted Treatment • Attended ACCME Accreditation Workshop in July 2018 • Presented a free CO*RE REMS ER/LA program at the Flagstaff Medical Center in August 2018 • Sponsored 7.5 hours of AOA Category 1-A CME credit for the 4th Annual Flagstaff Osteopathic Medical Conference in August 2018 • Posted 10 new online on-demand CME offerings on DOCME.org Osteopathic Charities • Launched the 2019 Birdies for Charity campaign Public Relations • Co-sponsored the 4th Annual Flagstaff Osteopathic Medical Conference with Flagstaff Medical Center • Participated in the Arizona Chapter of the American Academy of Pediatrics Hackathon • Participated in an AOMA & Arizona Medical Association President & Director Dinner


AOMA in Action

Public Health • Provided opioid law update to the Arizona Chapter of the American College of Physicians Opioid Summit • Represented AOMA on the Health Current Board of Directors • Represented AOMA on The Arizona Partnership for Immunization (TAPI) Steering Committee The Future of the Osteopathic Profession • Received Arizona Public Health Association’s (AzPHA) 2018 Health Education Media Maker Yearly award for the Doctors That DO Wellness Pop-Up Exhibit Program • Announced the 2019 AOMA Clinical Case and Poster Competition • Provided recommendations for student induction into Omega Beta Iota, the national political action honor society

Arizona Osteopathic Medical Association Promoting and protecting the osteopathic medical profession for 97 years The mission of the Arizona Osteopathic Medical Association is to promote the osteopathic medical profession, serve our members, provide osteopathic continuing medical education, and advocate for access to high quality, cost-effective healthcare.

For more information about any of these updates, call 602-266-6699 or email communications@az-osteo.org.

Protect your profession. Contribute to the AOMA Political Action Committee. www.az-osteo.org/PAC

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2018-2019 Board of Trustees

Arizona Osteopathic Medical Association

EXECUTIVE COMMITTEE

Angela DeRosa DO, MBA, CPE President

Danielle Barnett-Trapp, DO Vice President

Laurel Mueller, DO, MBA Immediate Past President

Christopher Labban, DO President Elect

Richard Dobrusin, DO, MS (Ost), FACOFP Secretary/Treasurer

Pete Wertheim, MS Executive Director

TRUSTEES

Not Pictured: Michelle Eyler, DO Member at Large

Brandon Abbott, DO, MPH, FAAP Member at Large

AOMA Digest Fall 2018

Elise Barney, DO District 2 Representative

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Craig Cassidy, DO, FACOO Specialists

Donald Curran, DO District 7 Representative


2018-2019 Board of Trustees

Susan Del Sordi-Staats, DO District 3 Representative

William Devine, DO District 1 Representative

Datcha Dorvil, DO, MPH Member at Large

David England, MS, DO District 5 Representative

Kendra Gray, DO Member at Large

David Leff, DO District 4 Representative

Michael Lokale, DO, MSc (Oxon), FAAFP New Physicians’ Representative

Julie Morrison, DO District 6 Representative

Homan Mostafavi, DO, MBA Member at Large

George Parides, DO, FACOI Member at Large

Bunnie Richie, DO, FAAN Member at Large

Marissa Jacobs, DO Resident Trustee

Jennifer Oster, MPH, OMS IV SOMA Student Trustee

Jamie Shawver, OMS IV AZCOM Student Trustee

Jeffrey Morgan, DO, MA, FACOI, CS Speaker of the House of Delegates

Charles A. Finch, DO, FACOEP Vice Speaker of the House

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Features

Innovations and Transformations By Jeffrey Morgan, DO, MA, CS, FACOI, Dean, A.T. Still University School of Osteopathic Medicine in Arizona

A.T. Still University's School of Osteopathic Medicine in Arizona (ATSU-SOMA) continues to be on the forefront of transforming the delivery of healthcare. ATSU-SOMA has received a $1.9 million grant from the Health Resources and Services Administration (HRSA) to support an innovative primary care fellowship for physicians and physician assistants, with the goal of strengthening the healthcare workforce in underserved communities nationwide. The Primary Care Transformation Executive Fellowship will prepare healthcare providers to address social determinants of health, improving population health, and enhancing primary care in America’s community health centers. In July, ATSU-SOMA welcomed new faculty to our team. Joining us are: • Victoria Bryant, PhD – Cancer Biology and Molecular and Cellular Biology • Tala Dajani, MD, MPH – Pediatrics and Endocrinology • Andy Grass, PhD – Anatomy • James Keane, DO – Internal Medicine and OMM • Robert Lewis, PhD – Physiology • Saudamini Wadwekar, MD – Family Medicine • Christina Weaver, DO – Emergency Medicine and Ultrasound • Earla White, PhD – Health Promotion and Education

Lastly, ATSU-SOMA is proud to be an ongoing member of the American Medical Association (AMA) Accelerating Change in Medical Education Consortium helping to lead the way in the development of Health Systems Science. The AMA is collaborating with medical schools to accelerate change in medical education and create a system that trains physicians to meet the needs of today's patients and to anticipate future changes. As part of an initiative launched by the AMA in 2013 to bridge the gaps that exist between how medical students are trained and how medical care is delivered in the modern healthcare system, the Consortium has already supported innovative training for an estimated 19,000 medical students across the country. ATSU-SOMA is one of 32 medical schools across the U.S. within the Consortium, and a proud contributor to the annotated bibliography titled Creating a Community of Innovation (https://www. ama-assn.org/sites/default/files/mediabrowser/18-214089-ACE-annotated%20 bibliography%20updates-online%20v2.pdf).

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Features

Passing the Baton By Lori Kemper, DO, MS, FACOFP, Dean, Midwestern University Arizona College of Osteopathic Medicine

Amidst all the changes that have been taking place in our country, many may have missed subtler changes in our profession. Many of those instrumental in the development of the osteopathic profession have passed the baton to the next generation of DOs. Surprisingly, much of the history of osteopathic medicine has been carried by Arizonans (or by transplants to or from Arizona). This past summer saw the retirement of two deans of colleges of osteopathic medicine: Boyd Buser, DO, the former dean of the Pikeville College of Osteopathic Medicine in Kentucky and our own Karen Nichols, DO, former dean of the Midwestern University Chicago College of Osteopathic Medicine. Both were instrumental in the transition of AOA accredited residency programs to the Accreditation Council for Graduate Medical Education (ACGME) Single Accreditation System. Both still serve on the ACGME as board members. To give even more evidence of the impact a few can have on our profession, both also served as members of the Board of Trustees, and the House of Delegates of the American Osteopathic Association and both also served as AOA President. I know, at least for Dr. Nichols, this time of retirement will not be a ceasing of work, but a time when she will be focusing on the profession and helping it to flourish despite the changes that are bound to take place as we complete the transition to the Single Accreditation System.

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The summer of 2019 will also see a significant change with the retirement next June of the CEO of the American Association of Colleges of Osteopathic Medicine (AACOM), Steve Shannon, DO. Dr. Shannon has been the CEO for about 10 years and has been instrumental in enculturating all new colleges of osteopathic medicine (COMs) and their branches and additional sites to our profession. The AACOM Board of Deans has established a search committee, engaged a search firm, and is actively seeking applicants to compete for this prestigious and influential position. Most recently, Midwestern University suffered a great loss with the passing of Arthur G. Dobbelaere, PhD, who served as Executive Vice President and Chief Operating Officer of Midwestern University. Besides being responsible for operations at MWU, such as human resources, campus engineering, media resources, and information technology, to name a few, Dr. Dobbelaere was the person who made the vision that Dr. Goeppinger and the MWU Board of Trustees had for an interprofessional healthcare campus in the Phoenix area become a reality. In great part, he and Dr. Goeppinger were instrumental in building this college of osteopathic medicine (AZCOM) in the middle of the desert. They brought osteopathic medical education to Arizona and then nurtured it so that AZCOM could be the largest medical school in the state of Arizona. We are thankful for these heroes of our profession and for the parts they have played in creating the current and future generations of DOs.


Features

Opioid Assistance & Referral

Recruit a new member, receive a $100 credit! Do you know someone who isn’t a member of the Arizona Osteopathic Medical Association . . . and should be? Recruit a new member and you’ll both receive a $100 credit toward membership dues or continuing medical education fees! Recruiting new members is simple: 3 Review your network of colleagues. You may be surprised who is not a member. 3 Check their membership status using the online member directory or by calling the AOMA office at 602-266-6699. 3 Ask them to join! Express how membership has benefited you. For details on how to recruit a new member* and receive your credit, visit the AOMA website at www.az-osteo.org under the Members tab or contact Janet Weigel, Director of Membership and Communications, at janet@az-osteo.org.

A free 24/7 hotline that assists providers with complex patients with pain and opioid use disorders, answered by medical experts at the Poison and Drug Information Centers in Arizona.

*New member must be an active, dues paying member. Does not apply to recruitment of “out-of-state” or “retired” members.

Arizona OAR Line

1-888-688-4222 The OAR Line is joint project between the Arizona Department of Health Services, the Arizona Health Care Cost Containment System and Poison and Drug Information Centers in Arizona.

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Features

A Look at Opioid-Related Closed Claims and Law Suits By Karen Wright, BSN, RN, ARM, CPHRM, Mutual Insurance Company of Arizona (MICA)

In the late 1990s and early 2000s, there was widespread concern regarding the underassessment and under treatment of pain and the subsequent designation of pain as the fifth vital sign.1 In response, opioid prescribing patterns were modified leading, in part, to the current national alarm regarding large increases in abuse, drug dependence, and overdose. More than fifty people die of opioid overdoses each day in the United States prompting the Centers for Disease and Control to call it an epidemic of opioid overdoses.2 The Medical Professional Liability Association (MPLA), formerly known as PIAA, Data Sharing Project (DSP), was established in 1985, and is an independent and collaborative database of medical professional liability (MPL) claims. To assess the clinical and financial implications of opioid-related MPL claims within the MPLA community, the DSP reviewed 91,000 closed claims and lawsuits reported between 2006 and 2015. Their findings were reported in the PIAA Research Notes, September 2017 edition.3

Three hundred-seventy closed claims were found with the patient outcomes of drug dependence, non-dependent drug abuse, and poisoning. Of these 370 closed opioid-related claims, 114 resulted in an indemnity payment.2 The PIAA DSP also noted the top five chief medical factors reported for these opioidrelated claims and suits were: 1. Medication errors 2. Failure to supervise or monitor a case 3. Failure to communicate with a patient 4. No medical misadventure* 5. Failure to recognize a complication of a treatment. These five chief medical factors represented ninety percent of the 370 opioid-related closed claims. For comparison, MPLA DSP separated the ten-year period of 2006 through 2015 into two five-year periods, 2006 through 2010 and 2011 through 2015. They found an upward trend in both the average indemnity and expense payments. The average indemnity payment increased by thirty-two percent and the average defense costs increased one-

Reprinted with permission from MPLA. Managing Opioids: Prescribing Practices and Claims. Research Notes. September 2017 Edition, Copyright 2017, PIAA.

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Features

hundred percent. In addition, the paid-toclosed ratio (the percentage of claims or suits closed with an indemnity payment) increased by twenty percentage points during the 2011 to 2015 time frame. Over the same ten-year period, sixteen percent of MICA’s medication related closed claims involved opioid prescribing. Twentynine percent of MICA’s opioid-related claims were closed with an indemnity payment, compared to MPLA’s thirty-one percent paidto-closed ratio. In addition, seventy-one percent of the opioid-related claims at MICA were associated with a patient fatality. Similar to the MPLA DSP, the average defense costs at MICA increased seventy percent when comparing the closed claims reported from 2006 through 2010 to 2011 through 2015. Unlike the MPLA DSP, MICA experienced a thirty-eight percent decrease in the average indemnity from 2006 through 2010 compared to 2011 through 2015.

Reprinted with permission from MPLA. Managing Opioids: Prescribing Practices and Claims. Research Notes. September 2017 Edition, Copyright 2017, PIAA.

References 1. Phillips DM. JCAHO pain management standards are unveiled. Joint Commission on Accreditation of Healthcare Organizations. JAMA. 2000; 284(4):428-9 2. Dowell D, Haegerich T, Chou R. CDC Guideline for prescribing opioids for chronic pain — United States, 2016. Recommendations and reports. 2016 March 18. Available from https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm 3. Managing opioids: Prescribing practices and claims. MPLA Data Sharing Project (DSP). PIAA Research Notes. 2017 September

*“No Medical Misadventure” is a claim brought against a clinician who had little or no contact with the patient resulting in an absence of medical misadventure. The claim can still have legal merit and therefore may result in payment.

Reprinted with permission from MPLA. Managing Opioids: Prescribing Practices and Claims. Research Notes. September 2017 Edition, Copyright 2017, PIAA.

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Features

Click for Control: Help with New State Mandate By Melissa Kotrys, MPH, CEO, Health Current

The Arizona Opioid Epidemic Act signed by Governor Ducey this past January will require each prescription for a Schedule II opioid to be transmitted electronically beginning January 1, 2019 for Arizona’s six largest counties and by July 1, 2019 for the remainder of the state. This new requirement, aimed at stemming the opioid crisis in Arizona, creates an urgent situation for Arizona prescribers because fewer than 25 percent of prescribers are currently set up for the electronic prescribing of controlled substances or EPCS. To increase EPCS in Arizona and prepare Arizona prescribers for this new state requirement, Health Current has launched the Click for Control campaign that includes a set of resources for providers as well as a series of free webinars. Information on this campaign can be found by visiting the Health Current website – www.healthcurrent.org – and clicking on the “EPCS – Controlled Substances” tab under Info Center. In a nutshell, the campaign is about three simple messages: • EPCS delivers benefits to prescribers such as the increased efficiency gained by managing all prescriptions in one place, as well as improved patient quality and reduced fraud. • Becoming EPCS-ready takes time, effort, and close work with your EHR vendor. Practices need to talk with their EHR vendor to develop a plan. • A one-time, one-year waiver is available for practices that face hardships in meeting the deadline.

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ONE-YEAR WAIVER AVAILABLE Many Arizona prescribers may face challenges and hardships in becoming EPCS ready for the deadline in their county. A one-time, one-year waiver is available to prescribers who face hardships that prevent the implementation of EPCS by the deadline. The waiver form for prescribers is available on the homepage of The Arizona State Board of Pharmacy website at pharmacy.az.gov under the heading Waivers for Electronic Prescribing. The deadline for waiver applications is December 15, 2018. If you have questions on EPCS or the Click for Control campaign, please contact Health Current at 602-688-7200 or eRx@healthcurrent.org. SAVE THE DATE: Health Current will review the progress of the Click for Control Campaign and other initiatives on December 3-4, 2018 at the 11th Annual Health Current Summit & Trade Show at the Renaissance Phoenix/Glendale Hotel and Spa in Glendale. This year’s Summit, Integrated HIE: The Progress of Patient Centered Care, will feature a number of HIE use cases and HIE initiatives that demonstrate the use of HIE and information technology in improving patient care and healthcare outcomes. More information on the Summit & Trade Show is available by visiting www.healthcurrent.org and clicking on the Summit & Trade Show tab under News and Events.


Features

An Arizona Campaign to Increase the E-Prescribing of Controlled Substances The e-prescribing of controlled substances (EPCS) improves patient safety, quality and practice workflow in addition to reducing fraud and prescribing errors. In addition, EPCS will soon be a state requirement for all prescriptions of a Schedule II opioid. Arizona Opioid E-Prescribing Requirement Beginning January 1, 2019, each prescription order for a Schedule II opioid in Arizona’s six largest counties (Maricopa, Mohave, Pima, Pinal, Yavapai and Yuma) must be transmitted electronically to the dispensing pharmacy. Beginning July 1, 2019, these same requirements go into effect in all other Arizona counties (Apache, Cochise, Coconino, Gila, Graham, Greenlee, La Paz, Navajo and Santa Cruz). Benefits of EPCS • Improves prescribing workflow with all prescriptions managed/stored in one application • Improves patient safety and quality • Reduces fraud and helps fight the opioid epidemic EPCS Steps for Prescribers 1. 2. 3. 4. 5.

Contact your EHR or e-prescribing vendor and ask if they are certified to do EPCS Complete identity proofing requirement Obtain dual authentication device or process Set up access controls Go live with EPCS and adjust workflow to manage all prescriptions in one application

One-Year Waiver Available: Deadline December 15, 2018 A one-year waiver is available to practitioners who face hardships that prevent the implementation of EPCS. If you determine that you will be unable to meet the EPCS requirements, you can download a waiver form from the Arizona State Board of Pharmacy at www.pharmacy.az.gov. Free Webinars Health Current is hosting a series of free webinars to learn how you and your practice can be ready for the new Arizona mandate that requires Schedule II opioid prescriptions be transmitted electronically starting January 1, 2019. Visit www.healthcurrent.org/events to register.

3877 North 7th Street, Suite 150, Phoenix, AZ 85014 | 602.688.7200 | healthcurrent.org H_EPCS AZ CampaignClickforControl_09-21-18

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AOMA Digest Fall 2018


Features

AOA CME Cycle Ending 12-31-18 The end of each three-year AOA CME Cycle and two-year licensure period often means angst and confusion for osteopathic physicians. How many CME credits do I need? How many CME credits have I earned? Where are all my CME certificates? HOW MANY CME CREDITS DO I NEED? The answer to this question has more than one answer. Continuing medical education credits are required for state licensure and board certification. Arizona State Licensure: Under A.R.S. 32-1825(B), a licensee is required to obtain 40 hours of Boardapproved CME during the two (2) years preceding license renewal. The Board shall approve the CME of a licensee if the CME complies with the following: 1. At least 24 hours are obtained biannually by completing CME classified by the AOA as Category 1-A; and 2. The remaining balance may consist of any category of CME, including CME activities sponsored by an accredited AMA or ACCME provider and certified by the accredited provider as AMA PRA Category 1 creditTM. Effective April 26, 2018, physicians authorized to prescribe Schedule II controlled substances are required to complete a minimum of three hours of opioid-related, substance use disorder-related, or addictionrelated continuing medical education each license renewal cycle as part of their existing requirements. A licensee may fulfill 20 hours of the CME requirement for a particular year by participating in an approved residency, internship, fellowship, or preceptorship during that year. AOMA Digest Fall 2018

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If you are unable to complete these requirements in a given calendar year, you may request an extension from the licensing board. More information is available on the Board of Examiners website at www.azdo.gov. AOA Membership and CME Requirements The requirement that physicians earn 120 general CME credits per three-year CME cycle to maintain membership is no longer being enforced per a vote from the AOA Board of Trustees on July 21, 2016. The change was made to lessen the burden of required CME reporting for physicians. Members who obtain one hundred and fifty (150) credits or more of AOA approved applicable CME credit in a three-year CME cycle will be given a certificate of excellence in CME. These hours must be earned by December 31, but reported no later than May 31 following the close of the current CME cycle. AOA Board Certified Physicians If you are AOA board certified, you must follow your specialty board’s CME requirements in order to maintain your board certification. Currently, AOA certification boards require physicians to earn 120-150 credits per CME cycle, with at least 50 of those credits in your specialty area. For details on requirements in your specialty, check with your certification board. In the upcoming 2019-2021 CME cycle, physicians will be required to earn at least 60 specialty CME credits from AOA- or ACCME-accredited sponsors. Individual AOA certifying boards may implement additional requirements, including osteopathicspecific CME requirements. The AOA Board of Osteopathic Specialists is determining how this change will be implemented. Check


Features

with your certifying board for details on requirements in your specialty. Physicians should consult their specialty boards to learn about CME requirements for maintaining board certification and about the Board of Trustees Resolution on CME for Osteopathic Continuous Certification, passed in March 2017. ABMS Board Certified Physicians Physicians who are both AOA and ABMS board certified are required to earn the same specialty CME credit hours as DOs who are AOA board certified only in order to meet AOA specialty requirements. Physicians who are solely certified in an ABMS specialty are required to obtain a minimum of ten (10) Category 1-A credits in AOA sponsored CME programs during each three year CME cycle in order to meet AOA specialty requirements. Specific information about the AOA requirements can be found in the AOA CME Guide or visit www.osteopathic.org. Please contact the certifying board for information regarding the use of preceptoring or other credits towards this requirement. HOW MANY CREDITS HAVE I EARNED? Members of the American Osteopathic Association (AOA) may access the hours reported on their behalf to AOA by AOAsponsored providers of continuing medical education. CME programs accredited by the Accreditation Council of Continuing Medical Education (ACCME) or the American Academy of Family Physicians (AAFP) are eligible for AOA Category credit. These hours must be self-reported to the Division of CME of the AOA by email, fax, or mail. Visit www.osteopathic.org or call 888-62-MYAOA. All continuing medical education credits earned from the Arizona Osteopathic Medical Association (AOMA) are reported to the AOA and posted to the individual physician’s Professional Development Portfolio in his or her account profile on the AOMA website. To

view your CME record with AOMA, go to the home page www.az-osteo.org and from the main navigation menu select CME/My CME. Login is required to access these records. WHERE ARE ALL MY CME CERTIFICATES? As a benefit of membership, all active AOMA members have the ability to add continuing medical education credits to their Professional Development Portfolio. Upon login to the AOMA website, access the records from the main navigation CME/My CME. Using the “Add Entry” option, you can enter CME credits earned from providers outside of AOMA. This online tool is a great way to keep track of all your CME and simplify the record keeping for membership and license renewals. Still have questions? Contact the AOMA office at 602-266-6699.

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AOMA Digest Fall 2018


AOMA News

Welcome New AOMA Members 2nd Year in Practice

Physician

Jacob Anderson, DO Family Medicine - Board Certified Phoenix, Arizona 602-839-4567

Richard Donlick Jr, DO Internal Medicine Kayenta, Arizona 928-697-4000

Out of State

Matthew C. Duke, DO Family Medicine/OMT - Board Certified Buckeye, Arizona 623-474-5811

Dean T. Koukos, DO Family Medicine - Board Certified Bluffton, South Carolina 803-259-5762 Georgia Young, DO Anesthesiology/Pain Medicine - Board Certified Cheyenne, Wyoming 307-638-0300

AOMA gratefully acknowledges all its members for your support of the osteopathic medical profession and your association. Your membership ensures that AOMA is looking out for you and enables us to accomplish great things on your behalf.

Thank you!

Arizona Osteopathic Medical Association Protecting and promoting the osteopathic profession for 97 years

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Roderick J. Flowers, DO Family Medicine - Board Certified Phoenix, Arizona 602-277-1551 Scott Gibson, DO Orthopaedic Surgery - Board Certified Flagstaff, Arizona 928-774-7757 Joyce L. Richards, DO Gastroenterology - Board Certified Cottonwood, Arizona 928-649-7913 John R. Spitalieri, DO Neurosurgery - Board Certified Prescott, Arizona 928-445-4818

In Memoriam We are all diminished when one of our members leaves us. We will miss them and continue on for the betterment of our profession in their memory.

Howard H. Hunt, DO


AOMA News

2018 AOA House of Delegates The Arizona Osteopathic Medical Association was well-represented at the 2018 American Osteopathic Association (AOA) House of Delegates. Led by AOMA’s Delegation Chair Kristin Nelson, DO and Vice Chair Shannon Scott, DO, twelve delegates, three alternate delegates, two student delegates, and two student alternate delegates attended the four-day event held in Chicago, Illinois on July 19 to 22, 2018. The delegates spent weeks reviewing all of the AOA resolutions and preparing strategic positions that aligned with AOMA priorities. AOMA Delegates and Alternates to the AOA Brandon Abbott, DO Stanley Brysacz, DO Angela DeRosa, DO William Devine, DO Charles Finch, DO Annette Gawelko, DO Lori Kemper, DO Christopher Labban, DO Jeffrey Morgan, DO Laurel Mueller, DO Kristin Nelson, DO, AOA Delegates Chair Karen Nichols, DO Larry Sands, DO Shannon Scott, DO, AOA Delegates Vice Chair Anthony Will, DO Kelly Champlin, OMS II Brysen Keith, OMS II Leslie Hahn, OMS II Jay Olson, OMS II

AOA President William S. Mayo, DO and President Citation Honoree Karen J. Nichols, DO (Photo by Patrick Sinco)

More than 500 delegates met to create AOA policy on diverse issues impacting physicians. Some of the issues addressed included physician burnout, suicide prevention training at medical schools, and continuing medical education specialty requirements.

Other highlights of the AOA House of Delegates: • William S. Mayo, DO was installed as the 122nd AOA President and encouraged AOA members to show osteopathic pride and seek opportunities to strengthen and enhance the profession by continuing to be mentors and leaders for the new generation of DOs • AOA and AOMA Past President Karen J. Nichols, DO was honored with a Presidential Citation, AOA’s highest honor, for her leadership and dedication to advancing osteopathic medical education. Dr. Nichols was the first woman to serve as AOA President • AOMA Past President Shannon Scott, DO was elected Third Vice President to the AOA Board of Trustees

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AOMA Digest Fall 2018


AOMA News

4th Annual FOMC With the summer temperatures still above 1000 in Phoenix and Tucson, it was a refreshing 750 with cool breezes in Flagstaff for the 4th Annual Flagstaff Osteopathic Medical Conference (FOMC) at Flagstaff Medical Center. More than 60 physicians and other healthcare professionals attended the day-long event offering 7.5 hours of AOA Category 1-A CME credit and AMA PRA 1 creditsTM.

DOCME.org is your premier source for high quality, pertinent online CME for osteopathic physicians AOMA offers OnDemand continuing medical education lectures through the DOCME.org online platform. More than 100 different programs are available on a wide variety of topics. AOA Category 1-A, 1-B, or 2-B credit may be earned for each course.

Orthopaedic surgeon Scott Gibson, DO was one of the presenters at the 4th Annual FOMC.

Co-sponsored by Arizona Osteopathic Medical Association and Flagstaff Medical Center, FOMC featured six lectures on a variety of topics: Care of the Actively Dying Patient by Bridget Stiegler, DO; Tuberculosis Challenges in the Navajo Nation in the Context of an Emerging Global Threat by Capt. Ha Tang, DO; Innovations in Orthopedic Surgery and DVT and PE Prophylaxis in Surgical Patients by Scott Gibson, DO; Diagnosis and Management of Dementia by Justin DeLange, DO; Hepatitis C - A Thing of the Past? by David Leff, DO; and Women’s Health Update by B J Ho, DO. Thank you to the speakers for their informative and timely lectures and all who attended the conference. Save the date for the 5th Annual FOMC on Saturday, August 17, 2019.

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Recently added lectures: • ABCs of Hepatitis • Facts & Fiction: The Truth About E-Cigs • Functional Medicine • Headache Medicine for the Non-Neurologist • Heart Health and Pregnancy • Man Up! Why Men Won’t See Their Doctor • Primary Palliative Care • Psoriasis • Thyroid Nodule Workup Check back often for new topics! Visit the AOMA website under the Education tab.

www.docme.org AOMA members receive a $10 discount on all AOMA-produced CME programs. Enter promo code AOMA2017.


AOMA News

Create a Recipe for Success at the AOMA 38th Annual Fall Seminar Join us for the AOMA 38th Annual Fall Seminar at the El Conquistador Tucson, a Hilton Resort. The theme of the event is Recipe for Success: Innovations and Applications. Twelve lectures will be presented over the weekend of November 10 & 11, 2018. AOMA has partnered with Touro University Nevada College of Osteopathic Medicine to offer both AOA Category 1-A and AMA PRA 1 CreditsTM. The Arizona Osteopathic Medical Association (AOMA) is accredited by the American Osteopathic Association (AOA) to provide osteopathic continuing medical education for physicians. The AOMA designates this program for a maximum of 12.25 hours of AOA Category 1-A CME credits and will report CME credits commensurate with the extent of the physician’s participation in this activity. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Touro University Nevada College of Osteopathic Medicine (TUNCOM) and the Arizona Osteopathic Medical Association. TUNCOM is accredited by ACCME to provide continuing medical education for physicians. TUNCOM designates this live activity for a maximum of 12.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Application has been submitted for AAFP Prescribed credits. Determination of credits is pending. Online registration is available at www.az-osteo.org/FallSeminar AOMA Member

$ 295

Non Member

$ 420

Retired or Honorary Life AOMA Member

$ 245

Non-Physician Clinician (NP, RN, PA)

$ 245

CME AGENDA Saturday, November 10, 2018 7:30 am to 8:25 am Campylobacter Infection Richard Shaughnessy, DO 8:30 am to 9:25 am Food Borne Illnesses: US and Global Food Security Challenge Capt. Ha Tang, DO 9:55 am to 10:50 am Coalescent Medicine – Recipe for Successful Pain Management Ann Cheri Foxx, MD 10:55 am to 11:50 am Low Testosterone and How to Fix it with Fat Adam Nally, DO 12:10 pm to 1:30 pm Luncheon Lecture: I’m the Doctor, So I’m in Charge, Right? Karen Nichols, DO, MA, MACOI, CS 1:35 pm to 2:00 pm Difficult Conversations Pamela Johnson, BSN, RN, CPHRM CONCURRENT AFTERNOON SESSIONS 2:15 pm to 3:40 pm OMM Pearls: There's an OMM Treatment for That? Richard Dobrusin, DO, MS (Ost.), FACOFP Gregory Hollick, DO, AOBFP, C-NMM/OMM Shannon Scott, DO, FACOFP Anthony Will, DO OR Understanding the Regulations & Policies for the Safe Prescribing of Opioids Pete Wertheim, MS Sunday, November 11, 2018 7:30 am to 8:55 am Two-Minute OMM Techniques for Common Primary Care Conditions Anthony Will, DO 9:00 am to 9:55 am The Science Behind Your DNA Ancestry Results Mylynda Massart, MD, PhD 10:10 am to 11:05 am Minimally Invasive LVADs and Hybrid Therapies Zain Khalpey, MD, PhD, FETCS, FACS 11:10 am to 12:35 pm The Clown as Sacred Healer Carl Hammerschlag, MD, CPAE All topics, speakers and times are subject to change.

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AOMA Digest Fall 2018


AOMA News

Birdies Mean Bucks for Arizona Osteopathic Charities birdiesforcharityaz.com Help Us Reach Our Goal! You can make Arizona Osteopathic Charities a big bucks winner by making a pledge in the Birdies for Charity competition at the 2019 Waste Management Phoenix Open to be held at the TPC Golf Course January 31 to February 3, 2019. Arizona Osteopathic Charities will receive every penny of collected pledges. By making a pledge, you can help provide free sports physicals for school athletes conducted by Team of Physicians for Students (TOPS), support DOCARE (international medical outreach), offer comfort for children who have suffered a death in their life at Camp Paz, and expand healthcare in underserved areas through MGY Capacidad. We Want Your 2 Cents - Literally! Simply pledge two cents or more for every birdie that will be made by the PGA Tour players, Thursday through Sunday, at the 2019 Waste Management Phoenix Open and you will be supporting Arizona Osteopathic Charities. It’s estimated that between 1,300 and 1,800 birdies will be made. ToRIZONA make RIZONA a pledge online go to birdiesforcharityaz.com and click on “Donate Now”. STEOPATHIC Contact Sharon Daggett at charities@az-osteo.org for more information. STEOPATHIC

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The Arizona Osteopathic Charities is a 501 (c) (3) non-profit charitable organization founded in 1997 by the leadership of the Arizona Osteopathic Medical Association. AOMA Digest Summer 2017 24 24 AOMA Digest Summer 2017 Tax ID #86-6052826 www.azdocharities.org

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AOMA Digest Fall 2018

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AOMA News

2019 AOMA Clinical Case Competition and Poster Forum Each year, the Arizona Osteopathic Medical Association sponsors a Clinical Case Competition and Poster Forum. The Poster Forum is open to all osteopathic medical students, residents, and faculty/preceptors across the state of Arizona. The Clinical Case Competition is open to third and fourth year osteopathic medical students attending medical school in Arizona. These scientific, peer-reviewed, evidence-based opportunities showcase the tremendous amount of top-quality scholarly activity that is developed on an annual basis. The 2019 competitions mark the eleventh year for these events and promise to be the best contests yet. Students submitting the top three clinical cases are invited to deliver an oral case presentation during the AOMA 97th Annual Convention on Saturday, April 13, 2019. Posters are displayed over the course of the Convention with the formal judging held on Saturday, April 13, 2019. The winners will be recognized at the awards ceremony and luncheon on Sunday, April 14, 2019. The AOMA is proud to sponsor these competitions, fostering first-class research and improved participation in the Association’s committee structure, as well as an increase in Association membership. Most importantly, it supports the mission and vision of the organization by promoting the osteopathic medical profession and providing high-quality medical education. Complete details for entry submission, including previous winning entries, are available on the AOMA website under the CME/Clinical Case & Poster Forum tab at www. az-osteo.org. Direct your questions to Kristen Strong at AOMA at 602-714-6574 or kristen@az-osteo.org.

IMPORTANT DATES Poster Abstract Submission Deadline: February 15, 2019 (including evidence of IRB submission) Clinical Case Presentation Deadline (in PDF format): February 15, 2019 (including evidence of IRB submission) Notification to Authors of Acceptance/Exclusion: February 25, 2019 Poster Submission Deadline (in PDF format) March 18, 2019 Clinical Case Finalists Submission Deadline (PowerPoint Presentation) March 18, 2019 Clinical Case Presentation April 13, 2019 Poster Forum Judging April 13, 2019 AOMA Awards Ceremony & Luncheon April 14, 2019

Maryann Davies’ winning Clinical Case poster from the 2018 competition.

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AOMA Digest Fall 2018


AOMA News

Mark Your Calendars! Two Important AOMA Events DO Day at the Legislature February 19, 2019 Reserve your spot to attend DO Day at the Legislature on Tuesday, February 19, 2019. The DO Day at the Legislature provides a great opportunity to get an up-close view of the legislative process and to meet your legislators. The day begins with an orientation followed by presentations from key legislators on healthcare issues. AOMA will help you arrange individual meetings with your legislators, and you will have the opportunity to attend House or Senate hearings throughout the day. Register at www.az-osteo.org/DODayRSVP

More than 40 different lectures are planned encompassing multiple specialties including family medicine, internal medicine, psychiatry, OMM, pediatrics, cardiology, OB/ GYN, gastroenterology, emergency medicine, and more.

AOMA 97th Annual Convention April 10-14, 2019 Hilton Scottsdale Resort & Villas Scottsdale, Arizona ARIZONA’S LARGEST ANNUAL MEDICAL MEETING! AOMA Digest Fall 2018

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This activity has been approved for AOA Category 1A Credit. This activity has been approved for AMA PRA Category 1 Credit™. Application will be submitted for AAFP prescribed credits.


ATSU-SOMA Receives $1.9 Million HRSA Grant to Strengthen Primary Care Workforce A.T. Still University School of Osteopathic Medicine in Arizona (ATSUSOMA) has received a $1,999,650 grant from the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA). The funding, which will be distributed over five years, will support an innovative primary care fellowship for physicians and physician assistants, strengthening the healthcare workforce in underserved communities. Led by Joy H. Lewis, DO, PhD, FACP, professor and chair of the public health department, the ATSU-SOMA team is uniquely positioned to address community health needs. The School has a national track record in curricular innovation, a charge to serve vulnerable populations, and a strong relationship with the National Association of Community Health Centers. The Primary Care Transformation Executive fellowship will prepare healthcare providers to address social determinants of health, improving population health and enhancing primary care in America’s community health centers (CHCs). “Building on our work with the American Medical Association’s Accelerating Change in Medical Education Consortium, this HRSA-funded initiative will join health systems science with community-based research experiences to better position primary care champions to address the social determinants of health,” says Dr. Lewis. “The grant will advance the training of practicing primary care physicians and physician assistants in the areas of leadership, team-based integrated healthcare, quality improvement, population health, social determinants of health, health policy, and health education – all components of health systems, and all elements of healthcare delivery we want our students to understand and practice,” says Jeffrey Morgan, DO, FACOI, CS, dean of ATSU-SOMA. “Our medical students, whose training is embedded in CHCs and the communities served by CHCs, will be the direct beneficiaries of this focused education in the science of health systems.” Acknowledgement and disclaimer: This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,999,650. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, or the U.S. government.

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AOMA Digest Fall 2018


Osteopathic Community News

David McCall, DO: Still Living the ATSU Mission David McCall, DO, ’13, recently moved back to his hometown of Waco, Texas to begin his career as a surgeon. After four years of medical school and five years in a general surgery program, the A.T. Still University-School of Osteopathic Medicine in Arizona (ATSU-SOMA) alumnus is ready to apply his skills as a medical professional to help others, both locally and globally. From a young age, Dr. McCall knew that healthcare was his calling. He grew up in Nigeria, where his parents worked as medical missionaries. The family moved back to Texas when Dr. McCall was in high school, but he continued to accompany his father on medical mission trips, providing much-needed care in underserved areas of Ghana, Haiti, and Cuba. “That’s what led me into medicine,” says Dr. McCall. After completing his undergraduate and graduate education at Baylor University, Dr. McCall began the process of applying to medical schools. In researching his options, he realized ATSU-SOMA was the perfect fit. “ATSU’s mission is to get students out into the community and train physicians who will engage in rural and underserved areas here in the U.S. and around the world. At my interview, I had a lightbulb moment. I said, ‘This is where I’m supposed to be.’ I was so excited when I got accepted.” Although Dr. McCall has put down roots in Waco, he plans to continue fulfilling ATSU’s mission by providing medical care to underserved areas around the world. In fact, his employment contract includes time off for medical mission trips. After years of medical mission work all over the world, Dr. McCall’s parents now run a ministry, Restoration Gateway, in Uganda. AOMA Digest Fall 2018

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The ministry serves an area that has been devastated by war. Its programs include an orphanage, a hospital, a dental center, and a school. “All the services they provide are critical to that area,” says Dr. McCall. “I’d love to see their ministry flourish.” Dr. McCall also has some well-known relatives who are committed to serving others at a local level. His wife’s sister is Joanna Gaines, star of the popular HGTV show, Fixer Upper. Joanna and her husband, Chip, give new life to old homes in Waco and surrounding areas, revitalizing neighborhoods and improving the community. The couple has also been very supportive of Restoration Gateway, holding fundraisers and even visiting the project in Uganda. As if a burgeoning career and medical mission work weren’t enough to keep him busy, Dr. McCall and his wife have their hands full with six young children. To maintain balance in his life, Dr. McCall is committed to being purposeful with his time, both at work and at home. “When I get home, I really try to engage with my kids and my wife and not let those moments go by and miss out,” says Dr. McCall. “I didn’t want to put everything on hold for five years.” Of course, with so much going on in his life, he does have to make some compromises. “Vegging out and watching TV on the couch is something of the past,” he jokes. For Dr. McCall, all the hard work has been worth it, and he has some encouraging words for aspiring medical professionals. “I always encourage people to pursue their dream, regardless of what it is,” he says. “Your journey is going to be unique; it doesn’t have to look like everyone else’s. If you are passionate about something, and that is what you really feel called to, pursue it wholeheartedly. Stay the course.”


Osteopathic Community News

Students Healing from Hurricane Maria Find Support at ATSU On September 20, 2017, Hurricane Maria — a powerful Category 4 hurricane with 150 mph winds — made direct landfall on Puerto Rico, drenching the island in feet of rain. Residents were prisoners in their homes, left without electricity, running water, phones, or internet. Among those affected were 25 students from A.T. Still University (ATSU), 20 from the PostProfessional Doctor of Physical Therapy program and five from the Post-Professional Doctor of Audiology program. With the assistance of ATSU’s Arizona School of Health Sciences (ATSU-ASHS) Dean Randy Danielsen PhD, PA, DFAAPA; Ann Lee Burch, PT, EdD, MPH, Vice Dean of ATSUASHS; Tammy Roehling, PT, DPT, director, transitional doctor of physical therapy; and Tabitha Parent Buck, AuD, professor and chair, the University quickly organized a $25,000 emergency fund for ATSU students in Puerto Rico. Thanks to the immediate efforts of ATSU President Craig Phelps, DO, ’84, and the controller’s office, the funds were distributed to each of the affected students within days. Transitional doctor of physical therapy student, Denisse Santiago, was living in Puerto Rico at the time Hurricane Maria swept through, and she was very thankful for the emergency relief funds sent from ATSU.

“This has been an incredible gesture and has certainly helped me and my family in this difficult time. Our routines have drastically changed and we face difficulties to perform even the most basic tasks every day. Please keep our island in your prayers. We have a long way to go,” said Santiago. ATSU’s program directors and faculty were also incredibly diligent about maintaining contact with the affected students. In addition to the emergency funds provided, deadlines for the students were extended and late fees were excused. Post-professional doctor of physical therapy student, Pura Santiago-Torres, was amazed by the tremendous support she received from ATSU during this trying time. “This gesture goes beyond what I ever could have expected and touches my heart and my husband’s. Thank you with all my heart, there are no words that can express the gratitude for what ATSU has done for us,” said SantiagoTorres. ATSU leadership and faculty were equally astonished at how each affected student persevered despite the disaster at hand. The dedication the students maintained for the program studies was unbelievable. While many of the students were still shrouded in uncertainty for their future, they described using their studies as a way to distract from their troubles. In spite of the odds stacked against them, all 25 students managed to stay on track, and many were able to travel to Arizona for commencement. Dr. Phelps commended these students’ perseverance during the June graduation ceremonies. “Everyone rolled up their sleeves and made something happen for the affected students,” said Dr. Burch. “Timing was everything. To have that caring, rapid response from invested faculty and leadership is really what ATSU is all about.” 29

AOMA Digest Fall 2018


Osteopathic Community News

ATSU-SOMA Holds First Culinary Medicine Workshop

ATSU-ASDOH Provides Dental Care at Juvenile Detention Facilities

A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) recently held its first culinary medicine workshop as part of the Osteopathic Wellness Lifestyle (OWL) program. Student participants learned to blend the culinary arts with researched-based medical science to treat and prevent many chronic diseases. The curriculum promotes the use of nutritious food as medicine in response to many common, chronic health concerns. For example, students learned about the correlation between diet and metabolic disease while preparing black bean sweet potato stew. They also explored the research on foods that fight cancer while cooking a tasty sesame broccoli dish with brown rice. “It has made me more aware of the effects diet has on health, and I plan to apply this knowledge by incorporating more detailed nutritional advice into treatment plans where appropriate,” says first-year student Benjamin Jiao.

Until early last year, if a child in Arizona’s juvenile detention facilities had tooth pain, dental care options were limited. Thanks to A.T. Still University Arizona School of Dentistry & Oral Health (ATSU-ASDOH), these youth now receive preventive care, dental education, and prompt treatment for dental emergencies. In partnership with Maricopa County, ATSUASDOH provides services for youth in detention centers at two sites. Basic care, including exams, cleanings, and fluoride varnish applications, is provided at county facilities. Youth with acute needs, such as pain and infection, are transported to ATSU-ASDOH’s Advanced Care Clinic on the School’s Mesa campus. To date, approximately 200 youth have received care through the program. Dental services are provided on-site by ATSU-ASDOH students under the guidance of dental hygienists on the ATSU faculty. Using teledentistry technology, faculty work with students to review records, photos, and X-rays collected in the field to develop treatment plans for the young patients. For patients, the benefits of the partnership extend beyond oral health and proper dental care may even minimize the negative behaviors that lead youth to detention facilities. “If we can help them get out of pain and be comfortable now, my hope is that the lack of pain leads to better behavior, which leads to a shorter sentence and a quicker turnaround in the system, so they can get their lives back,” says Scott Howell, DMD, MPH, FSCD, ’14, assistant professor at ATSU-ASDOH. The program was recently recognized by the National Association of Counties (NACo) with a NACo Achievement Award. NACo awards recognize innovative county government programs across the country.

In addition to nutrition, the OWL program covers many topics in lifestyle medicine such as exercise, sleep, and stress management. Despite the growing body of research that supports the correlation between lifestyle and chronic disease, most medical schools fail to meet even minimum standards of instruction in this area. To address this need, ATSU-SOMA has begun to incorporate its innovative osteopathic lifestyle medicine curriculum across all four years of students’ medical education. The curriculum is designed to encourage future physicians to approach patients with an emphasis on wellness, rather than disease. In doing so, the program addresses the overwhelming rates of physician depression and lifestyle imbalance, promoting wellness and self-care for medical students. AOMA Digest Fall 2018

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Osteopathic Community News

Incoming DO Students Receive Stethoscopes from Jason Madachy Foundation

Each member of the Midwestern University Arizona College of Osteopathic Medicine (AZCOM) Class of 2022 received a brand new stethoscope with the words “Excel in Leaving a Mark” engraved in the metal from the Jason Madachy Foundation. The stethoscopes are a gift made in remembrance of the late Jason Madachy, a medical student at Marshall University’s Joan C. Edwards School of Medicine who passed away unexpectedly in 2007. The Foundation’s annual tradition of providing stethoscopes continues Jason’s dream of touching hearts through medicine.

Midwestern University Receives 10-Year Accreditation from Higher Learning Commission Midwestern University has received official notice from the Institutions Actions Council of the Higher Learning Commission (HLC) that confirms that the University will continue with full accreditation for another 10-year cycle. The Higher Learning Commission's decision states that the University's next Reaffirmation of Accreditation will occur in the 2027-2028 accreditation cycle. This news comes at the conclusion of a comprehensive evaluation of the University's curriculum, standards of excellence, and clinical operations that took place in January,

and marked the end of the previous 10-year accreditation cycle. "Maintaining accreditation and meeting the rigorous standards required by the Higher Learning Commission requires a great deal of hard work and dedication from our entire Midwestern University family," said Midwestern University President and Chief Executive Officer Kathleen H. Goeppinger, PhD. "I wish to convey my very sincere thanks to our wonderful faculty, staff, and administrators for this fantastic achievement." 31

AOMA Digest Fall 2018


Osteopathic Community News

APPOINTMENTS, AWARDS & GRANTS Ashley Burkart (AZCOM 2021) was selected as a 2018 Paul Ambrose Scholar by the Association for Prevention Teaching and Research (APTR). Ms. Burkart was also selected to attend the Public Health Leadership Symposium in Philadelphia, PA. Ian Coker (AZCOM 2020) was elected President of the American College of Osteopathic Family Physicians (ACOFP) National Executive Student Board. Ryan Dyches (AZCOM 2019) was appointed as the Student Director for the American Osteopathic Foundation (AOF) Council of Osteopathic Student Government Presidents. Mr. Dyches also received the Arizona Osteopathic Charities Scholarship. Tracy Middleton, DO, FACOFP, Chair, Clinical Education, was named Educator of the Year by the American College of Osteopathic Family Physicians (ACOFP). William Peppo, DO, FACOI, FCCP, Chair, Clinical Education, was named Teacher of the Year by the American College of Osteopathic Internists (ACOI). Shannon Scott, DO, FACOFP, Assistant Dean and Medical Director, Multispecialty Clinic, was elected to the American Osteopathic Association Board of Trustees. Dr. Scott also was named the National Board of Osteopathic Medical Examiners’ (NBOME) Item Writer of the Year for COMLEX Level 2 CE. Kelly Sippel (AZCOM 2019) won first prize in the 8th Annual A. Hollis Wolfe Case Competition held in Glendale. Ms. Sippel also represented AZCOM in the National Case Competition at the American Academy of Osteopathy (AAO) Convocation. Kathy Vo (AZCOM 2019) received the Student Government Association (SGA) Research Scholarship. The following AZCOM Class of 2020 students were selected to receive the annual MICA Medical Foundation Scholarship: • Ian Elijah Johnson • Pete Jonathan Manchen • Sino Mehrmal

UPCOMING MWU EVENTS: MARK YOUR CALENDARS Midwestern University Fall Open House Saturday, October 27, 2018 9 am to 2 pm Glendale Campus 19555 N. 59th Avenue Glendale, Arizona 85308 AOMA Digest Fall 2018

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“Kitten Lady” Workshops College of Veterinary Medicine Saturday, November 10, 2018 10:30 am and 1:30 pm Glendale Campus 19555 N. 59th Avenue Glendale, Arizona 85308


Osteopathic Community News

MWU HONORS THREE NEW MEMBERS OF LITTLEJOHN SOCIETY Midwestern University President and Chief Executive Officer Kathleen H. Goeppinger, PhD, announced three new recipients of the Littlejohn Award, the University’s highest honor. Named for the Littlejohn brothers, physicians who in 1900 founded the American College of Osteopathic Medicine & Surgery - the precursor to the Chicago College of Osteopathic Medicine and founding college of Midwestern University - the award recognizes outstanding service to the community, healthcare professions, and the University. The winners are selected from Midwestern faculty, staff, and alumni for their outstanding service to the community, healthcare professions, and the University. This year’s honorees are alumna Shannon C. Scott, DO, FACOFP, Assistant Dean, Arizona College of Osteopathic Medicine, and Medical Director, Midwestern University

Multispecialty Clinic; faculty member Jose A. Hernandez, PhD, Chair, Biochemistry, College of Graduate Studies; and staff member Laurie J. Miller, RVT, CVT, CVPM, Practice Manager, Midwestern University Companion Animal Clinic.

Midwestern University honors 2018 Littlejohn Award winners Laurie J. Miller, RVT, CVT, CVPM; Jose A. Hernandez, PhD; and Shannon C. Scott, DO, FACOFP.

MIDWESTERN UNIVERSITY HONORS SERVICE, RAISES SCHOLARSHIP FUNDS AT BRIGHT LIGHTS, SHINING STARS GALA Academic, healthcare, business, and community leaders from around the Valley of the Sun joined together at Midwestern University on Saturday, October 13, 2018 at the annual Bright Lights, Shining Stars gala, which recognizes and honors community service and leadership. Kathleen H. Goeppinger, PhD, President and Chief Executive Officer of Midwestern University, presented the 2018 Shooting Star Award to Midwestern faculty members William H. Devine, DO and Dana S. Devine, DO and the 2018 COMET (Community Outreach: Motivating Excellence for Tomorrow) Award to artist Joe A. Tyler. Six Spirit of Service scholarships were awarded at the gala to students representing three Midwestern University colleges for the 2018-2019 academic year. The Spirit of Service

scholarship program recognizes outstanding Midwestern University students based on community service, leadership abilities, academic standing, and financial need. The annual black-tie-optional event, which raises scholarship funds for students in all of Midwestern University’s colleges, also featured a formal dinner, live entertainment, and a silent auction. Dana S. Devine, DO and William H. Devine, DO 2018 Shooting Star Award winners.

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AOMA Digest Fall 2018


Osteopathic Community News

AZCOM Class of 2022 MIM Icebreaker The Arizona College of Osteopathic Medicine incoming class of DO candidates recently spent a day at the Musical Instrument Museum (MIM) in Phoenix as part of their orientation activities. The new group of students had a chance to get to know each other in an informal setting and introduce themselves to AZCOM faculty. They were also treated to an interactive presentation from MIM, which included a scavenger hunt to identify various musical instruments from around the world located in the MIM collections. The activities were designed to help students understand the value of listening and observation as physicians, as well as relax before embarking on the challenges of didactic study. AZCOM Dean Lori Kemper, DO, FACOFP and Associate Deans Sean Reeder, DO, Katherine Mitzel, DO, FACEP, and Randall Nydam, PhD, accompanied the class.

Midwestern University Establishes the College of Graduate Studies Midwestern University President and Chief Executive Officer Kathleen H. Goeppinger, PhD, announced the addition of the new College of Graduate Studies. Formally established in July 2018, the College of Graduate Studies offers degree programs at the University’s Glendale, Arizona, and Downers Grove, Illinois, campuses and upholds academic excellence by pursuing the advancement of knowledge as part of the triad of education, research, and service. The College endeavors to share existing knowledge, to create new knowledge, and to apply knowledge that contributes to improving the health of humans, animals, and the environment through One Health principles and practice. The College is the new home for Midwestern’s Biomedical Sciences programs, which previously were offered under the auspices of the College of Health Sciences. Kyle Ramsey, PhD, serves as the College’s inaugural Dean. AOMA Digest Fall 2018

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Karen Nichols, DO Elected to ACGME and UFOS; Receives Presidential Citation At its meeting in September 2018, the Accreditation Council for Graduate Medical Education (ACGME) elected AOA and AOMA Past President Karen J. Nichols, DO, MA, MACOI, CS as Vice Chair of the Board of Directors. Since 2014 Dr. Nichols has been actively involved in the development of the Single Accreditation System for graduate medical education for both allopathic and osteopathic physicians. Her contributions include the addition of Osteopathic Neuromusculoskeletal Medicine as a new core specialty, the formation of the Osteopathic Principles Committee, and definition of Osteopathic Recognition for ACGMEaccredited programs providing training in osteopathic principles and practices. The ACGME is responsible for the accreditation of approximately 11,200 residency and fellowship programs and the 830 institutions that sponsor these programs in the United States. At the 2018 AOA Annual Meeting, Dr. Nichols was recognized by outgoing AOA President Mark Baker, DO with AOA’s highest honor, the AOA Presidential Citation. Dr. Nichols was also elected to serve as the chair of the United Federation of Osteopathic Societies (UFOS), a coalition of forty smaller state osteopathic organizations, the District of Columbia, and the Military. Dr. Nichols has dedicated her career to advancing osteopathic medical education through outstanding leadership. She was the first woman to serve as the president of AOMA, AOA, and the American College of Osteopathic Internists. She recently retired as Dean of Midwestern University Chicago College of Osteopathic Medicine in Downers Grove, Illinois.


Osteopathic Community News

Doctors That DO Pop-up Wellness Exhibits Win HEMMY

Shannon Scott, DO Elected Third Vice President to AOA Board of Trustees

The Arizona Public Health Association (AzPHA) awarded the 2018 Health Education Media Maker Yearly Award (HEMMY) to the AOMA Doctors That DO Pop-Up Wellness Exhibits. The exhibits were funded by a community outreach grant received from A.T. Still University and were created to educate the Arizona community about the DO philosophy of treating the mind, body, and spirit with a focus on wellness. A student-run committee comprised of representatives from both ATSU-SOMA and AZCOM led the project. Congratulations to all who participated.

During the 2018 American Osteopathic Association (AOA) Annual Meeting Shannon Scott, DO, FACOFP, was elected Third Vice President to the AOA Board of Trustees. Dr. Scott previously served on the AOA Board of Trustees as its first New Physician in Practice board member. She is Assistant Dean at Arizona College of Osteopathic Medicine and Medical Director of the Multispecialty Clinic at Midwestern University. Dr. Scott was 2016-2017 AOMA President.

Christopher Labban, DO Appointed to Mountain Vista Medical Center Governing Board

AOMA and the students were recognized at the AzPHA 90th Anniversary Celebration and Annual Awards on October 2, 2018.

Christopher Labban, DO, family physician and owner of Southwest Medical Center in Mesa, Arizona, has been appointed to the Mountain Vista Medical Center Governing Board. The Board is comprised of community and medical members who provide guidance and oversight to the hospital’s leadership. Mountain Vista Medical Center is a 178bed hospital owned and operated by Steward Health Care, a physician-led healthcare services organization headquartered in Dallas, Texas. Dr. Labban is the current AOMA PresidentElect.

Got a DOs in the News item? Left to right: Will Humble, MPH, AzPHA Executive Director; Pete Wertheim, MS, AOMA Executive Director; Darien Kinne, OMS IV, ATSU-SOMA; Elysia Tjong, OMS II, ATSU-SOMA; Christine Morgan, EdD, ATSU-SOMA; Samantha Easterly, OMS V, AZCOM; Marcus Johnson, MPH, AzPHA President.

Send it to communications@az-osteo.org and we will share it in the Digest.

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AOMA Digest Fall 2018


Osteopathic Community News

2018-2019 Calendar of Events October 26, 2018 Dinner with Doctors Maricopa County Medical Society 6:00 pm Phoenix, Arizona November 9, 2018 AOMA Board of Trustees Meeting 7:00 pm El Conquistador Tucson November 10, 2018 AOMA House of Delegates 4:00 pm El Conquistador Tucson

February 19, 2019 DO Day at the Legislature Arizona State Capitol Phoenix, Arizona April 10, 2019 AOMA Board of Trustees Meeting 7:00 pm Hilton Scottsdale Resort & Villas April 10-14, 2019 AOMA 97th Annual Convention Hilton Scottsdale Resort & Villas 6333 N. Scottsdale Road Scottsdale, Arizona April 12, 2019 AOMA House of Delegates 4:00 pm Hilton Scottsdale Resort & Villas

November 10 & 11, 2018 AOMA 38th Annual Fall Seminar El Conquistador Tucson, A Hilton Resort 10000 N. Oracle Road Tucson, Arizona January 26, 2019 AOMA Board of Trustees Meeting 9:00 am Midwestern University Glendale, Arizona

June 2019 AOMA Board of Trustees Meeting 9:00 am A.T. Still University Mesa, Arizona

Advertisers’ Index MICA...................................Inside Front Cover ProAssurance........................................Page 10 AzDHS OARLine....................................Page 13 Midwestern University Body Donation Program....................Page 19 DOCME...................................................Page 22 Arizona Osteopathic Charities.........Page 24 AOMA Career Center.......Inside Back Cover A.T. Still University Osteopathic Center Arizona...............Outside Back Cover

Update Your Member Profile and WIN! You could win a $100 VISA gift card. Please take the time to visit the AOMA website and login to update your professional profile information for the online AOMA Directory. Deadline to be entered into the gift card drawing is January 31, 2019. See what’s new on the AOMA website. Register for

www.az-osteo.org

the 38th Annual Fall Seminar; take an online CME course; or check out the resources for physicians. Visit often for future enhancements and features!

AOMA Digest Fall 2018

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Searching for a job? Looking to fill a position? Expanding your practice? The AOMA Career Center is your best resource for qualified osteopathic physicians. Dedicated to the osteopathic medical community, the AOMA Career Center is a valuable search and recruitment resource for professionals and employers in Arizona. The AOMA Career Center offers simple and easy-to-use tools to make searching for career opportunities and finding qualified candidates fast, efficient and successful.

PROFESSIONALS Keep your career on the move • POST a resume or anonymous career profile that leads employers to you • Search and apply to hundreds of fresh jobs by using robust filters • SeT UP efficient job alerts to deliver the latest jobs right to your in-box • aSK the experts about your career issues

eMPlOyerS

Find your next great hire • eMaIl your job to qualified professionals • Place your job in front of our highly qualified members • Search our resume database of qualified candidates • MaNaGe jobs and applicant activity right on our site • lIMIT applicants only to those who are qualified • FIll your jobs more quickly with great talent Visit the aOMa career center

Arizona Osteopathic Medical Association

Arizona Osteopathic Medical Association

Discover the difference the AOMA Career Center can make for you. To search jobs, post jobs, or learn more visit www.az-osteo.org/jobs.


Arizona Osteopathic Medical Association and Arizona Osteopathic Charities 5150 N. 16th Street, Suite A-122 Phoenix, AZ 85016

Join us for AOMA DO Day at the Legislature. Reserve your spot at www.az-osteo.org/DODayRSVP

A.T. Still University Osteopathic Medicine Center Arizona Our hands-on, whole-body approach and osteopathic manipulative medicine treatment can provide relief from pain in your first visit. 5845 E. Still Circle, Suite 109 Mesa, AZ 85206 Hours: Monday-Friday 8:00 a.m.-5:00 p.m. Phone: 480.248.8198

atsu.edu/aoma-omm

AOMA Digest Fall 2018  

The official publication of the Arizona Osteopathic Medical Association

AOMA Digest Fall 2018  

The official publication of the Arizona Osteopathic Medical Association

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