AOMA Digest Fall 2020

Digest Arizona Osteopathic Medical Association

D.O. means Dig On! Dr. A.T. Still

INSIDE Volume 35, No. 2 Fall 2020

Come Together & Dig On: 40th Annual Fall Seminar 2020-2021 AOMA Board of Trustees AOMA in Action

We can’t say it enough.

Thank you to all the healthcare professionals on the frontline of the COVID-19 pandemic.

Mutual Insurance Company of Arizona 2602 E. Thomas Road Phoenix, Arizona 85016 602.956.5276, 800.352.0402 www.mica-insurance.com

Volume 35, No. 2 Fall 2020

Digest

2020-2021 Board of Trustees President Richard Dobrusin, DO, MS (Ost), FACOFP

The Official Publication of the Arizona Osteopathic Medical Association

President Elect Danielle Barnett-Trapp, DO Immediate Past President Christopher Labban, DO, HPF Vice President Brandon Abbott, DO, MPH, FAAP Secretary/Treasurer James Keane, DO, MEd Executive Director/Editor

COLUMNS 2 President’s Message 4 Executive Director’s Message 8 AOMA 2020-2021 Board of Trustees 10 AOMA in Action

Josephine Zammuto Trustees Alphonse Ambrosia, DO, FACC Craig Cassidy, DO, FAOCO Donald Curran, DO Susan Del Sordi-Staats, DO Datcha Dorvil, DO, MPH

FEATURES 11 We Dig On For You! We DO! 13 Digging On Like DOs Do 16 When A Patient Wants Something Specific 20 Understanding the Impact of COVID-19 on Your Lease

David England, MS, DO Michelle Eyler, DO Kendra Gray, DO, FACOG William Jaffe, DO, FACOI Brendon Labban, DO Michael Lokale, DO, MSc (Oxon), FAAFP Donald Middleton, DO Julie Morrison, DO Homan Mostafavi, DO, MBA George Parides, DO, FACOI

AOMA NEWS 22 Welcome New AOMA Members 23 40th Annual Fall Seminar - Live Streaming 24 100 Years of Healing 25 6th Annual Flagstaff Osteopathic Medical Conference Recap 25 2021 Clinical Case Competition and Poster Forum

Bunnie Richie, DO, FAAN Student Trustees Issa Ismail, OMS II - SOMA Jay Olson, MS, OMS IV - AZCOM Speaker of the House of Delegates Jeffrey Morgan, DO, MA, CS, FACOI Vice Speaker of the House Charles Finch, DO, FACOEP

OSTEOPATHIC COMMUNITY NEWS 26 Arizona Chapter of the American College of Osteopathic Family Physicians

26 Arizona Osteopathic Charities - Birdies for Charity 27 Midwestern University Arizona College of Osteopathic Medicine 29 A.T. Still University School of Osteopathic Medicine in Arizona 32 Calendar of Events 32 Advertisers Index

AOMA Staff Director of Membership and Communications and Managing Editor Janet Weigel Director of Education Teresa Roland Operations Manager Kristen Strong © 2020

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AOMA Digest Fall 2020

President’s Message

Dig On! There is an ancient Chinese saying, “may you live in interesting times”.

Like it or not, we live in interesting times.

We are currently going through a period of time with uncertainty, danger, and conflict.

All of us have had our work, family life, Richard S. Dobrusin, and daily routines DO, MS (Ost), FACOFP dramatically affected 2020-2021 AOMA President by the current corona virus pandemic.

AOMA has not been immune from the events of 2020. The illness and passing of Executive Director Pete Wertheim, the transformation of the annual convention as a virtual event, the search for - and hiring of - our new Executive Director Josephine Zammuto, and the move to our new offices are just a sampling of the “interesting” challenges we have faced and endured.

The father of osteopathy, Dr. Andrew Taylor Still, wrote in his journals that “D.O. means Dig On.” Miners dig for gold.

Archaeologists dig for artifacts. Pirates dig for buried treasure. Pigs dig for truffles.

Farmers dig for potatoes. As osteopathic physicians, we “dig on” to get to the root of a problem and dig for knowledge and answers about how we treat and care for our patients, not just diagnose illness.

Besides the most common meaning “to break up, turn, or loosen with an implement or to prepare the soil (of a garden)”, the Merriam-Webster Dictionary definition also includes:

AOMA Digest Fall 2020

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Dig (

)

Verb: to bring to the surface, unearth; to bring to light or out of hiding; to work hard or laboriously; to poke, prod; to advance by or removing or pushing aside material Slang: to pay attention to, notice; to like, admire; to understand, appreciate We can dig in our heels or dig that new jazz record. We can dig into history or tease someone by giving them a dig.

When we sink a shovel into the earth for the groundbreaking of a new project, we are digging for a new beginning. And AOMA certainly has embarked on a new beginning in 2020.

• First of all, I can tell you without hesitation that I am personally convinced that bringing Josephine Zammuto on board as our new Executive Director was the right decision for the future of our organization. She is an outstanding addition to the Association.

• In July, AOMA received its provisional accreditation as an ACCME-accredited provider of continuing medical education, a designation earned by only a few osteopathic organizations.

AOMA has been an accredited sponsor of AOA continuing medical education since 1993. This is an important distinction for our Association. As a dually-accredited provider, AOMA is now authorized to provide both AOA Category 1 A credits and AMA PRA Category 1 CreditsTM for all its CME activities.

President’s Message

• In September AOMA moved into its new “digs” on Camelback Road and 19th Avenue. The new location is a beautiful space in a desirable office complex with a very favorable long-term lease.

Personally, I am “digging on” the interesting times ahead for AOMA and our profession.

• We believe that it is the future of medical meetings to include both a live and a virtual component and AOMA has made the necessary transitions to offer professional virtual programs that will complement its already outstanding live events.

• We are actively evaluating the effectiveness and the organizational structure of our committees.

• We are working to make AOMA an even better place to work by assessing our policies, procedures, and employee benefits.

• We are very much looking forward to the virtual 40th Annual Fall Seminar with the theme Come Together and Dig On. This event has been expanded to 20 hours and two and one-half days. (See page 23 for more information.)

• In 2021 we will celebrate the 100th anniversary of AOMA. The Anniversary Celebration Committee is planning a year-long observance, so stay tuned.

• AOMA will hold its 99th Annual Convention in April in Scottsdale. We are extremely hopeful that this Convention can be live and that we will finally be able to get together and see each other in person again.

• To commemorate the next 100 years of AOMA, we will be rolling out a new look for the Association, including an updated logo and website.

• We are building for the future of the Association with strong leadership succession, including President Elect Danielle Barnett-Trapp, DO, who will be a spectacular leader to carry on the work of our great organization.

It is a pleasure to serve as your AOMA President during these interesting times.

You can be assured that the AOMA staff, Executive Committee, Board of Trustees, and House of Delegates are “digging on” for you and your profession. We hope you dig what we are accomplishing on your behalf and that you will invite your friends and colleagues to dig on with us.

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AOMA Digest Fall 2020

Executive Director’s Message

The Pause That Refreshes Is it really fall, already?? In the four months since I joined AOMA as executive director, I have started the day with the motto “It’s a new day at AOMA!” and the challenge “What will we do better?” Today, I’d like to pause and reflect on some of the Josephine Zammuto happenings before my AOMA Executive Director arrival to Arizona and AOMA and a little about where we are headed.

At the onset of the coronavirus pandemic, the world pressed the “pause” button and life as we knew it changed. The Second Legislative Session of the 54th Arizona Legislature was no exception.

Even though the legislative session lasted 134 days, the Arizona Senate and House of Representatives were recessed on March 23, 2020, pausing after only 70 days. A total of 1,734 bills were introduced, of which only 90 passed and were signed into law.

Both chambers came back in late May to officially adjourn and rest sine die.

Most of the legislation that was passed addressed technical board and agency continuation. A “skinny” state budget was passed amid coronavirus concerns, racial inequality protests, and contentious primary races in a politically charged election year.

In the absence of new legislation, the plethora of Executive Orders that followed from Governor Ducey’s office aimed at mitigating the coronavirus crisis had significant impacts on the practice of medicine.

AOMA Digest Fall 2020

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Partnership is key to successful legislative advocacy efforts. With the terminal illness and passing of AOMA Executive Director Pete Wertheim, the Association relied heavily on our friends in the field. Contract lobbyist Steve Barclay, JD was invaluable this year representing AOMA’s interests throughout many long days and evening meetings with legislators and testifying in committees.

The AOMA Legislative Affairs Committee played an important role in analyzing and developing health care policies while advocating on behalf of DOs and their patients. Led by AOMA’s outstanding policy expert and chair Kit McCalla, DO, MBA, this dedicated and diverse group of volunteers tracked more than 100 bills and took policy positions on over 60 bills on behalf of AOMA. The AOMA Student Legislative Affairs Committee has grown to more than 100 students who are engaged in AOMA policies and strategic advocacy. Through the collective voices of physicians and students, the AOMA is continuously striving to strengthen its advocacy efforts and build impactful relationships with policymakers.

AOMA thanks our partners at the Arizona Medical Association, Arizona Dental Association, Arizona Public Health Association, Arizona Hospital and Healthcare Association, Arizona Academy of Family Physicians, American Academy of Pediatrics - Arizona Chapter, The Arizona Partnership for Immunization (TAPI), Arizona Alliance for Community Health Centers, and Arizona Nurses Association.

We also acknowledge the contributions of the Arizona College of Osteopathic Medicine at Midwestern University and A.T. Still University School of Osteopathic Medicine in Arizona, and many others who

Executive Director’s Message

helped lead and advance strong public policies in the state.

Before the pause, AOMA and its stakeholder partners worked diligently to support legislation to improve patient care and ease administrative burdens as well as oppose and defeat bills that would encroach on physicians’ scope of practice and potentially jeopardize patient safety.

As I write this message, the General Election is just a few weeks away. The August primary elections saw several incumbents with ties to both the Senate and House health committees lose in their Districts. Depending upon the outcome of a number of close races in the General Election, we could see a shift in party control of one or both of the Arizona Legislative Chambers. When the senators and representatives convene the First Regular Legislative Session of the 55th Arizona Legislature in January 2021, we expect that a some of the bills that died due to COVID-19 will be “refreshed” and some bills originating in the Senate may be fast tracked through committees and to the floor for vote.

Good health care policy is not based in party politics. Advocacy is a vital component to advancing and protecting the best interests of physicians and patients. The Arizona Osteopathic Medical Association is your best ally in assessing and monitoring the capabilities and activities of those who govern and regulate health care in Arizona.

Even though the world has been on pause, it’s a new day at AOMA. Association leadership and staff have continued to work diligently to “refresh” the AOMA’s focus on serving its members. In the coming months you will see the products of these labors as we prepare to celebrate the 100th Anniversary of AOMA. We’re excited to celebrate the trailblazers who established the osteopathic medical profession in Arizona. But to continue our work of protecting and promoting their vision for osteopathic medicine in Arizona, we need your sustaining support of the Association.

The Pause That Refreshes continued on page 6

To learn more about how AOMA works for you and your profession, the 2020 AOMA Legislative Report provides important information about the 2020 session and related legislative activities.

Visit the Advocacy Resources page on the AOMA website at https://www.az-osteo. org/page/AdvocacyResource. Access to this comprehensive legislative report is exclusive to AOMA members and is one of the many benefits of membership.

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AOMA Digest Fall 2020

Executive Director’s Message The Pause That Refreshes continued from page 5

Here are some great ways you can help and be a part of the exciting future of AOMA. • Maintain your membership with the Association AOMA membership doesn’t cost – it pays! For about $9 per week, AOMA membership is an affordable vehicle to keep abreast of national and local issues, protect your professional practice, enhance your specialized skills, further your career, and be a part of the future of osteopathic medicine in Arizona.

• Contribute to the AOMA Political Action Committee (AOMA PAC) The AOMA PAC is a most important tool for preserving and fostering the medical profession in Arizona, allowing us to endorse and support those candidates for state public office who share our concern about the future of health care and improved access to quality care in Arizona. Through AOMA PAC we can make monetary contributions to those legislative and statewide candidates who are in agreement with our principles and favor a strong Arizona health care system led by osteopathic physicians.

To help support these efforts and contribute go to www.az-osteo.org/PAC. • Recruit your colleagues Do you know another DO or MD who isn’t an AOMA member and should be?

A vibrant, growing membership base strengthens our voice. Recruit a new member and you will both receive a $100 credit toward membership dues or CME fees. Go to www.az-osteo.org/ Recruit to learn more.

• Serve on a Committee AOMA Committee members who serve are vital to the Association, providing guidance, oversight, and vision. Have an interest in education? The Professional Education Committee develops CME content. Passionate about advocacy?

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The Legislative Affairs Committee reviews and monitors pending legislation that impacts health care.

Great at networking and sharing your passion for the osteopathic profession?

The Membership Services Committee focuses on membership growth and satisfaction. Other interests? We have several committees for you to consider.

Please contact the AOMA office and let us know how you wish to be involved.

We’d love to welcome you on a committee!

• Attend an AOMA CME activity We are proud to be the only AOA and ACCME-accredited provider of continuing medical education (CME) in Arizona!! Now, with dual accreditation, AOMA is the premier source for CME in the State. The Association has always presented top-quality learning at our in person events, and during the (unique or uncertain) times we face during 2020, our commitment to you has not wavered. While it doesn’t beat the opportunity to connect with colleagues and friends in person, our virtual CME events deliver the CME you want and need in an easy and convenient format.

We look forward to when we can host you again in person.

The 40th Annual Fall Seminar is a favorite activity for satisfying end-ofthe year CME requirements and this year is expanded to two and one-half days offering 20 hours of CME. (Go to www.az-osteo.org/Fall2020 to register.)

The Flagstaff Osteopathic Conference presented 12 hours of CME over a new one and one-half day virtual format.

Looking ahead to April 2021, the AOMA 99th Annual Convention, the largest annual medical meeting in Arizona, is currently planned as a combined live and virtual event. AOMA live events

Executive Director’s Message

offer more than 50 hours of CME each year and through our collaboration with www.DOCME.org, AOMA members receive discounts on nearly 100 CME programs on demand. We’re doing our best to compete with your favorite at home streaming services!

The year 2020 has impacted all of us – personally, professionally, and philosophically. It has altered our world in countless ways, some forever. Humans are resilient and innovative. The temporary halt prompted our profession to take a fresh look at patient care: telemedicine exploded; vaccine development accelerated; 3-D printers created face shields and ventilator parts by the thousands; distilleries and breweries converted production from alcoholic beverages to hand sanitizer. With your continued support, AOMA is, and will continue to be, here to support you and your profession through it all.

THANK YOU, again, to all who have stepped up during the pandemic to ensure Arizonans who need health care can get it. You continue to be heroes, and we are proud to represent you.

We don’t know what is to come so for now, to borrow from the famous Coca-Cola slogan first introduced in 1929 as the world was heading into the Great Depression, The Pause That Refreshes, we invite you to “pause and refresh”; take a break in your own way, slow down, reflect, and have hope. Oh, and if you’re so inclined – enjoy an ice-cold, refreshing glass of Coke! Until next time…..

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AOMA Digest Fall 2020

2020-2021 Board of Trustees

Arizona Osteopathic Medical Association

EXECUTIVE COMMITTEE

Richard Dobrusin, DO, MS (Ost), FACOFP President

Stay strong!

Christopher Labban, DO, HPF Immediate Past President

Danielle Barnett-Trapp, DO President Elect

It’s an honor to represent you.

Brandon Abbott, DO, MPH, FAAP Vice President

James Keane, DO, MEd Secretary/Treasurer

Josephine Zammuto Executive Director

TRUSTEES

We’ve trained our whole lives for this!

Alphonse Ambrosia, DO, FACC District 4 Representative

AOMA Digest Fall 2020

Craig Cassidy, DO, FACOO Specialists

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Donald Curran, DO District 2 Representative

Susan Del Sordi-Staats, DO District 3 Representative

2020-2021 Board of Trustees

ng!

stro Stay

Datcha Dorvil, DO, MPH Member at Large

We’ve trained our whole lives for this!

David England, MS, DO District 5 Representative

Michelle Eyler, DO Member at Large

Kendra Gray, DO Member at Large

Fighting for you!

William Jaffe, DO, FACOI District 7 Representative

Brendon Labban, DO Member at Large

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

We’ve trained our whole lives for this!

Julie Morrison, DO District 6 Representative

Issa Ismail, OMS II SOMA Student Trustee

Donald Middleton, DO District 1 Representative

AOMA continues to serve you!

Homan Mostafavi, DO, MBA Member at Large

Jay Olson, MS, OMS IV AZCOM Student Trustee

George Parides, DO, FACOI Member at Large

Bunnie Richie, DO, FAAN Member at Large

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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AOMA Digest Fall 2020

AOMA in Action

AOMA in Action

AOMA is the voice of osteopathic medicine in Arizona, representing the profession as a health care stakeholder and community partner. This activity update covers the three-month period from July 1, 2020 to September 30, 2020.

Advocacy/Legislative Affairs • Published the 2020 AOMA Legislative Report.

Access to this comprehensive legislative report is exclusive to AOMA members and is one of the many benefits of membership.

• Represented AOMA on the Arizona Healthcare Advocacy Coalition (AHAC) • Participated in various stakeholder meetings related to the ongoing response to COVID-19 American Osteopathic Association (AOA) • Attended the AOA Annual Meeting and House of Delegates as a virtual event on July 17, 2020 • Attend the United Federation of Osteopathic Societies (UFOS) virtual meeting on July 18, 2020

Osteopathic Charities • Received more than $6,000 in donations in honor of Pete Wertheim. The money will be used to fund scholarships for osteopathic medical students attending medical school in Arizona The Future of the Osteopathic Profession • Welcomed more than 400 new student members to AOMA from the Class of 2024 at Midwestern University Arizona College of Osteopathic Medicine and A.T. Still University School of Osteopathic Medicine in Arizona

Member Services • Relocated AOMA office to its new location at 19th Avenue and Camelback in Phoenix • Increased frequency of the AOMA Dispatch eNewsletter to twice monthly to improve the timeliness of communications to members Public Health • Represented AOMA on The Arizona Partnership for Immunization (TAPI) Steering Committee • Represented AOMA on the Arizona Telemedicine Stakeholder meetings • Represented AOMA on the Arizona Hospital and Health Association PR Peer Roundtable Continuing Medical Education • Received provisional accreditation from the Accreditation Council for Continuing Medical Education (ACCME) as a provider of AMA PRA 1 CreditsTM , distinguishing AOMA as the only dually accredited provider of both AOA and AMA credits in Arizona • Reaccredited the Arizona Opioid Prescribing Education program (www.AzRxEd.org) through June 30, 2021 offering free opioid prescribing education to all prescribers • Expanded the 6th Annual Flagstaff Osteopathic Medical Conference to one and one-half days and sponsored 12.0 hours of AOA Category 1-A CME credit and AMA PRA Category 1 creditsTM which was held virtually on August 15 & 16, 2020 AOMA Digest Fall 2020

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Protect your profession.

Contribute to the AOMA Political Action Committee PURPOSE AOMA Political Action Committee (PAC) is an essential vehicle for preserving and fostering the osteopathic medical profession in Arizona. The PAC allows us to endorse and support those candidates for state public office who share our concern about the future of health care and improved access to quality care in Arizona.

CONTRIBUTE ONLINE! No more need for hard copy forms and checks in the mail. It’s easier than ever to contribute to the AOMA PAC and make a difference.

Go to www.az-osteo.org/PAC or scan the code.

Features

We ‘Dig On’ for You! We DO!

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

Amidst the life-altering pandemic that is COVID-19, we Dig On for you! We DO. For our students, staff, faculty, and our preceptor partners in the medical education of tomorrow’s physicians. For our community health center partners. And for our own health and wellbeing.

The impact of COVID-19 on the world’s population is well documented and personally felt by so many. That impact was felt in the medical education community as well, and played-out in the form of a mass transition away from in-person training to online learning across the United States.

A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) was no different in this regard, so we dug in, and followed the lead and recommendations of our national leadership organizations who urged a temporary move away from clinical training environments to online learning formats in mid-March. While 100% online instruction was not considered an optimal learning experience for tomorrow’s healers, ATSU-SOMA was well-positioned to make the move. Our curricular model already embraced distance learning and utilized the Zoom videoconferencing platform for instruction and meetings; so, transitioning to an all-Zoom classroom was less painful than we suspect it may have been for others. In fact, the level and frequency of communications between faculty, students, and staff seemingly increased as a result.

As more was learned about the risks associated with COVID-19 and the opportunity to resume clinical training was identified, our students found themselves once again engaged in in-person clinical training – albeit sporting masks, face shields, gloves, and other necessary personal protection equipment. Online

For hands-on clinical training in OMM skills, ATSU-SOMA students are assigned a practice partner for the entire year and work in small groups of six classmates.

learning, however, was fully embraced and will likely persist and develop further as we explore how best to meet the evolving learning preferences of today’s adult learners. Our virtual classrooms are well attended and are supportive of the needs of students who necessarily prefer to keep themselves and family members as safe as possible from the persistent risk of infection by SARs-CoV-2.

We Dig On for You continued on page 12

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AOMA Digest Fall 2020

Features We Dig On for You continued from page 11

To address the need and benefit of inperson training necessary to develop the medical skills unique to our osteopathic profession and practices, ATSU-SOMA has implemented limited on-campus training opportunities that follow closely the safety measures proposed by national, state, and local health experts. Small group gatherings, physical (social) distancing, frequent hand washing, face masks/ shields, and frequent disinfection of work and training spaces are all adhered to closely. Within this context, students readily embraced the limited in-person opportunity to hone and perfect their osteopathic diagnostic skills – a testimony to the character and dedication of our future osteopathic physicians.

So, while change is upon us, we choose to Dig On. We Dig On so that those less fortunate have someone to rely on. We Dig On to become better educators, better leaders, better people. We Dig On to become better in every way.

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www.docme.org AOMA members receive a $10 discount on all AOMA-created CME programs.

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AOMA Digest Fall 2020

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Features

Digging On Like DOs Do

By Lori A. Kemper, DO, MS, FACOFP, Dean, Midwestern University Arizona College of Osteopathic Medicine

Over the course of the last six months, things have been turned on their heads.

Early in the novel coronavirus pandemic, students at Midwestern University Arizona School of Osteopathic Medicine (AZCOM) began to be removed from rotations by hospitals and the AZCOM leadership team made the decision to pull students off rotations to pause them and give sites a chance to look at how safety could be maintained and how student education would look.

By the second week of the pause, the Clinical Chairs, under the leadership of Sean Reeder, DO, Associate Dean for Clinical Education, had created programming to help students finish their last few rotations in a virtual world. Kudos belong to the Clinical Chairs, who worked hard to keep students moving forward (Digging On like DOs do). Additionally, Katherine Mitzel, DO, Associate Dean for Curricular Integration moved our Curriculum Committee in a path to review and approve virtual courses in days, rather than the usual weeks or months.

Partnerships with hospitals in the Abrazo system allowed us to prepare a public health rotation that included experiential training. While I put the course together quickly, with assistance from Dr. Mitzel, I also want to acknowledge Anthony Will, DO and Andrew Yorgason, DO for taking on the course directorship of that class as I worked to do the monthly accreditation reports and work with the administrative team in getting the classes, students, and faculty back on campus safely.

AZCOM students in the Class of 2020 graduated on time in a virtual graduation in May and had plenty of time to move to their new residency sites. This gave us

a breather of a day or two to move our attention to the rising third- and fourthyear students. Hospitals had begun to allow us to train students again by the first week of June. All we needed was to give them the necessary personal protective equipment (PPE). PPE was, of course, in short supply.

The university found suppliers and began to collect that which would be needed, some in the tens of thousands of units, in order for students to remain on rotation and new first and second year students to learn in live, socially distanced (to the extent possible) clinical skills classes. Tracy Middleton, DO, Chair of the Department of Osteopathic Family and Community Medicine worked with her team to plan out the upcoming quarters of OMM and Clinical Medicine courses and, once again, set AZCOM on a path to keep its first and second year students moving forward (Digging On like DOs do).

The Midwestern University Multispecialty Clinic remained open as the coronavirus pandemic spread across Arizona.

Digging On Like DOs Do continued on page 14

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AOMA Digest Fall 2020

Features Digging On Like DOs Do continued from page 13

In the Midwestern University Multispecialty Clinic, our clinic switched to telemedicine overnight. Shannon Scott, DO, the clinic Medical Director and Assistant Dean for AZCOM did a wonderful job helping all of our physicians learn how to optimally care for patients using telemedicine, bill appropriately for the service, and pull students into the mix so they could have live experiences in the care of patients. She helped us keep our patients cared for at a difficult time (Digging On like DOs do).

It appears that a more diverse physician population will help improve the health care in minority communities. With the goal to increase diversity of the student body, the AZCOM Bridges Program has been developed. This program, in partnership with the College of Graduate

Studies at Midwestern University, will reserve up to 25 admission spots per year for underrepresented minority and underprivileged (per HRSA definitions) applicants. Students will be admitted to the Biomedical Science Program and AZCOM simultaneously, with their admission to AZCOM guaranteed for the following year if the students demonstrate quality work in the master’s program, as well as meet certain requirements while studying in that program. AZCOM will accept MCAT scores as low as 490 for this program, to allow students to really learn how to be strong students during the master’s program, rather than spend time and money retaking the MCAT in an attempt to raise their score.

AZCOM alumni work at the care of our communities.

Digging On like DOs do.

The coronavirus pandemic required physicians to swiftly and efficiently adapt to telemedicine for safe, contact-free patient visits. According to the Arizona Telemedicine Program at the University of Arizona, Medicare telehealth services increased by 11,718 per cent between March and April 2020.

Other payors reported similar increases. Source: https://telemedicine.arizona.edu/blog

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Features

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AOMA Digest Fall 2020

Features

When A Patient Wants Something Specific

By Karen B. Everitt, JD, BSN, Vice President, MICA Risk Management Services

Massive electronic communication networks, heavy advertising by pharmaceutical companies, and the availability of medical research online motivate patients to request specific medications, tests, procedures, and referrals. Research shows physicians and other health care practitioners often agree to the requests, even when their professional judgment tells them otherwise.

In a 2013 survey of 2,938 primary care physicians and specialists, approximately 40% of respondents reported sometimes or often prescribing a brand-name drug, even when an effective generic was available, because the patient requested it.1 Half the respondents to a 2014 state medical society survey said they have written unnecessary but patient-requested prescriptions and orders for antibiotics, opioids, tests, procedures, and hospital admissions to avoid conflict and ensure better patient satisfaction scores.2 Instead, physicians and other health care practitioners should rely on their education, training, and experience to make clinical decisions even when they feel pressured to acquiesce to patient requests.

Evidence of Acquiescence Through their desire to heal, comfort, and preserve patient relationships, physicians and other health care professionals may yield to patients’ requests. In one study, researchers produced two sets of clinical videos: an undiagnosed patient with symptoms suggesting sciatica and a patient diagnosed with chronic osteoarthritis of the knee.3 Actively practicing physicians developed the scenarios based on actual patient encounters. The researchers

AOMA Digest Fall 2020

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predicted that multiple videos utilizing varied patients of differing socioeconomic status, gender, race/ethnicity, and request styles (assertive or passive) and physicians of differing age, gender, and clinical experience would account for variances.

The patients had different professions and occupations: truck driver, salesperson, janitor, and lawyer. Independent primary care physicians reviewed the clinical content.

Half of the sciatica patients requested oxycodone and half of the osteoarthritis patients requested Celebrex. The way the patient worded the medication request was essentially the same. The physicians watched pairs of videos, first the passive request and then the active request.

Experienced primary care physicians from six states watched the videos and completed a survey of management of the patient and prescribing decision.

PASSIVE REQUEST The osteoarthritis patients told the physician they saw a television advertisement for Celebrex and that a coworker takes it and believes it works.

ACTIVE REQUEST The sciatica patients told the physician their spouse had some left-over oxycodone, the patient took one, and the patient was amazed at the relief.

Features

PRESCRIBING DECISIONS FOLLOWING SUSPECTED SCIATICA PATIENT’S ACTIVE REQUEST FOR OXYCODONE % physicians prescribing

19.8% 56.2% 12.5% 56.2% 34%

Physicians’ choice of medication Oxycodone Strong narcotic4 Weak narcotic5 NSAID No narcotic

PRESCRIBING DECISIONS WHERE SUSPECTED SCIATICA PATIENT PASSIVELY REQUESTED OXYCODONE % physicians prescribing 1% 29% 26% 64.6% 43%

Physicians’ choice of medication Oxycodone Strong narcotic4 Weak narcotic5 NSAID No narcotic

PRESCRIBING DECISIONS FOLLOWING OSTEOARTHRITIS PATIENT’S ACTIVE REQUEST FOR CELEBREX

% physicians Physicians’ choice prescribing of medication 53.1% 30.2% 33.3% 17.7%

Celebrex Narcotic Non-selective NSAID No NSAID

PRESCRIBING DECISIONS WHERE OSTEOARTHRITIS PATIENT PASSIVELY REQUESTED CELEBREX % physicians prescribing 24% 40.6% 51% 34.4%

Physicians’ choice of medication Celebrex Narcotic Non-selective NSAID No NSAID

The researchers chose narcotics for the study because they are usually effective for short-term use but generally not recommended for sciatica and possibly contraindicated for a patient whose occupation is driving. After watching the patient-requesting-oxycodone video, most study participants prescribed a “strong narcotic” and were less likely to prescribe a “weak narcotic.”

The researchers chose Celebrex for the study as a more expensive, but not therapeutically better medication than non-selective Cox-2 inhibitors. Study participants were more likely to prescribe Celebrex following the osteoarthritis patients’ requests and were less likely to choose another NSAID. The patient’s race/ethnicity, gender, socioeconomic status, and request style, and the study participants’ gender and experience level did not appear to affect the physicians’ decisions. The researchers concluded that patients’ requests alone influenced the physicians’ choice of medication. The style of the request, passive or active, seemed to have the greatest influence over the physicians’ decisions.

Active requests for a strong narcotic, Oxycodone, or Celebrex were almost always successful but other covariances were as influential as the request style. The higher the percentage of the physician’s income was dependent on third party payor quality of care measures and number of patient visits per the week, the more likely they would acquiesce. The participant’s level of personal responsibility for the financial success of the practice also seemed to result in compliance with patient requests.

Perceptions that administrative issues affected clinical decisions and belief that their compensation was unfair appeared to correlate with denial of the requests.

When a Patient Wants Something continued on page 18

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Features When a Patient Wants Something continued from page 17

The study had limitations, but the results reveal an opportunity for physicians and other health care professionals to more effectively respond to requests for opioids and specific medications, tests, and referrals and to improve communication.

The following professional liability risk strategies will help formulate a respectful and genuine response.

• Acknowledge the patient’s emotions, concerns, requests, and/or expectations.

• Consider why the patient made the specific request. The patient may have requested something specific out of fear, as a result of television or online advertising, or because of a family member’s or coworker’s experience.

Physicians should ask how the request will help the patient meet his/her treatment goals. The patient’s answers should help form the basis of the physician’s response.

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• Explore the patient’s occupation, hobbies, and family responsibilities related to requested and alternative medications. For instance, certain medications may be contraindicated if the patient is a commercial driver, uses woodworking tools, or operates heavy or dangerous machinery.

• Say “no” with an explanation. When a patient says s/he needs a magnetic resonance imaging (MRI) for a brain tumor, Dr. Chesanow, an internist writing in a Medscape article, suggests not immediately saying, “No.” Instead he says, “Well, an MRI is an option but let me tell you what I think we should do or what the best option is for you” or, “Okay, we can consider your request, but let me tell you what I think.” The internist’s other approaches are, “Well, we could do what you want but let me tell you why we shouldn’t,” and, “Let me offer some treatment options that aren’t what you asked for and tell you how we can get you feeling better so that you can [mow your lawn].”6 • Encourage and positively reinforce the patient’s efforts and good choices so far. Examples include, “Your concern is valid,” “I agree with you,” “I see your point,” and “You’re right.” Such statements indicate collaboration and shared decision-making without agreeing to the patient’s request.

• Discuss the risks and benefits of and the alternatives to the patient’s request.

• Document the request; the patient’s reason for the request; the discussion and patient’s acknowledgement of risks, benefits, and alternatives; whether the request is or is not contraindicated; and the patient’s decision or response.

Features

Saying no and having it accepted is a skill which can be developed. Learning to say no using the FAVER approach takes five steps.7 The watchful waiting, or wait and see approach, is another way to skillfully say no to an immediate request for something specific the physician does not believe is indicated.8 No matter the method used, learning to say no takes practice.

1. Campbell EG, Pham-Kanter G, Vogeli C, Iezzoni LI. Physician acquiescence to patient demands for brandname drugs: Results of a national survey of physicians, JAMA Intern Med, 2013;173(3):237-239, Last accessed September 28, 2019, at https://jamanetwork.com/ journals/jamainternalmedicine/fullarticle/1555818.

2. Impact of patient satisfaction ratings on physicians and clinical care, Patient Prefer Adherence, 2014;8:437-46, Last accessed September 28, 2019, at https://reference. medscape.com/medline/abstract/24729691 3. McKinlay JB, Trachtenberg F, Marceau LD, Katz JN, Fischer MA. Effects of patient medication requests on physician prescribing behavior: results of a factorial experiment. Med Care. 2014 April; 52(4): 294-299, Last accessed September 28, 2019 at https://www.ncbi.nlm.nih. gov/pmc/articles/PMC4151257/ 4. Hydrocodone, oxycodone, vicoprofen, roxicet, percocet 5. Codeine, tramadol, ultracet, propoxyphene napsylate 6. Chesanow N. 10 Ways to Say No to Patients -- and Still Keep Them Smiling - Medscape - Feb 17, 2016. Last accessed September 27, 2019, at https://www.medscape. com/viewarticle/854509_2.

7. Getting to no: how to respond to inappropriate patient requests, Last accessed September 28, 2019, at https:// www.aafp.org/fpm/2018/0100/p25.pdf.

8. May L, Franks P, Jerant A, Fenton J. Watchful waiting and diagnostic testing, J Am Board Fam Med 2016;29:710– 717

AOMA Career Center: Connecting Talent with Opportunity Looking for that ideal candidate?

Searching for a job?

Buying or selling a practice?

Need office space?

Have space for rent?

AOMA members receive a 20% discount off all Career Center products. Call the AOMA office to obtain the promo code.

Discover the difference the AOMA Career Center can make for you.

Go to www.az-osteo.org/Jobs.

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 99 years 19

AOMA Digest Fall 2020

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Understanding the Impact of COVID-19 on Your Lease

By Tracy Altemus, CCIM, Executive VP, Health Care Brokerage Services Agent and Murray Gares, CCIM, Senior VP, Tenant/Buyer Representation Agen

There has been an unprecedented amount of immediate economic challenges as a result of the COVID-19. Tenants of health care real estate include medical and dental practices and this sector has not been immune to the impact of the pandemic.

Businesses are seeing changes in the shortterm and could possibly see a long-term effect in how they conduct their practice such as operational shifts, reduced patient volume, and an increase in virtual office visits creating a consequential need to contain expenses.

Lease Clauses We may see a strengthening or revision on lease clauses in the future to include pandemic relief language. As a tenant it is important to stay aware of new lease language or clauses that may develop or be revised from this pandemic. For example there are clauses that may be able to be negotiated to provide a tenant the right for early lease termination based on a pandemic event.

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Force Majeure One clause that may be affected is the Force Majeure clause, which depending on how the applicable lease language is drafted, gives a tenant the right to be excused temporarily to perform any act (other than the payment of rent) required under the Lease due to certain extreme events such as an act of God, strikes, lockouts, labor disputes, and restrictive governmental laws or regulations beyond the control of either tenant or landlord.

Another probable future addition to this clause may be specific language referencing a “Pandemic� such as COVID-19 to be included as an excusable event. Including terms in regard to rent abatement or rent deferment is another likely addition to the Force Majeure clause but realize too that with that may come additional term added to the lease.

Business Interruption Insurance Another clause that may be affected by a pandemic event may be Business Interruption Insurance. Landlords may put the onus back on the tenant to carry Business Interruption Insurance that would cover a Pandemic event such as COVID-19.

Since this has never been underwritten by insurance companies, it may be a very expensive insurance rider if and when it comes available.

Features

Continuous Use Clauses Continuous Use clauses may also be revised as a result of COVID-19. These clauses are typically more prevalent in retail properties but they are seen in medical office leases as well. They require a tenant to use the premises on a continuous basis and non-compliance could result in a lease default. While this clause may not have been a concern in the past, tenants may want to consider modifying the requirements in the event of a pandemic.

While we are in the beginning stages of realizing the full impact of future lease language clauses, it is something to be aware of as they will certainly be brought up, discussed, and negotiated and to

whose favor is still to be determined. We recommend reviewing your contracts with a trusted commercial real estate professional and attorney as you are negotiating any lease.

There are many nuances to a lease that tenants should be aware of and expenses are just one of them. For your protection, it is always good to have broker representation and/or an attorney to help navigate the many facets of your agreement, so that you are insulated from surprises as much as possible.

Questions? Contact Ensemble Real Estate Solutions & Investments at 602-277-8558 or visit www.ensemble.net.

Positive Returns On Your Membership Investment www.az-osteo.org/BusinessPartners AOMA's Business Partners Program provides immediate access to national and local high-quality providers. Special rates have been negotiated and we have tested their ability to provide exceptional service for our association members.

Mutual Insurance Company of Arizona 602-956-5276 800-352-0402 www.mica-insurance.com

Real Estate Services Tracy Altemus,CCIM 602-277-8558 taltemus@ensemble.net www.ensemble.net

Financial Services Bryan Martinka 623-210-2314 bryan.martinka@westpacwealth.com www.westpacwealth.com

Know a trusted business you would recommend as an AOMA Business Partner?

Contact us at communications@az-osteo.org or 602-266-6699.

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AOMA News

Welcome New AOMA Members Physician Erba Carskadden, DO Family Medicine/OMT – Board Certified Emergency Medicine Sedona, Arizona 800-301-2820 Lee Johnson, DO Obstetrics & Gynecology – Board Certified Flagstaff, Arizona 928-522-1300 Devon Weprich, DO Internal Medicine – Board Certified Tucson, AZ John T. Crawford, DO Family Medicine – Board Certified Oro Valley, Arizona 520-825-0300

We also welcome the Class of 2024 at A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) and Midwestern University Arizona College of Osteopathic Medicine (AZCOM) as Student Members of AOMA. Medical students receive complimentary AOMA membership.

First year medical students entering ATSU-SOMA this fall total 160.

AZCOM’s first year student doctors number 252.

We wish these future DOs the very best in their studies!

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

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AOMA News

Come Together and Dig On! 40th Annual Fall Seminar Join us for the AOMA 40th Annual Fall Seminar - Livestreaming on November 6-8, 2020. The theme of the expanded event is Come Together and Dig On covering two and one-half days and offering 20 hours of lectures.

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 20.0 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). The Arizona Osteopathic Medical Association (AOMA) is accredited by ACCME to provide continuing medical education for physicians.

AOMA designates this live activity for a maximum of 20.0 AMA PRA Category 1 Credits™.

Physicians should only claim credit commensurate with the extent of their participation in the activity.

This Live activity, AOMA 40th Annual Fall Seminar: Come Together and Dig On, with a beginning date of 11/06/2020, has been reviewed and is acceptable for up to 20.0 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Lectures planned for the 40th Annual Fall Seminar include: • COVID-19: What We Have Learned So Far • COVID-19 on the Navajo Reservation • Public Health Response to COVID-19 • Telehealth: Best Practices and the Pandemic Learning Curve • Leading in Chaos • Physician Burnout/Happiness • Financial Assistance in a COVID World • Telemedicine Liability During COVID • A Domesticated Epidemic • Ways to Recover - Meditation/Mindfullness • Deciphering Dietary Patterns • Whole Person Self Care in Daily Small Bites

• Two and one-half days!

• 20 hours!

• On demand playback included!

• Stump the Doc Competition • Severely Elevated Asymptomatic Hypertension - Is it and Emergency?

• Painful Somatic Dysfunctions, Using CCP and the Rapid Structural Screening • Pediatric Update • Melanoma Update • The Role of Interventional Cardiology in Congenital Heart Disease • Cardiac Amyloidosis The full agenda for the Seminar is available at www.az-osteo.org/Fall2020. All topics, speakers, and times are subject to change.

Registration for the AOMA 40th Annual Fall Seminar includes on demand playback of the lectures. Register by November 5, 2020 and save $50. Online registration is available www.az-osteo.org/Fall2020 AOMA Member

$ 535

Non Member

$ 860

Retired or Honorary Life AOMA Member

$ 430

Non-Physician Clinician (NP, RN, PA)

$ 535

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AOMA Digest Fall 2020

AOMA News

Update Your Member Profile and WIN! AOMA will celebrate its 100th anniversary in 2021, and we need your help!

We are planning a year-long celebration and a special event to commemorate this milestone. AOMA is combing through its photographs and document archives, but we know there are many of you out there who have stories and memorabilia that will add to the effort. So far we have identified the following photos that are lacking in our collections. Can you or someone you know fill in the blanks?

Missing Past Presidents Photos: •• Lester A. Nowlin 1952-53 •• Van H. Fossler - 1953-54 •• Richard O. McGill - 1954-55 •• Thomas J. Odom - 1955-56 •• Russell Peterson - 1956-57 •• James Carson - 1957-58 •• Larry Belden - 1959-60 •• R.D. Bennett - 1962-63 •• Everett Gibson - 1963-64 •• C. Condie Call - 1964-65 •• Paul Edgar - 1967-68 •• Robert Kring - 1969-70 •• Robert Gooch - 1970-71 •• Thomas Kesson - 1971-72 •• James Brooks - 1972-73 •• David Leopold - 1973-74 •• L. George Hershey - 1975-76 •• Richard Reilly - 1977-78 •• R. E. Dennis - 1980-81 •• Jerry Hutchinson - 1983-84 •• William Johanssen - 1984-85 Interested in helping? We are in need of volunteers to go through boxes of old photos to help identify people and places.

Email Janet Weigel at janet@az-osteo.org.

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, 2021.

Register for the 40th Annual Fall Seminar - Virtual Streaming, download the AOMA 2020 Legislative Report, or take an online CME course. Visit often for future enhancements and features!

Patients need your full focus. Stop worrying about student loans. about student loans.

SoFi is here to help you take down student debt—with exclusive student loan benefits, for members. Plus, access financial education tools, guides, calculators, and more.

Claim your 0.25% rate discount‡ toward your student loans. Checking your rate will not affect your credit score.

SoFi.com/AOA Terms and Conditions Apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. To qualify, a borrower must be a U.S. citizen or permanent resident in an eligible state and meet SoFi's underwriting requirements. Not all borrowers receive the lowest rate. To qualify for the lowest rate, you must have a responsible financial history and meet other conditions. If approved, your actual rate will be within the range of rates listed above and will depend on a variety of factors, including term of loan, a responsible financial history, years of experience, income and other factors. Rates and Terms are subject to change at anytime without notice and are subject to state restrictions. SoFi refinance loans are private loans and do not have the same repayment options that the federal loan program offers such as Income Based Repayment or Income Contingent Repayment or PAYE. Licensed by the Department of Business Oversight under the California Financing Law License No. 6054612. SoFi loans are originated by SoFi Lending Corp., NMLS # 1121636. (www.nmlsconsumeraccess.org)

AOMA Digest Fall 2020

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AOMA News

6th Annual Flagstaff Osteopathic Medical Conference

2021 AOMA Clinical Case Competition and Poster Forum

Like most of the meetings and conferences held during recent months, the 6th Annual Flagstaff Osteopathic Medical Conference (FOMC) was converted to a virtual event held August 15 & 16, 2020. More than 150 physicians from across Arizona and the country tuned in for the expanded one and one-half day event with 12.0 hours of AOA Category 1-A CME credit and AMA PRA 1 creditsTM. Co-sponsored by AOMA and Flagstaff Medical Center, FOMC featured 24 lectures: Bariatrics Update for 2020; Asymptomatic Carotid Artery Stenosis; Common Spine Pathologies; Shoulder Pain Diagnosis and Treatment; Needles, Cocaine, and Shooting Up: Regional Anesthesia Basics; Current Trends: Trauma, Surgical Critical Care, and Acute Care Surgery; Management of Non-Burn Patients in a Burn Center; Acute & Chronic Sinusitis; Atrial Fibrillation: 2020 Update; Cardiovascular Prevention in the ERA of COVID-19; Peripheral Arterial Disease (PAD) and Indications for Revascularization; Vascular Access in Dialysis Patients; CGRP Antibody Therapy: A New Frontier in Migraine Treatment; BPH and ED – How to Diagnose and Manage, When to Refer; COVID-19: Updates and Lessons Learned; Prognostication in Serious Illness; Diagnostic Breast Imaging and Percutaneous Interventions; What Evaluation/Testing Does My Patient Really Need Prior to Undergoing Surgery?; Breast Reconstruction: Current Approaches and Outcomes; Prostate Cancer Imaging, What, When and How; Common Urologic Procedures for the Rural Surgeon; Thyroid Pearls; The Agony of De Feet; Update on Medical Education and the Road to Becoming a Physician Thank you to the speakers who contributed to the diverse and dynamic program! Thank you, too, to R. Zane Kelley, DO for his leadership and assistance in coordinating this event. We look forward to the 2021 FOMC.

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.

The 2021 competitions mark the 13th 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 as part of the CME agenda at the AOMA 99th Annual Convention on Saturday, April 10, 2021. The poster judging will also occur on Saturday, April 10, 2021, both live and virtually. The winners will be recognized at the awards ceremony and luncheon on Sunday, April 11, 2021.

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.

Questions? Contact Kristen Strong at AOMA at 602-714-6574 or kristen@az-osteo.org.

IMPORTANT DATES FEBRUARY 5, 2021 Poster abstracts, application, and IRB due Case report, application, and IRB are due FEBRUARY 22, 2021 Notification of acceptance or rejection to lead author MARCH 19, 2021 BY 12 NOON CST Poster submissions due APRIL 10, 2021 Poster Presentation and Judging Oral case presentation and judging APRIL 11, 2021 Winners announced at Awards Luncheon

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AOMA Digest Fall 2020

Osteopathic Community News

Due to the coronavirus pandemic, the in-person, live activities normally scheduled for AzACOFP were rescheduled as virtual events or cancelled.

ACOFP 57th Annual Convention & Scientific Seminars: The live event slated for March 16-22, 2020 in New Orleans was successfully reimagined as a virtual event. ACOFP was one of the first professional associations - national or state - to quickly convert the in-person convention to a livestreaming program.

Kudos to the ACOFP staff!

ACOFP Congress of Delegates: The 2020 ACOFP Congress of Delegates, originally scheduled for March 18 -19, 2020, was cancelled. The credentialed Delegates were sworn in electronically and voted on the following items of business:

• Approval of 2020 ACOFP Budget • Approval of Temporary Bylaws amendment All submitted resolutions for Congress 2020 will be held for consideration at the 2021 Congress.

All family physicians are invited to join the AzACOFP, a community of Arizona family physicians, residents, and osteopathic medical students committed to osteopathic principles. The Society supports its members through education and networking. Membership is just $100 per year.

To join, contact AzACOFP by calling 602-354-5208 or email acofp@az-osteo.org.

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 campaign at the 2021 Waste Management Phoenix Open. Arizona Osteopathic Charities will receive every penny of collected pledges. By making a pledge, you can help provide free sports physicals for school athletes (Team of Physicians for Students), support DOCARE (international medical outreach), help Camp Paz (camping retreat for children who have suffered a death in their life), and provide research awards and scholarships for medical students.

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 2021 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. To make a pledge online go to birdiesforcharityaz.com and click on “Donate Now”.

Contact Sharon Daggett for more information at charities@az-osteo.org.

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A

AOMA MWU Banner 0416.indd 1

Virtual Orientation Brings AZCOM Classes Together with Osteopathic Dignitaries The practice of medicine is not wizardry, but that does not mean that Harry Potter’s world was bereft of good ideas.

Unlike the Houses of the Hogwarts School of Witchcraft and Wizardry, the Houses adopted by the Arizona College of Osteopathic Medicine were not designed to compete with each other; rather, they allow AZCOM students to enjoy the camaraderie, fellowship, and teamwork that a House can provide its members.

Suggested by the students, faculty, and the Council of Student Government Presidents (COGSP), the AZCOM Houses allow students to stay connected with each other and with AZCOM students from other Classes.

As virtual orientation for the AZCOM Class of 2024 got underway prior to the start of the Fall term at Midwestern University, new students belonging to all of AZCOM’s Houses – named for various Doctors of Osteopathic Medicine – met together online with some of their House namesakes to discuss topics of importance to the Class and the osteopathic medical profession.

Second-year students from each House also joined in, bringing the total attendance to over 500 students and faculty.

Members of Chaudhry House listened to Humayun “Hank” Chaudhry, DO, CEO of the Federation of State Medical Boards, speak on the topics of licensing boards and future opportunities in the medical profession. William Anderson, DO, namesake of Anderson House, reminisced about his experience in the 1950s of becoming a Doctor of Osteopathic Medicine in a time when African Americans were excluded from traditional MD schools. Former American Association of Colleges of Osteopathic Medicine (AACOM) CEO Stephen Shannon, DO, one of the first DO members of the ACGME, also provided words of advice to the new students, including those in the House bearing his name. Drs. Ron Blanck and Richard Scheuring gave their perspectives on military and space medicine.

Although the meeting was held online because of separation requirements due to COVID-19 protocols, the students in attendance still felt a connection – to their Houses, to their College, and to their profession.

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Osteopathic Community News

AZCOM ESTABLISHES MINORITY SCHOLARSHIP FUND

The Arizona College of Osteopathic Medicine (AZCOM) at Midwestern University has announced the establishment of a new scholarship fund intended to foster student body diversity and extend opportunities for healthcare students from underrepresented minority groups.

The new Edna Dunning AZCOM Minority Scholarship Fund applies to incoming first-year osteopathic medical students belonging to minority groups as defined by the Health Resources and Services Administration (HRSA), including American Indian and Alaska Native communities, Black/African American, Hispanic/Latino, and Native Hawaiian/Pacific Islanders.

The scholarship funds will be awarded competitively to eligible students based on past academic performance; commitment to diversity, leadership, and community service; and demonstrated financial need, with consideration to applicants who are first-generation college students.

“This scholarship fund is an important step in our ongoing pursuit of creating a vibrant and diverse student body,” says Lori Kemper, DO, Dean of the Arizona College of Osteopathic Medicine. “These funds provide a stepping stone to healthcare careers for deserving minority students, as well as an investment in the health and well-being of their communities when they eventually begin practice.”

Details about the application process and eligibility requirements will be available on Midwestern University’s Financial Aid website at https://www.midwestern.edu/ admissions/tuition-and-financial-aid/ scholarships.xml.

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MIDWESTERN UNIVERSITY PARTICIPATES IN FALLS PREVENTION PROGRAM Falls are the leading cause of serious injuries and death for older adults. The National Council on Aging is encouraging older adults to take a free risk assessment questionnaire available on its website at https://www.ncoa.org.

In partnership with the National Council on Aging, Midwestern University Therapy Institute is offering resources for older adults to diagnose and treat issues connected to falls, including: risk assessment by skilled Midwestern University faculty specialists; CAREN virtual reality system provides diagnosis and therapy in a 3-D environment; physical therapy; occupational therapy; and vision therapy/rehabilitation.

There are five categories of symptoms that indicate a need for medical treatment: • Vertigo is the illusion of movement—a specific sensation of spinning or a feeling that the room is spinning.

• Presyncope is the perception that one is going to faint.

• Syncope is fainting.

• Disequilibrium is the sensation of losing one’s balance without vertigo or presyncope.

• Nonspecific lightheadedness is a vague sensation not characterized by the other three categories.

Osteopathic Osteopathic Community Community News News

Features

ATSU-SOMA Students Compete in VotER Cactus Cup A.T. Still University-School of Osteopathic Medicine in Arizona (ATSU-SOMA) students are in a heated competition as they battle for the top spot in the VotER Cactus Cup, going head-to-head with fellow top health care institutions in Arizona. While the competition remains fierce, the purpose behind it provides just one more way to serve the underserved.

Linda Chang, OMS II, completed a summer program with the National Medical Fellowship Primary Care Leadership Program at AltaMed Health Service Corporation. During the six-week program, Chang conducted research that focused on the relationship between civic engagement and the healthcare provider as a way to address health disparities. It was during this time that Chang became aware of the VotER initiative and wanted to get ATSUSOMA involved.

A nonprofit, VotER gives healthcare providers tools to help their patients register to vote or request a mail-in ballot.

The goal is to ensure healthy and safe voting experiences.

The daughter of two Vietnamese refugees growing up in the low-income urban community of East Los Angeles, Chang’s father was learning English and asked her for whom should he vote for president.

“I could barely read a chapter book in English at that point. That was way over my head,” Chang said.

When Chang turned 18 and became eligible to vote, she made it a priority to stay engaged and informed and to share that knowledge with her community.

With the support from ATSU-SOMA, Chang formed a partnership with ATSUSOMA’s Student Government Association (SGA) to help spread the word across the 16 community healthcare centers (CHCs) where ATSU-SOMA students are placed.

ATSU-SOMA’s SGA helped with the initial distribution of collateral, which included 500 badges, each with a quick response (QR) code linked to the VotER website.

Healthcare providers at the 16 CHCs were provided a badge to wear and given instructions on how to have a conversation with patients about registering to vote. If a patient hasn’t registered to vote, they can simply scan the QR code and complete registration on their smart phone or text “VOTE ATSU” to 34444 and start the process via text message.

The Cactus Cup is a friendly competition amongst West coast medical schools.

Each school has a unique QR code and website link to track how many voters are registered as a result of their medical students’ efforts. The competition continues through the end of October and ATSU-SOMA is currently ranked in first place.

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ATSU Hosts President’s Cultural Proficiency Speaker Series

ATSU-SOMA Students Wear Green to Raise Awareness

A.T. Still University of Health Sciences (ATSU) President’s Cultural Proficiency Speaker Series is an opportunity for ATSU’s campus community to engage in open and honest dialogue around race, class, culture, and equity.

The fourth installment of the series was presented virtually in September 2020.

This forum focused on voice, transparency, authenticity, trustworthiness, access, and opportunity on the path to cultural proficiency. Christi Griffin, JD, founder and CEO of the Ethics Project, and Anthony Palatta, DDS, EdD, chief learning officer, American Dental Education Association, were the featured speakers.

Throughout the President’s Cultural Proficiency Speaker Series discussions, the underlying theme is a call to action for open and honest dialogue about the disease of racism. Clinton Normore, MBA, vice president for diversity & inclusion, opened the discussion by reminding participants of a key pathway to cultural proficiency through mutual understanding and respect.

“A profound component of cultural proficiency is that we must be mature enough, if not human enough, to understand that we are not always going to agree all the time,” Normore said. “Being able to mitigate that understanding and agree to disagree and move on. Systems are predicated on a structure but are delivered with the individual’s perspective. We are all human beings and none of us is without fault.”

Part of moving forward includes involvement from everyone, not just one or two groups, but society as a whole. If you wish to be part of the conversation, contact Mr. Normore at cnormore@atsu.edu.

A.T. Still University-School of Osteopathic Medicine in Arizona (ATSU-SOMA) students participated in the Council of Osteopathic Student Government Presidents (COSGP)’s DO Day of Wellness on March 4, 2020 by wearing green in support of mental health awareness.

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ATSU-SOMA class of 2023 wearing green

COSGP promotes wellness of body, mind, and spirit through Osteopathic Medical Student Wellness Week. Each day is dedicated to one of the main tenets of the osteopathic philosophy. ATSUSOMA students participated in a variety of activities, from conversations with faculty who shared their personal stories of battling anxiety and depression, to spending time with support animals to relieve stress.

“By spreading awareness about this important issue, we can reduce the stigma associated with mental illness and hopefully help those physicians seek help before taking their own life. Spreading awareness can also encourage medical schools, residency programs, and hospitals to provide resources for their students and employees,” said Rachel Visconti, OMS III. The ATSU-SOMA Mental Health and Wellness Committee, a part of the Student Government Association on campus, plans monthly wellness initiatives to keep the focus on body, mind, and spirit wellness all year long.

Osteopathic Community News

• Are you in compliance with Arizona’s opioid laws and regulations?

• Are you utilizing the best practices for prescribing opioids to patients?

• Do you understand how Medication Assisted Treatment can help patients?

ANNOUNCING

www.AzRxEd.org AzRxEd.org Arizona Opioid Prescriber Education Program FREE online training on opioid laws, prescribing guidelines, and Medication Assisted Treatment.

Fully-accredited continuing medical education for Arizona license renewal requirements for all providers.

• 1.5 AMA PRA Category 1 CreditsTM • 1.5 AOA Category 2B Credits • 1.5 contact hours (0.15 CEUs) of continuing pharmacy education credit

• 1.0 AMA PRA Category 1 CreditTM • 1.0 AOA Category 2B Credit • 1.0 contact hours (0.10 CEUs) of continuing pharmacy education credit

• .5 AMA PRA Category 1 CreditTM • .5 AOA Category 2B Credit • .5 contact hours (0.05 CEUs) of continuing pharmacy education credit

Accreditation is provided by: • Arizona State University Office of Interprofessional Continuing Health Education • Arizona Osteopathic Medical Association • Arizona Pharmacy Association State Targeted Response Grant: This program was made possible by grant number H79TI080250 from SAMHSA. The views, opinions, and content of this program are those of the Arizona Osteopathic Medical Association and Arizona State University and do not necessarily reflect the views, opinions or policies of SAMHSA or HHS. Questions? Contact AOMA at 602-266-6699 or communications@az-osteo.org.

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Fall 2020 AOMAAOMA DigestDigest Summer

Osteopathic Community News

2020-2021 Calendar of Events October 15-19, 2020 AOA OMED and AOA House of Delegates Virtual Event October 24, 2020 AOMA Board of Trustees Meeting Virtual Meeting November 6-8, 2020 AOMA 40th Annual Fall Seminar Virtual Livestreaming Event February 6, 2020* AOMA Board of Trustees Meeting Phoenix, Arizona March 2021 DO Day at the Legislature Arizona State Capitol Phoenix, Arizona

March 18-21, 2021* ACOFP 58th Annual Convention and Scientific Seminars Orlando, Florida April 7, 2021* AOMA Board of Trustees Meeting Embassy Suites by Hilton Scottsdale Resort April 7-11, 2021* AOMA 99th Annual Convention Embassy Suites by Hilton Scottsdale Resort 5001 N. Scottsdale Road Scottsdale, Arizona 85250 April 9, 2021* AOMA House of Delegates Embassy Suites by Hilton Scottsdale Resort *May convert to a virtual event

Advertisers’ Index MICA................................................Inside Front Cover Midwestern University Body Donation Program...............................Page 12 DOCME................................................................Page 12 Cigna Medical Group.......................................Page 15 Arizona Osteopathic Charities......................Page 15 AOMA Career Center.......................................Page 19 SoFi.....................................................................Page 24 AzRxEd.org........................................................Page 31 VillageMD........................................Inside Back Cover A.T. Still University Osteopathic Medicine Center Arizona........................Outside Back Cover

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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SAVE THE DATE! AOMA 99TH ANNUAL CONVENTION

1 92 1 2O21 100 Years of Healing

April 7-11, 2021 Embassy Suites Scottsdale A Hilton Resort Scottsdale, Arizona

“

At Village Medical, I can practice medicine the way I’ve always wanted, with personalized patient care that improves health outcomes.

-Michael Keller, MD

”

Join the team that’s transforming primary care.

At Village Medical, our integrated care management and administrative support teams give you more time to focus on what matters most.

That level of support is one reason Dr. Keller decided to join us after 20 years practicing medicine: “Village Medical is there for the physician, so the physician can be there for the patient.”

If you’re looking for a change, we’re now hiring primary care physicians and APPs in: • Chandler • Gilbert • Litchfield Park

• Mesa • Peoria • Phoenix

• Scottsdale • Sun City West • Surprise

To learn more, contact Vice President of Business Development Sam Martinez at smartinez@villagemd.com

© 2020 Village Medical | 20-VM-090

& Arizona Osteopathic Charities 1951 W. Camelback Rd. Ste 105 Phoenix, Arizona 85015

Have you renewed your AOMA membership?

Don’t let this be your last issue!

Visit www.az-osteo.org to renew today!

A.T. Still University gives thanks to front-line workers, including Arizona’s osteopathic physicians, AOMA leadership, and AOMA staff, amidst the COVID-19 pandemic. We are grateful for all you do.

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