AOMA Digest Summer 2020

Digest Arizona Osteopathic Medical Association

Volume 35, No. 1 Summer 2020

Richard S. Dobrusin, DO, MS (Ost), FACOFP AOMA President 2020-2021 INSIDE New AOMA Leadership 98th Annual Convention - Virtual 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. 1 Summer 2020

Digest

2020-2021 Board of Trustees President Richard Dobrusin, DO, MS (Ost), FACOFP 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 Josephine Zammuto Trustees Alphonse Ambrosia, DO, FACC Craig Cassidy, DO, FAOCO Donald Curran, DO Susan Del Sordi-Staats, DO Datcha Dorvil, DO, MPH 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 Bunnie Richie, DO, FAAN

The Official Publication of the Arizona Osteopathic Medical Association

COLUMNS 2 President’s Message 4 Executive Director’s Message 6 AOMA in Action FEATURES 7 Hooray for Volunteers 8 Remembering Pete Wertheim, MS, DHL 11 A Doctor’s Privilege of Bearing Witness 14 The Impact & Importance of Osteopathic Medicine in Primary Care 15 Accelerating Change 16 Health Policy Fellowship: Read All About It! 18 Focus on the FAVER Method 19 The SUPPORT Act and Medicare Part B Coverage 20 Operating Expenses: What Tenants Should Know 22 DOs on the Frontline of the Pandemic AOMA NEWS 24 Welcome New AOMA Members 25 In Memoriam 30 Dinner with Doctors 31 39th Annual Fall Seminar 34 2020 DO Day at the State Legislature 35 98th Annual Convention

Student Trustees

• First Ever Livestreaming, Virtual Convention

Issa Ismail, OMS II - SOMA

• Clinical Case Competition and Poster Forum

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

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

• Annual Awards • Student Scholarship Essays

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Upcoming CME Events

OSTEOPATHIC COMMUNITY NEWS 49 Tucson Osteopathic Medical Foundation Scholarship Winners 50 Arizona Chapter of the American College of Osteopathic Family Physicians

51 A.T. Still University School of Osteopathic Medicine in Arizona 54 Midwestern University Arizona College of Osteopathic Medicine 57 DOs in the News 60 Calendar of Events 60 Advertisers Index

President’s Message

Challenges and Changes Like many Arizona residents, I am a transplant. I was born and raised in New York City, the youngest of five children. Ruth and Bernard Dobrusin were wonderful parents. My siblings and I were told we could attend any university in the world as long as it began with S.U.N.Y. (The Richard S. Dobrusin, State University of New DO, MS (Ost), FACOFP York). I completed my 2020-2021 AOMA President undergraduate degree in biology at S.U.N.Y in Albany, New York and in 1980 matriculated to the New York College of Osteopathic Medicine.

After graduation, I completed a rotating internship at Suburban General Hospital and my residency at the Hospital of the Philadelphia College of Osteopathic Medicine specializing in Osteopathic Manipulative Medicine. While in Philadelphia I met my wife Sheri through a personal ad in the Philadelphia magazine. We have been married since 1987.

After my residency we moved to Chicago and for the next four years I worked in a clinic on the southside to fulfill my obligation with the National Health Service Corp. This assignment included the opportunity to teach osteopathic manipulative medicine at the Chicago College of Osteopathic Medicine.

While in Chicago, our son Adam and daughter Danielle were born at the Olympia Fields Osteopathic Medical Center.

In 1991 we moved to Arizona. I opened my own family practice, Mesa Family Medical Center, and was heavily associated with Mesa General Hospital. I had the privilege of

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serving many roles at that hospital including chairman of the board, family practice chairman, family practice residency director, and director of medical education. That period of time strengthened my relationship with the Arizona osteopathic community and lifelong friendships were formed. It also was the beginning of long-standing relationships with Midwestern University Arizona College of Osteopathic Medicine and A.T. Still University School of Osteopathic Medicine in Arizona. Currently, I am transitioning to a new role as a supervising medical director for CIGNA Medical Group.

Throughout my Arizona career I have remained a loyal member of the Arizona Osteopathic Medical Association. When I joined the AOMA in 1991, the executive director was Ted Podleski and the Association conducted business out of a converted house.

Amanda Weaver became executive director in 1995, serving until 2014, and the office moved to its current location on 16th Street and Camelback. I was thrilled and honored to be nominated to serve on the executive committee and ultimately assume the presidency. I am grateful for the guidance and support of Pete Wertheim and my fellow Executive Committee members. This past year has certainly had some challenges and changes for our organization.

The tragedy of losing our executive director Dr. Pete Wertheim, first when he resigned in January 2020 due to illness and then when he lost his battle with brain cancer on May 24, 2020, has been especially difficult.

We are all saddened, both personally and professionally, by his passing. Janet Weigel, Director of Membership and Communications, stepped up and served as interim executive director.

President’s Message

We formed a “dream team” to conduct the search for a new executive director. Thank you to Christopher Labban, DO; Angela DeRosa, DO; Danielle Barnett-Trapp, DO; Brandon Abbott, DO; Jeffrey Morgan, DO; Lori Kemper, DO; Karen Nichols, DO; and Steve Barclay, JD, for your generosity of time and wisdom during this process. Josephine Zammuto joined AOMA on June 1, 2020 to lead the team.

After more than 25 years in the same location, we are moving the AOMA office.

We identified a building at 19th Avenue and Camelback that should serve our organization well for many years to come. We will complete the move in October and look forward to you visiting our new digs.

The Association has been faced with challenges associated with the COVID-19 pandemic and the organization has responded with strength, grit, and dignity.

Our annual convention could not be held as a live event and cancelling it would have resulted in a devastating financial loss.

Thanks to the incredible efforts of our AOMA staff - Janet, Teresa, and Kristen - the annual convention was held virtually and was a huge success. As we navigate these uncertain times, we are prepared to plan both virtual and live events as the situation demands.

We continue to work diligently to represent the needs of the osteopathic community in the legislature. Steve Barclay, JD, AOMA contract lobbyist, continues to be invaluable to the Association’s advocacy efforts.

As we plan for AOMA’s 100th anniversary, I look forward to serving as president of such a fine organization and working with the incredible staff and volunteers of the AOMA. Our Association is sound financially, we are a leader in the delivery of continuing medical education, and we are a respected stakeholder in health care policy.

I invite you to get involved with the Association: join a committee, donate to the PAC, volunteer to give a CME lecture, become a delegate to the AOMA House of Delegates.

Please ask your colleagues to join AOMA, the voice of osteopathic medicine in Arizona.

Plan to join us for the new and improved AOMA 40th Annual Fall Seminar on November 6-8, 2020. The theme of the Seminar is Come Together and Dig On, and that is exactly what we intend to do as we embark on the next chapter of the AOMA. The program has been expanded to two and onehalf days and offers 20 hours of continuing medical education. Due to the current coronavirus pandemic, the Fall Seminar will be presented as a virtual event. Visit www.azosteo.org/Fall2020.

There have been lots of changes and challenges at AOMA, but we are prepared to for what the future holds. Let me know how we are doing and how we can best meet your needs. Email me at president@az-osteo.org.

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Executive Director’s Message

A New Day at AOMA It is an honor to join the AOMA family as your new executive director. The excitement and joy that typically accompanies starting a new position is bittersweet, since learning of Pete Wertheim’s passing.

I know Pete was wellrespected and highly Josephine Zammuto revered in the local AOMA Executive Director health care community.

He touched so many lives and positively impacted health care for all Arizonans through his advocacy efforts. He will be fondly remembered by all.

Although I never had the pleasure of meeting Pete, I will benefit from his work.

Pete broke down barriers and gave AOMA a seat at the table with Arizona health care leaders. I pledge to continue to foster those good relationships and build new relationships throughout Arizona.

In the role only sixty days, I am humbled by the gracious and warm welcome from AOMA staff, you our members, and representatives of the Valley community. I look forward to meeting you and working closely together to advance the osteopathic medical profession.

My journey to AOMA is by way of a career in communications, public relations, business management, and human resources.

I was fortunate to build this diverse and complementary skill set in positions across the health care, higher education, nonprofit, and consumer products industries.

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I moved to Phoenix at the end of May, from Chicago, to join the AOMA. I can’t tell you how many times in the past few weeks I’ve been reassured by locals, “Don’t worry, it’s a dry heat!” Fear not, I moved to the beautiful state of Arizona in the summer, knowing full well what to expect!

I am no stranger to the osteopathic medical profession. My brother is a graduate of Midwestern University Chicago College of Osteopathic Medicine and serves the AOA and Osteopathic Physicians and Surgeons of California in various capacities.

I am fortunate to have the amazing and devoted staff at AOMA, a dedicated Executive Committee, and respected lobbyist to guide and orient me through the association’s business and nuances of the Arizona legislature. AOMA is on the forefront of delivering exceptional CME and, as evidenced by the 2020 Annual Convention, adaptable to meet the needs of our members.

We have an exciting year ahead as AOMA plans to celebrate the 100th Anniversary of its founding. In addition to finding interesting and creative ways to honor our history and those Arizonans who paved the way for the osteopathic medical profession, we will continue to work diligently to promote the profession, serve you our members, provide quality Continuing Medical Education using the best technology platforms, and join in the advocacy efforts to preserve access to health care. Two other areas of focus for me are engaging osteopathic medical students— the future of our AOMA—and association management toward efficient operations.

Executive Director’s Message

This is an unprecedented time for all of us.

I ask for your patience and understanding as we continue to define and modify our business operations model amid health and safety guidance around COVID-19. We are doing our part to support multiple advocacy efforts pertaining to Governor Ducey’s Executive Orders, to help protect the rights of physicians and the availability of health care for those in need.

Although the Arizona Senate and House suspended, and subsequently ended, the 54th Legislature - Second Regular Session, AOMA remains involved in protecting you and your patients. Along with AOMA contract lobbyist Steve Barclay, we are closely watching the upcoming primary and general elections.

We continue to meet with health insurers, the Governor’s office, and stakeholders on access to telemedicine for both patients

and physicians, health care financial relief, PPE supplies, provider shortages, practice encroachment, and more. Additionally, we have joined with the AOA and others to denounce racism and show solidarity for justice and equality for all people.

THANK YOU to all who have stepped up to help on the front lines during this pandemic.

Be it adapting your practice for appointments via tele-visits; working selflessly on the front lines at hospitals and clinics; coming out of retirement to help where needed; or volunteering in your community. You are all heroes!!

My passion is helping others through my work, and I am excited to explore how the AOMA can expand its role in meeting your needs and those of Arizonans. It’s a new day at AOMA! Let’s make it a great one. Be safe and stay healthy.

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.

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AOMA Digest Summer 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 five-month period from October 1, 2019 to June 30, 2020.

Advocacy/Legislative Affairs • Led and supported efforts to pass legislation to fund graduate medical education and physician loan repayment programs; defeated antivaccination bills, defeated unwarranted scope of practice expansion bills • Attended the Pfizer Leadership Conference in Charleston, South Carolina in December 2019 • Co-sponsored with the Arizona Medical Association, the Maricopa County Medical Society, and the Pima County Medical Society, the 2020 Arizona Legislative Reception • Hosted DO Day at the State Legislature in February 2020 • Participated in various stakeholder meetings related to the response to COVID-19 by state government, insurance companies, providers, and patient groups American Osteopathic Association (AOA) • Represented AOMA interests on the AOA Bureau of Federal Health Programs • Attended OMED 2019 in Baltimore, Maryland Attended the AOA LEAD Conference in Palm Beach, Florida in February 2020 • Represented AOMA on the Board of Directors of the Association of Osteopathic State Executive Directors Continuing Medical Education • Sponsored 13.25 hours of AOA Category 1-A CME credit and AMA PRA Category 1 creditsTM at the AOMA 39th Annual Fall Seminar in Tucson • Successfully reimagined the AOMA 98th Annual Convention as a virtual, livestreaming event and sponsored 37.75 hours of AOA Category 1-A CME credit and AMA PRA Category 1 creditsTM • Offered 40 different lectures at the AOMA 98th Annual Convention and provided specialty credits in 20 different disciplines • Created and posted 30 new online on demand CME courses to DOCME.org Member Services • After a nationwide search, hired Josephine Zammuto as AOMA Executive Director • Welcomed new AOMA Business Partner WestPac Wealth Management • Launched the AOMA Legacy Society, an endowment program for Honorary Life Members to invest in the future of the osteopathic profession

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Political Action Committee • Raised $8,835 in PAC contributions from AOMA members • Contributed $15,600 to 30 state legislators Public Health • Attended the Arizona Public Health Association (AzPHA) Healthy Aging Conference • Received the HEMMY Award from the AzPHA for the Arizona Opioid Prescriber Education program - wwwAzRxEd.org, a free online continuing medical education on Arizona’s opioid laws and regulations, prescribing guidelines, and treatment options for opioid use disorder to satisfy state required continuing medical education • Represented AOMA on the Governor’s Breakthrough Project on Arizona Opioid Epidemic, DHS Rx Advisory Committee, and the ASU Medical Advisory Board addressing the opioid epidemic • Represented AOMA on The Arizona Partnership for Immunization (TAPI) Steering Committee • Represented AOMA on the Health Current Board of Directors Osteopathic Charities • Raised more than $3,000 through Birdies for Charity pledges • Awarded scholarships of $500 each to two students, one from SOMA and one from AZCOM, for the annual essay competition • Disbursed contributions totalling $6,000 to three non-profit organizations The Future of the Osteopathic Profession • Hosted Dinner with Doctors in October 2019, attended by 60 students and 22 physicians • Student doctors served as moderators at the AOMA 39th Annual Fall Seminar • Hosted a reception for the College of Osteopathic Student Government Presidents in Scottsdale, Arizona in January 2020 • Attended the annual Residency Fair at Midwestern University in January 2020 • 68 students and 14 physicians attended the 2020 DO Day at the State Legislature in February • Awarded $1,000 to student winners in the 2020 AOMA Clinical Case Competition and Poster Forum • A total of 48 posters were entered in the 2020 AOMA Poster Forum

Features

Hooray for Volunteers

By Janet Weigel, AOMA Director of Membership and Communications

The concept of volunteering and philanthropy is uniquely American. No other country in the world’s citizens donate as much of their time, treasure, and talents as those of the USA. Alexis de Toqueville was a nineteenth century French aristocrat, diplomat, scientist, and historian best known for his work Democracy in America, a detailed study of American society and politics published in two volumes, in 1835 and 1840. Only 26 years old when he came to the United States and Canada in 1831, Tocqueville traveled extensively, recording his observations of life in the young nations. Though he spent only nine months in North America, he gleaned many profound insights about American society.

Tocqueville recognized, applauded, and immortalized North American voluntary action on behalf of the common good.

He wrote: “I must say that I have seen Americans make a great deal of real sacrifices to the public welfare; and have noticed a hundred instances in which they hardly ever failed to lend a faithful support to one another.” The observations on philanthropy, altruism, and volunteerism made by Alexis de Tocqueville in 1831 are true today. And these are amply evident in AOMA members.

Volunteering is generally considered an altruistic activity where an individual or group freely gives time "to benefit another person, group or organization".

Volunteering is also renowned for skill development and is often intended to promote goodness or to improve human quality of life.

The year 2020 will be one I will remember for the rest of my life. And not because of the COVID-19 pandemic or the loss of our friend and colleague Pete Wertheim.

What I will remember and cherish is the generosity of time, wisdom, support, and love exhibited by the AOMA family during a tremendously difficult time. The AOMA Executive Committee, the Board of Trustees, and the Succession Planning Task Force members offered staunch support and commitment to the AOMA staff and the Association’s future. I know, to my core, that no other Association - osteopathic or otherwise - has the depth of commitment from its past, present, and future leadership.

I will also remember the dedication of AOMA members to fighting the novel coronavirus: the physicians on the front lines caring for patients; the physicians doing quadruple duty as partners, parents, employees/bosses, and home-schooling teachers; the physicians volunteering in their communities.

Funny thing about volunteering - it’s a want to, not a have to. Volunteers don’t do it for a paycheck. Most don’t want to be in the spotlight. As long as volunteers are respected and appreciated, they will continue to show up and contribute. But if no one says “thank you” or too much is demanded of them, they will find another worthy organization to support.

So, to all of you who support the AOMA with your dues, your service on Committees, your PAC contributions, your participation as lecturers, your attendance at events, and the countless other ways, I say a heartfelt THANK YOU. We can’t do it without you.

AOMA members are the best!

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Remembering Pete Wertheim, MS, DHL Peter Squires Wertheim, MS, DHL, passed away on May 24, 2020 following a brave battle with glioblastoma multiforme.

Born November 10, 1970 in Yonkers, New York, Pete moved to Arizona in 1987.

Pete served as Executive Director of the Arizona Osteopathic Medical Association (AOMA) from June 2014 to January 2020.

During his tenure with AOMA, legislative advocacy was a top priority. By developing and encouraging physicians and medical student advocates to protect and promote osteopathic medicine for patients, he achieved notable legislative victories, including expanded access to health care for children, medical student training opportunities, primary care initiatives, and public health programs.

Pete, his team, and AOMA leaders helped the association rise to prominence on the national stage by earning the 2016 and 2019 prestigious Strategic Team Award Recognition (STAR) honors from the American Osteopathic Association for innovation and excellence among state medical associations. Respected by his peers in the osteopathic world, Pete served as President of the Association of Osteopathic State Executive Directors until his diagnosis in December. Pete was a 2019 Honorary Inductee to Omega Beta Iota, National Osteopathic Political Honor Society.

Pete’s career in health care public policy spanned the legislative and government sector, private industry, and not-for-profit.

For 20 years he dedicated his efforts to developing and implementing good public policy. Pete received numerous awards for his contributions. Most recently the Phoenix Business Journal recognized Pete with a 2019 Most Admired Leader Award for his work with the Arizona Department of Health Services and Arizona State University College of Health Sciences in developing prescriber education on the new AOMA Digest Summer 2020

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opioid prescribing laws. In February 2020, A.T. Still University honored Pete with a doctorate of humane letters, a distinction bestowed in recognition of his passion for advocacy and transparency in health care policy, his dedication to the members of the osteopathic profession, and the significant contributions he made in protecting and improving access to health care for Arizonans.

Pete not only worked hard, he played hard. He loved soccer (futebol!), meat, beer, fun, hiking, and traveling, But the love of his life was his wife, Adela. Pete met Maria Adela Grando in 2015 and the two of them embarked on a life of adventure that was sadly cut short by his diagnosis.

Pete’s ashes will be spread in Argentina, his wife’s homeland and a place he visited often. He will be remembered as the wonderful person he was, personally and professionally. We all miss him, but he will remain in the hearts and thoughts of all of us who loved him so much. May his soul rest in peace.

Features

AOMA Colleagues Share Their Memories of Pete There are two sides of Pete I will remember. There is the serious, hard-working, driven man who was simply passionate about what he did. He did not do things to be in the spotlight, but because they were the right things to do.

Pete was conscientious and dedicated - and donated more to the AOMA PAC than most members because he believed in helping us accomplish our goals. Members could call him anytime and he would answer his phone to help.

I was the first AOMA president to work with Pete for the full year and I feel so privileged to have that experience.

I remember him apologizing for too many “boring policy changes”. We would laugh knowing they were a necessary evil (and often wondering if anyone else was even paying attention!) He constantly tried to build on past successes, while making sure to take our association into the future.

The second side of Pete I will miss is the one who became my friend over the years. He was kind and really funny. I’ll miss having a beer with him after AOA meetings. I’ll miss hanging out with him and the staff outside the lecture hall at the conventions. I’ll miss calling him for advice or to share a new job experience. I’ll miss not being able to celebrate his birthday (because he did NOT want it celebrated), but donating to the PAC instead. The list could go on and on.

Pete was truly a unique person. I am so fortunate for having known him and my life was enhanced because of his friendship. I will miss him more than words can say.

Kristin Nelson, DO When I think of Pete, I can’t help but smile and think of the dichotomy of personality that made him one of the “most interesting men in the world”. Pete was AOMA’s biggest supporter and leader and someone that gave his all to his efforts regardless of the nature. He was fierce and unrelenting when pursuing a goal, activity, or a passion.

He was also one of the most generous and compassionate men I ever had the honor to know. If you had an important cause or charitable activity, Pete was the first to jump in with a donation or unwavering support. He took great pleasure in helping others, all the while wanting to be back in the shadows when it came to recognition. He embodied the true definition of humility.

However, don’t let all this angelic behavior fool you. Pete had a fun devilish side and while I was president of AOMA, I had a front row seat to his humor and playful nature. He was surprisingly funny and had a childlike enthusiasm especially when it came to spending time with his beloved wife, Adela.

He made our hard work and efforts fun to say the least.

During his last months, Pete still managed to call and text and provide words of wisdom, love, and support, as well as funny anecdotes. He is my spirit animal!! I was blessed to work and play closely with Pete during my tenure on the executive board of the AOMA. To say that Pete will be missed is the greatest understatement I have ever made. I hold him deeply in my heart and know that he is watching over all of us and likely having a beer and telling jokes with all the other angels in heaven.

Angela DeRosa, DO, MBA, CPE

Pete Wertheim made an important impact on my life and the lives of so many. I met Pete for the first time during his interview for the AOMA. I honestly thought someone gave him all the answers ahead of time because we instantly connected. Without a doubt, he was the right person for the job. As I was entering as the new AOMA president and he was the new executive director, I had personal doubts about my own abilities to lead the association. Pete’s wisdom, mentoring, and thoughtfulness helped me work through those fears. He quickly redirected them with “Pete notes” and was always available for last-minute prep calls or random questions. Pete helped me understand the high ground in policy and how to influence change strategically. He was our trusted sounding board during many difficult decisions.

Pete will be remembered for his great sense of humor and the ability to deliver messages that engaged his audience.

He was so committed and determined, we wondered if he ever slept. He was an agent of change in the way we see ourselves as advocates and building our reputation. His foresight and vision of prioritizing early student engagement made it easy to connect. He held tight to our traditions in the true sense of osteopathic medicine. I will cherish the AOMA trips in July to the AOA House of Delegates. One of the traditions Pete started was a group dinner, usually Italian, at various spots throughout Chicago. Always an adventure in eating, he gathered us in some interesting places where we laughed and shared amazing life stories among our delegate team. Really ALL AOMA events felt like we were one big family. Pete made sure all were welcome, all discussions important, and all were heard. Even though he didn’t really like dancing at the annual meeting receptions, we knew he reserved many talents for his cherished circle of friends and dear family members. What I respect about Pete the most is that he not only built professional relationships for AOMA and the community, he also helped us build stronger relationships among ourselves. Over these treasured years, Pete helped me become a better person and knowing he believed in all of us made the difference.

Shannon Scott, DO Remembering Pete continued on page 10

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Features Remembering Pete continued from page 9

I served as President of AOMA from 2017 to 2018. This was a year fraught with a few tensions and controversies, as we saw other health disciplines attempt to creep into our balewick - pharmacists wanting to give vaccines, PA’s pushing to work without supervision of a physician, just to name a few.

And suddenly - BAM!!! - the opioid crisis took the front seat. And the governor was moving to tighten prescribing regulations. Pete was exceptional! He took the reins with me and guided us through the process. I remember leading a conference call on a Sunday afternoon in August to get input from DO leaders statewide. Pete’s expertise in legislative advocacy moved us forward, protected us, advocated for us.

His efforts gave us a real seat at the table.

He was a person of honesty and integrity. Even when he was being recruited by competing organizations that wanted to tap in to his expertise, he let the Executive Committee members know about it - even though it left me terrified that he might leave during my term!

Pete was the most diplomatic person I have ever met.

He understood and respected my reluctance to support a national PAC that supported political candidates whose ideals were in direct conflict with my own. And he did this with grace and poise.

Pete convinced us how important it is to keep our own state Board of Osteopathic Examiners, despite the governor’s efforts to combine us with the MD’s. He went after AHEC and exposed unscrupulous practices that were detrimental and unfair to the osteopathic medical schools.

I will miss Pete. But lucky me, for having the opportunity to work with him. And lucky us, AOMA, for having him as our Executive Director. Pete left us with a legacy that will endure… if we let it and we work for it. I hope we do.

Laurel A. Mueller, DO, MBA Shortly after Pete became AOMA Executive Director, I reached out to him about an issue with the Industrial Commission of Arizona (ICA). As a member of the Governor’s Committee on Evidence-Based Guidelines for Opioid Prescribing, I was reviewing the proposed guidelines when I discovered language that would allow the ICA to disqualify providers from treating patients covered under workers’ compensation, based on onerous criteria inserted into the document. I had not yet met Pete, but upon my calling him, he immediately understood the gravity of the situation and went to work to help solve the problem. Pete was very wellconnected with both the Arizona policymakers and the health care community. His knowledge, tenacity, experience, and commitment to the patients of Arizona helped save the day!

This is how my professional relationship with Pete began and blossomed well into my presidency of the AOMA, four years later. Pete, you’re truly loved and missed!

Christopher Labban, DO

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Features

A Doctor’s Privilege of Bearing Witness

By Sharon Obadia, DO, FNAOME

In this era of medicine, when physicians are so often discontented with being pulled from valued patient interactions by constraints of the electronic health record and patient productivity expectations, we must remember the easily overlooked but critical charge of the physician that is to bear witness to a patient’s story as a primary function in the role as “healer”. We cannot lose sight of this vital action that quietly tells a patient, “I see you. I hear you. I recognize that your hardships are real and you are struggling.”

The privilege of bearing witness that is bestowed upon us as physicians is something that we may not always consciously recognize we do, but must begin to highlight and actively role model to our students so that this most precious aspect of the art of practicing medicine is not lost to technology and productivity demands as we train the next generation of physicians. I will also venture to say that listening to and then reflecting on a patient’s story is often the most rejuvenating and thought-expanding part of a physician’s workday.

As I have travelled further along in my journey as an internist, I have come to realize that one of my most treasured facets of patient care has been in bearing witness to patients in their times of greatest crisis. My career path has diverged over the years from solely patient care to entrenchment in academic medicine administrative duties. I recently found myself yearning to maintain a clinical connection with the place that I held most dear when working with patients, Circle the City (CTC), Phoenix, Arizona’s first post-hospital respite center for people experiencing homelessness founded in 2012

by Sister Adele O’Sullivan, MD. In May of 2017, when I was no longer able to maintain a consistent patient panel at CTC due to my increasing administrative responsibilities, I asked myself why am I continually drawn to CTC, how can I stay

connected, and what is it that I still have to offer students when not seeing patients in a clinical setting anymore? I recognized that what I cherish most about being at CTC is the act of bearing witness to a patient’s story and having a first year medical student share and learn from that experience with me. This led me to create a simple program called Circle the City Stories in 2018 in which, one afternoon per month, I meet at CTC with a first year medical student from my academic institution, A.T. Still University School of Osteopathic Medicine in Arizona. I begin our time together by telling the student the story of how Circle the City came to be through Sister Adele’s hard work, perseverance, and love. We spend the rest of our afternoon slowly touring the facility and informally meeting with patients residing there. Through these casual hallway, TV room, smoking area, and dining room conversations, we listen quietly, bearing witness to patients’ stories surrounding their experiences of homelessness and health crises.

A Doctor’s Privilege continued on page 12

Sister Adele O’Sullivan, MD, then Student Doctor Jeremy Berger, and Dr. Sharon Obadia at the Circle the City clinic.

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Features A Doctor’s Privilege continued from page 11

The patients we encounter invariably express appreciation for getting to know us and for us taking the time to get to know them. They often share intimate details of their lives, and it is not uncommon for a patient to say, “You know, I’ve never told anyone that before”. Whether it be details of being severely beaten by a teenage son with untreated schizophrenia, a traumatic childhood at the hands of an abusive parent that was never detected by authorities leading to the patient self-medicating with alcohol, or being shot in the abdomen by a father with dementia who didn’t recognize his own estranged son entering his house unannounced, each person unabashedly shares their truth with us. I believe this is because they sense that we are listening.

We are listening…and we are learning.

Before approaching a person receiving care at CTC, I ask my students to pay attention to the first thought that comes into their mind about that person. What is the initial bias that they have? I ask them to listen to it, reflect on it, and then approach the patient. I tell my students to listen to this person’s story as carefully as if they were holding a stethoscope to the patient’s lips. I remind them not to be afraid to ask probing questions. I explain, “When your patient sees that you care and are listening, there is often a visible sense of relief that you see in the unburdening of a load onto someone in a perceived position of authority that cares.

Patients often want you to ask thoughtful questions that get further to the heart of their struggle.” I also tell my students that our patients’ stories can be heavy for us to hear, but I believe it is an essential aspect of our role, as getting to a patient’s truth is vital in their healing process.

After listening to a person’s story, I ask my students if their first assumption was correct. Most often, it is not. I also share my own first biased thought, so the students know it is normal that we all meet each other with formed conscious and subconscious biases. For instance, as a student and I once AOMA Digest Summer 2020

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approached a gaunt and weathered man draped over a chair with his head falling backward with the Arizona sun beating down on him, I told my student my first thought and bias. I said that I thought this would likely be someone coming off crystal meth sent to CTC to heal from a wound infection due to injection drug use. My student, likely wishing to please me and seem street smart about patients, too, quickly agreed with me.

As we then introduced ourselves, sat and listened to the man tell us why he was at CTC, he took us into his world. He was a chef in a restaurant downtown, and although he had never smoked (or used any other drugs), he had recently been diagnosed with stage IV lung cancer and had just gotten back from a chemotherapy treatment cycle. He shared that he not only felt nauseous and weak, he also felt hopeless for his future as he had lost his job and then apartment a few months later due to being too sick to work.

We went on to sit with him for about an hour as he told us about his family back home and the regrets he had in not being able to see them one more time before he died.

At the end of our time together, this man held our hands in his and thanked us for listening. We thanked him, too, and my student marveled to me afterwards that we had been so wrong in our initial impression of him. I agreed, and we went on to discuss the power of bias and how we can overcome it by thoughtfully listening to our patients’ stories and reflecting on our initial assumptions.

Ricky, a patient at the Circle the City Clinic, receives an OMM treatment from Student Doctor Esther Son.

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Midwestern University

Dr. Sharon Obadia with two ATSU-SOMA students, Angela Marchant and Jeremy Berger, volunteering at Circle the City in 2017.

After my first Circle the City Stories session with one of my students, I felt restored by it, but wondered if the student gained anything from the experience. Later that evening, I received an email from that student. He wrote, “Thank you for such a life changing experience today! I 100% encourage every incoming student to challenge their misconceptions by participating in Circle the City Stories, as it is a reminder for why we are doing this.” Soon after, another student wrote to me after an afternoon at CTC stating, “It was a very humbling experience and a gift to learn about the patients, and I appreciated all of the insight you shared with me.”

Through Circle the City Stories, I have kept my most treasured connections with clinical medicine - bearing witness to patients’ experiences and teaching and role modeling for future physicians to do the same. In writing this article, my hope is to shine a spotlight on this privilege that we have and in doing so, we can enhance it as a most rewarding career benefit for ourselves and our students as we continue to teach them compassionate patient care in the years to come.

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AOMA Digest Summer 2020

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The Impact & Importance of Osteopathic Medicine in Primary Care

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

On January 17-18, 2020, the Council of Osteopathic Student Government Presidents had its winter meeting in Arizona. The first day was hosted by Midwestern University Arizona College of Osteopathic Medicine (AZCOM). During that day, I was asked to do a short presentation on the history of AZCOM. Our sister school, Chicago College of Osteopathic Medicine was one of the first five colleges of osteopathic medicine; Midwestern University got its start in 1900.

Its Glendale campus began to build in 1995, with AZCOM matriculating its first class in 1996. On May 20, 2020, AZCOM graduated 238 new osteopathic physicians.

In looking at the impact of those 24 years of classes, I thought it interesting to note that AZCOM expanded its class size to 250 in 2008. That was the year after A.T. Still University matriculated its first class at School of Osteopathic Medicine, Arizona (SOMA) in Mesa and the University of Arizona matriculated its first class of 24 in Phoenix. In 2008 AZCOM was, and is today, the largest medical school in the state of Arizona. It was also the first medical school in the Phoenix area, having preexisted 11 years prior to the year that University of Arizona welcomed its first small class in downtown Phoenix.

Reviewing impact requires that we look at what graduates do upon completion of their training. I am proud to say that AZCOM students entered family medicine residencies in record numbers (and percentages) since they first began to graduate. For a number of years, AZCOM was ranked number one among medical schools (DO and MD) in the number of family medicine residents. Unfortunately, AOMA Digest Summer 2020

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the American Association of Family Physicians tired of reporting too many colleges of osteopathic medicine at the top of their rankings and discontinued the practice of reporting a number of years ago.

However, family medicine has continued to be either the top or second match for our students, recruiting some 45-50 students per year. Additionally, pediatrics and internal medicine raise the primary care match to at least 50% of each graduating class. Last year, those three resulted in a 65% match. The actual numbers of graduates entering primary care are not small, a 50% match in any given year would be between 120 and 130.

Osteopathic medicine overall is recruiting the kinds of students who choose to be on the front lines of patient care. Recently, I heard that pediatric residencies throughout the United States have recognized that a full 20% of their residents are DOs. With 25% of all medical students today enrolled in colleges of osteopathic medicine, I would expect that percentage to increase in the coming years.

When I spoke with the national student leaders of our profession in January, I shared with them the fact that osteopathic medicine was started by a pioneer and that the pioneering spirit is one of the things that sets us apart. Once you understand that the body has the ability to heal itself, you will never look at the care of a patient the same way again. I am proud to be a DO and hope to aid our students in seeing that it is positive to “Choose DO� every time they make a decision in their careers.

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Accelerating Change

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

A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) is one of 37 medical schools in the U.S. represented in the American Medical Association’s (AMA) Accelerating Change in Medical Education Consortium - a collaboration designed “…to accelerate change in medical education and create a system that trains physicians who meet the needs of today’s patients and anticipate future changes (AMA, 2020). In the Fall of 2019, ATSUSOMA hosted members from all consortium schools, and the event was summarized by the AMA as follows: In October, representatives from the AMA Accelerating Change in Medical Education Consortium of undergraduate medical education and GME institutions met to address well-being in clinical and non-clinical learning environments.

Co-led by faculty and learners from consortium institutions, the meeting allowed for participants to apply a systems-thinking approach to learner and faculty well-being, identify components of a well culture and deconstruct the barriers to creating a well institution. The campus at A.T. Still University— School of Osteopathic Medicine in Arizona offered an idyllic setting to discuss well-being and participate in activities that promote wellness and mindfulness, including paced breathing exercises, yoga and journaling. Participants left with tools

and resources to assist them in sharing the framework and strategies for creating a culture of well-being at their own institutions.1 The opportunity to host the AMA Consortium’s thematic meeting and discuss well-being and the creation of a well institution fits well with ATSUSOMA’s recent HRSA grant award titled Pathways to Primary Care Behavioral Health (PCBH) Integration in the Nation’s Health Centers: Creating Master Adaptive Learners Where the Need is Greatest.

Among other objectives, the grant will focus on the development of residents in leadership roles, medically assisted treatment (MAT), substance use disorder (SUD), and the economics of health care for the poor and underserved, including rural health care. Additionally, ATSU-SOMA and ATSU-ASDOH (the Arizona School of Dentistry & Oral Health) are currently working to map and subsequently infuse our respective curricula with both the Arizona Pain and Addiction Curriculum (with a special focus from the osteopathic & oral health perspectives in addressing pain with alternatives to opioid Rx) and the CIHS SAMHSA-HRSA Core Competencies for Behavioral Health and Primary Care.

A collage of images from the AMA Accelerating Change in Medical Education Consortium held at ATSUSOMA in October 2019.

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AOMA Digest Summer 2020

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Health Policy Fellowship: Read All About It!

By Valerie Sheridan, DO, FACOS, FACS

Have you ever read a good book? One that when you finish a chapter, you immediately want to go to the next? The Osteopathic Health Policy Fellowship program was like that good book to me. From the orientation process to the last day presenting our final policy issues, the program kept me intrigued and passionate to learn and do more. It was extremely organized and filled with broad learning topics regarding advocacy issues.

Most importantly, was learning the difference between politics and policy. According to the World Health Organization, health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. Whereas, politics refers to a set of activities associated with the governance of a country or an area. It involves making decisions that apply to a group of members.

The purpose of the program was to ensure the development of health professionals to possess the necessary skills to influence positive change in public policy, systems, and how to appropriately impact our communities. There was an emphasis on pro/con conflict as the context for every discussion. It was and is important to look at every issue from a different level or perspective than your own. The role of the physician in health policy is very important to our changing health care environment.

The fellowship consisted of meeting monthly to stay informed and get involved aiming to make a difference in the future.

Each ‘chapter’ of this adventure was a commitment to supporting the osteopathic medical profession and how best to deliver high quality cost-effective health care to all through advocacy efforts. We visited many of the osteopathic medical schools and focused on policy issues looking at cost, AOMA Digest Summer 2020

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quality and access to care. Each member of the cohort was assigned current, relevant topics to research and present to the group throughout the fellowship. Topics ranged from gun control, the opioid crisis, student loan repayment options, big pharma issues, climate change and others. My topic was on Artificial Intelligence (AI) in health care. As we move into this next decade, AI will continue to change our lives not only personally but professionally.

Each cohort member mastered the ability to write a concise analysis brief identifying the issue’s history, stakeholders, recommendations (intended and unintended consequences) and references.

We each presented our topics at the last meeting and some of us have since presented our topics to other groups/ organizations. The ability to share this story with others and promote the program has been truly rewarding. Successful legislative advocacy efforts can only occur with collaboration in analyzing and developing health care policies advocating for our profession as physicians, for our patients and for our future health care workforce—students and residents.

I truly didn’t want the fellowship to end…just like not wanting to read the last chapter of the book, knowing the story would be over. However, I am fortunate. I can continue the story by being an example to others, which is what I intend to do. I am truly grateful to the Arizona Osteopathic Medical Association for sponsoring me as a Fellow and for this opportunity.

Since 1994, the health policy fellowship program has prepared leaders within the osteopathic profession to prepare, analyze, and react to health policy.

The graduates help meet the need for qualified osteopathic professionals to carry out health policy roles at the local, state, and national levels on both public and professional forums. The AOMA has sponsored twenty Health Policy Fellows.

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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.

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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 Digest Summer 2020

Features

Focus on the FAVER Method The FAVER Method for Responding to Patient Requests for Inappropriate or Unnecessary Care

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

The first step in managing the professional liability risk in acquiescing to requests or demands for unnecessary or inappropriate care is recognizing your own discomfort upon hearing the patient’s request. Physicians and other members of the health care team can read or listen to statements and note their emotional response to the statements. For example, listening to or reading the statement, “My uncle has a brain tumor. I have headaches that are getting worse. I want an MRI as soon as possible,” and identifying your emotional response. Another example statement is, “Vicodin isn’t working anymore. I want oxycodone.” Imagine the statements in an inappropriate context, such as the patient had a migraine work up four years ago and everything was consistent with migraine headaches or the patient has not complied with recommendations for physical therapy or family counseling.

The developers of the FAVER method say the second step usually leads to one of two answers: fulfilling the request is bad medicine or fulfilling the request is dishonest, illegal, or violates a policy.1

One goal of the FAVER method is the physician leaving the interaction feeling effective, empowered, and energized, which promotes physician well-being. The assumption the patient knows the request is inappropriate turns the physicianpatient relationship in a negative direction.

The third step, viewing the patient most favorably and assuming the patient does not know the request is inappropriate, redirects the relationship in a positive direction.

Clarity, the tread of step four, requires an explicit statement that the patient’s request is inappropriate and an explanation of why. The explanation should be short to conserve your time, prevent debate, and keep you on point.

The FAVER developers offer some tactics for the fifth step, reestablishing your connection to the patient. One tactic is saying, “I wish…” An example is, “I wish oxycodone was safe to use for your pain.

I know you’ve said it works well for you.

Unfortunately, it is not a safe treatment for your type of pain.” Using this phrase puts you on the patient’s side without complying with the inappropriate request.

Most physicians and other health care practitioners are willing to maintain their patient relationships even when patients ask for something unreasonable or inappropriate and these risk management strategies will support their ability to safely do so.

Reference 1. Kane M, Chambliss L. Getting to no: How to respond to inappropriate patient requests. Fam Pract Manag, 2018; 25(1):2530, Last accessed September 28, 2019, at https://www.aafp.org/ fpm/2018/0100/p25.pdf

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Features

SUPPORT Act and Medicare Part B Coverage Submitted by Noridian Health care Solutions, LLC, a CMS Medicare Administrative Contractor

To fight the opioid epidemic, the passage of the SUPPORT (Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities) Act in October of 2018 established Medicare Part B coverage for certain opioid use disorder treatment services. One of the most recent benefits starting on or after January 1, 2020 is Medicare’s coverage of Opioid Treatment Programs (OTPs). As of end of 2019, about 1700 OTPs nationwide have been certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) which is one of the requirements. OTPs provide medication assisted treatment for people diagnosed with opioid use disorder and are authorized to use medication such as buprenorphine, naltrexone, and methadone to treat OUD. Opioid Use Disorder Treatment services provided by OTPs include the following: • U.S. Food and Drug Administration (FDA)-approved opioid agonist and antagonist medications for the treatment of OUD • Dispensing and administering such medications (if applicable) • Substance use counseling • Individual and group therapy • Toxicology testing, including presumptive and definitive testing • Intake activities • Periodic assessments

OTP services are not considered physician services and are paid outside the Medicare Physician Fee Schedule. To assist in potential financial barriers, the Medicare Beneficiary’s Part B Fee for Service copayment is waived, but the deductible will still apply.

For billing purposes, CMS has established a new specialty code (D5) for Opioid Treatment Program and new Place of service code (POS) 58 for claims submission purposes: POS 58: Non-residential Opioid Treatment Facility (A location that provides treatment for opioid use disorder on an ambulatory basis. Services include methadone and other forms of Medication Assisted Treatment (MAT)).

Resources: https://www.cms.gov/Outreach-andEducation/Medicare-Learning-NetworkMLN/ MLNProducts/Downloads/OTP-enrollmentfactsheet-MLN6325432.pdf https://www.cms.gov/Center/Provider-Type/ Opioid-Treatment-Program-Center https://med.noridianmedicare.com/web/jfb/ specialties/mental-health https://www.cms.gov/About-CMS/AgencyInformation/Emergency/Downloads/Opioidepidemic-roadmap.pdf

The Opioid Treatment Program benefit is a bundled payment structure assigned a flat dollar payment amount. The bundled payment consists of a Drug Component and a Non-Drug Component. The NonDrug component for instance, covers counseling, therapy, toxicology testing, and drug dispensing and administration (if applicable).

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AOMA Digest Summer 2020

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Operating Expenses: What Tenants Should Know

By Tracy Altemus, CCIM, Executive VP, Health care Brokerage Services Agent

Most leases have some sort of pass through for operating expenses of a building. A tenant either pays its share of expenses above an amount that was included in the initial rent, either with a Base Year expense stop or a defined expense stop (if a full service or modified gross lease), or 100% of the landlord’s operating expenses (if a triple net lease).

The devil is in the details and it is important to know what is or is not included in operating expenses of a building. The list of expenses varies widely, so it is highly important that you understand what your lease calls for. It is also wise to review/audit the operating expense reconciliations from your landlords annually.

A few things to look for/ask for when negotiating a lease: 1. Gross up of expenses: This is a concept where the landlord will calculate the variable building expenses (such as utilities, janitorial, management fees) as if the building is 100% occupied; note that many leases just gross up to 95% occupancy. This is fair and actually benefits the tenant by not having large variances in expenses from year to year as a building leases up. That said, if you have a triple net lease, the tenant can save if the landlord doesn’t gross up. In addition, if you have a base year in a full service or modified gross lease, be sure your base year is also grossed up.

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A quick example to show what grossing up is and why it is fair: If you occupy 2,000 sf and that happens to be 50% of the total building and the rest of the building is unoccupied, the cost to clean your suite may be $2000 for the year. When the landlord is reconciling operating expenses the actual expenses would be $2000 and you would be responsible for your pro-rata share of that. Thus, you would pay $1000, even though it actually cost $2000 for your suite. The landlord will gross up that variable expense to what it would cost if the building were 100% occupied, so they would assume that the total operating expenses were $4000 and that you are responsible for 50% (or $2000), which is the actual cost of your suite.

2. Capital expenses: Most multi-tenanted medical buildings exclude capital expenses from operating costs. With the proliferation of condominiums and the interest in retail settings, we are seeing more and more include an amortized portion annually (which should be based on the useful life of the capital improvement, e.g. if it were a roof that was being amortized and its useful life was 20 years, then 1/20 would be amortized per year) or even the entire amount of a capital expense. You need to be aware of what your lease calls for and should try to exclude capital expenses if possible. At a minimum, if a capital expense is done in the last year of the lease, you should at least exclude that, as you won’t see the benefit of the investment.

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3. Cap on expenses: Many landlords will agree to cap increases on what they call controllable expenses, which typically means expenses other than utilities, property taxes, and insurance. However, all of that is negotiable therefore you need to discuss what you can get. The caps typically are 3% to 6% over the prior year’s expenses, so they can’t pass on increases above that in any one year. Landlords will often say they will agree to a cap but on a cumulative, compounding basis. This means that if your cap is 5% per year and one year the expenses increase 6%, they could only pass on 5%; but, if they only increase 3% the next year, then they can pass on that extra 1% from the prior year as well.

This is because cumulatively the total expense increase for 2 years was less than 10% (or, 5% per year).

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.

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AOMA Digest Summer 2020

Features

DOs on the Frontline of the Pandemic Datcha Dorvil, DO, pediatric internist, Indian Health Services, Winslow, Arizona

Pictures of Dr. Datcha Dorvil before and after trying on a new face shield given to her by colleague.

Excerpted from Dr. Dorvil’s post on June 4, 2020.

Exhausted physically, emotionally, and mentally. Shortly after these photos were taken, I spent the next 18+ hours admitting to the hospital and taking care of COVID-19 patients. I have been taking care of COVID-19 patients since March. However, I have noticed an increase in cases requiring hospitalization over the past week. Some I diagnosed with the virus in the outpatient setting back in mid to late May and they had very little to no symptoms but this week needed to be hospitalized as their symptoms progressed.

I admitted to the hospital young and old patients - some over 60 and under 35. I admitted to the hospital some with comorbidities and some had NO chronic problems. I admitted to the hospital some people of the same family unit-one right after another.

I had patients begging to not be intubated during their hospital course unless it was the last resort as I painfully watched them go into acute respiratory failure as the supplemental oxygen, nonrebreather mask, and high flow oxygen were not working and their oxygen saturation continued to plummet. Some will recover, some will recover slowly, and a few I wonder if they will make it. Ironically, this week, one of the AOMA Digest Summer 2020

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main complaints for most when assessing their respiratory status was “I can’t breathe” or “I am having a hard time catching my breath.”

The spike in the cases should not be a surprise since the state I reside in started to “open up“ about two weeks ago. Also, during Mother’s Day/Memorial Day weekends, some people participated in gatherings without masks, social distancing, or taking proper precautions.

Now the ugly head of racism in America is in the spotlight around the world over the past week due to the senseless death of George Floyd and other African-Americans. I noticed this week that I have been triggered by the racial events and this has caused me to deal with events of racism that I have experienced and suppressed. I am still working on confronting these issues so I can forgive and move on but was not expecting to have to deal with those issues in the middle of fighting a pandemic.

I have noticed some similarities with dealing with COVID-19 and racism.

• Both are highly contagious.

• Both are stifling and oppressive.

• Both can be silent killers.

• Both magnify/highlight health disparities/inequities in this country.

• Both cause physical and mental destruction.

• Both cause social distancing.

• Both isolate.

• Both have a negative impact on society and the economy.

• Victims do not think it could happen to them.

• Victims may cry or whisper out “I can’t breathe!”

• Victims can be impacted by both at the same time!

• You can have it and not know it but SPREAD IT AND INFECT OTHERS! • Both are not going anywhere soon but we must take the proper precautions to combat and prevent.

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As places continue to “open up”, as you take part in peaceful gatherings and protests, as WE Engage in meaningful and productive conversations and activities that help us change race relations in this country, we are still in the middle of a PANDEMIC! This is not to place fear but to state a fact! Don’t ignore that. We are at a crossroads in this country on race relations because people would not listen. DO NOT REPEAT THIS SAME ATTITUDE AND BECOME APATHETIC ABOUT COVID-19. And this virus DOES NOT DISCRIMINATE! Please do not be cavalier about the COVID-19 or the virus of racism and think neither will knock at your front door. It is not about PREFERENCE! IT IS ABOUT SAFETY! IT IS ABOUT PRESERVATION OF LIFE. Please continue to adhere to safety precautions as we navigate through these difficult times!

Gregory Whitaker, DO, anesthesiologist, Mt. Sinai Hospital, New York, New York New York was particularly hard hit during the early stages of the COVID-19 pandemic.

Dr. Gregory Whitaker, spent three weeks treating patients in the ICU at Mt. Sinai Hospital in New York City. He shared thoughts on his decision and the experience.

Ultimately, the decision to go to NYC was based on wanting to be a part of something bigger than myself. I believe that anyone involved health care has an innate passion for assisting others in need, regardless of the situation or location.

My employer sent out a survey in late March to determine interest and availability for those willing to repurpose themselves in response to the COVID-19 crisis. We were asked about our comfort level in terms of working in either emergency departments or intensive care units. Wanting to leverage time spent in intensive care environments while overseas in the military, the decision to avail myself towards ICU care was easy.

I worked 12 hour overnight shifts, from 7 pm until 7 am, for 3 nights straight. After taking a couple of days off, I would repeat the cycle through the month. I helped cover 8 ICU locations at our facility, totaling of 65-75 patients. I provided ventilator, sedation, and vasoactive medication management.

Most of the hospitals in the greater NYC area, whether they were major academic medical centers or community based institutions, were essentially COVID-19 facilities. Suburban facilities were overrun during the early stages of the surge.

Conversely, the major academic hospitals, though busy with overwhelming COVID-19 patients, seemed to have the resources in both equipment and personnel to handle the crisis from what I personally witnessed.

My personal thought is that Arizona should apply lessons learned from previously afflicted areas to better respond to our current surge.

I’m currently working in the ICU at my home institution in Arizona, working 12 hour overnight shifts like in NYC. While the patient volume is lower, the acuity is the same. It is a privilege to assist my critical care colleagues in caring for these very complex patients.

Dr. Greg Whitaker in New York City during the peak of the crisis there. He was in quarantine for two weeks upon returning to Arizona.

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AOMA Digest Summer 2020

AOMA News

Welcome New AOMA Members 1st Year in Practice

2nd Year in Practice

3rd Year in Practice

John R. Alessi, DO Family Medicine – Board Certified Geriatric Medicine Pain Medicine Chino Valley, AZ 928-445-4860

Melissa Chambers, DO Pediatrics – Board Certified Pediatric Endocrinology – Board Certified Phoenix, AZ 602-933-0935

Ross Barker, DO Anesthesiology – Board Certified Pain Medicine – Board Certified Glendale, AZ 888-698-6727

Leigh Anne Costanzo, DO Family Medicine/OMT – Board Certified Mesa, AZ 480-610-7100

Rachel Giroux de Armendariz, DO Family Medicine – Board Certified Phoenix, AZ 877-809-5092 Fatma Hanif, DO Pediatric Hospitalist Mesa, AZ 480-412-5687

Angela Feng, DO Family Medicine Mesa, AZ 480-827-7400

Tony Gunsul, DO Family Medicine Bend, OR 541-706-5935 Ian Chi-Yi Lin, DO Psychiatry – Board Certified Phoenix, AZ 602-222-2752

Aman Seth, DO Internal Medicine Glendale, AZ 602-588-5555

Brent Han, DO Family Medicine Las Vegas, NV 702-445-2168

Tasoula Vorvolakos, DO Pediatrics – Board Certified Pediatric Infectious Disease Scottsdale, AZ

Dmitri Segal, DO Diagnostic Radiology – Board Certified Phoenix, AZ 602-246-2584

Out of State Manish Jayesh Desai, DO Endocrinology – Board Certified Lancaster, CA 661-729-7100

Lauren Giannini Leber, DO Diagnostic Radiology Wellesley, MA Geoffrey Leber, MD Plastic Surgery Wellesley, MA Scottsdale, AZ 480-945-5522

Kristin Graziano, DO Family Medicine Dulce, NM 575-759-7256 Kenneth Hammonds, DO Family Medicine San Francisco, CA

Melanie Willis-Lorenzen, DO Family Medicine Ridgecrest, CA 760-499-3855

Joan Ellen Kandel, DO Family Medicine – Board Certified Dulce, NM 575-759-3211

AOMA Digest Summer 2020

Cindy Mayer, DO Neurology Nuclear Medicine Seattle, WA 206-277-6240 Mark McManigle, DO Family Medicine – Board Certified Rohnert Park, CA 707-206-3044 Roderick Vogel, DO Family Medicine Mt. Pleasant, MI 989-953-5320 Leland Werner, DO Family Medicine – Board Certified Port Hueneme CBC Base, CA 805-982-6342

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AOMA News

Physician Abigail Alviar, DO Pediatrics – Board Certified Chandler, AZ 480-776-0440

Jeffrey Gamber, DO Surgery – Board Certified Phoenix, AZ 602-222-1900

Joshua A. Millstein, DO Internal Medicine – Board Certified Phoenix, AZ 888-698-6727

James G. Ard, DO Family Practice – Board Certified Show Low, AZ 928-338-3551

John Gietzen, DO Family Practice – Board Certified San Luis, AZ 928-722-6098

Dung T. Nguyen, DO Internal Medicine – Board Certified Tucson, AZ 520-869-0460

David Bennett, DO Emergency Medicine Family Medicine - Board Certfied Gilbert, AZ 480-543-2485 Kirk Brisnehan, DO Family Medicine – Board Certified Phoenix, AZ 480-961-2303 Christopher Ebersole, DO Diagnostic Radiology – Board Certified Flagstaff, AZ 928-773-2515 Hajera Fatima, DO Family Practice/OMT – Board Certified Chandler, AZ 480-496-0000 Tracy Lynn Freeborn, DO General Surgery – Board Certified Phoenix, AZ 602-936-5406

Sholom M. Gootzeit, DO Oliver Oatman, DO Physical Medicine & Rehabilitation Pediatrics – Board Certified – Board Certified Pediatric Endocrinology – Certified Surprise, AZ Phoenix, AZ 623-214-7600 602-933-0935 Stuart Hoffman, DO Sleep Medicine – Board Certified Neuromuscular Medicine – Board Certified Clinical Neurophysiology – Board Certified Neurology – Board Certified Florence, AZ

Edward Young Park, DO Nephrology – Board Certified Peoria, AZ 602-843-5455 Mehul Patel, DO Gastroenterology – Board Certified Phoenix, AZ 623-780-0100

Joshua A. Levy, DO Physical Medicine & Rehabilitation – Board Certified Phoenix, AZ

Craig Peters, DO Cardiology – Board Certified Phoenix, AZ 602-861-1168

Nathan Matthews, DO Family Practice/OMT Mesa, AZ 480-882-7370

Shannon H. Smalley, DO Emergency Medicine – Board Certified Phoenix, AZ 602-839-6968 W. Brian Womack, DO Family Practice – Board Certified Fort Mohave, AZ 928-768-9496

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.

Richard Carnicky, DO

Samuel M. Feinstein, DO

Robert S. Cohen, DO, FACOI

Eustace Johnson, DO

Nigel Da Silva, DO

William C. Stonecipher, DO

Jennifer Yuen, DO Neurology/Child Neurology – Board Certified Phoenix, AZ 602-933-0970 Ron Zuiderweg, DO Nephrology – Board Certified Glendale, AZ 623-547-4668

25

AOMA Digest Summer 2020

AOMA News

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 September 30, 2020.

The newly redesigned AOMA website launched in early 2020. Check out the new look! Register for the 40th Annual Fall Seminar or take an online CME course. Visit often for future enhancements and features!

Thank you

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?

www.mica-insurance.com

AOMA Digest Summer 2020

26

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.

TRADITIONAL 3-DOSE HEPATITIS B VACCINES MAY CREATE A FALSE SENSE OF SECURITY THAT PUTS PATIENTS, HEALTHCARE PROVIDERS, AND INSTITUTIONS AT RISK.1,2 IT’S TIME TO DO SOMETHING DIFFERENT. HEPLISAV-B provided faster and higher rates of protection than Engerix-B.3*

INDICATION HEPLISAV-B is indicated for prevention of infection caused by all known subtypes of hepatitis B virus in adults 18 years of age and older.

IMPORTANT SAFETY INFORMATION Do not administer HEPLISAV-B to individuals with a history of severe allergic reaction (e.g., anaphylaxis) after a previous dose of any hepatitis B vaccine or to any component of HEPLISAV-B, including yeast.

Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of HEPLISAV-B. Immunocompromised persons, including individuals receiving immunosuppressant therapy, may have a diminished immune response to HEPLISAV-B. Hepatitis B has a long incubation period. HEPLISAV-B may not prevent hepatitis B infection in individuals who have an unrecognized hepatitis B infection at the time of vaccine administration.

The most common patient-reported adverse reactions reported within 7 days of vaccination were injection site pain (23%-39%), fatigue (11%-17%), and headache (8%-17%).

Please see Brief Summary of Prescribing Information on the following pages. © 2019 Dynavax Technologies Corporation.

HEPLISAV-B is the only 2-dose vaccine that can be administered in 1 month and is unanimously recommended by the ACIP.3-5

HEPLISAV-B protected >90% of adults in head-to-head trials with Engerix-B, including hyporesponsive patients.3†

*In study 2, the immunogenicity population comprised 1121 subjects who received HEPLISAV-B and 353 subjects who received Engerix-B. The mean age was 54 years for both groups. The primary analysis compared the seroprotection rate at week 12 for HEPLISAV-B with that at week 32 for Engerix-B. Noninferiority of the seroprotection rate induced by HEPLISAV-B compared to Engerix-B was demonstrated.3 † Trial 3 study design: A clinical trial in adults aged 18 to 70 years who received HEPLISAV-B (N=4537) or Engerix-B (N=2289). The primary analysis evaluated the noninferiority of the rate of protective immunity at week 28 induced by HEPLISAV-B (n=640) to Engerix-B (n=321) in patients with type 2 diabetes mellitus. A secondary immunogenicity objective was to demonstrate the noninferiority of the rate of protective immunity with HEPLISAV-B at week 24 compared with Engerix-B at week 28 in all subjects and in subgroups defined by age, sex, body mass index, and smoking status among adults aged 18 to 70 years.6 Abbreviation: ACIP, Advisory Committee on Immunization Practices.

REFERENCES: 1. Mast EE, Weinbaum CM, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults. MMWR Recomm Rep. 2006;55(RR-16):1-33.

2. Louther J, Feldman J, Rivera P, Villa N, DeHovitz J, Sepkowitz KA. Hepatitis B vaccination program at a New York City hospital: seroprevalence, seroconversion, and declination. Am J Infect Control. 1998;26(4):423-427.

3. HEPLISAV-B [package insert]. Berkeley, CA: Dynavax Technologies Corporation; 2018. 4. Kim DK, Hunter P; for the Advisory Committee on Immunization Practices. Recommended adult immunization schedule, United States, 2019. Ann Intern Med. 2019;170(3):182-192. 5. Schillie S, Harris A, Link-Gelles R, Romero J, Ward J, Nelson N. Recommendations of the Advisory Committee on Immunization Practices for use of a hepatitis B vaccine with a novel adjuvant. MMWR Morb Mortal Wkly Rep. 2018;67(15):455-458. 6. Jackson S, Lentino J, Kopp J, et al.

Immunogenicity of a two-dose investigational hepatitis B vaccine, HBsAg-1018, using a toll-like receptor 9 agonist adjuvant compared with a licensed hepatitis B vaccine in adults. Vaccine. 2018;36(5):668-674.

Visit HeplisavB.com to learn more.

All rights reserved.

December 2019

US-19-00-00244

BRIEF SUMMARY OF FULL PRESCRIBING INFORMATION

Table 1 Study 1: Percent of Subjects Who Reported Local or Systemic Reactions Within 7 Days of Vaccination

HEPLISAV-B [Hepatitis B Vaccine (Recombinant), Adjuvanted] Solution for Intramuscular Injection 1 INDICATIONS AND USAGE HEPLISAV-B is indicated for prevention of infection caused by all known subtypes of hepatitis B virus. HEPLISAV-B is approved for use in adults 18 years of age and older.

2 DOSAGE AND ADMINISTRATION For intramuscular administration.

2.1 Dose and Regimen Administer two doses (0.5 mL each) of HEPLISAV-B one month apart.

2.2 Administration HEPLISAV-B is a clear to slightly opalescent, colorless to slightly yellow solution.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. If either of these conditions exists, the vaccine should not be administered.

Administer HEPLISAV-B by intramuscular injection in the deltoid region using a sterile needle and syringe.

3 DOSAGE FORMS AND STRENGTHS HEPLISAV-B is a sterile solution for injection available in 0.5 mL single-dose vials and prefilled syringes. [see How Supplied/Storage and Handling (16.1)].

4 CONTRAINDICATIONS Do not administer HEPLISAV-B to individuals with a history of severe allergic reaction (e.g. anaphylaxis) after a previous dose of any hepatitis B vaccine or to any component of HEPLISAV-B, including yeast [see Description (11)].

5 WARNINGS AND PRECAUTIONS 5.1 Managing Allergic Reactions Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of HEPLISAV-B. 5.2 Immunocompromised Individuals Immunocompromised persons, including individuals receiving immunosuppressant therapy, may have a diminished immune response to HEPLISAV-B. 5.3 Limitations of Vaccine Effectiveness Hepatitis B has a long incubation period. HEPLISAV-B may not prevent hepatitis B infection in individuals who have an unrecognized hepatitis B infection at the time of vaccine administration.

6 ADVERSE REACTIONS 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a vaccine cannot be directly compared to rates in the clinical trials of another vaccine and may not reflect the rates observed in practice.

A total of 9597 individuals 18 through 70 years of age received at least 1 dose of HEPLISAV-B in 5 clinical trials conducted in the United States, Canada, and Germany. Data from 3 of these trials are provided below.

Study 1 in Subjects 18 through 55 Years of Age Study 1 was a randomized, observer-blind, active-controlled, multicenter study in Canada and Germany in which 1810 subjects received at least 1 dose of HEPLISAV-B and 605 subjects received at least 1 dose of Engerix-B® [Hepatitis B Vaccine (Recombinant)].

Enrolled subjects had no history of hepatitis B vaccination or infection. HEPLISAV-B was given as a 2-dose regimen at 0 and 1 month followed by saline placebo at 6 months.

Engerix-B was given at 0, 1, and 6 months. In the total study population, the mean age was 40 years; 46% of the subjects were men; 93% were white, 2% black, 3% Asian and 3% Hispanic; 26% were obese, 10% had hypertension, 8% had dyslipidemia, and 2% had diabetes mellitus. These demographic and baseline characteristics were similar in both vaccine groups.

Solicited Local and Systemic Adverse Reactions Subjects were monitored for local and systemic adverse reactions using diary cards for a 7-day period starting on the day of vaccination. The percentages of subjects who reported local and systemic reactions are shown in Table 1.

Table 1 Study 1: Percent of Subjects Who Reported Local or Systemic Reactions Within 7 Days of Vaccination HEPLISAV-B % Post-Dose* Reaction Local

Engerix-B %

Post-Dose*

Post-Dose*

1

2

1

2

Headache

16.9

12.8

19.2

12.3

9.5

Malaise

9.2

7.6

8.9

6.5

6.4

N=1784

N=1764

N=596

N=590

N=561

1.1

1.5

1.8

1.7

1.8

Reaction

Fever‡

3

Note: only subjects having data are included. Clinical trial number: NCT00435812 *HEPLISAV-B was given as a 2-dose regimen at 0 and 1 month followed by saline placebo at 6 months. Engerix-B was given at 0, 1, and 6 months † Redness and swelling ≥ 2.5 cm. ‡ Oral temperature ≥ 100.4°F (38.0°C).

Unsolicited Adverse Events: Unsolicited adverse events within 28 days following any injection, including placebo, were reported by 42.0% of HEPLISAV-B recipients and 41.3% of Engerix-B recipients.

Serious Adverse Events (SAEs) Subjects were monitored for serious adverse events for 7 months after the first dose of vaccine. The percentage of subjects reporting serious adverse events was 1.5% in the HEPLISAV-B group and 2.1% in the Engerix-B group. No acute myocardial infarctions were reported. No deaths were reported.

Potentially Immune-mediated Adverse Events Potentially immune-mediated adverse events that occurred within 7 months of the first dose of vaccine were reported in 0.2% (n = 4) of HEPLISAV-B recipients and 0.7% (n = 4) of Engerix-B recipients. The following events were reported in the HEPLISAV-B group in one subject each: granulomatosis with polyangiitis, lichen planus, Guillain-Barré syndrome, and Grave’s disease. The following events were reported in the Engerix-B group in one subject each: Bell’s palsy, Raynaud’s phenomenon, and Grave’s disease. One additional Engerix-B recipient with a history of mixed connective tissue disease had p-ANCA-positive vasculitis.

Study 2 in Subjects 40 through 70 Years of Age Study 2 was a randomized, observer-blind, active-controlled, multicenter study in Canada and the United States in which 1968 subjects received at least 1 dose of HEPLISAV-B and 481 subjects received at least 1 dose of Engerix-B. HEPLISAV-B was given as a 2-dose regimen at 0 and 1 month followed by saline placebo at 6 months. Enrolled subjects had no history of hepatitis B vaccination or infection. Engerix-B was given at 0, 1, and 6 months. In the total population, the mean age was 54 years; 48% of subjects were men; 82% were white, 15% black, 1% Asian and 6% Hispanic; 44% were obese, 30% had hypertension, 30% had dyslipidemia, and 8% had diabetes mellitus. These demographic and baseline characteristics were similar in both vaccine groups.

Solicited Local and Systemic Adverse Reactions Subjects were monitored for local and systemic adverse reactions using diary cards for a 7-day period starting on the day of vaccination. The percentages of subjects who experienced local and systemic reactions are shown in Table 2.

Table 2 Study 2: Percent of Subjects Who Reported Local or Systemic Reactions Within 7 Days of Vaccination HEPLISAV-B %

Engerix-B %

Post-Dose* Reaction Local

Post-Dose*

1

2

1

2

3

N=1952

N=1905

N=477

N=464

N=448

Injection Site Pain

23.7

22.8

18.4

15.9

13.8

Injection Site Redness†

0.9

0.7

0.6

0.2

0.2

Injection Site Swelling†

0.9

0.6

0.6

0.6

0.2

Systemic

Engerix-B %

Fatigue

12.6

10.8

12.8

12.1

9.4

Post-Dose*

Headache

11.8

8.1

11.9

9.5

8.5 5.1

1

2

1

2

3

Malaise

7.7

7.0

8.6

7.1

N=1810

N=1798

N=605

N=603

N=598

Myalgia

8.5

6.4

9.6

8.0

4.5

N=1923

N=1887

N=472

N=459

N=438

Injection Site Pain

38.5

34.8

33.6

24.7

20.2

Injection Site Redness†

4.1

2.9

0.5

1.0

0.7

Injection Site Swelling†

2.3

1.5

0.7

0.5

0.5

17.4

13.8

16.7

11.9

10.0

Systemic Fatigue

HEPLISAV-B %

Fever‡ 0.6 0.6 0.6 0.9 0.7 Note: only subjects having data are included. Clinical Trial Number: NCT01005407 *HEPLISAV-B was given as a 2-dose regimen at 0 and 1 month followed by saline placebo at 6 months. Engerix-B was given at 0, 1, and 6 months † Redness and swelling ≥2.5 cm. ‡ Oral temperature ≥ 100.4°F (38.0°C).

Unsolicited Adverse Events Unsolicited adverse events within 28 days following any injection, including placebo, were reported by 35.4% of HEPLISAV-B recipients and 36.2% of Engerix-B recipients.

Serious Adverse Events Subjects were monitored for serious adverse events for 12 months after the first dose of vaccine. The percentage of subjects reporting serious adverse events was 3.9% in the HEPLISAV-B group and 4.8% in the Engerix-B group. Acute myocardial infarction occurred in 0.1% (n=2) of HEPLISAV-B recipients and 0.2% (n=1) of Engerix-B recipients.

Autoimmune Adverse Events Subjects were monitored for the occurrence of new-onset potentially immune-mediated adverse events for 12 months after the first dose of vaccine. Events were adjudicated as to whether they were autoimmune by an external group of experts blinded to treatment assignment. As determined by the adjudicators, new-onset autoimmune adverse events were reported in 0.2% (n=3) of HEPLISAV-B recipients: two subjects with hypothyroidism and one subject with vitiligo. None of these events was considered related to vaccination by the expert group. No new-onset autoimmune adverse events were reported in the Engerix-B group. Although not referred to the external group of experts, one HEPLISAV-B recipient was determined to have Tolosa-Hunt syndrome which is presumed to have an immune-mediated etiology. This event was not considered related to vaccination.

Deaths One subject (0.05%) died of a pulmonary embolism in the HEPLISAV-B group and 1 subject (0.2%) died of heart failure in the Engerix-B group. Neither death was considered related to vaccination.

Study 3 in Subjects 18 through 70 Years of Age Study 3 was a randomized, observer-blind, active-controlled, multicenter study in the United States in which 5587 subjects received at least 1 dose of HEPLISAV-B and 2781 subjects received at least 1 dose of Engerix-B. Enrolled subjects had no history of hepatitis B vaccination or infection. HEPLISAV-B was given as a 2-dose regimen at 0 and 1 month followed by saline placebo at 6 months. Engerix-B was given at 0, 1, and 6 months. In the total study population, the mean age was 50 years; 51% were men; 71% were white, 26% black, 1% Asian, and 9% Hispanic; 48% were obese, 36% had hypertension, 32% had dyslipidemia, and 14% had type 2 diabetes mellitus. These demographic and baseline characteristics were similar in both vaccine groups.

Unsolicited Medically-Attended Adverse Events Subjects were monitored for unsolicited medically-attended adverse events, those for which a subject sought medical care, for 13 months after the first dose of vaccine. Overall, medically-attended adverse events were reported in 46.0% of HEPLISAV-B recipients and 46.2% of Engerix-B recipients. Herpes zoster was reported in 0.7% of HEPLISAV-B recipients and 0.3% of Engerix-B recipients. Unsolicited medically-attended adverse events within 28 days following any injection, including placebo, were reported by 20.1% of both HEPLISAV-B and Engerix-B recipients.

Serious Adverse Events Subjects were monitored for serious adverse events for 13 months after the first dose of vaccine. The percentage of subjects who reported serious adverse events was 6.2% in the HEPLISAV-B group and 5.3% in the Engerix-B group. Acute myocardial infarction (AMI) was reported in 0.25% (n=14) of HEPLISAV B recipients and 0.04% (n=1) of Engerix-B recipients. An analysis of serious adverse events likely representing myocardial infarction (MI) was conducted using the standard Medical Dictionary for Regulatory Activities (MedDRA) query (SMQ) for MI. This analysis identified a total of 19 HEPLISAV-B subjects (0.3%) and 3 Engerix-B subjects (0.1%) with events included in the SMQ for MI (these events include the 15 reports of AMI). Additional evidence, including information on temporal relationship and baseline risk factors, does not support a causal relationship between HEPLISAV-B administration and AMI. Among the 19 events identified as MI in HEPLISAV-B recipients, three occurred within 14 days, nine occurred within 53-180 days, and seven occurred more than 180 days following any dose of HEPLISAV-B. Among the three events identified as MI in Engerix-B recipients, one each occurred 13, 115, and 203 days following any dose. All 19 HEPLISAV-B recipients and 3 Engerix-B recipients reported one or more baseline risk factors for cardiovascular disease.

Autoimmune Adverse Events Subjects were monitored for the occurrence of new-onset potentially immune-mediated adverse events for 13 months after the first dose of vaccine. Events were adjudicated as to whether they were autoimmune by an external group of experts who were blinded to treatment assignment. As determined by the adjudicators, new-onset autoimmune adverse events were reported in 0.1% (n=4) of HEPLISAV-B recipients [one each of: alopecia areata, polymyalgia rheumatica, ulcerative colitis, and autoimmune thyroiditis (with concurrent diagnosis of papillary thyroid carcinoma)]. None of these events was considered to be related to vaccination by the external experts. No new-onset autoimmune adverse events were reported in the Engerix-B group.

Deaths During the study death was reported in 25 subjects (0.4%) in the HEPLISAV-B group and 7 subjects (0.3%) in the Engerix-B group. No death was considered related to vaccination.

7 DRUG INTERACTIONS 7.1 Use with Immune Globulin There are no data to assess the concomitant use of HEPLISAV-B with immune globulin.

When concomitant administration of HEPLISAV-B and immune globulin is required, they should be given with different syringes at different injection sites.

7.2 Interference with Laboratory Tests Hepatitis B surface antigen (HBsAg) derived from hepatitis B vaccines has been transiently detected in blood samples following vaccination. Serum HBsAg detection may not have diagnostic value within 28 days after receipt of HEPLISAV-B.

8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to HEPLISAV-B during pregnancy. Women who receive HEPLISAV-B during pregnancy are encouraged to contact 1-844-443-7734.

Risk Summary All pregnancies have a risk of birth defect, loss, or other adverse outcomes. In clinically recognized pregnancies in the US general population, the estimated background risk of major birth defects is 2% to 4% and of miscarriage is 15% to 20%.

There are no clinical studies of HEPLISAV-B in pregnant women. Available human data on HEPLISAV-B administered to pregnant women are insufficient to inform vaccine-associated risks in pregnancy.

In a developmental toxicity study, 0.3 mL of a vaccine formulation containing 2.5 mcg HBsAg and 3000 mcg cytosine phosphoguanine (CpG) 1018 adjuvant was administered to female rats prior to mating and during gestation. These animal studies revealed no evidence of harm to the fetus due to this vaccine formulation [see Data].

Data Animal data Developmental toxicity studies were conducted in female rats. Animals were administered 0.3 mL of a vaccine formulation containing 2.5 mcg HBsAg and 3000 mcg CpG 1018 adjuvant twice prior to mating, and on gestation days 6 and 18 (a single human dose of HEPLISAV-B contains 20 mcg HBsAg and 3000 mcg CpG 1018 adjuvant). No adverse effects on pre-natal and post-natal development up to the time of weaning were observed.

There were no vaccine-related fetal malformations or variations observed.

8.2 Lactation Risk Summary It is not known whether HEPLISAV-B is excreted in human milk. Data are not available to assess the effects of HEPLISAV-B on the breastfed infant or on milk production/excretion.

The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for HEPLISAV-B and any potential adverse effects on the breastfed child from HEPLISAV-B or from the underlying maternal condition. For preventive vaccines, the underlying condition is susceptibility to disease prevented by the vaccine.

8.4 Pediatric Use Safety and effectiveness of HEPLISAV-B have not been established in individuals less than 18 years of age.

8.5 Geriatric Use Clinical trials included 909 adults 65 through 70 years of age who received HEPLISAV-B. Among subjects who received HEPLISAV-B, a seroprotective level of antibody to HBsAg was achieved in 90% of those 65 through 70 years of age compared to 96% of those aged 18 through 64 years of age.

Safety and effectiveness of HEPLISAV-B in adults older than 70 years of age were extrapolated from findings in subjects younger than 70 years of age.

8.6 Adults on Hemodialysis Safety and effectiveness of HEPLISAV-B have not been established in adults on hemodialysis.

17. PATIENT COUNSELING INFORMATION • Inform vaccine recipient of the potential benefits and risks associated with vaccination, as well as the importance of completing the immunization series.

• Emphasize that HEPLISAV-B contains non-infectious purified HBsAg and cannot cause hepatitis B infection.

• Advise vaccine recipient to report any adverse events to their healthcare provider or to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 and www.vaers.hhs.gov.

• Provide the Vaccine Information Statements, which are available free of charge at the Centers for Disease Control and Prevention (CDC) website (www.cdc.gov/vaccines).

Manufactured by: Dynavax Technologies Corporation Emeryville, CA 94608 USA © 2019, Dynavax Technologies Corporation. All rights reserved.

US-19-00-00243

AOMA News

Dinner with Doctors More than 60 students and 22 physicians enjoyed an evening of socializing and networking at the fourth annual Dinner with Doctors on Friday, October 18, 2019.

The Maricopa County Medical Society (MCMS) Courtyard was a beautiful venue on a warm, fall night. Good food and great conversation created a casual, comfortable atmosphere that allowed students to ask questions of the physicians and learn how to get involved with AOMA. Thank you to Mutual Insurance Company of Arizona (MICA) and MCMS for your support of this event. Plan on joining us in October!

Above: Delicious food, refreshing libations, and great conversation were in full abundance under the lights in the Courtyard at the Maricopa County Medical Society during the fourth annual Dinner with Doctors.

Left: First year SOMA students Issa Ismail and Aliza Tan talk with Lawrence Ryan, DO, about family medicine.

Below: Jonathan Kim, OMS I at AZCOM, and Dane Caputo, DO, discuss emergency medicine.

AOMA Digest Summer 2020

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AOMA News

AOMA 39th Annual Fall Seminar Honoring Our Heritage, Shaping Our Future More than 200 osteopathic physicians, students, and other practitioners gathered in Tucson in November 2019 for the AOMA 39th Annual Fall Seminar.

The two-day event at the El Conquistador Tucson, A Hilton Resort, offered 13.25 hours of AOA Category 1-A CME credits and AMA PRA 1 creditsTM including specialty credits in Family Medicine/ OMT, Internal Medicine, Psychiatry, Gastroenterology, and Otolaryngology.

Lecture topics included measles, vaccine hesitancy, ADHD, anxiety disorders, OMM, C. diff, chronic diarrhea, nose bleeds, nasal polyps, and allergic rhinitis.

The AOMA Professional Education Committee, chaired by Lori Kemper, DO, FACOFP, acknowledges all the speakers who contributed to the success of the Seminar with their expertise and experience in the lectures. Thank you to Gina Wu, DO; Bob England, MD, MPH; Randall Ricardi, DO; Paul Beljan, PsyD; Andrea Raby, DO; Karen Nichols, DO; Sristi Nath, DO; Carlton Richie III, DO; Nathan Nakken, DO; F. P. Wedel, DO; Kevin Garey, PharmD; Amy Foxx-Orenstein, DO; Bryan Friedman, DO; and David Mendelson, DO. Many thanks to the osteopathic medical students who moderated the lectures: Glen Clark, OMS IV; William Phillips, OMS I; Nancy Phu, OMS IV; Samantha Rudy, OMS III; Nicole Sassounian, OMS I; and Jalicia Sturdivant, OMS IV. Congratulations to the winners of the Exhibit Hall Prize Drawing: Deborah Hudak, DO, and Donald Middleton, DO. Each won a $150 VISA gift card. It pays to visit our exhibitors!

Thank you to our sponsors and exhibitors SPONSOR Blue Cross Blue Shield of Arizona EXHIBITORS

Arizona Army National Guard Arizona Osteopathic Charities Brain Injury Alliance Equality Health Network Grassp, Inc. John Driscoll & Company MGY - CAPACIDAD Midwestern University AZCOM Midwestern University Body Donation Program Mutual Insurance Company of Arizona Save the Cord Foundation/Arizona Public Cord Blood Program SimonMed Imaging Steward Health Care Network U.S. Army Medical Recruiting Weight Loss Institute of Arizona

Plan to attend the new and improved AOMA 40th Annual Fall Seminar on November 6-8, 2020. The 2020 event is expanded to two and half days, 20 credits, and will be a livestreaming, virtual event.

Check it out at www.az-osteo.org/2020Fall.

If you missed the Fall Seminar, many of the lectures were recorded and are now available online at www.docme.org. AOMA members receive a discount on all AOMAproduced content. Email or call the office at 602-266-6699 for the coupon code.

31

AOMA Digest Summer 2020

AOMA News

AOMA 39th Annual Fall Seminar

1

2

3

4

5

6

1. Thomas Waggoner, DO, and Kavitha Waggoner, DO, enjoy breakfast in the Exhibit Hall.

2. Brian Butterfield, DO, and Donald Curran, DO, swap stories over a cup of coffee.

3. Gary Gaffield, DO, James Hess, DO, Lee Goedecke, DO, and John McCracken, DO, break bread during the Fall Seminar.

4. Gary Erbstoesser, DO, and his wife Debbie are regulars at the Fall Seminar.

5. Karen Nichols, DO, and hubby Jim say “cheese”!

6. Melissa Spanggaard, DO, Theresa Cisler, DO, April Estes, DO, and Nicole Thrift, DO, share good food and conversation.

AOMA Digest Summer 2020

32

AOMA News

7

8

9

11

10

12

7. Tracy Middleton, DO, and Donald Middleton, DO, are all smiles for the photographer.

8. It’s a family affair for brothers Chris Labban, DO, and Brendon Labban, DO. 9. Scott Steingard, DO, and Sharon Steingard, DO, escaped to Tucson for the weekend.

10. The Fall Seminar is a great opportunity for colleagues to relax. Just ask Kate Worden, DO, Shannon Scott, DO, and Karen Nichols, DO. 11. Sarah Colwell, DO, (center) is surrounded by her mom Susan Colwell, daughter Allyson, and son Jayson, and dad David Colwell.

12. Timothy Durr, SOMA Class of 2022, Danielle Barnett-Trapp, DO, Jay Olson, MS, AZCOM Class of 2021, and Richard Dobrusin, DO, relax after the AOMA House of Delegates meeting.

13. Gregory Whitaker, DO, F. Timm McCarty, DO, Marty McCarty, and Bradley Downing, DO, toast to a successful evening reception.

13

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AOMA Digest Summer 2020

AOMA News

2020 DO Day at the State Legislature DO Day at the State Legislature is the AOMA annual lobby day at the Arizona State Legislature for DOs and medical students, providing a great opportunity to get an up-close view of the legislative process and to meet your legislators.

Held February 18, 2020, 68 osteopathic medical students from AZCOM and SOMA arrived at the state capitol to see government in action. The students were joined by 14 osteopathic physicians for the day.

State Treasurer Kimberly Yee hosted AOMA for the day and spoke with the students about the importance of engaging in the policymaking process.

This was the Fifty-fourth Legislature - Second Regular Session for the state of Arizona and DO Day occurred during a very busy time as more than 1700 bills were introduced in the first 18 days of the session - a new record. Party caucuses and committee meetings prevented the over-scheduled legislators from speaking

with the students and physcians. In lieu of these presentations, the students became more familiar with the ALIS, the Arizona Legislative Information System, where constituents can monitor bills and sign on in support or against proposed legislation.

AOMA contract lobbyist Steve Barclay, JD, and Kit McCalla, DO, Chair of the AOMA Legislative Affairs Committee, shared some insights on the scope of legislation under consideration in current legislative session.

AOMA Interim Executive Director Janet Weigel quizzed students during a Policy Trivia Game to test their knowledge. Correct answers earned an AOMA mug, “You can’t spell DOCTOR without D.O.” Students and DOs met individually with their district representatives and discussed important issues impacting the practice of medicine.

The date is still be determined for next year’s AOMA DO Day at the State Legislature. Watch your email for updates.

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1. Richard Dobrusin, DO (center) and students met with Arizona Representative Raquel Teran from District 30.

2. Lt. Col. Kit McCalla, Chair of the AOMA Legislative Affairs Committee, emphasized the importance of advocacy.

3. Steve Barclay, JD, AOMA lobbyist, reviewed the pressing issues during this session.

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fun during the event. Lively music interludes - Who’s Zoomin’ Who? by Aretha Frankling and ZOOM by The Commodores - and some humorous videos about toilet paper kept us entertained during the breaks. We even had a visitor from the the future! Check it out at www.az-osteo.org/TheDoctor.

AOMA 98th Annual Convention Virtual Streaming!

Over 600 physicians participated in the Arizona Osteopathic Medical Association 98th Annual Convention - Livestreaming for five days on April 1-5, 2020. It was no “April Fools Day” when the COVID-19 pandemic required the reimagining of the Convention as a virtual event. The theme of this year’s Convention was Finding Health, with attendees tuning in from Hawaii to Massachusetts and everywhere in between for the 36 different lectures offering 37.75 hours of AOA Category 1-A CME Credits and AMA PRA Category 1 CreditsTM, sponsored

by Touro University Nevada College of Osteopathic Medicine.

Thank you to all the speakers who presented the lectures under unusual circumstances.

Topics included telemedicine, COVID-19, head injuries, OMM, cancer updates, liver function tests, CBD facts, vaping, addiction medicine, heart disease, psychiatric evaluations, seasonal allergies, and rare diseases.

If you were not able to attend the AOMA 98th Annual Convention, many of the lectures presented have been converted to on demand offerings available now on DOCME. Visit www.docme.org to view the complete catalog.

Many thanks to the members of the AOMA Professional Education Committee for planning the event: Lori Kemper, DO, Chair; George Chen, DO: Andrew Chung, DO; Susan Del Sordi-Staats, DO; Charles Finch, DO; Stuart Friedman, DO; James Keane, DO; Brendon Labban, DO; David Leff, DO; Michelle Mifflin, DO; Donald Morgan, DO; Jeffrey Morgan, DO; Laurel Mueller, DO; Sharon Obadia, DO; Lawrence Sands, DO; and Jennifer Vanyo-Novak, DO. Even though everyone was sheltering in place while earning their CME and we all missed the camaraderie and social aspects of the Convention, we were able to have a little bit of

The Emergency Medical Hologram, aka actor Robert Picardo, paid Convention attendees a visit from the 24th Century aboard the Starship Voyager.

We are grateful to our sponsors and advertisers who supported our first-ever virtual event. While we did not have an Exhibit Hall during the Convention, daily drawings were held for participants who correctly identified the featured advertiser of the day. Twenty five winners each received a $50 VISA gift card.

Mark your calendars for April 7-11, 2021 for the AOMA 99th Annual Convention at our new location at the Embassy Suites by Hilton Scottsdale Resort.

Thank you to our AOMA 98th Annual Convention Sponsors PLATINUM Mutual Insurance Company of Arizona (MICA) SILVER A.T. Still University Midwestern University SPONSOR Blue Cross Blue Shield of Arizona 35

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Sheltering in Place While Earning CME

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1. Prentiss Adkins, DO, was up at 4 am each morning so he could login from his home in Hawaii. Aloha!

2. Brendan Curley, DO, kept an eye on his kids while watching poolside.

3. Joshua Levy, DO, got “exotic� during his lunch break.

4. Sharon Obadia, DO, gives a thumbs up to the lectures presented during the livestreaming Convention.

5. Calvin Polland, DO, tuned in from Colorado.

6. Steve Barclay, JD, arrived at the AOMA office well-prepared to give his Arizona Legislative Update lecture.

7. Melanie Willis, DO, had the all the essentials for the Convention: Coffee, dark chocolate, and virtual CME. 8. Jennifer Vanyo-Novak, DO, and her entire family participated: husband Thomas Novak and daughters Grace and Emma.

9. Greg Whitaker, DO, appreciated the opportunity to stay home and earn his CME.

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1. Randall Woods, DO, loved this year’s location, especially his great parking space!

2. Carl Bynum, DO, had the best seat in the house for the Convention.

3. Steve Boles, DO, suits up to prevent a “virtual virus”.

4. Heatheranne Bal, DO, and her daughter got up early for Saturday morning yoga.

5. Frank Salisbury, MD, and Barbara Tilben, DO, had company while learning about vaping.

6. WFH/CFH: work from home/CME from home ala Lori Kemper, DO. 7. Whose fuzzy slippers are those? Jennifer Tidroski, DO! 8. Multi-tasking at its finest: virtual CME and exercise!

9. Sherry Roles, DO, took advantage of on demand playback while camping in her backyard.

10. Time for a quarantonic with lime courtesy of Bradley Downing, DO.

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12th Annual AOMA Clinical Case Compeition and Poster Forum Promotes Scholarly Activity Poster Forum

A total of 48 posters in four categories were entered into the 2020 Forum. For the first time ever, all presentations were conducted virtually on Saturday, April 4, 2020. Posters were evaluated by a panel of judges. Cash awards of $250 were given to 1st Place winners in each of the three student categories, provided through a grant from the HonorHealth Foundation. All the poster submissions may be viewed at www.az-osteo.org/PosterEntries.

Student Case Poster 1st Place - Individuality in Care of Children with Hypertrophic Cardiomyopathy – Lauren Krance, OMS III 2nd Place - One in a Million: A Case of Tumor Lysis Syndrome in a Patient with Multiple Myeloma – Eric Dong, MPH, OMS III 3rd Place - Paralysis Due to an Unusual Case of a Spinal Epidural Abscess – Kayla Fletcher, OMS III Student Research Poster 1st Place - Adherence to Iron Chelation Therapy, Health-Related Quality of Life and Other Patient-Reported Outcomes Among Parents of Children with Hemoglobinopathies Receiving Chronic Blood Transfusions: A Cross-Sectional Study - Usman Beg, OMS II 2nd Place - Can a Smartphone Digital Endoscope Improve Anatomical Recognition of the Inner Ear Landmarks, Comfort and Confidence in First Year Medical Students? - Tanya Omar, OMS I & Rawan Sultan, OMS I 3rd Place - Impact of a Whole-Foods, Plant-Based Nutrition Group Visit on Patients Living in an Underserved Community – Tasha Harder, OMS IV & Meaghan Connolly, OMS III Student Performance/Population Improvement Project Poster 1st Place - An Evaluation of the Nutrition and Health Awareness Program on Health Knowledge, Health Literacy and Activity Levels - Sara Brundage, OMS III 2nd Place - Improving Evaluating Responsiveness of Underserved Chicago Communities to Colorectal Cancer Screening Recommendations - Sokkha Hak, OMS III 3rd Place - Improving Mental Health Diagnosis and Treatment by Primary Health Care Providers Through Introduction of a Quick Reference Guide - Harmandeep Grewal, OMS III Resident Poster 1st Place - Sarcoidosis: A Less Common but Equally Important Cause of Chest Pain to Consider in the Emergency Department - Justina Truong, DO, PGY4 2nd Place - Imperforate Hymen: Keep the Differential Broad - Sasha Reid, DO, PGY2 3rd Place - Morel-Lavallee Lesion - Delayed Presentation of an Often Missed Traumatic Injury - Daniel Porter, DO, PGY3 AOMA Digest Summer 2020

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Clinical Case Competition

Students from Arizona osteopathic medical schools submitted case abstracts to the AOMA Case & Poster Committee in February 2020. The Committee reviewed all of the cases and selected the top three to be presented virtually during the Clinical Case Competition on Saturday, April 4, 2020 sponsored by Midwestern AZCOM and A. T. Still University SOMA. The first place presenter receive a cash award of $250, funded by a grant from the HonorHealth Foundation. st Place - Early-Onset Preeclampsia with Pulmonary Edema and Massive Ascites: A 1 Rare Presentation of Severe Preeclampsia or Concomitant Diagnoses? - Elizabeth St. Laurent, OMS IV 2nd Place - Superior Mesenteric Artery Syndrome: The Hidden Dangers of Extreme Weight Loss - Tracy Lin, OMS III 3rd Place - Inflammatory Myopathies: Dermatomyositis in a Previously Healthy Male Kathryn Middleton, OMS III The call for abstracts for the 2021 Clinical Case Competition and Poster Forum will announced this fall. Abstract submissions will be due in February 2021. Visit the AOMA website at www.az-osteo.org/PosterForum for the abstract application, submission guidelines, deadlines, and to view previous winning cases and posters.

Sara Brundage, OMS III at ATSU-SOMA, earned 1st Place in the Performance/Population Improvement Project category with her poster on the Nutrition and Health Awareness Program.

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AOMA Annual Awards Honoring the Osteopathic Profession LIFETIME ACHIEVEMENT AWARD Craig R. Cassidy, DO, FAOCO

PHYSICIAN OF THE YEAR AWARD Steven C. Boles, DO, FASAM

Presented to long-time members who have advanced the osteopathic medical profession in Arizona with unwavering commitment to quality patient care.

The highest honor for a member who provides his/ her community with compassionate, comprehensive, and caring medical services on a continuing basis; is directly and effectively involved in community affairs; and supports his/her community, state, professional associations, and humanitarian program.

Craig R. Cassidy, DO, FAOCO, has been an AOMA member since coming to Arizona and joining Sanford Moretsky, DO, in practice in 1981. A Fellow of the American College of Ophthalmology and Otolaryngology, he is consistently nationally and locally recognized as a top ophthalmologist in Phoenix. He is the team ophthalmologist for the Arizona Rattlers and the Phoenix Mercury and previously served in that capacity for the Phoenix Suns.

Before attending Kansas City University of Medicine and Biosciences to pursue his degree in osteopathic medicine, Dr. Cassidy received his bachelor of science in pharmacy and worked as a registered pharmacist in Kansas. After graduating from medical school, he completed an internship at Zieger-Botsford Hospital in Farmington Hills, Michigan and was Chief Resident at Detroit Osteopathic Hospital and Kreske Eye Institute.

Dr. Cassidy and his wife Colleen have been married for 40 years and have five children and four grandchildren.

Dr. Cassidy has served on the AOMA Board of Trustees since 2003 representing the osteopathic specialists. His wisdom and experience provide much-appreciated insight for AOMA governance.

He is very deserving of this recognition.

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Steven C. Boles, DO, FASAM, a native Arizonan, has been a dedicated member of the Arizona osteopathic community since finishing his training at Phoenix General Hospital in 1983.

After completing rehab in Tucson in 1997 (at the urging of his wife, and the very strong suggestion of the licensing board), Dr. Boles trained under C.J. Shaw, MD, in Addiction Medicine at St. Luke’s Behavioral Health Hospital. He became board certified in Addiction Medicine in 1999, and was the 14th osteopathic physician to become a Fellow of the American Society of Addiction Medicine in the United States. A past president of the state chapter of the Arizona Society of Addiction Medicine, he has been listed in Phoenix Magazine’s Top Doc selection for Addiction Medicine on five different occasions, from 2012-2020. As an adjunct professor at AZCOM, Dr. Boles has been a Family Practice and Addiction Medicine preceptor & mentor for hundreds of osteopathic medical students. He truly embodies the ideal of modern osteopathic medicine.

Dr. Boles has been happily married to his wife, Natalie, for 26 years. They have three children: daughter Stephanie and sons Jonathan and Bradley.

He is honored to be recognized with this award.

AOMA News

EMERGING LEADER AWARD Brandon H. Abbott, DO, MPH, FAAP

RESIDENT OF THE YEAR AWARD Marissa K. Jacobs, DO

Recognizes an outstanding osteopathic physician in practice less than five years whose accomplishments and actions have been instrumental in motivating and inspiring others.

Recognizes an outstanding osteopathic resident from Arizona who goes above and beyond to bring a sense of pride to the profession.

Brandon H. Abbott, DO, MPH, FAAP, has done more in his short career than many who are years his senior. He is a board-certified internist and pediatrician practicing at North Country Healthcare in Flagstaff, Arizona, focusing on transitional care for children with chronic medical illnesses. A member of the first graduating class of A.T. Still University School of Osteopathic Medicine in Arizona, Dr. Abbott earned a Master of Public Health at the University of New England College of Osteopathic Medicine during medical school. He completed his residency in internal medicine and pediatrics at the State University of New York at Buffalo before returning to Arizona.

Dr. Abbott is also a part time staff physician for Doctor on Demand, a telemedicine company. He has served on the AOMA Board of Trustees since his days as a student and has contributed to our Association through his leadership, expanded GME through his involvement with the new family medicine residency program at North Country Healthcare beginning in 2020, advocated in policy to testify for increased GME funding, and volunteered his time at many functions such as DO Day at the Legislature and presented lectures at AOMA CME events.

Dr. Abbott and his wife Tiffany live in Flagstaff with their daughters Matilda and Ona.

Marissa K. Jacobs, DO, is a graduate of Midwestern University Arizona College of Osteopathic Medicine and is Chief Resident in the St. Joseph Hospital Family Medicine Residency Program in Phoenix, Arizona.

Dr. Jacobs has served on the AOMA Board of Trustees as the Resident Trustee for the past two years, marking perfect attendance at all board meetings - no small feat for a resident!

Dr. Jacobs was born in Montreal, Canada and moved to Arizona at age 12. She attended Arizona State University and earned a bachelors degree in anthropology. While at ASU, Dr. Jacobs spent three months in Ethiopia during a study abroad program and this compelled her to pursue a career in medicine.

Dr. Jacobs was recently married to her husband Blake Cormie, a public defender with Yavapai County.

Post-residency, Dr. Jacobs will be joining HonorHealth in their NOAH Clinic, a federally qualified health care center in Glendale, Arizona.

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PRESIDENT’S AWARD Peter S. Wertheim, MS, DHL Honors a member who has contributed significantly to the AOMA via the Board of Trustees, House of Delegates, and/or Committees.

Peter S. Wertheim, MS, DHL, served as Executive Director of the Arizona Osteopathic Medical Association from June 2014 to January 2020. Pete’s career in health care public policy spanned the legislative and government sector, private industry, and not-for profit. For 20 years he was dedicated to developing and implementing good public policy.

Early in his career he served as a legislative research analyst and policy advisor to the Arizona House of Representatives. His work as the Chief Legislative Liaison at Arizona Department of Health Services led to the critical funding for a new forensic unit at the Arizona State Hospital. He served in the private sector as a health care lobbyist and was Vice President for Strategic Communications for the Arizona Hospital and Health care Association.

In 2013, Pete became the Communications and Public Affairs Manager for the City of Prescott, just six days before the tragic Granite Mountain Hotshots fire that claimed the lives of 19 firefighters. His authentic and compassionate mitigation of media relations during this painful time helped the community navigate this horrific ordeal.

Pete received numerous awards for his contributions, including the Senator Nichols Award from the Arizona Public Health Association, the Health Policy Hero Award from the American College of Physicians, the IASIS Health care Chairman’s Award, and the Maurice Miller Advocate of the Year Award from the Arizona Council of Human Service Providers. The Phoenix Business Journal recognized Pete with a 2019 Most Admired Leader Award.

Sadly, Pete lost his battle with glioblastoma multiforme in May 2020. We miss you, Pete.

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EXCELLENCE IN OSTEOPATHIC MEDICAL EDUCATION AWARD Marc A. Kaplan, DO Honors a physician or non-physician who has contributed significantly to the advancement of osteopathic medical education in Arizona.

Marc A. Kaplan, DO, is a family practice physician in Sierra Vista, Arizona, establishing Kaplan Family Care Center in 1986.

A native Arizonan, Dr. Kaplan grew up in Phoenix.

After completing an associate degree at Phoenix College, he earned his undergraduate degree at Arizona State University and received his doctor of osteopathic medicine from Kirksville College of Osteopathic Medicine.

Dr. Kaplan fell in love with southern Arizona, specifically Sierra Vista, after serving in the U.S. Army as a General Medical Officer and Flight Surgeon at Ft. Huachuca. He is an icon in the community of Sierra Vista, serving the area for nearly 40 years. His enthusiasm for teaching osteopathic students and residents is unparalleled.

In addition to maintaining his private practice, he is the Family Medicine Residency Program Director for Canyon Vista Medical Center ensuring future primary care physician residents obtain top-quality education.

Dr. Kaplan has been an AOMA member since 1983 and is a staunch supporter of the Association, its members, and the medical profession. He served as the physician member of the Arizona Board of Optometry from 1995-1999 and is a Member Emerius of the Board of Trustees of the Sierra Vista Regional Health Center. In 2009, Dr. Kaplan was recognized by the Arizona State Association of Physician Assistants with the PA and Physician Team of the Year Award.

Dr. Kaplan and his wife Sandy have been married for 22 years. They have three children and five grandchildren.

AOMA News

OUTSTANDING MENTOR AWARD Denise R. Sackett, DO Honors a physician who has volunteered time to students or physicians as a mentor and is known as “one who makes a difference” in that person’s life.

Denise R. Sackett, DO, is an Assistant Professor in Clinical Science Medicine at A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA). A graduate of Kirksville College of Osteopathic Medicine, Dr. Sackett is board certified in family medicine. She and her husband S.K. Sackett, DO, own Sundance Medical Associates, LLC in Gilbert, Arizona. Patients, students, and family are her passions.

Dr. Sackett has been a preceptor for students for her entire medical career. Three years ago, she realized that teaching was a real passion and decided to join the academic community at ATSUSOMA. She has quickly become a favorite faculty member for the students as her passion for teaching is demonstrated daily in her preparation for teaching activities in medical skills, small groups, and lecture format. Her liveliness and enthusiasm is contagious and students enjoy being taught by her and learning along the way.

Dr. Sackett is also a dedicated advisor to her students. She keeps an open door and keeps in touch with her students. She has SOMA students shadow her at her private clinic, advises the Student Chapter of the ACOFP, and volunteers to discuss work/life balance and owning a private practice.

DISTINGUISHED SERVICE AWARD Steve Barclay, JD Honors a physician or non-physician who has significantly contributed to improving the community and promoting osteopathic medicine; donated his/her time and/or efforts to improve mankind; and/or has volunteered his/her time and provided significant contributions and services to the community and/or the Association.

Steve Barclay, JD, has been the AOMA contract lobbyist since 2017. Mr. Barclay received his Bachelor of Arts degree from Oral Roberts University in Tulsa, Oklahoma and his law degree from the University of Notre Dame Law School in South Bend, Indiana. In law school he was a member of the Notre Dame Lawyer Law Review, serving as Assistant Editor and attended Notre Dame’s London Law Programme, spending his second year of law school in London, England. Mr. Barclay has been repeatedly selected in the government relations practice area in the latest edition of The Best Lawyers in America and has been recognized as one of the Arizona’s Top AVRated Lawyers by Martindale-Hubbell and ALM. His firm has also received Best Law Firms recognition for the past five years in US News & World Report.

With the resignation, and subsequent passing, of AOMA Executive Director Pete Wertheim, Mr. Barclay has been an invaluable asset to AOMA’s legislative policy process. He also served as a member of the Succession Planning Task Force during the search for a new executive director. Sadly, in 2014 and 2015 Mr. Barclay shepherded the Arizona Medical Association through an almost identical situation when its VP of Government Relations, David Landrith, died of brain cancer.

Steve is a rock and a rock star.

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DISTINGUISHED SERVICE AWARD Joseph V. Klag, DO, FACC, FSCAI Honors a physician or non-physician who has significantly contributed to improving the community and promoting osteopathic medicine; donated his/her time and/or efforts to improve mankind; and/or has volunteered his/her time and provided significant contributions and services to the community and/or the Association.

Joseph V. Klag, DO, FACC, FSCAI, is board certified in internal medicine and cardiovascular diseases. He received his medical degree from the Philadelphia College of Osteopathic Medicine and completed his residency at the State University of New York. Dr. Klag has served as the principal investigator in many clinical trials. Before retiring in 2015, he practiced in Phoenix and has been recognized by patients and peers as one of the best physicians in Maricopa County. Dr. Klag has spent greater than 20 years training osteopathic medical students, interns, and residents at multiple institutions. During his career, he was consistently one of the best trainers and dedicated countless hours to teaching.

Dr. Klag and his wife Marsha are active in the community, donating their time, treasure, and talents to worthy endeavors including Nuestros Pequeños Hermanos (NPH), an organization caring for more than 6,000 vulnerable children in nine Latin American countries. He has been on the regional board for NPH for many years and served as board chairman in 2015. For the past six years, Dr. Klag has hosted an annual golf tournament to raise funds for NPH. Another project close to their hearts is “Get on the Bus”, a program of The Center for Restorative Justice Works that brings children to visit their incarcerated mothers on Mothers’ Day. Dr. and Mrs. Klag enjoy dividing their time between the Valley and the White Mountains.

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DISTINGUISHED SERVICE AWARD Kelli M. K. Glaser, DO, FACOFP Honors a physician or non-physician who has significantly contributed to improving the community and promoting osteopathic medicine; donated his/her time and/or efforts to improve mankind; and/or has volunteered his/her time and provided significant contributions and services to the community and/or the Association.

Kelli M. K. Glaser, DO, FACOFP, is an Associate Professor of Family Medicine at A.T. Still University School of Osteopathic Medicine. A graduate of Kansas City University College of Osteopathic Medicine, she has worked as an osteopathic medical educator since 2008.

Dr. Glaser is truly committed to a lifetime of service in the osteopathic profession. Before coming to Arizona five years ago she served on the board of directors for the Colorado Society of Osteopathic Medicine and Denver Regional Osteopathic Medical Society, ascending to the roles of Vice President and President respectively.

At the national level, she recently completed ten years of service on the board of DOCARE international where she held multiple executive committee roles including the Presidency. She also serves the osteopathic community by volunteering on bureaus and committees for the American Osteopathic Association, America College of Osteopathic Family Physicians, and as a Delegate for the Arizona Osteopathic Medical Association.

She has volunteered for the International Primary Care Education Alliance, where osteopathic family physicians are retraining specialist physicians in China to transition into the field of primary care.

Dr. Glaser also regularly volunteers at Circle the City in Phoenix providing Osteopathic Manipulative Treatment for those experiencing homelessness.

AOMA News

STUDENT DISTINGUISHED SERVICE AWARD Honors a student currently enrolled in an osteopathic medical school who has provided significant contributions and service to the school, community, and AOMA.

AZCOM – Jay F. Olson, MS, Class of 2021 Student Doctor Jay Olson, MS, is a third year medical student at Midwestern University Arizona College of Osteopathic Medicine. Jay grew up in small town Minnesota, attended St. Mary’s University of Minnesota, and moved to Arizona in 2015 for his Masters in Biomedical Science before matriculating to AZCOM in 2017.

Jay has been very active in the AOMA as a volunteer and leader, serving on the House of Delegates, Board of Trustees, and Student Legislative Affairs Committee. He also is involved with the Council of Osteopathic Student Government Presidents, representing AZCOM on a national level.

Following graduation in 2021, he looks to begin a psychiatry residency, ideally in Arizona.

Outside of health care, Jay enjoys volunteering with RipplePHX - an HIV/AIDS awareness group in Phoenix, cooking, and spending time with his chihuahua, Romy.

SOMA – Darien Jourdaine Kinne, Class of 2020 Darien Jourdaine Kinne is a fourth year osteopathic medical student at ATSU-SOMA. A staunch advocate for OMM and osteopathy, she was an osteopathic fellow at ATSU-SOMA treating patients in the campus OMM Clinic, adding a fifth year to her medical education.

Darien began her involvement with AOMA in her first year as a student moderator at the Fall Seminar and soon became active with the Osteopathic Charities, DO Day at the Legislature, and most recently as a member of the Student Legislative Affairs Committee and Board of Trustees. As a Charities board member, she serves as a liaison between the Board and SOMA students.

After graduation, Darien will begin a family practice residency in Minnesota.

Under “normal” circumstances, all of the award honorees would have been recognized during the AOMA Annual Awards Ceremony and Luncheon held in conjunction with the AOMA Annual Convention.

With the need to postpone live events until we can safely gather again as an osteopathic family, please join us in celebrating the careers, accomplishments, and potential of these outstanding individuals.

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Arizona Osteopathic Charities’ Student Scholarship Winners Students from A.T. Still University School of Osteopathic Medicine in Arizona (SOMA) and Midwestern University Arizona College of Osteopathic Medicine (AZCOM) are invited to submit an essay answering the question “How do you plan to contribute to the future of osteopathic medicine in Arizona and the United States?” Two students – one from each college – are chosen to receive a $500 scholarship. Winners are chosen based on the 500-word essay, financial need, and good academic standing. Here are this year’s winning essays.

As I walked into the H.O.M.E clinic for the first time, a musty odor from moisture and old furniture triggered a flashback to the time I arrived in Canada as a refugee. It was a familiar odor I remembered from “Welcome house” in Vancouver; A place where newcomers were provided with settlement services, somewhat similar to the housing facilities near the H.O.M.E clinic.

While we were waiting to be assigned to groups to see patients, I recalled memories of a more challenging time in my life. About a decade ago, I too, was in a building similar to this; anxious about a new place to live with a new language to learn and a different culture to adapt to.

Mona Sabetrasekh Fast forwarding a decade, it was time to see my first real patient. I was OMS II - AZCOM filled with excitement and curiosity. We saw several patients, two of which I was able to help by providing simple OMT techniques.

Throughout the night, we heard many stories about the struggles those families were facing: loss of a job, an unexpected split form a partner and financial burden of medical conditions they were recently diagnosed with. It was heart-breaking to not be able to provide every patient with what they needed due to limited medical supplies. However, I’ve come to realize that my knowledge of OMM was part of me; it was only limited by my mastery of each technique.

We were able to relieve the back pain of a pregnant patient with 8 children using “lumbar decompression”, while she was being educated on proper use of contraceptives and various social resources available to her. At that instance, holistic care through achieving a harmony between “body, mind and spirit” was crystal clear more than ever. I could fully comprehend what it meant by a concept taught in our OMM curriculum that being an osteopathic physician means that you have more tools to offer to your patients.

Reflecting back to my experience that night, I was feeling excited for what my future as an osteopathic physician will have for me. I realize that a desire to practice as a primary care osteopathic physician not only enables me to empathize with those struggling through tough times through a close doctor-patient relationship, but also, I have many opportunities to grow personally and professionally by incorporating osteopathic pillars in my daily practice.

Living in Arizona reminds me of my hometown, the beautiful weather and desert surrounding the cities. It feels like a second-home for me where I am given a once-in-alifetime opportunity to learn medicine and to practice it in order to maximize the health of my future patients.

Osteopathic philosophy enables me to connect to the communities around me at an individual level; My aim is to expand on this “tool-box” and to excel at these techniques in addition to my training. So that if I’m walking to another H.O.M.E clinic, I trust that I could offer OMT to an eligible patient no matter how limited the medical supplies will be.

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AOMA News

I am a ninja warrior. Equipped with my feet, I battled through the tightness of my mom’s back until I felt the pop beneath my toes.

This was my daily ritual to help my mom with her back pain by walking on her back. At that time, I had my heart set on becoming a ninja warrior. Growing up, I realized that my desire to become a ninja warrior would translate into a career in osteopathic medicine.

In college, I got second and third degree burns due to an oil fire that had seared through my legs. During the recovery process, I became increasingly interested in how my body repaired itself. Amazed by my body’s ability, I decided to invest more time into physical activity and Alisa Seng tried powerlifting to increase my muscle strength. I read everything on OMS II - SOMA lifting: how to apply correct form, ways to prevent common injuries, and how to improve one’s nutrition. My curiosity to learn more about the capabilities of the human body grew and I reveled in the science behind self-recovery. Through dedication and research, I achieved my goal to lift 225 pounds!

I started training many of my female peers to help them reach their fitness peak. In the middle of one of our workouts, my friend, June, fainted and I found out that June suffered from bulimia. I felt awful as I realized that I had neglected to provide June with a more holistic approach to achieving her fitness goals. Therefore, I became passionate about helping other women stay active in all-encompassing ways that stressed more body positivity. I loved watching them make significant progress in their strength both physically and spiritually.

As an EMT, I met Jessica, a fifteen-year-old girl who was going through her third ectopic pregnancy. Jessica confessed to me that she had fears about birth control and felt she couldn’t afford it. I encouraged Jessica to share this information with her physician, stating that as a health care provider he would help educate Jessica about different forms of contraception and find something that could work for her. I felt accomplished with being Jessica’s confidant and getting her the help she needed. All she needed was a better understanding of what was available to her. I appreciate that osteopathic medicine is a more inclusive approach to solving health care challenges that allows patients to get the care they need in different forms and become educated about their own health.

I may not have become a ninja warrior, but I found a new passion in osteopathic medicine and improving women’s health. Due to my experiences, I now understand that the human mind, body, and spirit flow together, changing one produces a ripple effect in the rest. I see the endless possibilities in using my own hands as tools to treat and diagnose issues. I hope to become a mentor for other women who would like to pursue medicine and to help encourage my patients to feel empowered to be a woman.

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Osteopathic Community News

EXPANDED TO 1 1/2 DAYS. 12 HOURS OF CME. LIVESTREAMING EVENT. 6th Annual Flagstaff Osteopathic Medical Conference Saturday, August 15, 2020 8 am to 5 pm & Sunday, August 16, 2020 8 am to 12:15 pm VIA ZOOM 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 12.0 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 Arizona Medical Association (ArMA) through the joint sponsorship of Flagstaff Medical Center and the Arizona Osteopathic Medical Association. The Flagstaff Medical Center is accredited by ArMA to provide continuing medical education for physicians.

This activity has been approved for AMA PRA Category 1 Credits™.

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AOMA Digest Summer 2020

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Online registration is now available at www.az-osteo.org/Fall2020 SAVE $100! Early Bird Registration Price increases after October 6, 2020 AOMA Member Physician

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Osteopathic Community News

TOMF FOUNDERS’ SCHOLARSHIP AWARDS

By Steve Nash, Executive Director, Tucson Osteopathic Medical Foundation

Rochelle Almario OMS III

Aubrey Ingram OMS II

Salil Kalarn OMS III

Chandresh Nandani OMS III

Nancy Phu OMS III

Elysia Tjong OMS III

Scholarships totaling $37,500 were awarded by the Tucson Osteopathic Medical Foundation (TOMF) to six medical students with Arizona ties or rotating in Tucson. All the students attend one of three regional osteopathic medical schools.

Midwestern University Arizona College of Osteopathic Medicine: Phoenix native and second year medical student at Aubrey Ingram was awarded a $7,500 scholarship. She is the Student Government Association President and an Arizona student delegate to American Osteopathic Association’s House of Delegates.

Third year medical student Chandresh Nandani has done more to enjoy Tucson during his rotations than most people who live there.

He is president of the Gay Straight Alliance, a member of the AOMA Legislative Committee, and was awarded a $5,000 scholarship.

A.T. Still University School of Osteopathic Medicine in Arizona: Third year medical student Salil Kalarn is a Phoenix native who earned undergraduate and master’s degrees from the University of Arizona. Along with publishing academic papers he is active in

volunteer medical missions both within the US and overseas. He was awarded a $7,500 scholarship.

Elysia Tjong is a third year medical student with an ongoing interest in research. She won 1st place at the school’s Inter-professional Cross-Campus Collaborative Case and in 2018 her project “Doctors that DO” Wellness Pop-Up Exhibit Program won the Arizona Public Health Association Health Education Media Maker award. She was awarded a $5,000 scholarship.

Burrell College of Osteopathic Medicine: Rochelle Almario has lived in Tucson since she was age 13. She is now a third year medical student who impressed a Tucson hospital attending physician who wrote, “Ms. Almario is an outstanding representation of what the osteopathic profession is working to recruit and train as the next generation of osteopathic physicians carry the profession forward.” She was awarded a $7,500 scholarship.

Third year medical student Nancy Phu accepted the challenge of attending a new osteopathic medical school in a state where osteopathic medicine is not as well known. She has worked on committees to improve the new medical school’s student experience and is an active member and former executive leader of Sigma Sigma Phi, the honorary osteopathic service fraternity. She takes pride in setting a record high of 1,400 community service hours during her term. Ms. Phu was awarded a $5,000 scholarship.

The TOMF Founders’ Scholarship program honors the osteopathic physician founders of Tucson General Hospital, opened in 1949 and sold about four decades later. Proceeds from the sale funded the Tucson Osteopathic Medical Foundation. TOMF has awarded the Founders’ Scholarships annually since 2015. To date, TOMF has awarded more than $160,000 to osteopathic medical students from Midwestern University-AZCOM and A.T. Still UniversitySOMA. This is the first year students were eligible from Burrell College of Osteopathic Medicine in Las Cruces, New Mexico.

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Osteopathic Community News

The Arizona Society of the American College of Osteopathic Family Physicians (AzACOFP) selected two Class of 2020 graduating osteopathic medical students, one from Midwestern University Arizona College of Osteopathic Medicine (AZCOM) and one from A.T. Still University School of Osteopathic Medicine in Arizona (SOMA), to be recognized with the Student Distinguished Service Award for exemplary commitment and service to osteopathic family medicine.

This year’s recipients are Ian Coker from AZCOM and Abigail Moeller from SOMA. Both new DOs have matched into family medicine residencies - Dr. Coker in Kentucky and Dr. Moeller in Minnesota.

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

The AzACOFP is the Arizona state society of the American College of Osteopathic Physicians. The Arizona Society was established in 1985. Its mission is to promote osteopathic family medicine through professional and personal support, advocacy, mentoring, and community service to provide access to high-quality care for patients.

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AOMA Digest Summer 2020

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Osteopathic Community News

Features

ATSU- SOMA Celebrates 2020 Commencement A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU-SOMA) celebrated the achievements of 98 graduates from the class of 2020 during a virtual commencement ceremony on Friday, May 22, 2020.

Gary M. Wiltz, MD, served as commencement speaker for the ceremony. Dr. Wiltz is chair of ATSU’s Board of Trustees, and CEO of Teche Action Clinic, a network of 13 federally qualified community health centers in southwest Louisiana.

Graduates were congratulated by ATSU President Craig Phelps, DO, ’84; Norman Gevitz, PhD, ATSU senior vice president of academic affairs; and Jeffrey Morgan, DO, MA, FACOI, CS, dean of ATSU-SOMA. Dr. Morgan challenged the graduates to “be the necessary good in the world as the next generation of leaders and healers in the osteopathic medical profession.” Congratulations Class of 2020!

NFMR Receives ACGME Initial Osteopathic Recognition The National Family Medicine Residency (NFMR) Program, a collaborative effort between A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU-SOMA) and the Wright Center for Graduate Medical Education in Scranton, Pennsylvania, has received initial osteopathic recognition from the Accreditation Council for Graduate Medical Education (ACGME).

NFMR offers training opportunities at health care partner sites across the country including El Rio Health in Tucson, Arizona, HealthSource of Ohio in New Richmond, Ohio, HealthPoint in Auburn, Washington, and Unity Health Care in Washington, DC. “I am thankful for the strong partnerships with our community health centers that make NFMR possible,” said Lawrence LeBeau, DO, chair, graduate medical education at ATSU-SOMA. “Together, we will continue to grow, improve, and advance our innovative national consortium osteopathic family medicine program.”

In October 2018, NFMR received ACGME initial accreditation by the Family Medicine Review Committee and has now made the full transition into the Single Accreditation System.

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Osteopathic Community News

ATSU-SOMA Announces Student DO of the Year

Dr. McCoy Develops New Approach to Team Care Training

Renée Crawford, Class of 2020, has been nominated by her peers at A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU-SOMA) as the School’s Student DO of the Year.

Crawford was nominated for the award given by the American Association of Colleges of Osteopathic Medicine’s (AACOM) Council of Osteopathic Student Government Presidents (COSGP) award. Each osteopathic medical college nominates one student who “goes above and beyond the average osteopathic medical student” based on their service to their college, leadership and research experiences, and dedication to the osteopathic profession.

From her nomination announcement, Crawford’s achievements include efforts to increase underrepresented minorities in medicine through mentorship, community service, and pipeline projects. Crawford leads the Student National Medical Association (SNMA) chapter on the ATSUSOMA campus.

Lise McCoy, EdD, MTESL, assistant professor at A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSUSOMA) is the senior editor and director of Team Care Connections – Improving Teambased Care for Vulnerable Populations, a new digital magazine for health care professionals.

Dr. McCoy develops content for providers who are often working with patients with complex health and social needs. Each issue of Team Care Connections uses realworld scenarios and examples provided by health practitioners to present team-based strategies for tackling common challenges faced by primary care teams.

The magazine employs a variety of engaging features to complement the articles. Icons throughout the magazine provide a map to interactive features such as videos, expert commentary, lightboxes, tips, and tools.

The second issue of Team Care Connections, Conversations about Moral Distress and Moral Injury, was published in February 2020. You can checkout both issues of Team Care Connections at https:// ipe.asu.edu/team-care-connections.

ATSU-SOMA Receives Graduate Health Professions Scholarship A.T. Still University School of Osteopathic Medicine in Arizona (ATSUSOMA) student Kayla Mowatt, Class of 2020, a service member of the U.S. Air Force was a recipient of ATSU’s Graduate Health Professions Scholarship (GPS).

Mowatt credits the GPS program for introducing her to the Student National Medical Association (SNMA) and changing the course of her medical school career.

She has started her family medicine residency at Nellis Air Force Base in Nevada.

The GPS program is designed to accentuate the University’s unique AOMA Digest Summer 2020

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mission of service and leadership in whole person health care.

This tuition scholarship is a targeted approach to attract and educate students whose life contributions and experiences are consistent with the ATSU mission to provide patient care in underserved areas.

The GPS was created for historically underrepresented groups and/or underrepresented minority groups.

Osteopathic Community News

Love Conquers Violence Foundation Partners with ATSU-SOMA Natalie Beissel, DO, MS, ’16, had just started her fourth year of medical school at A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU-SOMA). The Minnesota native was completing rotations at El Rio Community Health Center in Tucson, Arizona. She was excelling academically–ranked in the top 10 percent of her class. Compassionate and energetic, she embodied traits of the ideal physician. In addition to being highly respected by faculty members and peers, she had a loving, supportive family. Her whole life was ahead of her, along with a promising career in internal medicine.

On July 30, 2015, everything changed. Natalie was killed in a tragic act of domestic abuse at her home in Tucson. Her family members found themselves in a state of shock, disbelief, and unexplainable sadness.

In May 2016, the Beissel family attended the annual ATSU-SOMA Innovator’s Gala to award the first scholarship in Natalie’s name. The next day, at the ATSU-SOMA Commencement Ceremony, Natalie was granted her doctor of osteopathic medicine degree posthumously.

The Beissels held their first Bags for Nat event in 2017 to support of domestic violence awareness. The event, which celebrated Natalie’s life and her fun-loving personality, raised nearly $23,000 in a single afternoon. Half of the proceeds went to her scholarship fund, and half went to the Domestic Abuse Project, a Minneapolis-based organization that provides programs to prevent domestic violence. Bags for Nat was such a success, the family decided to hold another event the following year.

Last year, the family decided they wanted this initiative to become more than an annual event. They founded Love Conquers Violence, a nonprofit organization with a mission to honor Natalie and increase domestic violence awareness and education.

While Bags for Nat will remain the primary event, Love Conquers Violence has added more events to reach families and children.

The Beissel family recently hosted the fourth annual Bags for Nat tournament. In the last four years, Love Conquers Violence has donated more than $84,000 to provide an annual scholarship of $2,500 to a fourth-year ATSU-SOMA student ranked in the top 15 percent of his or her class, who also demonstrates a caring personality toward patients and coworkers - a trait Natalie embodied.

A.T. Still University is so grateful to the Beissel family and the Board of Love Conquers Violence for the continued support of our students.

Learn more about Love Conquers Violence and how you can make a difference to those affected by domestic violence across the United States by visiting https:// loveconquersviolence.org/.

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AZCOM CELEBRATES THE CLASS OF 2020 IN VIRTUAL COMMENCEMENT CEREMONIES On Friday, May 22, 2020 Midwestern University celebrated the graduations of master’s and doctoral degree recipients who are beginning their professional careers in health care, including the AZCOM Class of 2020. Graduates participated in online commencement ceremonies featuring video addresses from University administration.

Graduation celebrations for the students were hosted on social media platforms the week leading up commencements.

As part of her keynote address, Kathleen H. Goeppinger, PhD, President and CEO of Midwestern University, acknowledged the many achievements of the graduates during their years of rigorous study and clinical experiences. She encouraged them to remember the values they learned as Midwestern University students. “If you could be one thing, be kind. Be kind to your patients, be kind to your families, be kind to your new colleagues, and most importantly, be kind to yourself,” Dr. Goeppinger urged.

The AZCOM Class of 2020 celebrated 237 new DOs in their virtual commencement ceremony. Each ceremony featured remarks from members of the graduating class and a special recognition for students pursuing military health care careers.

Congratulations to the Class of 2020!

GLENDALE CAMPUS DEDICATES SCIENCE HALL On June 22, 2020 members of the Midwestern University community met together with University President and CEO Kathleen H. Goeppinger, PhD, to dedicate the campus’ newest building: Dr. Arthur G. Dobbelaere Science Hall. The edifice honors the longtime Executive Vice President and Chief Operating Officer of Midwestern University, who passed away unexpectedly in September 2018.

Arthur G. Dobbelaere

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The new facility will house administrative offices, classrooms, and laboratory spaces for the College of Graduate Studies.

Dr. Dobbelaere was a beloved figure in the University community for decades. In his administrative role, Dr. Dobbelaere was directly responsible for coordinating the construction of new campus buildings, and the Science Hall that bears his name was one of them.

“This building is the last of our Glendale Campus buildings that Dr. Dobbelaere had planned and for which he laid the foundation before his untimely passing,” Dr. Goeppinger remarked. “As recommended by our faculty, the Board of Trustees thought it fitting to name this beautiful building after him. ”

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3/30/16 1:33 PM

Osteopathic Community News

AZCOM STUDENTS ELIGIBLE FOR NEW MPH PROGRAM

AZCOM STUDENTS VOLUNTEER DURING IN-DEPTH SUMMER CAMP

Students from the Arizona College of Osteopathic Medicine have the opportunity to enroll in a new online educational program designed to enhance their future practice opportunities.

The new Master of Public Health (M.P.H.) Program at Midwestern University is a 56 quarter-credit hour online program that offers interprofessional opportunities to join health care teams that link human, animal, and ecosystems health management and employ One Health principles. The program is rolling out this summer as a dual-degree option for the University’s osteopathic medicine, dental medicine, optometry, and veterinary medicine students.

Seven Arizona College of Osteopathic Medicine (AZCOM) students have already been accepted into the dual-degree program.

For five days in July, AZCOM student volunteers offered their time and effort to help high school students learn about health care careers at Midwestern University’s Health Careers Institute for High School Students.

Faculty and student volunteers taught workshops in anatomy, physiology, and introductory skills for various health professions, with a special focus on how to prepare for college and what to expect from each profession. Due to restrictions in place concerning the COVID-19 pandemic, the Health Careers Institute was adapted this year into an online-only format. Midwestern University shipped each participant a care package full of materials to practice handson skills during each presentation, such as suturing, taking vital signs, studying anatomical structures, and more.

The program is offered at no cost to participants and is open to current high school juniors and seniors. Thirtyfour participants were selected based on their interest in science and the health professions, as demonstrated by coursework, volunteer activities, high school transcript, a teacher recommendation, and an application.

The annual Institute is sponsored by Midwestern University and the BHHS Legacy Foundation. BHHS Legacy Foundation works to help communities in ways that make them healthier for everyone. Its goal is to improve the population’s health and prepare the state’s workforce through highly effective programs and services.

AZCOM CLASS OF 2020 MATCHES BY THE NUMBERS Although the COVID-19 pandemic precluded public Match Day gatherings, AZCOM students from the Class of 2020 still celebrated the next step in their health care careers by opening their coveted match envelopes. Ninety-six percent of AZCOM’s graduating class successfully matched this year.

The largest AZCOM graduate matches were to internal medicine (63 students), family medicine (47 students), emergency medicine (24 students), surgery (19 students), and psychiatry (10 students).

The total number staying in Arizona for postgraduate training is 50 students (21% of the class). Congratulations to the Class of 2020!

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Osteopathic Community News

AZCOM STUDENTS RECEIVE LOCAL, NATIONAL RECOGNITION Two Arizona College of Osteopathic Medicine students have recently received awards at the local and national level for their commitment to osteopathic excellence.

Jay Olson (AZCOM 2021) received the Distinguished Student Service Award from the Arizona Osteopathic Medical Association (AOMA). Student Doctor Olson is a current Student Trustee with the Association and was previously a student delegate to AOMA’s House of Delegates. The awardees are nominated by the Deans of Arizona osteopathic medical schools.

Jason Hirshberg (AZCOM 2020) earned the Excellence in Public Health from the U.S. Public Health Service (USPHS) Physician Professional Advisory Committee. Mr. Hirshberg is one of 110 medical students from across the country chosen to receive the award that recognizes medical students who advance public health in their communities and who exemplify the USPHS mission to protect, promote and advance health and safety.

Jay Olson, MS AZCOM 2021

Jason Hirschberg AZCOM 2020

AZCOM STUDENTS CHOSEN FOR AzAFP EMERGING LEADERS DAY PROGRAM Four Arizona College of Osteopathic Medicine students were selected to participate in the Arizona Academy of Family Physicians (AzAFP) Emerging Leaders Day Program, held in late February at the Arizona State Capitol.

Yanjin Li (Class of 2023), Irena Grauzinis and Selina Martinez (Class of 2022), and Allison Walen (Class of 2021) were selected by AZCOM to attend the event in downtown Phoenix.

The event’s first day featured a briefing on issues of legislative importance to the AzAFP, as well as a dinner for all participants. On the second day, students met with Arizona legislators and had the opportunity to sit in on a meeting of the Arizona Senate Health Committee.

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From left to right: Selina Martinez (AZCOM 2022), Irena Grauzinis (AZCOM 2022), Yanjin Li (AZCOM 2023), and Allison Walen (AZCOM 2021) attend the AzAFP Leaders Day Program iat the Arizona State Capitol.

Osteopathic Community News

Glaser Receives 2019 Allaby Award

Nichols Chair-elect of the ACGME Board of Directors The Board of Directors for the Accreditation Council for Graduate Medical Education (ACGME) announced Karen J. Nichols, DO, its new chair-elect. As chair-elect, Dr. Nichols will assume the board chair’s duties if the chair is absent or is unable to perform those duties. She will continue to serve on the ACGME’s executive committee and as a member of the standing committees for education, policy and monitoring. She is also chair of the governance committee.

Dr. Nichols is the first osteopathic physician to serve as ACGME chair-elect.

Garrison Earns Award Justin Garrison, DO, a family practice physician, along with Kurtis Manley, PA, from Kingman Regional Medical Center were awarded Physician/ Physician Assistant Partnership of the Year by the Arizona State Association of Physician Assistants. The award recognizes a working physician and physician assistant duo who collaborate to improve patient care and exemplify the unique relationship of trust, collegiality, and mutual respect that is essential in health care. Congratulations, Dr. Garrison.

DOCARE International has honored Kelli Glaser, DO, FACOFP with the Ernest A. Allaby Founders Award.

The award recognizes an individual who are committed to serving the medical underserved.

A DOCARE past President, Dr. Glaser’s impact on the organization cannot be overstated. She has distinguished herself as a brilliant, enthusiastic and inquisitive scholar, demonstrated commitment to international medicine, and worked tirelessly to advance DOCARE’s mission and organizational capacity.

Dawn Walker, DO Appointed to Osteopathic Board Dawn K. Walker, DO, owner of Walker Family Medicine in Willcox, Arizona, has been appointed by Governor Douglas A. Ducey as a membre of the Arizona Board of Osteopathic Examiners in Medicine and Surgery (AZBOEMS).

Dr. Walker has taken her oath of office and began serving on the AZBOEMS during the regularly scheduled meeting, Saturday, February 29, 2020.

Dr. Walker has the utmost respect for the AZBOEMS, her fellow colleagues, and the board’s mission. She feels very honored and excited to be selected by Governor Ducey.

DOs in the News continued on page 58

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AOMA Digest Summer 2020

Osteopathic Community News DOs in the News continued from page 57

AzRxEd Program Receives HEMMY Award The Arizona Opioid Prescriber Education Program (AzRxEd.org), developed by the Arizona Osteopathic Medical Association and the Arizona State University College of Health Solutions, received top honors for professional health education by the Arizona Public Health Association (AzPHA) at its 2019 awards ceremony.

The AzPHA Health Education Media Making Yearly (Hemmy) Award recognizes health education programs designed to educate a target audience. AzRxEd.org is a unique, free, online education program providing the latest information about Arizona’s opioid laws and regulations, prescribing guidelines and treatment options for opioid use disorder.

Launched in June 2019, the program satisfies the three-hour continuing medical education units (CME) required

by Arizona law for all licensed health care professionals who prescribe opioids.

Shannon Scott, DO Dances for Arizona’s Children Shannon Scott, DO, FACOFP, and AOMA Past President recently competed in Arizona’s Children Foundation’s 5th Annual Dance Challenge. The annual fundraising event partners community superstars with professional dance instructors for exciting performances. Dr. Scott and her partner, professional dancer Andrew “Drew” Mitchell, took top honors for the judges’ favorite performance and for raising the most in pledges, totalling more than $12,000.

The energetic performance had the crowd on its feet, especially when the duo was joined by Dr. Scott’s daughter Sydney.

Sydney Scott, Drew Mitchell, and Dr. Shannon Scott took first place in Arizona’s Children Association 5th Annual Dance Challenge.

Left to right: Aimee Sitzler, MSW, AzPHA President; Pete Wertheim, MS, AOMA Executive Director; Kristen Will, MHPE, PA-C, ASU College of Health Solutions Director of Executive Education; Janet Weigel, AOMA Director of Membership and Communications; and Will Humble, MPH, AzPHA Executive Director

Founded in 1912, Arizona’s Children Association is one of the oldest and largest statewide comprehensive child welfare and behavioral health not-for-profit agencies in Arizona. Located in all 15 Arizona counties, the Association provides a variety of programs and services to meet the needs of more than 40,000 children, youth and families each year.

Got a DOs in the News item? Send it to communications@az-osteo.org and we will share it in the Digest.

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• 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.

AOMA Digest Summer 2020

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Osteopathic Community News

2020-2021 Calendar of Events August 15 & 16, 2020 6th Annual Flagstaff Osteopathic Medical Conference Virtual Streaming Event

February 6, 2020* AOMA Board of Trustees Meeting Phoenix, Arizona

Fall 2020* Dinner with Doctors Phoenix, Arizona

February 2021 DO Day at the Legislature Arizona State Capitol Phoenix, Arizona

October 15-19, 2020 AOA OMED and AOA House of Delegates Virtual Event November 6, 2020 AOMA Board of Trustees Meeting Virtual Meeting November 6-8, 2020 AOMA 40th Annual Fall Seminar Vitual Livestreaming Event November 7, 2020 AOMA House of Delegates Virtual Meeting

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 13 DOCME...............................................................Page 13 MICA...................................................................Page 17 AOMA Career Center.......................................Page 26 MICA...................................................................Page 26 Dynavax..............................................................Page 27 Arizona Osteopathic Charities......................Page 47 SoFi.....................................................................Page 50 MICA...................................................................Page 50 AzRxEd.org........................................................Page 59 VillageMD........................................Inside Back Cover A.T. Still University Osteopathic Medicine Center Arizona........................Outside Back Cover

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!

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.

AOMA Digest Summer 2020

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Arizona Osteopathic Medical Association

Protecting and promoting the osteopathic profession for 99 years

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-Michael Keller, MD

”

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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

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

© 2020 Village Medical | 20-VM-090

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

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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