Cap Scan 05-15

MAY EDITION, VOLUME 2015, NO. 5

2015 CELEBRATION AWARDS DINNER – A DOCTORS’ DAY TRADITION

By Shannon Boyle, CMS Communications and Marketing Coordinator

The fourteenth annual Celebration Awards Dinner was a special night for our award honorees, Dr. Al C. McCully and Dr. Armand B. Cognetta, Jr. The event was held, in honor of Doctors’ Day, on March 26th at the FSU University Center Club. There were many smiling faces in the crowd supporting the award winners. Dr. Al McCully was awarded the I.B. Harrison, M.D. Humanitarian Award, and Dr. Armand Cognetta was awarded the Outstanding Physician Award. Our CMS President, Dr. Joshua Somerset, did a great job emceeing the event.

Dr. Somerset thanked the Celebration Awards Dinner Steering Committee and the Capital Medical Society staff for their hard work in organizing and coordinating this event.

(L-R) 2015 Outstanding Physician Award Recipient, Armand B. Cognetta, Jr., M.D, with 2015 I.B. Harrison, M.D. Humanitarian Award Recipient, Al C. McCully, M.D.

Steering Committee Alfredo Paredes, M.D., Chair Kelly Hutchinson, Alliance Chair Shannon Boyle Tracey Hellgren, M.D. Rita Kaelin, CMS Alliance Cynara Miller, CMS Alliance Amy Pagano, CMS Alliance Debra Placilla, CMS Alliance Mara Rumana, CMS Alliance Gina Tran, CMS Alliance Pam Wilson Carol Winchester, CMS Alliance

(L-R) Dr. Ernesto Umana; Pam Wilson, CMS Executive Director; and Dr. Nancy VanVessem, Title Sponsor, Capital Health Plan.

Dr. Somerset recognized and welcomed seven new CMS physicians, in attendance: Dr. Barbara Demby Abrams, Dr. Babatunde Adekola, Dr. Scott Asher, Dr. Raj Bendre, Dr. John Holt, Dr. Rohan Joseph, and Dr. Jeremy Sunseri.

A moment of silence was held to honor several physicians who passed away this past year: Dr. John Barthelmess, Dr. William Kohler, Dr. Jack MacDonald, Dr. Charlotte Maguire, Dr. Millard Roberts, and Dr. Harry Tucker.

CONTINUED ON PAGE 3

CAPITAL MEDICAL SOCIETY 2015 MEETINGS CALENDAR May 19, 2015 CMS Membership & CME Meeting “HCV – Back To The Future” Amulya Konda, M.D. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks

May 28, 2015 CMS Doctor/Daughter Banquet 6:00 pm Golden Eagle Country Club

September 15, 2015 CMS Membership & CME Meeting “Rheumatology Update” Less Shrestha, M.D. 6:00 pm Maguire Center for Lifelong CAP SCAN - A CAPITAL MEDICAL PUBLICATION 1 LearningSOCIETY at Westminster Oaks

MISSION: TO PROMOTE THE PRACTICE OF MEDICINE FOR THE ULTIMATE BENEFIT OF THE PATIENT. (850) 877-9018 Fax: (850) 878-0218 www.capmed.org

BOARD OF GOVERNORS Joshua Somerset, M.D., President J. Daniell Rackley, M.D., President-Elect Tracey Hellgren, M.D., Secretary/Treasurer Alfredo Paredes, M.D., Immediate Past-President Shelby Blank, M.D. Garrett Chumney, M.D. David Dixon, D.O. Shakra Junejo, M.D. Maribel Lockwood, M.D. Amy Pagano, CMS Alliance President Paresh Patel, M.D. Philip Sharp, M.D. Ernesto Umaña, M.D. Kenneth Whithaus, M.D. Pam Wilson, Executive Director Family Medicine Residents William Carlson, M.D./Anna Hackenberg, M.D. Internal Medicine Residents Chris Rosadzinski, M.D./Prerna Satyanarayana, M.D.

PUBLICATION EDITOR Charles E. Moore, M.D.,

MANAGING EDITOR Shannon Boyle

GRAPHIC DESIGN Young Design

ARE YOU INTERESTED IN WRITING AN ARTICLE FOR CAP SCAN? Please contact Dr. Charles Moore at cmoore5186@aol.com and Shannon Boyle at sboyle@capmed.org. All articles submitted will be reviewed by your peers prior to publishing.

Cap Scan is published during the first week of each month and is the official publication of the Capital Medical Society. Advertising in Cap Scan does not imply approval or endorsement by the Capital Medical Society. The opinions expressed are those of the individual authors and do not necessarily reflect the official policies of the Capital Medical Society.

If you are a member of the Capital Medical Society and would like a copy of the Minutes from the Board of Governors meeting, please call the CMS office.

Thank you.

2

I N T H I S I SS U E :

CMS FAMILY FUN NIGHT

2015 Celebration Awards Dinner …

2015 Outstanding Physician Award …

2015 I.B. Harrison, M.D. Humanitarian Award …

Professional Notes …

New CMS Members …

CMS Lunch & Learn …

2015 CMS Doctor/Daughter Banquet …

Reflections from the Editor …

Viewpoint …

Practice Management …

Book Review …

Jean McCully We Care Network R.N. Program Coordinator …

CMS Foundation …

CMS Foundation: We Care Network …

1 6 12 15 16 17 18 19 21 24 26 27 30 31

HAPPY BIRTHDAY! {MAY BIRTHDAYS}

B. David Robinson, M.D. – 1st

Mark Saunders, M.D. – 16th

Nancy Chorba, M.D. – 2nd

Patricia Hogan, M.D. – 18th

Marc Fisher, M.D. – 2nd

Kenneth Brummel-Smith, M.D. – 19th

Shawn Ramsey, D.O. – 3rd

Jayati Singh, M.D. – 19th

William Comer Cherry, Jr., M.D. – 4th

John Mahoney, M.D. – 20th

Joel Kramer, M.D. – 4th

Christopher Price, M.D. – 20th

Charles Long, M.D. – 4th

Victoria Te, M.D. – 20th

Thomas Noel, M.D. – 4th

Kurt Luhmann, M.D. – 21st

David Smith, M.D. – 4th

Al McCully, M.D. – 22nd

Anthony Wright, M.D. – 5th

David Hood, M.D. – 23rd

Spencer Gilleon, M.D. – 6th

Steven Medvid, M.D. – 23rd

Andrew Hsia, M.D. – 6th

Aaron Appiah, M.D. – 25th

H. Timothy Paulk, M.D. – 6th

Jerry Harris, M.D. – 26th

Ira Price, M.D. – 6th

Jeffrey Crooms, M.D. – 27th

Robert Steele, M.D. – 6th

Gordon Low, M.D. – 27th

Nola Munasifi, M.D. – 7th

Jeffrey Rawlings, M.D. – 27th

Don Zorn, M.D. – 9th

John Agens, M.D. – 28th

Luz Prieto-Sanchez, M.D. – 10th

Stephen LaRosa, M.D. – 29th

John Bailey, D.O. – 13th

Hector Mejia, M.D. – 29th

Sam Ashoo, M.D. – 14th

David Oberste, M.D. – 29th

Hari Kolli, M.D. – 14th

Daniel Yang, M.D. – 29th

Floyd Jaggears, M.D. – 15th

Suzanne Harrison, M.D. – 30th

Hugh VanLandingham, M.D. – 15th

Mehul Patel, M.D. – 31st

HAPPY BIRTHDAY! WE ARE SO GLAD YOU WERE BORN!

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

DID WE MISS YOUR BIRTHDAY? IF SO, PLEASE EMAIL ROSALIE CARLIN AT RCARLIN@CAPMED.ORG!

2015 CELEBRATION AWARDS DINNER

Dr. Somerset thanked the volunteers in the We Care Network.

He noted that We Care volunteers donated more than $6 million in care last year and a cumulative total of more than $60 million in the last 21 years.

After explaining that the Outstanding Physician Award honors a physician who has demonstrated outstanding leadership in the profession of medicine, Dr. Somerset asked the past recipients of this award, in attendance, to stand and be recognized: Dr. Thomas Hicks, Dr. Charles Williams, Dr. Dean Watson, and Dr. Alma Littles. Dr. Cognetta joined these esteemed physicians, as well as those who could not attend, as one of those honored with this prestigious award.

Dr. Charles Williams, friend and colleague of Dr. Cognetta, presented Dr. Cognetta with the Outstanding Physician Award. (You can read Dr. Williams’s remarks on page 6 and Dr. Cognetta’s thoughts upon receiving the award on page 10.)

Dr. Somerset then discussed a brief history of the I.B. Harrison, M.D. Humanitarian Award. The criteria for the award are predicated on the values that came to be associated with the late Dr. I.B. Harrison: compassion, service, respect, wisdom and integrity. He asked all past recipients of the award to stand and be recognized. Those in attendance were: Dr. Pat Woodward, Drs. Julia and Louis St. Petery, Dr. Don Zorn, Dr. James Geissinger, Dr. David Miles, and Dr. Nelson Kraeft. Dr. Al McCully joined these esteemed physicians, as well as those who could not attend, as the 2015 recipient of this prestigious award.

We thank our 2015 Celebration Awards Dinner sponsors, without their generous support this event would not be possible.

Title Sponsor

Presenting Sponsors

Supporting Sponsors FSU College of Medicine FSU College of Nursing HealthSouth Rehabilitation Hospital of Tallahassee SunTrust Tallahassee Memorial HealthCare Foundation Thomas Howell Ferguson P.A. CPAs Event Sponsors Big Bend Hospice Boys Town Capital Regional Medical Center

Dr. Charles Williams, friend and former colleague of Dr. McCully, presented Dr. McCully with the I.B. Harrison, M.D. Humanitarian Award. (You can read Dr. Williams’s remarks on page 12 and Dr. McCully’s remarks upon receiving the award on page 14.)

The Capital Medical Society would like to extend their appreciation to the CMS Alliance for providing the carnations, corsages, boutonnieres, and the beautiful floral arrangement in front of the stage. The red carnation is the symbol for Doctors’ Day. CMS

Florida Medical Association Hancock Bank MagMutual Prime Meridian Bank Southeastern Urological Center TMH Federal Credit Union United Way of the Big Bend Westminster Oaks Active Living Community CONTINUED ON PAGE 4

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 3

2015 CELEBRATION AWARDS DINNER

Presenting Sponsor, Dermatology Associates of Tallahassee: (l-r) Dr. Jeremy Sunseri, Dr. Bob Soni, Dr. Armand Cognetta, Dr. Stephen Richardson, Dr. Okanta Jackson, Dr. W. Harris Green, and Brian Schaper.

Supporting Sponsor, FSU College of Medicine: (l-r) Cindy Tyler and Dr. Suzanne Harrison.

Supporting Sponsor, FSU College of Nursing: Miriam McLarty.

Supporting Sponsor, SunTrust: (l-r) Mike Daily, Leigh Graham, Brett Allen, and Charles Hopkins.

Supporting Sponsor, Tallahassee Memorial HealthCare Foundation: Tim Fortunas and Paula Fortunas.

Supporting Sponsor, HealthSouth Rehabilitation Hospital of Tallahassee: (l-r) Dr. Jamuna Sivakanthan, Dale Neely, and Tiffany Vause.

4

Presenting Sponsor, Tallahassee Memorial HealthCare: Mark O’Bryant.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Supporting Sponsor, Thomas Howell Ferguson P.A. CPAs: Winston Howell, Yvonne Howell, Nicole Walgamott, and Brian Walgamott.

(L-R) Ken Bender and Dena Strickland, Event Sponsor, Boys Town, with Kelly Hutchinson, Steering Committee Alliance Chair, and Dr. Hank Hutchinson.

2015 CELEBRATION AWARDS DINNER

Family and friends of Dr. Armand Cognetta were present to honor him with the Outstanding Physician Award.

(L-R) Arnold McKay and R. Jai Gillum, Event Sponsor, United Way of the Big Bend, and Gini West and Nigel Allen, Event Sponsor, Big Bend Hospice.

Dr. John Katopodis and Evi Katopodis

Event Sponsor, MagMutual: Staige Hoffman.

Event Sponsor, TMH Federal Credit Union: Eric Thiele and Liz Thiele.

Event Sponsor, Capital Regional Medical Center: (l-r) Jill Leone and Jenni Striplin.

We Care volunteer dentist, Walt Col贸n, D.M.D., and Marybeth Col贸n.

Event Sponsor, Florida Medical Association: (l-r) Shari Hickey and Lauren Byrd.

The family of Dr. Al McCully was present to honor him with the I.B. Harrison, M.D. Humanitarian Award.

Event Sponsor, Westminster Oaks Active Living Community: Carol Wilson and Don Wilson.

Dr. Alfredo Paredes with Diana Cureton, Event Sponsor, Hancock Bank.

(L-R) Nila Padalia; We Care volunteer dentists, Eve James, D.M.D. and JP Bastien, D.M.D.; Kokila Padalia; Dr. Jitendra Padalia; and We Care volunteer dentists, Viraj Manocha, D.M.D. and Ashok Manocha, B.D.S.

(L-R) Dr. Joshua Somerset, CMS President and emcee for the evening, and J. Daniell Rackley, CMS President-Elect.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

5

2015 OUTSTANDING PHYSICIAN AWARD

DR. CHARLES WILLIAMS’S PRESENTATION TO DR. ARMAND B. COGNETTA, JR., RECIPIENT OF THE 2015 OUTSTANDING PHYSICIAN AWARD It is a special honor to discuss this year’s Outstanding Physician of 2015, Dr. Armand Cognetta.

Tallahassee is very fortunate to have many outstanding physicians which makes this community a wonderful place to practice medicine. However, this year’s recipient certainly stands out and is most outstanding. It is difficult to cover his many accomplishments and contributions in the space allotted.

It has been said, “What counts in life is not the mere fact that we have lived, it’s what differences we have made in the lives of others that will determine the significance of the life we lead.”

Dr. Cognetta has certainly made differences in the lives of many people. He is an example of what training, determination, skills, hard work and a big heart can accomplish.

Dr. Cognetta is the founder of Dermatology Associates of Tallahassee with over 100 employees and 12 physicians.

He was born and raised in Connecticut. His biggest influences were his Mama and Daddy. His father was a general practitioner and his mother was a nurse. To quote Shannon Boyle, “They instilled in him the importance of helping people and the value of dedication and hard work along with kindness and compassion.”

He certainly has been a hard worker. He goes in at 6:30 a.m. and usually doesn’t leave until after the sun goes down. It is my understanding he has had no lunch break in 30 years.

Like his Dad he was going into Family Medicine. He graduated from the University of Connecticut Medical School and arrived here in Tallahassee in 1979 in a 1966 Volvo without air conditioning and completed a Family Practice residency. When I met him in 1979 I knew he was smart. You can always tell somebody who is smart. They think like you do.

Many times in life we have a life changing event. In 1980 during his shift, he was called to deliver a baby that was breech. Thank goodness for the nurse Heidi Chavers and the good Lord he got through it. He finally got the buttocks out but the head wouldn’t come out. He tried to reach up and place his fingers in the baby’s 6

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

mouth and pull and still that didn’t work. He started praying and said, “Good Lord help me and I’ll do something else.” Heidi suggested forceps. Miraculously the baby came out fine. The good Lord kept his word and Dr. Cognetta kept his.

During his Family Practice residency he was sent down to Carrabelle on a rotation and became friends with many oystermen with skin problems. After completion of the residency in Tallahassee he returned for additional training at the University of Alabama in Birmingham and completed a dermatology residency.

He focused on skin cancer because of its high occurrence in Florida. He sought the best and most successful treatment for melanoma and found it in a method called the Mohs surgery. In 1991 he completed a fellowship in Mohs micrographic surgery at the University of Alabama.

He now receives referrals from Georgia, lower Alabama, Florida and from many other dermatologists. The average patient travels over 50 miles. His practice has clinics in Marianna, Madison, Blountstown, Dowling Park and Carrabelle.

Dr. Cognetta now has become well known as an educator, researcher and clinician who promotes and achieves excellence. His broad and diverse contributions to dermatology are now recognized on the national and international levels, in addition to his teaching and serving as a mentor to hundreds and perhaps thousands.

I would like to give a quote from Dr. Harris Green, “Armand Cognetta is profoundly gifted with insight into cutaneous oncology and his dedication to the field over the years has been obvious and evident by his ongoing research to better understand cutaneous tumor biology and treatment. In addition to mentoring and training PA’s, pre-meds and medical students over the years, he has trained over 12 fellows in cutaneous oncology, dermoscopy, Mohs surgery, reconstruction and superficial radiation therapy. He will certainly have a lasting impact on our field and community.”

He is a Clinical Professor at FSU College of Medicine.

To further advance the future of dermatology, Dr. Cognetta has been working with the FSU College of Medicine to develop a community based dermatology residency program which is set to start in July of 2015.

I’d like to mention a few of his many accomplishments. He has served on at least 10 committees of the Capital Medical Society including the CMS Services Board, President of the Florida Society of Dermatology and multiple committees and task forces of the American Academy of Dermatology, President of the Dermatological Photographic Society, Board of Directors of the American Cutaneous Oncology Society, Founding Chairman of the Board of the Florida Skin Cancer Foundation, and Founding Director of Goodwood Foundation.

2015 OUTSTANDING PHYSICIAN AWARD

He has over a dozen major research projects. Dr. Cognetta served as Co-Director of Clinical Trials for MelaFind along with other top melanoma experts in the country. Dermatology Associates was the number one site in the country for acquisition of melanomas for the pivotal trial – the largest study ever conducted on melanoma detection – which led to the FDA approval of this advanced technology in 2012.

He has written over 40 national publications including multiple books. He co-authored “Color Atlas of Dermatoscopy” which is commonly referred to as a bible on early detection of melanomas.

Dr. Cognetta lectures nationally on the topic of radiation therapy of skin cancers. In 2013 he was the featured speaker on radiotherapy in treatment of skin diseases at the Memorial Sloan Kettering in New York. As lead author, Dr. Cognetta reported findings on his research in an article titled “Superficial X-ray in the Treatment of Squamous Cell Carcinomas” published in the Journal of the American Academy of Dermatology. The study was the largest series ever done on superficial x-ray for skin cancers.

In 2013 he was the lead author in the book “Radiation Therapy for Skin Cancer”. This was done in conjunction with Dr. Mendenhall who practices radiation oncology at the Medical School of the University of Florida.

Dr. Cognetta has received many honors and awards. These include the McGraw Hill Lange Award. He was awarded the Annual Ethics in Business Award in memory of Bill Duggar by the Rotary Clubs of Tallahassee, Wakulla and Monticello in 2012.

He supported a home in Boys Town that houses foster boys and has completely underwritten all the expenses for a home for many years and has received the Boys Town “Youth in Spirit” award. To show you his heart is in the right place, each year he picks a family from the We Care Program, Bond Clinic or Neighborhood Clinic and provides them with a wonderful Christmas.

Dr. Cognetta is a wonderful and loving husband to Suzanne and father to three wonderful children. He has a very supportive wife in Suzanne. His daughter Dominique was able to come down from South Carolina and join Armand and Suzanne at their table.

However the other two sons were unable to attend because of their schooling and distance. We did receive a written response from his two sons Marco and Armand III. His son Armand wrote, “Hey Dad, I wish I could have made it tonight. I just wanted to let you know how proud of you I am, and how much of a role model you have been for me. I wouldn’t be the person I am today if you hadn’t taught me the value of hard work and the virtue of intellectual curiosity. But the important thing I learned from you was how to be a good person, and I hope one day I will be able to help one-tenth as many people as you have. Congratulations Dad! Now just don’t let it go to your head.”

Marco responded and said, “Hi Dad. Sorry that I couldn’t make it.

Congratulations, this award is so well deserved. Thanks so being such an inspiration to me and I appreciate all that you have done for me so much. Proud of you Dad.” When the announcement was made that Dr. Cognetta would be receiving the Outstanding Physician Award for 2015 I received multiple letters from peers, friends and patients. Perhaps Sue Conte has known him the longest. She states, “When my Dad was in the last weeks of his life and under the care of Hospice, Armand voluntarily came to the house to check on his skin problem and tried to make him more comfortable. He spent some time with him that evening.

His simple act of kindness meant more to my father (and to us) than he will ever know. He has cared for my mother for over 25 years (and removed 30 skin cancers). At 90, she still has a crush on him.”

Sue Conte further states, “Armand has been a strong supporter of community-wide charities, a leader in medical innovation, a life-long supporter and participant in medical education, and has worked hard to develop a pre-eminent dermatology practice in the home town he adopted more than 35 years ago. All this while he and his wife raised a beautiful family in Tallahassee. I am proud to call him a friend for this many years.”

Dr. Cognetta has provided the means for patient’s transportation and lodging for multiple appointments. One patient stated that he paid for her airplane ticket and medical expenses to see the Chief of Dermatology at Columbia Hospital in New York. Another patient who had limited insurance states that Dr. Cognetta erased her medical bills after multiple surgeries. This patient states, “Tears of joy were falling down my face after hearing of the abundant gift from above. God had surely used his servant, Dr. Armand Cognetta, Jr. to bless me on that day.” This is only a few of the many stories I received.

Dr. Cognetta has done research, teaching, mentoring, national lectures, multiple publications and written books but his biggest contribution is his heart.

Please join me in thanking and congratulating Dr. Cognetta.

CMS

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 7

8

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Congratulates Dr. Armand B. Cognetta, Jr., M.D., 2015 Outstanding Physician Award Winner and Dr. Al C. McCully, M.D., 2015 I.B. Harrison, M.D. Humanitarian Award

www.BarnesCapGroup.com

|

(850) 894-2930

|

318 North Calhoun St., Tallahassee, FL 32301

Securities Offered Through Allen, Mooney, & Barnes Brokerage Services Member FINRA/SIPC, Investment Advisory Services offered Through Allen, Mooney, & Barnes Investment Advisors

It Happens.

You’re a good doctor. But one day you will be glad to have FD Malpractice Insurance.

Actions against U.S. medical practices now average 85,000 cases per year. We’re a Florida leader in professional protection. We only work for medical professionals.

First for Doctors. FD is a different kind of malpractice insurer. You have a force with the resources to take on any case. We know the court system. Multiple strategic partnerships increase our success rate. Your Insurance claim resolution is rapid, private, and often without patient compensation. partnershipwith withFlorida the Capital Our partnership Osteopathic Medical Association Society (CMS) provides (FOMA) provides a a 10%discount discounttotomembers. members.

10%

800.352.3627

fdinsurancecompany.com

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 9

2015 OUTSTANDING PHYSICIAN AWARD

DR. ARMAND COGNETTA’S THOUGHTS UPON RECEIVING THE OUTSTANDING PHYSICIAN AWARD I was overwhelmed by Charles Williams’s portrayal of my career in medicine. Not only did he deliver it with humor and humanity but its depth and style left me literally speechless. He portrayed me in a much better light than I deserved or think of myself. Like a deer in the headlights, all I could remember was Brian Sheedy, a previous recipient’s sage advice when I asked him for some pointers.

His advice, “Keep it short, everyone wants to go home”, rung in my ears. My speech that night was ad lib and off the cuff but as Al McCully so eloquently expressed, “It was from the heart.” I would like to add a few anecdotes that I had planned to tell before my mind went blank. I feel these helped shape my career.

I did grow up in a medical household.

My mother was an RN who read poetry and sang to all of her 6 children nightly.

She did the same for her patients and from her I learned about the power of compassion in healing. My father was a general practitioner in a small town before the days of ER physicians and hospitalists. We lived across the street from the hospital. The best way for me to spend time with him was to accompany him on house calls. Medicine was not the glamorous profession as it is portrayed today. I remember one family who had problems with multiple miscarriages. My father took over their care and their first son was born, whom they named Armand. Several healthy children later a second son was born, whom they named Bennett. Their last son, who was about my age, they named Cognetta. This is one of many examples of the love and respect that went both ways between physicians and their patients. The endurance and stamina they had and the relationship they had with their patients shaped me early on.

I came to Tallahassee to do my internship in Family Medicine in 1979 against the advice of many of my peers and mentors who chose residencies in the Northeast.

10 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Coming to Tallahassee was to me “the road less traveled.” I knew when I first visited Tallahassee that I would be trained in medicine by a dedicated group of doctors that comprised the medical staff. The backbone of this community was Ira B. Harrison. I, along with all the Family Practice residents, worked closely with Dr. Harrison during our residency.

He was a demanding but a very fair taskmaster. He always put patients on a pedestal. He believed in the days before MR and CT scans when patients would tell you what was wrong with them. He was actually the greatest listener I ever met. During morning report his ears would perk up when a resident, myself included, would fumble through a report and he would latch on to something, usually an omission or commission that would steer the patient’s course in the right direction. I remember, specifically, a rather large person being admitted one Sunday evening with abdominal pain. The residents worked her up with X rays, lab and ultrasound and found nothing. The next day, the resident had the surgeons see her and she was not felt to have a surgical abdomen. Her pain continued and on Wednesday, the resident re-consulted surgery and an exploratory laparotomy was scheduled for later in the day. Dr. Harrison felt something was amiss and led us all out of morning report to the patient’s bedside. When he arrived at the side of the bed we sat back and watched something I will never forget. With his bad knee straight under the bed, he sat very low and leaned close to the patient. He asked her several questions. The intensity and focus of his listening and concentration reminded me of a medium in a séance. After obtaining a history, he began his exam. We all helped him turn the patient to examine her back and in the dim light of the hospital room, he pointed out to us dermatomal grouped blisters on her right mid back.

Another time, we had an intern giving report about one of his admits going south in the ICU. Ultimately, the intern divulged he had to call an attending directly. Dr. Harrison asked why he had not called his senior resident first and the intern blurted out that he had tried but his phone number was unlisted. Sparks flew and a few minutes of smoke and brimstone Dr. Harrison declared, that if you practiced medicine in Leon County, you should have your number listed, period. Mine, and I believe everyone in that room,

2015 OUTSTANDING PHYSICIAN AWARD

have had our numbers listed ever since. Dr. Harrison was our William Osler and I believe his influence is still very alive today in our community.

At this time I would like to congratulate Al McCully for his 50 plus years of service to his community and patients.

Never once have I seen him without a big smile on his face and eager to care for whoever needed him. This includes seeing him come to the ER in the middle of the night when patients needed him. I think I can say with certainty that he is the kind of physician who exemplifies the qualities that Dr. Harrison stood for and he truly deserves this award.

I would like to finish a story here that Dr. Williams began about a certain difficult delivery. During our second year, we were on call for OB every other night for 3 or 4 months a year. This was back in the day when you could, other than the Emergency Room doctors, be the only other MD in the hospital. That particular night, a young couple, comprised of a chemistry grad student and his wife, came as a primap footling breach. Thanks to the help of two very experienced OB nurses, prayer and extreme good fortune, a healthy child was born. Dr. Brickler came in about 15 minutes after the delivery to a peaceful scene and apparent healthy and happy mother and child. He made one of his typical quips like, “I was waiting in my driveway for you to call” and then said goodnight to all. Thirty two years later, at a dinner in honor of the late great FSU Chemist, Michael Kasha, MD, we were all asked to introduce ourselves and describe our relationship with him. There were two Nobel Prize winners present and many distinguished physical chemists in the room, who introduced themselves and described his influence on them one by one. When my turn came, I stated that I was his dermatologist but how he was always interested in our work on MelaFind and had given us advice on microspectrophotomety of certain colors we saw that were unique to melanoma (i.e., slate grey, milky red and amber). I could see a person slightly younger across the room ears perk up when he heard my name and after, he came over to my table to talk. He asked me if I knew an obstetrician by the name of Cognetta. It soon became apparent that it was his daughter we delivered that night. I immediately asked how she was doing and he relayed that she had graduated from the University of Virginia and was in a prestigious grad school in California. I cannot tell you the sense of relief I had.

I want to thank the selection committee for this award, which must be an impossible task, given the caliber of

our physicians in this community. I would like to thank Dr. Joshus Somerset and all of the CMS leadership and membership, as well as our extremely able administrator, Pam Wilson. Shannon Boyle is a true professional and helped orchestrate this event along with the rest of our CMS staff, including Rosalie and all. I am especially grateful to my partners, physician assistants and nurse practitioners and, I am very proud of all of them. We are realizing a dream of, in addition to training Mohs surgeons, starting a residency program under George Cohen, MD, and with the support of FSU College of Medicine. I would also like to thank my incredible colleagues in plastic surgery, radiation oncology, and dermatopathology who help me daily and all of you who entrust me with your patients. I will endeavor to live up to this award in the years to come.

Every physician owes the success of their practice to their nursing staff, front office staff and administration. I thank mine from the bottom of my heart and give special credit to Maureen Webb, RN, who has been instrumental in setting the tone of our practice. We are all very fortunate to practice in the Florida panhandle and care for the hard working patients we enjoy serving. Many of them remind me of the true life individuals in “Simpler Times.” I once again thank Dr. Williams for his friendship and mentoring, and for showering us with stories over the years which have taught us so much about humanity. Speaking of friends, I would like to thank Suzanne and our friends who are here tonight. Friends, especially those outside of medicine, keep you balanced and well-rounded.

I have always told my students and fellows that at the end of the day if we are not hurting a little or a lot, we have not given enough of ourselves that day. However, at the end of the day, it is our spouses and family we go home to. I have had the incredible good fortune of being married for thirty one years to a beautiful and understanding woman, who I give credit for helping with my failures and successes. She has raised three wonderful children: Armand, Dominique, and Marco and imbued in them great character. My daughter, Dominique, who is an OR nurse in Charleston, SC is here tonight. My wife says you can always judge a person by how they handle a rainy day, lost luggage and tangled Christmas tree lights. Despite having failed in all of the above, she still loves me and has been a great source of strength to me. As Dr. Somerset put it so well at his presidential acceptance speech, “She has, day-by-day, made me a better person” and helped me accomplish my life’s work. Thank you, Suzanne, for your patience, support and love. CMS CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 11

2015 I.B. HARRISON, M.D. HUMANITARIAN AWARD

DR. CHARLES WILLIAMS’S PRESENTATION TO DR. AL C. MCCULLY, RECIPIENT OF THE 2015 I.B. HARRISON, M.D. HUMANITARIAN AWARD It is a great honor for me to talk about the recipient of this year’s I.B. Harrison Award, Dr. Al McCully. Dr. Harrison would be honored that Dr. Al McCully is receiving this award. Dr. Harrison’s values included compassion, service, respect, wisdom and integrity. Dr. McCully has these same values.

It is hard for me to talk about Dr. Al McCully without mentioning Jean McCully. They were quite a team. Jean McCully received many honors and was the Woman of the Year in Tallahassee in 1986.

Last year at the I.B. Harrison Award, I mentioned to Jean that I hoped someday Al McCully would receive this award.

She looked at me with tears in her eyes and said “Charlie, if he ever gets it, tell everybody thank you from the bottom of my heart.” So tonight without tears in her eyes she’s looking down with a big smile on her face and on her behalf I say, “Thank you.”

However, they are not dead who live in lives they leave behind. In whom they have blessed, they live a life again and shall live through the years. She continues to live through you after being influenced by her just like Dr. Harrison.

We have a wonderful medical community with groundwork being laid by people like M.T. Mustian, Dr. Nelson Kraeft, Dr. Orson Smith, Dr. Alex Brickler and people like Dr. Al McCully. I have known Dr. McCully for over 40 years and observed his many contributions to this medical community, the Capital Medical Society, and to the Tallahassee community at-large. It is no overstatement that Dr. McCully has dramatically changed the lives of many people in this community.

When I arrived over 40 years ago, Dr. McCully came by to see me within 1 week and welcomed me and told me he was glad I was here. He won’t even remember this incident, but I do. My Mama once said, “Remember the little things in 12

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

your life for one day they may be the big things.” Looking back that was a big thing.

Dr. McCully has served on the Board of Directors as well as its President for many years of the Charles A. Frueauff Foundation. He has been a lifelong friend of the Frueauff family and has arranged multiple grant awards from the Foundation for several non-profit organizations in Tallahassee. This includes over $600,000 to the Capital Medical Society Foundation, over $1.2 million to the TMH Foundation and almost $1 million to the Big Bend Hospice.

According to Mrs. Paula Fortunas, “Dr. McCully’s fine hand in philanthropy are evidenced in the Bixler Emergency Center, Lifeline Services, the Diabetes Center, the Women’s and Children’s Center and the new freestanding Cancer Center.” She further states, “Much of the TMH Foundation’s success is directly attributable to Dr. McCully.

His guidance and direction have positively and powerfully influenced the work of the TMH Foundation for the ultimate benefit of Tallahassee Memorial and those it serves.”

In 1983, Al McCully, Jean McCully, and Jim Beck spearheaded the effort to find a Tallahassee home for the Big Bend Hospice. Dr. McCully served on the first Board (Founding Board) of Big Bend Hospice. Al McCully and Jean McCully made quite a team and did so without fanfare.

Dr. McCully also served on the Board of Westminster Retirement Community. He was responsible for the donation of significant funds to Westminster from the Frueauff Foundation.

Many who are younger in this medical community may not be aware of his many accomplishments and honors.

These include President of the Capital Medical Society, Board of Directors of the Capital Medical Society, Board of Directors of CMS Foundation including its Vice President,

2015 I.B. HARRISON, M.D. HUMANITARIAN AWARD

President of the TMH Medical Staff, Chair of the TMH Board of Directors, Chair of the TMH Foundation Board of Directors, Chair of TMH Surgical Staff, President of the Florida Urological Society, President of Springtime Tallahassee, President of Tallahassee YMCA, President of Tallahassee Exchange Club, President of United Way in 1977, and many other positions. He was also Chair of the Board at TMH when the Family Practice Residency was initiated. He was the first doctor to admit a Medicare patient to TMH. He was a loving husband and is a wonderful father and grandfather and a great supporter of all the many accomplishments of Jean McCully.

It must not be overlooked that he served in World War II just like Baxter Byerly and both of them were recently escorted by Pam Wilson on an Honor Flight to and from Washington, DC on behalf of World War II veterans. Dr. McCully and Dr. Byerly, we thank you for your service during that trying time.

Dr. McCully is respected, admired and loved because of his fine character, his integrity and his contributions not only to the Capital Medical Society but to this community.

Dr. McCully was born in Tupelo, Mississippi. His father died when he was 9 and his mother was deaf. He learned sign language before he could talk. He came up the hard way. You’ve heard of rags to riches but rags would have been a step up for him. His Uncle Homer and Aunt Annie helped raise him and he was raised right.

In the 1940’s as a youngster right out of high school Dr. McCully joined the Navy and after World War II he obtained the GI Bill and scholarships enabled him to go to college at the University of Mississippi to get some learning.

He was torn between baseball and pre-med. He was somewhat an athlete.

After college at Ole Miss he attended the University of Tennessee Medical School and also interned in Memphis, Tennessee. During his intern years he met Jean who was at that time sweetheart of a dental fraternity and he stoled her away. It was difficult for him to get dental work in Tennessee after that.

He went to Tupelo, Mississippi to practice family medicine as a payback for some of his scholarships. He also did some practice in Saltillo, Mississippi where at times he treated Elvis Presley’s grandmother.

Dr. McCully decided to go back for a surgical type of residency. He decided on urology because urological patients were so grateful when you relieved their pain and helped them to urinate.

After finishing his urology residency in 1961, he joined Dr. Larry Smith and Dr. Bob Webster in Tallahassee. He was in urological practice here in Tallahassee from 1961 through 1995 and subsequently went to the VA from 1995 to 2011.

Dr. McCully has made a difference to the lives of not only those who know him personally but to those who have benefitted from his myriad contributions to the Capital Medical Society, the medical community and to the Tallahassee community at-large.

I can think of no better person to receive the I.B. Harrison Award.

Memories are our treasures here on earth and Dr. McCully, we thank you from the bottom of our hearts for the precious memories and all of your contributions. CMS

In college his anatomy lab was in the basement where he was supposed to dissect a cat. There was a window in the basement where he would crawl out to practice his pitching and was serving as substitute pitcher for the University of Mississippi. Eventually he had to decide between baseball and pre-med. Apparently, he made the right choice.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 13

2015 I.B. HARRISON, M.D. HUMANITARIAN AWARD

DR. AL MCCULLY’S ACCEPTANCE SPEECH UPON RECEIVING THE I.B. HARRISON, M.D. HUMANITARIAN AWARD First, let me introduce the members of my family who have come here tonight. They have all been very supportive of me during this stressful past year. Bob, Bill and Terry, Patti and Mark Trudeau, Mari McCully, Brian Shoemaker and his wife Lauren, and Shannon McCully and her friend Peter Bernal.

A dear friend and mentor once told me that if you just speak from your heart, the words will come to you. But at this moment, when I find my name listed alongside the wonderful men and women who have received this award, words are hard to come by. I feel very humble and grateful.

While I have this opportunity, I would like to give kudos to our very own We Care Program. We Care is truly the signature program of the Capital Medical Society.

Dr. Harrison practiced the very embodiment of the mission of We Care.

My wish is that we could make the entire 4-county community aware of the tremendous contribution given, free of charge, to the medically indigent.

When I lived and practiced in Saltillo, Mississippi, my payment was often times just a hamper of butter beans or black-eyed peas. Then after moving to Tallahassee, it became a mess of mullet or a gallon of raw oysters!

Since my wife, Jean, taught and showed me much about compassionate caring, I would like to tell you about an almost surreal event that took place at Big Bend Hospice. I ask those who heard this story at the dedication of the Jean McCully Family Hospice House to indulge me.

I was standing with Anna, God Bless Her, in Room 12 of the Margaret Dozier Hospice House watching Jean gasp for breath, her lungs hungering for air.

Anna said to me, “Dr. McCully, you go tell ‘Miss Jean’ that it’s all right to let go.”

My answer was “Anna, I just can’t do that”.

I had the privilege to practice as a colleague in the Capital Medical Society with Bud Harrison for about 30 years or more. Bud was what I would call a “Doctor’s Doctor”.

He had the unique ability to combine both the art and the science of medicine. In so doing, he set the bar so high, it made it difficult, if not impossible to reach.

Anna replied, “Yes you can. She loves you and she will do what you say.”

I half stumbled over to her bedside and whispered into her ear that it is okay to let go.

In a few minutes, she let go.

Taking the advice of my friend and mentor, let me say from the bottom of my heart “thank you, thank you, thank you”. CMS

14 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

PROFESSIONAL NOTES

PROFESSIONAL NOTES Arthur Clements, M.D., PhD, an OB/GYN with North Florida Women’s Care, has been appointed the Section 1 District Chair for the American Congress of Obstetricians and Gynecologists. Dr. Clements was past president of the Florida Obstetrics and Gynecologic Society, past FSU College of Medicine OB/GYN Clerkship Director and Education Director and past NICA board member.

Andrea Friall, M.D., an OB/GYN with North Florida Women’s Care, has been appointed the Section 1 District Vice Chair for the American Congress of Obstetricians and Gynecologists. Dr. Friall is the Current Chair of the Tallahassee Memorial HealthCare Credentials Committee and Chair Elect for the Tallahassee Memorial HealthCare Medical Staff. She is a past board member of the Florida Obstetrics and Gynecologic Society.

There are only 12 leadership positions like these in Florida and two are held by Tallahassee physicians in the same medical practice, North Florida Women’s Care. For years, Dr. Clements and Dr. Friall have supported Women’s Health Care issues by attending the Congressional Leadership Conference in Washington, DC and lobbying Senators and Representatives on behalf of the women of Florida.

Suzanne Harrison, M.D., Associate Professor and Education Director for Family Medicine at the FSU College of Medicine, received an Exceptional Mentor Award by the American Medical Women’s Association in April. This award honors women who take time out of their busy schedules to contribute to the advancement of women in medicine.

Friend of CMS Foundation and member of the CMS Foundation Scholarship Committee, Myra Hurt, Ph.D., Senior Associate Dean for Research and Graduate Programs at the FSU College of Medicine, received the Woman in Science Award by the American Medical Women’s Association in April. This award is given to a woman physician who has made exceptional contributions to medical science, especially in women’s health, through her basic and/or clinical research, her publications, and through leadership in her field.

Gizatchew Ketsela, M.D., FACP, an infectious diseases physician practicing with the Southeastern Center for Infectious Diseases (SCID) has been elected a Fellow of the American College of Physicians (ACP). The distinction recognizes achievements in internal medicine, the specialty of adult medical care.

GADSDEN COUNTY MEDICAL PROFESSIONALS HONORED On February 27, at the Pat Thomas Academy, the 2015 Ebony and Ivory Affair hosted by the Gadsden County Democratic Women’s Club honored 12 physicians from Gadsden County. The theme of the event was, “Gadsden’s Medical Professionals: A Life Line in Our Democracy.” Included in the 12 physicians honored were Dr. Alma Littles and Dr. Pat Woodward.

Congratulations, Dr. Clements, Dr. Friall, Dr. Harrison, Dr. Hurt, Dr. Ketsela, Dr. Littles, and Dr. Woodward!

CMS Members: If you receive accolades, please let us know so we can include you in this section! Email the details to Shannon Boyle at sboyle@capmed.org.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 15

NEW CMS MEMBERS

CAPITAL MEDICAL SOCIETY IS PLEASED TO WELCOME THE FOLLOWING MEMBERS:

Teresa Skojac, M.D. Medical School: Uniformed Services University of the Health Sciences Internship/Residency: Eglin AFB Fellowship: Emory Specialty: Family Medicine Practice: Chief Medical Officer, Tallahassee VA Outpatient Clinic

Russell Cole, M.D. Medical School: Emory University Internship/Residency: McLennan County FMRP

Mary Watson, M.D.

Specialty: Family Medicine

Medical School: Florida State University

Practice: TMH Family Medicine

Internship/Residency: TMH Family

Residency Program

Medicine Residency Program Specialty: Family Medicine Practice: Resident, TMH Family Medicine

Natarajan Rajagopalan, M.D.

Residency Program

Medical School: Kilpauk Medical School Internship: MRCP Royal College of Physicians Julia Weeks, M.D.

Residency: Baylor College of Medicine

Medical School: University of Alabama

Specialty: Pulmonary Medicine

Internship/Residency: TMH Family

Practice: Capital Regional Pulmonary

Medicine Residency Program

Associates

Specialty: Family Medicine Practice: TMH Family Medicine Residency Program

NEW MEMBER BENEFIT: “HEAL” Cap Scan is very proud to announce that our membership will

That said, the Capital

now be receiving, compliments of the FSU College of Medicine,

Medical Society considers it

“HEAL,” a beautifully produced magazine devoted to the humanistic

an honor that by this means

ideals of medical practice expressed through Art and Literature. This

our membership should be

magazine, the brainchild of José Rodriguez M.D., who remains its

made more closely aware,

Editor-in-Chief, was conceived in the hope of providing medical

and welcomed to, all that the

students, their faculty, and physicians at large with a venue wherein

FSU College of Medicine has so much achieved so very quickly. We can

their creative talents could be expressed. H.E.A.L., standing for

thank Dr. Rodriguez not only for the pleasure of the magazine, but also

Humanism Evolving through Arts and Literature, will embarrass

for the gift of being sent it.

no coffee table. Within it is to be found Poetry, original Art,

16

Photography, and Essays from experience. You are encouraged to

Take a look! Write a poem! Send a photo! Tell a tale! You can be a

submit your own works.

contributing part to a very good thing! So hop onto www.med.fsu.edu/heal.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS LUNCH & LEARN

CAPITAL MEDICAL SOCIETY LUNCH & LEARN Capital Health Plan, 1491 Governors Square Boulevard

On March 25th, Scott Marshall and Tom Carluccio, with Octane, gave an excellent program on “Reputation

MARK YOUR CALENDARS FOR THE LAST SPRING 2015 LUNCH & LEARN SEMINAR

Intelligence: Hear What Your Patients Are Saying

SEMINARS ARE HELD AT THE CAPITAL HEALTH

About You Online”. You

PLAN ON GOVERNOR’S SQUARE BLVD. - AND WE

can reach Mr. Marshall at (843) 475-1638 or scott@theoctaneeffect.com or Mr. Carluccio at (850) 320-3199 or tom@theoctaneeffect.com.

Express Printing sponsored the March 25th

THANK THEM FOR PROVIDING THIS LOVELY VENUE

May 20, 2015

Lunch and Learn. Tony Shah and Walter Ciliberto were in attendance as representatives of Express Printing. You can reach Mr. Shah at (850) 222-9777 or tony@iprintquick.com.

On April 15th, Gordon F. Bailey, III and Kelly James, with Florida Blue Center for Health Policy, gave an excellent program

Payment Advocacy Hear a legislative update with an emphasis on issues that impact provider reimbursement and practice administration.

Speaker: Jarrod Fowler, Florida Medical Association Sponsor: Diana Cureton, Hancock Bank Time: 12 Noon to 1:30 PM (Seminar starts at 12:30 PM) Place: CHP Auditorium, 2nd Floor, 1491 Governors Square Blvd.

Cost: $10 per person

on the “Status/Overview and Legislative Update on the Affordable Care Act”.

For more information or to register, call Rosalie Carlin at 877-9018.

You can reach Mr. Bailey at (904) 905-8230 or Gordon.Bailey2@floridablue.com or Mr. James at (904) 905-5742 or The CMS Lunch & Learn Seminars will resume in the Fall. Mark your calendars and watch for updates on topics and speakers!

Kelly.James@floridablue.com.

Office Depot sponsored the April 15th Lunch and Learn. Terry Bush was in attendance as a representative of Office Depot. You can reach Mr. Bush at

September 16 October 21 November 18

(850) 624-9979 or terry.bush@officedepot.com.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

17

CMS DOCTOR/DAUGHTER BANQUET

Capital Medical Society

Doctor/Daughter Banquet Thursday, May 28, 2015 6:00 pm Golden Eagle Country Club 3700 Golden Eagle Drive

CMS Members: Bring your daughters and/or granddaughters of any age out for a fun-filled evening!

Dinner Choices: § Petite Filet and Shrimp, 6 oz Filet paired with 3 Jumbo Shrimp and served with a starch and vegetable. $27.00 § Eggplant Parmesan, Breaded Eggplant layered with Marinara Sauce and Mozzarella Cheese, then Baked. $20.00 § Children’s Chicken Finger Platter, Served with French Fries. $12.00 All meals served with Field Greens & Walnut Salad and Dinner Rolls.

Activities include: face painting, pottery painting, wax hand molds, and cupcake decorating (for fun and for dessert!)

Cash Bar

~If you plan to paint, bring an apron or old cover up~ Member Name: Dinner Choice: Guest Name: Dinner Choice:

We Thank Our Sponsors For Their Support!

Guest Name: Dinner Choice: Guest Name: Dinner Choice:

Supporting Sponsors Hancock Bank

Total Amount Enclosed: $

SunTrust

The Krizner Group

Please make your check payable to: Capital Medical Society 1204 Miccosukee Road, Tallahassee, FL 32308

Discount Portrait Packages offered by Betsy Barfield Photography

Please complete the information and return to the CMS office no later than May 21!

Event Sponsor

18

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

REFLECTIONS FROM THE EDITOR

CONSULTATION

By Charles Moore, M.D.

If I were a dog, comfortably domiciled, petted, let out and in, and provided with excellent veterinarian services for the least need, I believe I would surely be content.

But what if, being that very same dog, I am also stone deaf, totally blind, run constantly into walls, get lost out of doors two feet from the gate, cannot find my way out of a closet, bark all night in my crate, poop wherever I wish on the carpets, and am afflicted by a canine version of Alzheimer’s?

asked ourselves with whom we might consult? Who could, so to speak, “get through?” Who has the experience? Who has dealt, themselves, with the ill, the hurt, the blind, the incontinent, and the deaf who might penetrate the dark density of Toby’s brain, and let in a bit of light?

“How about another dog?” I said to Lynn. “No, not just any old dog, but some intelligent, highly articulate dog with whom we could consult, who has actually had a lot of experience dealing with Toby’s issues. You know, someone like ‘Rikki,’ Chuck Mitchell’s dog, the poster-girl for Tallahassee Memorial’s Animal Therapy Program?”

This is our sweet Toby, a lovable rescue mutt picked up some years ago when even then, even we who loved him found him a bit dense and lacking in communication skills. He has wandered through his life unbeknownst, and still wanders without the least need, like “Alfie,” to wonder “what’s it all about?” When we have guests, his now blind eyes “look” vaguely up at them with a vaguely hopeful expression, at least so it appears, and everyone breaks into tears, and loses their appetite for the pity of it all.

We say, or rather shout, “good old Toby,” but he hears nothing and meanders off, running into yet another inconvenient wall, which hurts us a little, but bothers him nothing at all, for he has the sturdy head of an ox. He is in no pain. His life, I suppose, is happier than most humans. Still, we ask ourselves what help we might be able to offer? Who to consult? No priest, doctor, lawyer, vet, or shrink will have any answers to the questions we might pose.

Lynn, my sweet lover of all animals and happily me as well, is excellent at dog and cat-speak, and even knows a good deal of “chicken.” If some cat or dog or chicken cries out, she understands immediately what they are specifically saying, e.g. “Help! Help!

I have been trapped in the laundry machine, you have turned it on, and I am drowning topsy-turvey.” Or else, “Hey, this is a new brand of cat food, which is really sadly lacking in its miserable little proportion of fishiness, and I wish you would instantly go to Publix and get me a fat Mahi-Mahi.” Or from the chickens, “Hey, Mom, there’s a hawk flying right above me looking hungry.” Lynn knows to rush out with her broom, and all is saved.

She has naturally tried, having this gift, to sit down and have a good, long, Motherly dog-talk with Toby, but, as I said, he hears nothing, sees nothing, and won’t talk himself. So…we

RIKKI

I went on to describe how I had met Rikki awhile back, admired her impeccable credentials, and the brilliance with which she led Chuck about on his leash. Beyond which, allow me a few words of compliment also to Mark O’Bryant, TMH CEO, etcetera etcetera, whose own positive past experience with a former hospital led him to embrace, in 2011, “Animal Therapy” for Tallahassee Memorial.

It does, I think, require a bit of “out-of-the-box” thoughtfulness to contemplate allowing furry creatures into the bedrooms of patients when, after all, they are not allowed in mere restaurants for fear they might slobber on someone’s food or bite an ankle.

Beyond which is also required an equally “out-of-the-box” Program Director, in this case the veritable life-blood and sinews of the program, as Chuck calls her, Stephanie Perkins. Look, if you ever have a patient in need of a nice animal visitation, or wish instead of flowers to send a hospitalized friend the gift of someone CONTINUED ON PAGE 20

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 19

REFLECTIONS FROM THE EDITOR

pettable, give a call to the pet therapy office, right in TMH, 4315352, and ask to speak to Stephanie’s on-premises executive assistant, the very helpful Heather.

Although not allowed in the neonatal unit, you may have seen either Chuck or another of his 150 number team of animal therapists doing their visitations in the hospital; bringing with them, let me add, so much good cheer, so many smiles, and something so much of “home” to an environment that otherwise most of us would prefer being otherwhere than. As Chuck so neatly put it when I rounded with him, “ours is a low tech, touchable therapy in the midst of a high tech, no-touch world.”

Before doing rounds with Rikki and Chuck in the rehab unit, Rikki lying quietly at Chuck’s feet, it was impossible not to notice how simply everyone who passed by would stop to pet and admire her.

Chuck filled me in on what animal therapy is all about, and the strides it has made even beyond hospital visitation. For example: Patty Mitchell, Chuck’s wife who is also a certified “animal therapist,” has assisted some 85 young dyslexic students learn to better read. The trick is that the kids read aloud to the DOG, rather than to the Teacher, the former being warm, lovable, furry, and with a waging tail, unlike the teacher who, no matter how warmly involved still stands for an intimidating adult world of “passing” or “failing.”

And how much worse than even school is the cold disinterest of the Courtroom where there is absolutely nothing huggable or fuzzy. Chuck took an understandable pride in the fact that his Tallahassee group has the honor of being the longest running operation in the U.S. for bringing dogs into the courtroom. For children, particularly, the encouragement of seeing a doggy face and a pink tongue offers a means of freedom from the cold, threatening atmosphere of such places. With Rikki there, as Chuck told me, a little girl who had been molested, scarcely able to speak of it, was able to respond to the questions asked of her by addressing her answers to Rikki instead of the Court. With the approbation of no less than our own State Attorney, Mr. Willie Meggs who, despite his lack of fame as a lover of dogs, came to appreciate the value of their presence, Florida Statue 92.55 allowing dogs in the courtroom was passed in 2011 by a margin of 132 to 0. Next time you are deposed, bring your dog. You have the right to that comfort.

So, when you see a dog wandering the hospital give him or her a pat on the head, or even a hug. They are trained professionals, after all, and take refresher CME evaluations twice a year under the auspices of “Pet Partners International.” And do not be surprised if you encounter other than just dogs; among the 150 therapy dogs that do rounds with you at TMH there are also some cats, notably the three-legged rescue cat “Drifter,” four birds, a 20 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

goat, two dwarf miniature horses, and the only “Therapy Mule” known to be employed as an animal therapist. The mule, by the way, will not be getting in the elevator with you; but in convenient locales can stick his head through a window, or visit with patients who can walk or wheelchair onto a patio. So size does not matter: locally we have “Querida,” the world’s smallest therapy dog, a Chihuahua, who weighs only two and a half pounds. And then there is the Bull Mastiff who weighs 225.

Does anyone have a nice elephant?

There is so much more to be said. Suffice it that most of us, like all the patients I saw on my rounds with Rikki, all of whom are so necessarily condemned to an uncomfortable mattress, without their own pillow, exhausted with television, and merely otherwise awaiting the next shot of morphine, find themselves with a sudden big smile on their faces as they welcome Rikki, trailing Chuck on his leash, to their room. The warmth of home and hearth. The softness of a living fur coat. The wagging of a tail. The love which animals so non-judgmentally bring to us. You feel better. And so you ARE a little better.

You might not even need your shot of morphine.

Thus, as it proved, did we apply to Rikki for a consultation. She was kind enough to make a house-call to us, bringing the inevitable Chuck since she has not yet learned to drive. After the first few wags of her tail, she was all business. She sat down with Toby and had a nice chat. Since then Toby has not run into a single wall, and looks at us as if he were possibly actually having a thought.

We have been delighted! We almost begin to think that Toby, too, after a good bath could maybe aspire to becoming an Animal Therapist himself!

TOBY

Lynn, listening with that acute ear of hers, even thought she heard him mumble as much. CMS

VIEWPOINT

CODE BROWN

By Joshua Somerset, M.D.

Why did I choose to become a Gastroenterologist? I actually get asked this question quite often. The usual situation is immediately preceding a rectal examination, when I am putting on latex-free gloves. A young adult with rectal bleeding or rectal pain, while unclothed and vulnerable, will pipe up with, “Can I ask you a question?” I know what’s coming! With a look of angst in their eyes and mild disgust on their face, the question is posed. “Why did you pick this specialty?” Usually, I try to deflect the question with something like, “I just followed my gut.” Or “I always liked to explore caves when I was a kid.” Who has time for a more detailed explanation about the virtues of Gastroenterology?

Now that I have to put pen to paper, I guess a more elaborate explanation is in order.

So here’s my story. As long as I can remember I wanted to be a physician. My parents tell me that going back to my early childhood I told anyone who would ask that I wanted to be a doctor. In fact, it became such a part of my psyche that I can’t even remember thinking I would do anything else. I remember having a discussion with my high school guidance counselor about going to medical school. I naively asked him what minimum grades I had to maintain to be accepted into medical school. When I got a blank stare for a response, I went off to college assuming that my high school counselor was clueless.

Somewhere along the way, I got recalibrated and started to recognize the dedication required for medical school. Soon enough, I was starting my 4th year of medical school at the University of Florida. I really enjoyed all of my clinical rotations and was uncertain about which residency to pursue. I met an Otolaryngologist who was bright, well published, and skilled at complex head and neck cancer surgeries. I spent several rotations during my 4th year of medical school in this specialty, but was drawn to the field more as a result of the individual than the actual specialty. My wife (fiancée at that time) was interested in psychiatry. After interviewing in ENT from NYU to San Antonio, I was ready to arrange for a couples match (ENT was a January match before the traditional March Match Day).

I remember finding out in early January that I did not match in ENT. I was embarrassed, confused, and more than a little deflated.

More troubling was that I had no idea what residency I wanted to pursue. My self-pity and indecisiveness was starting to not only

sabotage my residency prospects, but also my future wife’s as she was tied to me via the couple’s match. I was struggling to decide between General Surgery or Internal Medicine, when I really wanted a blend of both. At this point, two people deserve credit.

My surgical advisor (a pediatric surgeon), Dr. Daniel Ledbetter told me, “only choose surgery if you would be miserable not being a surgeon.” And my wife -- she was going to rank Emory, Baylor and MUSC for psychiatry and I could join her at one of these programs if I could get my act together. I quickly scrambled to arrange Internal Medicine interviews in Atlanta and Houston on their last possible interview date.

My wife and I were much more upbeat on the traditional match day when we found out we would be spending the next 4 years in Atlanta. I started my Internal Medicine residency looking for a specialty with a high blend of procedures to complement the more cognitive component of traditional Internal Medicine. I had ephemeral interest in Cardiology and Pulmonary Medicine before discovering the field of Gastroenterology. This field had the right mix of internal medicine but had a heavy technical component of “fixing” bleeding varicies, excising large precancerous polyps, and removing gallstones from infected and obstructed common bile ducts.

Since my wife’s psychiatry residency was four years, and Internal Medicine was 3 years, I chose to stay for GI Fellowship at the same institution where I did Internal Medicine. To me the tortuous path to gastroenterology was a blessing. In retrospect, every time I think back to those times 15 years ago, I am so thankful for the way things worked out. I truly love what I do, and it is a tremendous challenge to imagine doing anything else.

As a side note: When I was finishing my GI Fellowship and interviewing for jobs, I was walking into the Atlanta VA for a rotation, when Alberto Fernandez, a Pulmonary fellow was slumbering out of the VA after a tough night of moonlighting in the Atlanta VA ER. We stopped to chat, and I told him that I had interviewed in Tallahassee and liked the practice but felt unsure about going back to Florida. He told me that he was definitely going back to Florida, and he would bring his family to Tallahassee the next year if I could find him a good pulmonary practice.

Editor’s Note: Cap Scan thanks Dr. Somerset for sharing with us the reasons why he went into the field of Gastroenterology. It is a question often wondered regarding his vital specialty, but rarely asked outrightly, and we believe never so well answered until now. Clearly, Dr. Somerset brings to his field the same enthusiasm and intelligence that have led him to be elected our Society’s President. Beyond which, if I may say so, he has what so many of us lack, namely an on-site Psychiatrist at home, his wife Wendy, who has clearly kept him beautifully balanced. Our compliments and thanks to her as well!

CMS

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

21

VIEWPOINT

BLADDER CANCER

By J. Daniell Rackley, M.D.

The fact that bladder cancer gets insufficient press is well illustrated by the fact that I had no idea that May is bladder cancer awareness month until Pam Wilson asked me to write this article for Cap Scan. Bladder cancer will always take a back seat to its more popular and somewhat more controversial genitourinary malignancy, prostate cancer; however, it remains a very prevalent and lethal disease. According the 2015 American Cancer Society statistics, there will be approximately 74,000 new diagnoses of bladder cancer and 16,000 Americans will die from this disease this year. This makes bladder cancer the ninth leading cause of cancer death in the United States.

Ninety percent of bladder cancers are urothelial cancers, also known as transitional cell cancers. Other rare bladder cancer subtypes are squamous cell carcinoma and adenocarcinoma. Since the urothelium begins in the renal pelvis and lines the ureter and bladder as a continuous layer, TCC can occur anywhere along the GU tract; however, renal pelvis and ureteral transitional cell cancers are not included in the bladder cancer statistics, despite having the same basic causality. 90% of patients with bladder cancer, regardless of subtype, present with microscopic hematuria.

Other possible symptoms include pain during urination, frequent urination, or feeling the need to urinate without being able to do so. These signs and symptoms are not specific to bladder cancer, and are also caused by non-cancerous conditions, including prostate infections, over-active bladder and cystitis. There are many other causes of hematuria, such as bladder or ureteric stones, infection, kidney disease, kidney cancers and vascular malformations. Patients with advanced disease may present with pelvic or bony pain, lower-extremity edema, or flank pain. Rarely a palpable mass can be detected on physical examination.

Bladder cancer survival, like most cancers, is highly dependent on stage and grade at the time of diagnosis. For all practical purposes, transitional cell cancers can be considered high grade or low grade, and this is the most important distinction that is made at diagnosis, because high grade bladder cancers are more likely to result in death. 50% of bladder cancer diagnoses are made while the tumor is confined within the urothelium (Ta). 35% of cases present with either T1 or T2 disease, i.e., the cancer is confined within the bladder. 4% of patients present with metastatic disease at the time of diagnosis.

The causality of bladder cancer is typically exposure to environmental carcinogens, the most common being inhalation of tobacco smoke. There is a linear relationship between smoking and bladder cancer risk. Other occupational exposures including 22 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

environmental solvents and industrial dyes are also linked with bladder cancer. As the bladder is a reservoir for the waste elimination, the bladder urothelium is in constant contact with the carcinogens that are removed from the blood stream. Occupations at risk are bus drivers, rubber workers, motor mechanics, leather (including shoe) workers, blacksmiths, machine setters, and mechanics. Hairdressers are thought to be at risk as well because of their frequent exposure to permanent hair dyes. Interestingly, the most common form of bladder cancer in Egypt is squamous cell carcinoma caused by chronic bladder inflammation as a result of the highly prevalent schistosomiasis.

The American Urological Association has a standard set of guidelines for microscopic hematuria that include cystoscopy and abdominal and pelvic computed tomography with and without IV contrast. These 2 tests will pick up the majority of bladder cancers; however small tumors can sometimes be missed. High-grade cancers will often have positive urine cytology.

The treatment of bladder cancer is highly variable depending on stage and grade. Low-grade cancers are nearly always superficial (Ta) and can be managed with transurethral resection of the bladder tumor (TURBT). All bladder tumor resections should immediately followed by intravesical instillation of Mitomycin-C which significantly decreases the recurrence rate.

Higher-grade cancers are more likely to present at higher stage. T1 cancers are invasive into the lamina propria. These cancers can initially be treated with resection followed by Bacillus CalmetteGuerin (BCG) induction immunotherapy. BCG is the attenuated strain of tuberculosis which is used as a tuberculosis vaccine in some countries. Exposure to the bladder urothelium results in a type 4 hypersensitivity response with T cells being induced to kill the local cancer cells. This results in a marked decreased recurrence rate.

T2 cancers involve invasion into the muscularis propria and the gold standard of treatment in the United States is radical cystectomy with or without neoadjuvant chemotherapy. Removal of the urinary bladder obviously necessitates creation of some form of urinary diversion, the most common being an ileal conduit. Younger, healthier patients may opt for creation or an orthotopic neobladder which avoids the use of a stoma appliance.

Some T2 patients may be treated with external beam radiation treatment or combination of chemotherapy and radiation.

The prevalence of bladder cancer continues to increase in this country which may be related to increasing amounts of environmental exposures. The fact that a large number of patients present with advanced stage disease suggests that we can do a better job of screening. The American Urological Association guidelines state that if a patient has microscopic hematuria on 2 of 3 urinalyses, they should be screened for bladder cancer with cystoscopy. Also, any patient with a heavy smoking history and irritative voiding symptoms should probably be screened. Hopefully with more diligent screening and avoidance of environmental exposures, we will eventually see the prevalence of bladder cancer decline in this country. CMS

VIEWPOINT

SUMMERTIME TRAVEL CHECKLIST

By Philbert J. Ford, M.D., Southeastern Center for Infectious Diseases, www.mySCIDdoc.com

Summer vacation will be here before you know it! Some families

5.

Hand Washing

will travel to another city or state, some families will travel to another country. Wherever your destination, keep these important travel health tips in mind: 1.

Vaccinations-Remember the three (3) R’s: a.

Routine-These can vary depending on age of traveler, but think about measles, flu and

b.

6.

a.

Pack hand wipes

b.

Pack antibacterial hand sanitizer

c.

Wash hands often

Miscellaneous reminders

tetanus

a.

Stay hydrated-drink bottled water

Recommended-These are based on your

b.

Know your physical limitations-i.e.; hiking

destination, but can include

tours, scuba adventures, etc

hepatitis A and B, typhoid, Japanese

c.

encephalitis…

c.

Pack sunscreen

Required-Immunizations that are required for

d.

Pack a first aid kit

entry into a specific country; such as yellow fever 2.

Preventive medications

Sometimes getting sick or injured while on vacation can’t be helped. Do you know where to seek medical attention on your cruise ship or at your final destination? Does the town where you are serving your mission trip have a hospital? Make sure you know

3.

a.

Malaria prophylaxis

b.

Motion or altitude sickness

Prescriptions

how to get in touch with the Embassy and make sure someone back home knows your travel itinerary.

Keeping all of these tips in mind while traveling during your summer break will help you

a.

Carry everything with you

b.

Make sure you have enough to last the duration

and good health. And if you are

of your trip

traveling this summer, post your

come home with good memories

c.

This includes glasses and contact lenses

d.

Include your over the counter medications

photos to our Facebook page at www.Facebook.com/mySCID and use #scidtravel. Check out our website at www.MySCIDdoc.

4.

Insect repellant a.

Inspect spray

b.

Long sleeves, long pants

c.

Mosquito net-if applicable to your destination

com and click on the travel clinic link for more tips and resources.

Travel smart. Travel safe. Travel healthy.

CMS

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

23

PRACTICE MANAGEMENT

WHEN IT COMES TO YOUR ONLINE REPUTATION, PHYSICIAN HEAL THYSELF These staggering numbers illustrate the scale by which your

By Scott Marshall, Octane – a creative agency

patients control conversations and how much they TRUST content generated by others more than that created by traditional media. A practice’s reputation and brand image is no longer simply based on what is advertised to the patient, but rather defined by the patient’s overall experience with you and your staff.

Your social reputation has been crafted by these opinions that are scattered throughout the internet. It is paramount that your practice understands where to access this vital information and how to handle it appropriately. Because, again, the entirety of your brand and reputation is what you say about yourself (your digital

Nowadays, it seems everyone has an opinion and an overwhelming

footprint) and what others say about you (your digital shadow).

need to share that opinion with anyone that will listen. No one is safe as these social critics feverishly review everything from a

To determine the origin of each review, we must find the source

local hotel to a restaurant and even you, their doctor. Yes, not even

to which it is attached. We call this source the Business Listing,

doctors are immune to this growing epidemic.

which is a fundamental element of any marketing campaign.

A Business Listing consists of three key pieces of information:

The truth is they’re not just SHARING their experience, they

Name, Address, and Phone number (NAP). It can also include

are creating searchable data that is being seen by others that are

a multitude of other information such as a website address, list

SEARCHING for information about your practice. Sites like

of services, photos, business categories, and other fields and

Facebook, Google, Twitter, Health Grades, Vitals, Yelp, Google+

information. Business Listings serve as signposts for patients and

are being used millions of times per day to learn more about

corroborative evidence for search crawlers. The more listings you

products or services they need, and that is just the tip of the

have that are consistent with one another then the more crawlers

iceberg. In fact, there are 100’s of patient-related sites designed to

and search engines trust that your business information is accurate.

provide a platform for your patients to generate reviews or search

A business with no directory presence is a business effectively

for information about your medical practice.

rendered undiscoverable — by search engines and patients alike!

Here are a few eye-opening statistics to prove the significance of

In order to optimize reviews and track them properly, your

the social media and online search eco-system.

Business Listing needs to be entirely accurate and consistent across

208 million: number of active monthly users on Facebook in the United States and Canada1

data aggregators, locally-relevant search engines/directories and industry-focused directories. This step will also significantly help increase local search engine optimization (SEO) because of their

67 million: number of reviews on Yelp2

impact with Google’s search algorithm.

300 million: number of monthly active users on Google+3

Once your business listing has been optimized, reviews and online

98%: percentage of Yelp users have made a purchase at a business

Reviews are, arguably, the currency of the local data economy. If

they found on Yelp4

listings are the infrastructure, then Reviews are the road signs and

12 billion: number of monthly Google searches5

mentions become much more efficient to manage and locate.

rest stops — they effectively make and guide patient choices. What other patients say about your medical practice, again, has more impact than ever before. Dare we say it: reviews can be the tipping

Facebook – ©Statista.com – 2015 2 http://expandedramblings.com/index.php/yelp-statistics/ 3 http://expandedramblings.com/index.php/google-plus-statistics/ 4 http://expandedramblings.com/index.php/yelp-statistics/3/ 5 http://expandedramblings.com/index.php/google-plus-statistics/ 1

point between a practice making it and a practice going under.

Octane is a creative agency based in Tallahassee that specializes in online reputation management, advertising, marketing and communication solutions.

Mr. Marshall can be reached at scott@theoctaneeffect.com for assistance.

24 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS

Social Media Has Changed the Game

Your Patients Are Shaping Your Brand and

Affecting Your Bottom Line

What is your

SPARQ Score?

Online Reputation • Social Media Website SEO • Google Ranking

Find out with a

a VA $3 LU 00 E

FREE Octane SPARQ Analysis!

Contact us: ignite@theoctaneeffect.com

© 2015 Octane, Inc.

Ignite Octane to connect with your audience. Let our innovative approach to problem solving take your practice in a new and prosperous direction.

20% DISCOUNT: Capital Medical Society Members* on our SPARQ Services Package for

*20% discount will only be applied to the SPARQ Services Package, a 90 day program for online reputation optimization. Offer expires 10/31/2015.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

25

BOOK REVIEW

The interpretive doctor explores the values and goals the patient has, given the seriousness of their medical situation, and helps them come up with the option most likely to fulfill their goals.

MAINTAINING SENSE OF SELF AS AGING LIMITS CHOICES

By Nancy Chorba, M.D., Medical Director, Big Bend Hospice As baby boomers age, death is becoming less of a taboo subject in our culture. The new book by Atul Gawande titled Being Mortal, Medicine and what Matters in the End is a remarkable read filled with statistics, vignettes and truths about how the culture and medical community has evolved in the way end of life care is handled. Dr. Gawande, a Harvard trained surgeon practicing in Boston and a teacher at Harvard School of Public Health, discusses the increasing longevity and lack of attention given to the emotional well-being of debilitated, frail patients.

He reviews the emergence of community hospitals in the 1950’s, the subsequent boom of nursing homes, followed by the birth of hospices and assisted living facilities in the 1980’s. The author spoke with geriatricians, oncologists, palliative care specialists as well as hospices. He listened to patients and walked the end of life journey with his father and grandmotherin-law. He likened nursing homes to jails where patients have no choice but to eat, dress and bathe when told, highlighting the fact that these institutions were created to free up hospital beds not address patients’ individual needs. Assisted living facilities were opened as an alternative to nursing homes, but the definition of an assisted living facility is broad and many don’t encourage patients’ choices. The use of geriatricians has been found in a controlled study to keep people out of nursing homes allowing them to maintain function longer than typical primary care doctors. While geriatricians focus on functional abilities, hospice and palliative care physicians focus on symptom management and having the difficult conversations that help patients make choices to experience what matters most to them in the time left in their life. Unfortunately, many patients never encounter either of these specialties.

The author describes three different types of conversations doctors have when relaying information to the patient. The paternalistic doctor tells patients the best next move and provides the decision for them. Informative doctors relay the advantages and disadvantages of various options and ask the patient what they would like to do next.

26 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Dr. Gawande, in relaying his father’s end of life journey, spoke of a doctor in Boston and one in Cleveland discussing the best possible course to follow concerning a somewhat rare spinal cord tumor (astrocytoma). One doctor recommended immediate surgery to prevent quadriplegia (a paternalistic approach) and the other, using more of an interpretive approach, explained most tumors like his are slow growing and his father could wait and have the operation when his functional abilities declined more. At the time, his father, who was an urologist, was still able to perform surgery and play tennis, so he opted for waiting as he believed he would have time to have the operation before full quadriplegia occurred. Four years later Gawande’s father did need the operation as the tumor was interfering with his walking abilities. This was followed by radiation, discussions of chemotherapy, and waning functionality. Despite Gawande’s mother also being a physician, no one in the family was ready to hear the word hospice. Nevertheless, the family accepted hospice care and the hospice team improved his father’s pain and nausea. The hospice RN also recommended a paid caregiver to prevent falls.

These changes brought more stability and routine back in his life, allowing his father to entertain more visitors and live the life he wanted. His father, who had been wheelchair bound, even attended the author’s graduation address at Ohio University where he surprised everyone by walking with his son across the basketball floor to his seat. His father continued to make heartbreaking but autonomous choices for himself as his disease progressed, and died several months later.

Dr. Gawande points out conversations with patients confronting limited options with finite positive outcomes are difficult and require courage as well as time. Physicians have little incentive to have these conversations. Yet, consistent with Dr. Gawande’s conclusions, when I do take the time to assist patients and families with the numerous choices that arise near the end of life, I discover it is the most rewarding aspect of my job. Assisting in this process honors the spirit of the patient, assists in a peaceful death and contributes to the legacy the patient leaves for their family.

I urge you to read this remarkable book and will leave you with Dr. Gawande’s conclusions: “That our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.” CMS

JEAN MCCULLY WE CARE NETWORK R.N. PROGRAM COORDINATOR

WE CARE NETWORK WELCOMES NEW PROGRAM COORDINATOR Sue Michaels, R.N. was promoted to the We Care Network leadership role of Jean McCully We Care Network R.N. Program Coordinator in March, following the resignation of Monica Demott, R.N. The two nurses had the opportunity to smoothly transition over three months, which has enabled the case management team to continue to build on the good leadership of Monica Demott and Rose Marie Worley. The addition of a program leader with clinical experience has improved the clinical review of referrals and prescription requests, as well as, helping facilitate onsite referral reviews and training at community health center locations.

“I was drawn to We Care because I enjoy the variety and positive outcomes that case management brings,” said Sue Michaels. “I appreciate the mission of We Care because I have seen many low-income residents of Leon and Gadsden Counties during my past Home Health experience and understand their need for health services.”

Sue Michaels was born and raised near Harrisburg, Pennsylvania and moved to Florida (near Tampa) in 1981. She became an LPN in 1984 and an RN in 1988 when she moved to Tallahassee and was hired by TMH as a newly graduated RN. Sue has experience in Cardiology, Medical-Surgical, Wound Care, Home Health Care, Walk-In clinics, and Geriatrics.

Susan became Charge Nurse on TMH Cardiac Progressive Care Unit, was Clinical Manager of Mahan Medical and Westminster Oaks Retirement Center Walk-In clinics, Director of Nursing at NHC Homecare, Wound Care Case Manager at CRMC, and Clinical Nurse coder at CHP. She and Pam Wilson were colleagues during their tenure at Westminster Oaks. They are thrilled to be working together again.

She is very proud of her 21 year old daughter who is in the TCC Registered Nursing program.

2015 MEETINGS CALENDAR October 20, 2015 CMS Membership & CME Meeting “Prevention of Medical Errors” – 2 Hour CME Scott Sellinger, M.D. and Jesse Suber, Esq. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks November 10, 2015 CMS Membership & CME Meeting “Advanced Cardiac Imaging – Cardiac MRI” Greg Hartlage, M.D. and Ernesto Umaña, M.D. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks December 3, 2015 CMS Foundation Holiday Auction 6:30 pm University Center Club at FSU

Because CLEAN is a Priority New Century Cleaning Services has been providing commercial cleaning to Tallahassee and its surrounding communities for over 16 years.

You can count on our skilled and professional staff to ensure your business or office is cleaned to the highest standard.

Sue enjoys crafts, outdoor activities, and both Carolina Shag and Ballroom dancing. CMS CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

27

2311 Two Pond Lane - Tallahassee - 7.89 acres

Whether from inside or outdoors this 5,620 sq/ft home truly combines nature’s tranquil peace with the finest in elegant modern living. Five bedrooms; 4 full baths; 2 half baths; screened pool; guest cottage. Two acre private pond.

Only 15 minutes from either hospital. $1,250,000.

CALL Tina Goff at LINDA DIX REALTY (850) 508 -1891

Defending southeast physicians for more than 32 years We invest our financial strength in you • The best Florida attorneys

• Doctor2Doctor® peer support

• Florida peer physician claims review

• Consistent dividends*

• Industry leading Patient Safety

• Owners Circle® rewards program

Medical malpractice insurance for Florida physicians These agents are experts on the products and services MagMutual offers in Florida:

Staige Hoffman MagMutual 813-781-3184

Rob Remig

Fisher Brown Bottrell Insurance 850-432-7474

MagMutual.com * Dividend payments are declared at the discretion of the MAG Mutual Insurance Company Board of Directors. Since inception, MAG Mutual Insurance Company has distributed more than $150 million in dividends to our policyholders.

Insurance products and services are issued and underwritten by MAG Mutual Insurance Company and its affiliates.

28 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

UNRIVALED

GOOD MEDICINE HAS ITS REWARDS—$338 REWARDS—$338 MILLION WE HAVE RETURNED OVER $338 MILLION TO OUR MEMBERS THROUGH OUR DIVIDEND PROGRAM. When our insured physicians in the state of Florida keep patients safe and keep claims low, we all win. The Doctors Company is strong, with 76,000 members and $4.5 billion in assets. This strength allows us to defend, protect, and reward the practice of good medicine like no other.

5% DIVIDEND FOR QUALIFIED FLORIDA MEMBERS

JOIN YOUR COLLEAGUES AT THE DOCTORS COMPANY 800.352.0320 WWW.THEDOCTORS.COM

REWARDS

A5406_FL_CapitalCMS_UR_Div_May20150_f.indd 1

4/15/15 1:49 PM29 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS FOUNDATION

Reasons to Give: Funds raised by generous donors benefit the We

Care Network. The We Care Network is a past Blue Foundation Sapphire Award winner and its impact on the community was featured in the Sept/Oct 2014 issue of the Tallahassee Magazine.

The We Care Network provides over $6 million in donated specialty medical and dental care to the community’s low-income uninsured annually.

In addition, donations support medical school scholarships for medical students at FSU College of Medicine committed to returning to NW Florida

DONATE TO THE CMS FOUNDATION

after completion of their residencies. In 2014,

WE THANK OUR DONORS

$40,000 in scholarships were awarded to nine FSU

We thank the following people/organizations who made a donation to the CMS Foundation:

Gifts to Honor and in Memoriam:

For the CMS Foundation Betsy Barfield Photography Pam Wilson

In Honor Dr. and Mrs. Charles Williams – In Honor of Joshua Simmons, M.D.

College of Medicine students.

You can make a donation to the CMS Foundation in memory of someone who has passed away or in honor of someone, such as a fellow physician you hold in high esteem or has taken care of you or your family. CMS will send an acknowledgement letter to those you memorialize and honor.

How to Give: Through the generosity of donors, three funds have been created in order to establish financial stability

The mission of the Capital Medical

to meet our mission. You can donate any time to one of CMS Foundation’s funds.

Society Foundation is to support the

1) The CMSF Endowment 2) The We Care Network Endowment

charitable efforts of physicians and

3) The Scholarship Fund

others, increase access to healthcare, promote education and serve the

Checks should be made payable to the CMS Foundation and indicate on the memo line of your

community’s health needs through

check to which fund you would like to donate.

Bring your check to the CMS Office or mail it:

innovative projects that are exemplary, affordable and dignified.

30 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Capital Medical Society ~ 1204 Miccosukee Road ~ Tallahassee, FL 32308.

CMS FOUNDATION: WE CARE NETWORK

THANK YOU! To our CMS members and We Care partners who saw new patients for the We Care Network in March 2015.

Your generosity and support of the We Care Network makes a difference.

PHYSICIANS Ricardo Ayala, M.D. Marie Becker, M.D. Robert Bradford, M.D. Viet Bui, M.D. Joseph Camps, M.D. Michael Cavallaro, M.D. Raymond Cottrell, M.D. Jeffrey Crooms, M.D. Ray Dolly, M.D. David Dolson, M.D. David Durden, M.D. Kristin Harmon, M.D. Larry Harper, M.D. Celeste Hart, M.D. Robert Hoyne, M.D. David Huang, M.D. James Hunt, D.O. Iman Imanirad, M.D. Simha Jagadeesh, M.D. Amit Jain, M.D. Arjun Kaji, M.D. James Killius, M.D. Amulya Konda, M.D. Stephanie Lee, M.D. Carey Linker, M.D. Kurt Luhmann, M.D. Michael Mangan, M.D. Ovidiu Marina, M.D. Steven Ostrov, M.D. Michael Pentaleri, M.D. Duncan Postma, M.D.

James Renehan, M.D. Tim Ruark, M.D. William Sawyer, M.D. Scott Sellinger, M.D. Philip Sharp, M.D. Hardeep Singh, M.D. Joseph Soto, M.D. Robert Steinmetz, M.D. Mary Swain, M.D. Timothy Sweeney, M.D. John Thabes, M.D. David Vermess, M.D. Brian Wilson, M.D. William Yaakob, M.D. DENTISTS Eric Amundson, D.D.S. William Baldock, D.D.S. JP Bastien, D.M.D. Brian Beck, D.M.D. Susan Byrne, D.M.D. David Cardman, D.M.D. Walter Colón, D.M.D. Brittney Craig, D.M.D. Michael Hartley, D.M.D. William McFatter, D.D.S. E. Lynn McLarty, D.D.S. Jim McSoley, D.M.D. Lawrence Pijut, D.M.D. Erin Shiveler, D.M.D. Frank Swerdzewski, D.D.S. James Sykes, D.M.D. Jay Walton, D.D.S. Lawrence Weaver, D.D.S. Ed Zapert, D.M.D. FACILITIES Affordable Dentures Anesthesiology Associates Beachton Denture Clinic Capital Regional Medical Center Dermatology Associates Desloge Home Oxygen Leon County Dental Clinic Pathology Associates Radiology Associates Seven Hills Surgery Center Southeastern Surgery Center Tallahassee Diagnostic Imaging Tallahassee Endoscopy Center Tallahassee Health Imaging Tallahassee Memorial HealthCare Tallahassee Orthopedic and Sports Physical Therapy Tallahassee Outpatient Surgery Center TMH Family Medicine Residency Program Women’s Imaging Center

The We Care Network strongly encourages our volunteer physicians and dentists to send their value of donated services to us. The value of donated services is important for us to share with our funders and the community.

You can send your value of donated services via fax to Sue Michaels, R.N. at (850) 201-0085 or mail to 1204 Miccosukee Road, Tallahassee, FL, 32308. Thank you!

Please contact Sue Michaels, R.N. at smichaels@capmed.org or 201-0130 if you are a We Care volunteer and you provided volunteer specialty care in the month of March 2015 and your name is omitted.

We thank our referring providers from March 2015: Eboni Allen, ARNP

Marjorie Kirsch, M.D.

Anne Ananga, ARNP

Elaine Larkins, ARNP

Dhananjay Bendre, M.D.

Esaias Lee, M.D.

Shelby Blank, M.D.

Stephanie Lee, M.D.

Faith Blocker, ARNP

Juan Martinez, M.D.

Jonna Bradley, ARNP

Damon McMillan, M.D.

Sherry Bramblett, ARNP

T. Adam Oliver, M.D.

Daniel Breivogel, ARNP

Rose Origa, ARNP

Kendall Campbell, M.D.

Dianne Pappachristou, D.O.

Christie Chiu, M.D.

Stephen Quintero, M.D.

Lysmar Dinguis, M.D.

James Renehan, M.D.

Elizabeth Fajer, M.D.

Temple Robinson, M.D.

Anneka Gaffney, ARNP

Tim Ruark, M.D.

Sasha Gittens, M.D.

Mark Saunders, M.D.

Judy Griffin, ARNP

Robert Snider, M.D.

Hantz Hercule, M.D.

Alanna Steaple, ARNP

Susan Horton, ARNP

Nina Sumlar, M.D.

Amit Jain, M.D.

Scott Tetreault, M.D.

Julie Kelch, M.D.

Leonard Tolley, D.D.S.

Howard Kessler, M.D.

Marianne Towler, ARNP

DURING THE MONTH OF MARCH, THE WE CARE NETWORK: RECEIVED 90 REFERRALS, WITH 54 PATIENTS NEW TO THE PROGRAM

SCHEDULED 104 $157,689 IN DONATED CARE APPOINTMENTS WITH WAS REPORTED BY WE CARE VOLUNTEER PHYSICIANS AND VOLUNTEERS CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 31 31 DENTISTS

Prsrt. Std. U.S. Postage

PAID

Tallahassee, FL Permit 801

Cap Scan Newsletter 1204 Miccosukee Road Tallahassee, FL 32308 Return Service Requested