JUNE EDITION, VOLUME 2015, NO. 6
CAPITAL MEDICAL SOCIETY LEADS EFFORT TO PROTECT INTERESTS OF DONATING PROVIDERS By Pam Wilson, CMS Executive Director
Donating medical provider, Dr. J. Daniell Rackley with a We Care patient.
Donating dental provider, Dr. Michael Hartley with a We Care patient.
During what was to have been a routine monitoring visit on October 24, 2014 by Florida Department of Health’s Volunteer Health Care Provider Program (VHCPP) of Capital Medical Society Foundation’s We Care Network, the stage was set for a crash course for eight months of learning about sovereign immunity and VHCPP. During that monitoring visit, the auditor retracted years of reports stating that We Care Network was in compliance using FLDOH-approved electronic Referral Form (DH1032) and required an immediate move to manual completion of the Referral Form and the previously approved electronic version of the Eligibility Form (DH1032E). More significantly, during that visit, it was shared that all volunteer providers would have to complete new five year Agreements with FLDOH to replace their current perpetual Agreements. These Agreements are critical to a provider having sovereign immunity protection when providing donated medical care. They are vital to the over 300 donating specialty medicine providers and 45 donating dental providers who participate in the We Care Network and donate over $5 million in specialty
medical and dental care each year. Although our assistance was offered to sort through the changes needed to VHCPP and to consider recontracting administration, that offer was initially declined. Having a short tenure at Capital Medical Society, the need to become well-versed on the VHCPP quickly became imperative. After reviewing copious communications with FLDOH from past monitoring visits, I scheduled appointments to meet with We Care Network’s past Program Coordinators and Executive Director Karen Wendland. On November 13, with the help and venue of Jeff Scott, FMA General Counsel, we participated in a conference call with Cheryl McFarland, Ph.D., Chief of Community Health Assessment, FLDOH and Jan Myrick, J.D., Deputy General Counsel, FLDOH with We Care Network represented by Dr. James Stockwell, Monica Demott, Jean McCully We Care Network R.N. Program Coordinator, and Shannon Boyle, CMS Communications and Marketing Director, to discuss our concerns regarding pending Agreement revisions and the removal CONTINUED ON PAGE 3
CAPITAL MEDICAL SOCIETY 2015 MEETINGS CALENDAR September 15, 2015 CMS Membership & CME Meeting “Rheumatology Update” Less Shrestha, M.D. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks
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 December 3, 2015 CMS Membership & CME Meeting CMS Foundation Holiday Auction “Advanced Cardiac Imaging – Cardiac MRI” 6:30 pm Greg Hartlage, M.D. and Ernesto University Center Club at FSU Umaña, M.D. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks MEDICAL SOCIETY PUBLICATION CAP SCAN - A CAPITAL 1
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
Volunteer Health Care Provider Program … Professional Notes … Reflections from the Editor … Viewpoint … Alliance Corner … Practice Management … CMS Membership Meeting Minutes … Florida Board of Medicine … Medical/Legal … CMS Foundation … CMS Foundation: We Care Network …
1 4 6 9 13 14 16 18 20 22 23
HAPPY BIRTHDAY! {JUNE BIRTHDAYS}
Melissa Martin, M.D. – 1st
Nancy Loeffler, M.D. – 14th
Scott Asher, M.D. – 2nd
Scottie Whiddon, M.D. – 15th
Connie Speer, M.D. – 2nd
Carlos Zapata, M.D. – 17th
Christopher Sundstrom, M.D. – 2nd
Whit Oliver, M.D. – 18th
A. Lane Janney, M.D. – 3rd
Barbara Williams, M.D. – 19th
James Killius, M.D. – 3rd
William Yaakob, M.D. – 19th
Kirk Mauro, M.D. – 3rd
Gary Hansen, M.D. – 20th
Edwin Crane, M.D. – 5th
Jitendra Padalia, M.D. – 20th
Winston Ortiz, M.D. – 5th
Frederic Vroom, M.D. – 20th
Robert Ashmore, M.D. – 8th
Kristin Harmon, M.D. – 23rd
Shane Rignanese, M.D. – 8th
Jose Mendoza, M.D. – 23rd
Shafi Mohamed, M.D. – 9th
Sam Moorer, M.D. – 23rd
Okanta Jackson, M.D. – 10th
Joseph Mazziotta, M.D. – 24th
Suzanne Morgan, M.D. – 10th
Myrle Grate, Jr., M.D. – 25th
David Saint, M.D. – 11th
Madhuri Sankuratri, M.D. – 25th
Scott Sellinger, M.D. – 11th
Ronald Saff, M.D. – 27th
Timothy Bolek, M.D. – 12th
Leslie Emhof, M.D. – 28th
Leonard Leichus, M.D. – 13th
Russell Cole, M.D. – 29th
Earl McKenzie, III, M.D. – 13th
Amit Jain, M.D. – 29th
Donald Willis, M.D. – 13th
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!
VOLUNTEER HEALTH CARE PROVIDER PROGRAM
of the electronic form option in this EMR age. We left that meeting unclear if we had made an impact. I began to alert others of the pending changes using the Council of Florida Medical Society Executives as a platform. No one else had heard of the pending changes. I contacted others at the FLDOH with whom we partner and learned they knew nothing about the pending changes. Even our partners at the Leon County Health Department were unaware of the pending changes that were currently being drafted. With a tip from a friend at Leon County Health Department, we became aware that Proposed Rule 64I2.04(1) (b) would be posted on January 22, 2015 with a 20 day period to post comment. With the collaboration of Mark Cruise, Executive Director of Florida Association of Free and Charitable Clinics, St. Petersburg, FL, and their counsel, Jon C. Moyle, and Stephanie Garris, Executive Director of Grace Medical Home, Orlando, FL, comments were posted with recommendations that addressed not only administrative issues with required forms, but issues that would impact volunteer health care providers, such as, removing all pending language regarding terminating a provider’s Agreement if the health care provider does not accept and provide services to any qualified and referred patient for a period of twelve (12) consecutive months. All of these new partners pooled their comments to create a unified effort and to request a Rules Hearing.
At 7 a.m. on March 12, 2015, Capital Medical Society hosted a pre-Hearing meeting for these united partners along with interested Board members and others with past affiliations to the creation and development of the VHCPP program, to prepare for the Hearing scheduled two hours later. As your Executive Director, I could not have been prouder of our efforts, our partnerships, or our united passion to do what was right for volunteer health care providers in Florida. The Hearing was a helpful dialogue with FLDOH’s facilitation and openness to questions and feedback. We also appreciated that FLDOH addressed many of the concerns voiced in our November conference call by implementing several of the suggestions to improve the VHCPP process administratively with electronic form recommendations. In late April, the publication of the Notice of Change was published, opening up a twenty (20) day window to file a petition to challenge the validity of the proposed rule as changed. That step would require an Administrative Hearing. That window closed on May 18th. We anticipate the changes will go into effect in June, 2015. We are grateful to the FLDOH for making a number of the changes to the provider Agreement and forms that will help clinics, networks, and others serve eligible patients. We appreciated the opportunity to have constructive dialogue with Department officials at the March 12,, 2015 public workshop and that the Department made changes in a number of areas discussed including
removing the one year termination clause in the “Volunteer Health Care Provider Program Agreements Between the Health Care Provider and the Department of Health.” We didn’t get everything that we requested, so the dialogue with the FLDOH continues through the mail. The recontracting of volunteer providers will likely begin to roll out later in 2015 when there has been time for FLDOH to fine-tune its protocol. Capital Medical Society will be here to assist our We Care Network donating providers through the process. October 24th seems like light years ago. All in a day’s work. CMS
In Memoriam
Donald O. Alford, M.D. 1935 – 2015
Wendell C. Heaton, Jr., M.D. 1933 – 2015
Eric T. Nicholson, M.D. 1965 – 2015
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 3
PROFESSIONAL NOTES
PROFESSIONAL NOTES All dressed up and enjoying the TMH Golden Gala on April 23rd starring John Legend!
The Florida State University College of Medicine received a Family Medicine Top Ten Award from the American Academy of Family Physicians. The 2015 award winners were announced and recognized on April 27, 2015 at the Society of Teachers of Family Medicine Annual Spring Conference in Orlando, Florida.
Tameka Funny, D.O. won the Women on Fire AwardTorchbearer category, presented by Tallahassee Woman Magazine, on May 5, 2015. The Torchbearer represents a woman in the community who is helping young people on the road to success in their careers and lives. Over 150 nominations were submitted for these awards.
Dr. Tracey Hellgren, Pam Wilson, Shannon Boyle, and Michael Boyle.
HAVE YOU LIKED US ON FACEBOOK?
Congratulations, FSU College of Medicine and Dr. Funny!
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.
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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
Stay up-to-date with Capital Medical Society news and events by adding us to your news feed today!
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REFLECTIONS FROM THE EDITOR
THE TOOTHPASTE SAYS IT ALL By Charles Moore, M.D.
After getting off the plane very nearly the first thing she said, in perfectly understandable if somewhat hesitant English, was, “I want some toothpaste.” “Well, of course,” I replied, all innocence. “It can certainly be arranged.” And thus, more or less, arrived Svetlana Astakhova, age 25, straight from the Ukraine, Kiev to be precise. No… no…I beg you, do not draw any conclusions from such bare statistics that she came by way of some “Ukrainian Website,” seeking a green card or whatever else little old Tallahassee might offer. She came as a result of my wife’s and my invitation, which had been extended some few years ago, but which only now, finally, found itself capable of fulfillment. Before she so curiously asked for toothpaste during those moments as we drove her from the airport, we had given her a big hug. We had congratulated her on having found the time to get off from her work, as a lawyer these three years past, and got her papers, visa and passport all in order. We asked of her Mom and Dad, both friends as a result of the work in Crimea by a small surgical group with which I have been associated. For the past eight years we had annually visited the Republic Children’s Hospital in Simferopol, Crimea, to attempt some bits of surgical good on sundry Crimean orphans. Svetlana’s Father, Dr. Alexander Astakhova, was not only CEO of a 400 bed hospital, but responsible for the health care needs of all the children in Crimea. We had known Svetlana since she was in her teens.
We all slept well, and the next day I was allowed to fabricate a big breakfast. We took her to the private studio apartment I had been granted by a friend, within walking distance of downtown, so that during her two weeks here she would have some privacy, and as well not feel trapped 15 miles out in the country with folks 3 times her age. Her first day after arrival we took her to a Kentucky Derby Party, fully hatted, and introduced her to numerous young people, including our own unmarried daughter, who kindly swept her away on the wings of youth and enthusiasm. The toothpaste was all but forgotten in the rush of our goings and comings. Just in case our own experience might be helpful to you next time you have a visitor from Ukraine or Kazakhastan, we contrived to spend three beautiful days on St. George Island; lunch at Fanny’s at Goodwood, touring the house; oysters in Apalachicola; a visit to the light house and a rowdy night of country music at St. Marks; Wakulla Lodge and the boat cruise, sighting alligators; a tour of Pebble Hill; luncheon al fresco at Andrews outdoors; a walk-about in Thomasville where we ate cheese; an FSU baseball game; a very interesting tour of the law school; “Mad Max” in 3-D; we went to my piano lesson where she played four pages of a lovely Bach Fugue; and a couple of days in court, watching our justice system at work, compliments of judicial friends. We had a beer at Finnegan’s. We ate everything.
Now she was here. And her very first request was for toothpaste! Of course, as we drove from the airport, there was much to be said, and more when we got her to our house for a light little supper, then throwing her, exhausted after the long trip, to bed upstairs. Lynn and I sat around for a while, nursing a final glass of wine, much admiring Svetlana’s English, which was remarkable given she had never practiced it, as they say, in immersion. 6
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
Lynn, Svetlana, and I visit Dr. Jim and Elaine Geissinger at their cottage on St. George Island.
REFLECTIONS FROM THE EDITOR
Good and wonderfully exhausting fun for all. More to the point, there was a serious side to all of this, too. Even heart-breaking; a glimpse of the reality that lies behind the polished sound-bites of our news media. Svetlana moved to Kiev about a year ago, leaving her parents and the Crimea she loved because she did not want to be forced to take up Russian citizenship, nor live in what has now become Russia. Her Mother, already influenced by Russian propaganda, believed that the Fascists in Kiev would kill her because she speaks Russian instead of Ukrainian…somewhat subtle though the language differences are. As for her Father, he was awarded, shortly after the Russians took over Crimea, a certificate of commendation for the excellence of his twenty years of service to Crimean children; two hours later, in his office, two policeman entered and informed him that he no longer had a position and was to vacate the premises immediately. We who knew him and his wife are now scarcely in touch with them, except in the blandest way, since every e-mail is scrutinized by the Russian state, seeking out and willing to punish the smallest hint of the most subtle sedition. Her parents remain in Crimea because it is their home; Svetlana has painfully left, the freedoms of her own post-Soviet upbringing unable to accept the repressions that have now descended on that lovely peninsula. Are you interested in what else she had to say? Never mind that it has become very difficult for her to visit her parents. She did mention that there is lately suddenly sprung from the earth in Russian Crimea a cemetery, just over the visible horizon, tucked away for no one much to see, where there are rows and rows of graves. These are the resting place of Russian soldiers, unacknowledged and unmarked, for the very specific reason that there was “no Russian military presence fighting in Crimea or eastern Ukraine.” The families of these young men will never know of how or when their sons went missing.
And then, of course, there are the orphans. Svetlana did not know for sure, but she thought that many of the orphanages, which in my own experience I had found not only touching but places where the care was so attentive, are now closed. The Russians have taken the children to “somewhere,” the older ones Svetlana had heard simply being trained for army service. “What about the war in the east?” I asked. “Who can tell,” she replies. Who can indeed! We think that it will simmer along, erupting into greater degrees of violence now and again, Mr. Putin eager but patiently capable of keeping up the pressure, gradually absorbing more and more of the Ukraine. It is his right to do so, he surely thinks. What will stop him? Who knows? He is building with every passing month an ever greater army against which one can only wonder if NATO or we could hope to stop. Who knows? Despite all, Svetlana holds firm to the belief that Ukraine will survive as a European country. At the law school we learned that there is a program, which after a year of study allows foreign attorneys to be awarded a Master’s Degree in United States Law. Such a nice addition to one’s legal credentials! Was the bee put into Svetlana’s bonnet? Who knows what evolves out of what! On her last night here, with dinner at our house…barbequed spare ribs with all the trimmings…I suddenly remembered. “The toothpaste!” I cried out. “We didn’t get it! Why did you so want it?” Did she squint her eyes? Did she say “Ha!” I am not sure. She may have done both, but then said “the only toothpaste we can get in Kiev is Russian. I wanted AMERICAN toothpaste!” The next morning, before picking her up to take her to the airport, I snuck around and got six tubes of the best, glitziest American toothpaste, wrapped ‘em up, put on a ribbon or two, and managed to get her to find a place for this little gift in her suitcase. CMS
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 7
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VIEWPOINT
AN UNANTICIPATED JOURNEY By Pat Woodward, M.D.
I thought of beginning with “I was born”, but instead
during the freshman year of med school that I felt certain
decided to skip ahead in telling my story. I grew up
this was a good fit and something I really enjoyed doing.
on a farm four miles north of Quincy, worked for my father in the summers, was involved with the raising
As far as what to do beyond med school, I was in
of farm animals, took vocational agriculture courses
a milieu at Emory where Internal Medicine and,
in high school, and participated in all Future Farmer
in particular, Cardiology were the highest and best
of America (FFA) activities. I enjoyed the fields and
options for students to pursue after graduation. In fact,
woods but in spite of all this never had a passion to
during our first lecture presented by Dr. Willis Hurst
pursue farming as an occupation and was concerned
he asked how many of us intended going into general
about the vagaries of crop outcomes and the annual
practice. My friend Oliver Sanders and I, both small
efforts involved in financing the next year’s crop.
town boys, were the only two in a class of sixty five who raised our hands at the time. Oliver ultimately
After high school, therefore, I attended Davidson
went into Psychiatry and I later chose Pediatrics.
College to pursue a liberal arts education not knowing
I enjoyed all my clinical rotations in med school
what my college major would be. I quickly realized
but particularly the clinical teaching we received
that pre-medicine was a strong major there and that
in Pediatrics from Dr. Richard Blumberg and Dr.
my friends who intended to be physicians were already
Dorothy Dodd, who had come to Emory to teach
certain of that career path. Although I admired my
rather late in her career. I spoke with Dr. Blumberg
family physician, Dr. Taylor Wood Griffin, I had never
about going into Pediatrics but wanted more
thought of pursuing such a career until well along in
experience in clinical rotations beyond med school
my freshman year. That gave me a bit of a late start in
so looked into available rotating internships and was
obtaining the three years of chemistry, two of biology,
accepted at Parkland Hospital in Dallas, Texas where I
and one of physics required for the pre-med major and
spent my first year after graduation. I had considered a
entrance into medical school. Still undecided, I did
residency in general practice, finding only two or three
begin with first year chemistry in my sophomore year
such programs available at the time. During Christmas
and, of course during my junior and senior years took
break my senior year I did visit one such program at
five science courses, each with afternoon labs. During
the University of Kansas Medical Center in Kansas
my senior year I applied to med school and was accepted
City, Kansas. I remember that visit as cold, bleak, and
at Emory, entering there in the fall of 1958 along with
a place I did not consider spending the next two or
five others from Davidson that year. It was actually
three years.
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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 9
VIEWPOINT
During the internship at Parkland, my first rotation
Editor’s Note: I am not sure if anyone can be granted the
was pediatrics and one of my mentors was Dr.
“I.B. Harrison Award” simply on the basis of being a gentle,
John Nelson, who became an authority in Pediatric
wonderful, very nice person. You have to also embody, of
Infectious Diseases. At some point during the year I
course, all the best virtues and ideals that as physicians we
visited the University of Florida and was accepted into
aspire to being, but only a very few...call it one a year...are
the Pediatric Residency program there. I also applied
thus honored by standing out from the remaining crowd of
for and was accepted to be deferred for military duty
us. Dr. Woodward was so recognized early on in the history
under the Berry plan, whereby I was commissioned
of the “I.B. Harrison Award.” His commitment for so many
in the U.S. Army with the agreement that I would be
years to his pediatric patients in Quincy has now become the
called for active duty after completion of my Pediatric
stuff of legend. Nor to forget, please, his having always been
residency. Two years later I entered the Army Medical
a most gentle, wonderful, very nice person.
Corp as a captain, received basic training at Fort Sam Houston, and was sent to Nurnberg, Germany where I served for two years at the 20th Station Hospital. I worked in the hospital and pediatric clinic there with four colleagues and felt those two years were of great
CAPITAL MEDICAL SOCIETY LUNCH & LEARN
benefit in preparation for entering clinical practice after being discharged. Of interest for me was that Dr. John Nelson had also spent his tour of duty in that same hospital, and was fondly remembered by the nurses there. My family and I returned to Quincy in 1967, where I practiced Pediatrics until retiring in 2001. In a sense I have come full circle, spending time on the farm where my siblings and I are involved in raising timber on the land that our father and grandfather farmed before us. That is my story.
CMS
10 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
Mark your calendars for the Fall Lunch & Learn seminars and watch for updates on topics and speakers! September 16 October 21 November 18
VIEWPOINT
favorite characters. Doc managed to be involved with
DOC ADAMS By Frank Skilling, M.D.
everyone on the show at one time or another, and he often gave sage advice to Matt or Kitty or anyone passing through Dodge. He seemed to embody the type of physician we all
I’ve only gotten to know one person fairly well who was
wanted to have when we were sick or injured. He just knew
a media star, whatever that means in today’s world of
exactly what to do for a patient, and he could spot a horse
instant internet celebrities who show up and are gone in the
thief or a bank robber a mile away. Many of the injured
proverbial fifteen minutes. I did stand next to O.J. Simpson
characters were patched up by Doc Adams and sent on
in 1979 while he picked up a to go order at a breakfast
their way or sent to jail as their case necessitated. He was
café in San Francisco’s North Beach, and in 1992 I rode
no-nonsense, direct, perceptive, loyal and unflappable. And
in an elevator with Howard Stern as he left his New York
in 1971, Doc Adams himself was in dire need of a good
radio studio before leaping into a waiting limousine and
surgeon.
speeding off. My wife, who reads People Magazine regularly, didn’t recognize either one of them at the time. I did, but I didn’t let either one of them know that I knew who they were. Stern seemed surprised I didn’t. O.J. was in too big a hurry to notice me. Unlike a lot of Tallahasseans, I don’t particularly care if I have an autographed photo of Bobby Bowden in my home, even though I think he is a fine man. Since Bear Bryant died, I’ve had trouble getting excited about any living football coach.
At that time I was a junior medical student at the University of Alabama in Birmingham, one of the premier centers for cardio-vascular surgery. Milburn Stone had developed severe heart disease which required open heart surgery, then a relatively new field. Even though he lived with his family in Los Angeles, he was referred to John Kirklin, who was one of the post-World War II developers of the field. While Kirklin was chairman of surgery at Mayo Clinic, he pioneered the post-operative care for these patients. Indeed
The one exception to my nonchalance was Milburn Stone,
it was said that Kirklin spent the night sleeping on a cot at
who played the character Doc Adams on the TV show
the bedside of the first thousand cardiac surgery patients
Gunsmoke from 1955 until 1975. Doc Adams was a crusty
he operated upon. The post-op ICU at UAB was noted for
frontier doctor who was the confidante of Marshal Matt
providing care that was unsurpassed anywhere in the world.
Dillon, Miss Kitty and Chester on the hugely popular
A few medical students in their third or fourth years were
Saturday night series which was consistently the number
hired to work as ICU assistants at night to help care for the
one program in the “golden age” of TV. It was a fictional
many patients who had undergone heart surgery during
story set in Dodge City, Kansas, and it captivated millions
the day. I applied for a job while I was on my psychiatry
of viewers including my physician father, who rarely
rotation which was usually finished by 5 PM. Once hired,
watched TV at all. However, his Saturday nights were
I would report to the ICU and work until 11 PM or so.
dedicated to the thirty minutes spent in Dodge City, and
It was a great experience, and the first time I’d had a real
Matt (James Arness) and Doc Adams were clearly his
job in medicine that actually paid me something. I also
CONTINUED ON NEXT PAGE
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 11
VIEWPOINT
was allowed to observe teaching rounds with the residents
in the audience, and the network was inundated with
without having the embarrassment of being asked questions
telegrams from doctors all over about Doc’s mistake. To
in front of other students. Kirklin’s evening rounds
prevent it from being repeated he put red nail polish on
were famous for being pointed, formal, educational and
the right earpiece and always looked for that color before
humiliating at times for all who were training under him.
putting the stethoscope on. Since the show was broadcast in
Milburn Stone already had open heart surgery at UAB when I first met him, and he had post-op complications that
black and white at the time, the nail polish was not visible on screen.
necessitated keeping him under constant monitoring in the
It was apparent to me that neither Milburn nor Jane cared
ICU for many weeks. An enclosed cubicle was constructed
much for the glitter of Hollywood. Several of his California
which allowed him to be kept in bed without being visible
friends visited him including Dennis Weaver (Chester) who
to others in the ICU. His wife Jane was given liberal visiting
dropped in one day. I asked Jane if James Arness would
privileges and often spent most of the day with him there.
consider visiting, but she said that he was so upset when he
He was on bed rest, but allowed to sit up in a chair for
heard that “Millie” required surgery that Arness saw him
part of the evening. I monitored his vital signs, checked
pre-operatively in Los Angeles but decided not to come to
the primitive monitors and helped administer medications
Alabama while he was recuperating. She fashioned a wall
under the nurse’s directions. We had a lot of time to talk,
of get well cards, letters and telegrams from friends and
and I found him weak, but always affable and engaging.
viewers, and I would gaze on them while carrying out my
Jane directed his activities and tried to keep him occupied
bedside duties. One I remember particularly was from John
with conversation about news from home and family. They
Wayne, a longstanding friend of Stone’s. Wayne had one
were both Kansans and radiated the practical values of
lung removed years before because of cancer, but was still
their mid-west upbringing. Sometimes I managed to steer
in the movie business. In his memorable scrawl he wrote,
the conversation to Gunsmoke and its cast. He admitted
“To Doc Adams, With your bad heart and my one lung we
that the character of Doc Adams was one that he patterned
will still be able to ride the range together again, Get Well,
on his own grandfather who was a general practitioner in
Duke.” (Duke was Wayne’s nickname dating to childhood
rural Kansas at the turn of the twentieth century. I relayed
when he had a pet dog with the same name.)
how my father had chuckled over many of Doc Adams’s witticisms.
I never saw Milburn Stone again after my interlude in the ICU with him and Jane. He recovered and returned to
He said that Doc Adams was watched by millions of
California to reprise Doc Adams again until Gunsmoke folded
viewers, but he was scrutinized by the physicians in the
in 1975. He died in 1980. Harking back to John Wayne’s note
audience. Stone was careful to check out any medical
to Doc, I can picture them conversing about the “celebrities”
procedure or recommendation prior to filming to make
of the present day as they ride the range again. With perhaps
sure it was authentic. He told me how during one episode
the exception of Clint Eastwood, none of today’s “media
he had pulled his stethoscope out of his pocket to listen
stars” could hold up a candle to either of them. Maybe that’s
to a patient’s chest and accidentally put the earpieces in
why I’m not impressed with celebrities now.
backwards. The mistake was obvious to all the physicians
12
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
CMS
ALLIANCE CORNER
Dr. Maureen “Paulie” Bruns Received the FSU College of Medicine’s 2015 Access to Care Award, Given Annually in Honor of Robin McDougall
Dear CMS Alliance Members, Supporters, and Friends, The past couple of months were busy ones in the Alliance. In April, we toured the FAMU School of Nursing and presented them with a $1,200 check for scholarships. In May, we partnered with Capital Area Healthy Start Coalition to support them in their second annual “Baby Shower” fundraiser. This year they honored Dr. A.D. Brickler for his service to the community and his delivering over 30,000 babies. This was a fun and successful evening. A big thank you to CMS and CMSA members for your contributions and support.
Pictured (l-r): Amy Pagano, CMSA President; Dr. Ruena Norman, Dean of FAMU School of Nursing; and Melissa Inglese, CMSA Treasurer.
Dr. Ken Brummel-Smith, Chair of the Department of Geriatrics, FSU College of Medicine introduced Dr. Maureen “Paulie” Bruns as the recipient of the 2015 Access to Care Award, after recognizing Robin McDougall, LCSW, in whose honor the award is presented. Dr. Bruns has demonstrated a strong interest in providing access to health care for underserved populations. “Access to Care is so fundamental to health care. If you can’t get access, you can’t get care. So it doesn’t matter what quality the care is that is provided, if you can’t get it,” said Dr. Brummel-Smith. “Dr. Bruns has worked very hard to make sure that people have access to care, especially people who often don’t get the care that they need.” An example of Dr. Bruns efforts in improving access to care is her creation of a “Falls” program to prevent falls in older adults. “Surprisingly, falls are a major cause of death in older adults,” said Dr. Brummel-Smith. Dr. Bruns will be completing her Internal Medicine residency at Providence St. Vincent Medical Center in Portland, Oregon. She was most grateful to receive the $1,000 award and plaque and to receive the award with her daughter in the audience for the presentation. CMS
Kristy Goldwire, Executive Director for Capital Area Healthy Start Coalition, presented Dr. A.D. Brickler with the Angel Plaque.
My year is already half over and I’m looking forward to the rest of the year. Here is a preview of what’s to come. Keep an eye out for your dues statement in the beginning of July. The Capillary newsletter will be mailed in August. Our next general membership meeting will be September 23 from 10:00 am-12:00 pm at A La Provence (1415 Timberlane Road). This is a very special meeting because we will be honoring past presidents of CMSA. I hope everyone enjoys the break over the summer! Warm regards, Amy Pagano, CMSA President
(L-r) Robin McDougall, LCSW, with 2015 award recipient, Maureen “Paulie” Bruns, M.D.
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 13
PRACTICE MANAGEMENT
WHAT IS TODAY’S HEALTH INFORMATION EXCHANGE (HIE) By Dan Kaelin, M.D.
In medicine, there are a lot of acronyms and many we made up
or HIE. Putting the EMR and HIE together is frequently labeled
ourselves along the way to help us memorize various things. In the
the EHR (Electronic Health Record) especially when combined
electronic world of medical data, acronyms seem to be the way
with a patient’s PHR (Personal Health Record) or PMR (Personal
people speak and can be very confusing. Try these for example:
Medical Record).
EMR, HER, PMS, PHR, PMR, RHIO, ANSI, CLIA, LOINC, MU, EMR, ONC, HIT, HIE, etc …
Most practitioners think that in order to participate in HIE there must
How many of you reading this know what these acronyms stand
must wait until this can be accomplished to discuss HIE. But the
for? How many know that these are all acronyms related to your
reality in today’s world is most of this inter-office and inter-facility
electronic medical records? How many know that these are just a few
communication is a manual process that is extremely time consuming
of the terms that are used to record, evaluate, document and transmit
and takes away from efficient patient care. Faxing is the primary
electronic records for the purpose of patient care? I doubt many of
method used for this process and is cumbersome, time consuming,
us can keep up with all the acronyms let alone the technological
inefficient, not auditable and most import is absolutely NOT HIPAA
behind them, but we need to understand how they affect our practice
compliant. In addition the average number of fax attempts per
of medicine. These acronyms relate to electronic tools that can help
successful transmission in most medical practices is over 2!
us be more efficient, cost effective, practice safer and monitor patient outcomes on a more real time basis. This can only occur however if we take our knowledge of how to take care of patients and use these
be a computer to computer communication occurring and feel they
While it would be nice if all of our “systems” talked seamlessly to each other, like the vendors promise, that is not reality. The
tools appropriately and not let the tools take care of the patient.
good news however is that efficient HIE can be accomplished
There have been and will continue to be many examples of
have to be “reworked”. Fax can be converted to scan. Print can be
frustration over the conversion to electronic records. Almost all of
converted to send. Referrals can be sent and received electronically
these occur when an office, facility or practice tries to let the new
with attached documents as needed. Many phone calls can
“system” dictate the flow of patient care. This does not have to be
become messages sent and responded to as part of office workflow
the case. These electronic tools can help streamline a process and
instead of an interruption to office workflow. Each function is able
will allow us to improve care if used correctly. To utilize these tools
to be audited and is fully HIPAA compliant. These are just a few
you do not need to know as much about them as you might think.
of the examples that can help an office improve efficiency.
What you need to know is how you work. If you understand how
with simple changes in existing processes. The system does not
you work, using technology can be much simpler.
We are unique in this community in that we have through www.
Step one is to inventory your practice and understand the basic flow
successful HIE in the Southeast. We have more competing entities
of the patient through the facility. This includes how information
and disparate systems communicating with each other through
is collected, presented and used during the care of the patient. This
this portal electronically than most across the United States. In our
portion of care would be utilized in the office EMR (Electronic
community we process more messages, transmit more patient data,
Medical Record). Think of this portion as the system used to assist
have more patient inquires, process more electronic referrals and have
with all the functions and data inside the facility.
a higher rate of local participation than any city in the state. We have
Step two is to decide how information gets in and out of the facility. This might include referrals with outside information, patient forms, lab or x-ray reports, hospital records, insurance communications, etc. This part is the Health Information Exchange 14 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
BigBendHealth.com (supported by HIE Networks) the most
started the transformation to seamless sharing of data that hopefully will be reality in the future. For now however take advantage of what is available in our community. As more of us participate in our community HIE the value for every patient improves.
CMS
PRACTICE MANAGEMENT
UP IN THE CLOUD: IS IT SAFE TO STORE PROTECTED HEALTH INFORMATION ON REMOTE SERVERS? What exactly is the cloud? Cloud storage is a network of remote servers that allow for centralized data storage and online access to these resources. Your files are stored on a server connected to the Internet instead of being stored on your own computer’s hard drive. The cloud is convenient and cost-effective, providing a way to automatically back up your files and folders. Despite these benefits, recent publicity around hacks of public cloud storage websites has raised concerns about whether it is appropriate for medical practices and facilities to store health records and information in the cloud. Is cloud storage a safe way to store protected health information (PHI)? As with many new technologies, the safety level of the cloud, and whether it’s appropriate for use, depends on the vendor. There are several issues you will have to keep in mind: · Are the vendor’s security standards appropriate? You will have to research each vendor you choose. Make sure the company has a good reputation and solid security policies. · How much data will you be storing? Ensure the vendor can handle the amount of data you would like to move to the cloud. · Ensure your data is encrypted when being uploaded to or downloaded from the cloud. This is also your responsibility. Make sure your browser or app requires an encrypted connection before you upload or download your data.
· Make sure your data is encrypted when stored in the cloud. Data protected by law, such as medical information or personal identifiers, should never be stored in the cloud unless the storage solution is encrypted. Only selected members of your organization should be able to decrypt the data, and your organization should create policies detailing under what circumstances information can be decrypted. · Understand how access is shared in your cloud folder. Many cloud storage providers allow you to share access to your online folders. Be familiar with the details on how that sharing works. Awareness of who has access and how is critical to monitoring activity within your stored data. Understand your options if the cloud provider is hacked or your data is lost. Virtually all cloud service providers require a user to sign an agreement that the user has very little, if any, remedy if a hack or a loss of data occurs. Cloud storage can be a valuable asset to medical practices and facilities, but make sure you have absolute confidence in the service provider’s ability to keep the data safe and secure. Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/ patientsafety. CMS
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 15
CMS MEMBERSHIP MEETING MINUTES
Teresa Skojac, M.D. – Tallahassee VA Outpatient Clinic
Minutes CMS Membership Meeting April 21, 2015
Mary Watson, M.D. (Resident) – TMH Family Medicine Residency Julia Weeks, M.D. – TMH Family Medicine Residency
The mission of the Capital Medical Society is to promote the practice of medicine for the ultimate benefit of the patient. I.
D. Introduction of new Jean McCully We Care Network R.N. Program Coordinator
Business Meeting – Capital Medical Society A. Welcome – Dr. Joshua Somerset, President, called the meeting to order at 6:30 pm. He welcomed the members and sponsors in attendance. Dr. Somerset thanked Westminster Oaks for use of their beautiful facility.
Dr. Somerset introduced and welcomed the new Jean McCully We Care Network R.N. Program Coordinator, Sue Michaels. Sue assumed the role of Program Coordinator in March and joins We Care with years of clinical experience.
B. Dr. Somerset thanked our sponsors for the evening:
E. CMS Member Benefits Dr. Somerset reminded the CMS members to take advantage of all the benefits their CMS membership offers. He also announced a new CMS member benefit, DocbookMD. Pam Wilson helped secure this exclusive HIPAA-secure messaging application. Dr. J. Daniell Rackley did a brief demonstration of the app.
Presenting Sponsor Physicians Indemnity, A Risk Retention Group – Dr. Kriston Kent and Steve Adler Meeting Sponsors Boehringer-Ingelheim – Cori Bennett and Anne Springer
II.
Pfizer/Bristol-Myers Squibb – Debra Placilla and Cynara Miller
Dr. Somerset announced upcoming events and meetings:
Sanofi – Gavin Boone and Tom Sferes
May 19, 2015 – CMS Membership/CME Meeting, “HCV – Back to the Future” by Amulya Konda, M.D., 6:00 pm, Maguire Center for Lifelong Learning
C. New Members Dr. Somerset announced five new CMS members approved since the last membership meeting: Russell Cole, M.D. – TMH Family Medicine Residency Natarajan Rajagopalan, M.D. – Capital Regional Pulmonary Associates
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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
Upcoming Events/Meetings
May 28, 2015 – Doctor/Daughter Banquet, 6:00 pm, Golden Eagle Country Club III.
Tonight’s CME Program – this is a 1 Hour Category One Program Topics: “Using Electronic Resources in Clinical Encounters” – “Using Resources in
CMS MEMBERSHIP MEETING MINUTES
Interactive Patient Encounters to Assist in Medical Decisions” and “Selecting the Best Medical Apps for Your Practice and Patients”
Meeting Sponsor, Sanofi: (l-r) Tom Sferes and Gavin Boone.
Speakers: Ken Brummel-Smith, M.D. and Nancy Clark, M.Ed. Dr. Brummel-Smith and Ms. Clark gave excellent and informative programs on useful electronic resources for CMS members. Physician CME Proof of Attendance Forms will be sent to participants who attend the entire CME program. IV.
Adjourn – Dr. Somerset adjourned the meeting at 7:45 pm.
One of our speakers for the evening, Dr. Ken BrummelSmith.
Presenting Sponsor, Physicians Indemnity, A Risk Retention Group: (l-r) Dr. Kriston Kent and Steve Adler.
Meeting Sponsor, BoehringerIngelheim: (l-r) Anne Springer and Cori Bennett.
One of our speakers for the evening, Ms. Nancy Clark.
Please Thank Our Sponsors for the April 21st CMS Membership Meeting Presenting Sponsor
Meeting Sponsors Meeting Sponsor, Pfizer/BristolMyers Squibb: (l-r) Debra Placilla and Cynara Miller.
Boehringer-Ingelheim Pfizer/Bristol-Myers Squibb Sanofi
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
17
FLORIDA BOARD OF MEDICINE
License Status Types for Renewal The different status types of a medical physician license can be confusing. The information below is to help you better understand the status of your license and the renewal requirements for each status. CLEAR ACTIVE – The licensed practitioner is clear to practice his/her profession in the state of Florida. The practitioner is obligated to update his/her profile data. To renew this license, the fee is $389. Note: For the renewal in 2016, licenses renewing “Active to Active” will see a onetime reduced fee of $279. This status is subject to the CME requirements shown below. CLEAR INACTIVE – The licensed practitioner is not authorized to practice in the state of Florida, but maintains a license. The practitioner is obligated to update his/her profile data, complete the Physician Workforce Survey, and update his/her financial responsibility. To change an active license to inactive status at renewal, the fee is $389. To renew this license “Inactive to Inactive”, the fee is $150. This status is subject to the CME requirements shown below. DELINQUENT – The licensed practitioner held a CLEAR ACTIVE or CLEAR INACTIVE license, but failed to renew the license by the expiration date. The licensed practitioner is not authorized to practice in the state of Florida. The practitioner is obligated to update his/her profile data and update his/her financial responsibility. The fees for renewing this status range from $510-$1099 and can be found under the Fees tab on http://flboardofmedicine. gov/medical-doctor-unrestricted. This status is subject to the CME requirements shown below.
18
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
RETIRED – The licensed practitioner is not practicing in the state of Florida, but maintains a retired license status. The licensed practitioner is not authorized to practice in the state of Florida. The practitioner is not obligated to update his/her profile data. The cost to change an active status license to a retired status at the time of renewal is $55. To request retired status, a physician must submit a signed statement which includes full name, license number, and mailing address. This status is NOT subject to the CME requirements shown below. CME Requirements: General Hours: 38 Medical Errors: 2 Domestic Violence: 2 Required every 3rd biennium-included in the 40 hours Please Note: The 2016 renewal represents the first year when reporting CME course completions will be mandatory. Are you renewal ready? The Florida Department of Health sends renewal notices to licensees at least 90 days prior to the expiration date of their license. We encourage you to verify that your mailing address is correct in our system to ensure receipt of the renewal notice.
FLORIDA BOARD OF MEDICINE
Where do you find the laws, rules and the Board web site?
Physician Extenders
Florida Statutes (laws): http://www.leg.state.fl.us/statutes/index.cfm
Physicians often supervise physician extenders in their daily practice. If you currently supervise any physician extenders or are considering supervising a Physician Assistant, an Advanced Registered Nurse Practitioner, an Anesthesiology Assistant or a Medical Assistant, take a few minutes and become familiar with the laws and rules related to supervising those extenders. Remember, the physician is responsible for the actions of the extenders he/she supervises. Grounds for Disciplinary Action; Action by the Board and the Department, Section 458.331(1)(dd), Florida Statutes, provides the following as grounds for disciplinary action: Failing to supervise adequately the activities of those physician assistants, paramedics, emergency medical technicians, advanced registered nurse practitioners, or anesthesiologist assistants acting under the supervision of the physician. Below are applicable laws and rules related to various physician extenders.
Florida Administrative Code (Rules): http://www.leg.state.fl.us/statutes/index.cfm Board’s website: http://www.FLBoardofMedicine.gov Sign up to receive, at no-cost, automatic e-mails containing information regarding every new item put on the Board website, including new laws, rules, alerts and advisories. You can subscribe and unsubscribe by going to the Board’s website, entering your email address and clicking “subscribe”.
Office Surgery Rule Changes DATE: April 7, 2015 TO: Physicians Registered for Office Surgery FROM: Office Surgery Registration and Inspection Program SUBJECT: Rule Changes Effective April 6, 2015 Rule 64B8-9.009, F.A.C. & Rule 64B15-14.007, F.A.C.
Extender
Law
Rule
Physician Assistants
s. 458.347, F.S.
Rules 64B8-30, F.A.C.
s. 458.348, F.S.
Anesthesiology Assistants
s. 458.3475, F.S.
Rules 64B8-31, F.A.C.
s. 458.348, F.S.
Rule 64B8-35, F.A.C.
Advanced Registered Nurse Practitioners
Medical Assistants
s. 458.3485, F.S.
NA
Recently, the Joint Boards of Medicine and Osteopathic Medicine Office Surgery Subcommittee made certain changes to Rule 64B8-9.009, F.A.C. (Medical version) and Rule 64B15-14.007, F.A.C. (Osteopathic version). The Committee determined that the rule regarding the standard of care for office surgery needed updating to: · Clarify the various levels of office surgery · Update anesthesia monitoring guidelines · Clarify training requirements · Clarify and update required equipment and supplies The rules can be found at https://www.flrules.org/.
CMS
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 19
MEDICAL/LEGAL
HEALTH CARE PROFESSIONALS FACE STRICT REPERCUSSIONS FOR MISUSE OF FLORIDA’S PRESCRIPTION DRUG MONITORING PROGRAM By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law After much political wrangling and lobbying, in 2009, Florida enacted the
the dispenser of a controlled substance to report the dispensing to the
Electronic-Florida Online Reporting of Controlled Substances Evaluation
PDMP. There are certain exceptions when reporting to the PDMP, such as
(E-FORCSE), currently codified in Section 893.055, Florida Statutes. More
when a physician or other health care practitioner administers or dispenses
often, it is referred to simply as the prescription drug monitoring program
a controlled substance to a person under the age of 16 years, dispensing
(PDMP) by Florida physicians.
medications within the Department of Corrections, or a pharmacist dispensing a one-time 72-hour emergency resupply of a controlled substance
Since the beginning, the PDMP has been plagued with issues ranging from
to a patient, see Section 893.055 (5), Florida Statutes.
funding, patient privacy concerns and the legal uses of the database. All health care professionals should know and understand the PDMP. The
PDMP Reports and Information Not Admissible in Evidence.
consequences of misusing the program could be devastating, even resulting in a felony charge.
As stated in the act itself, the reports and the information contained in the PDMP are not admissible into evidence in any civil or administrative action
Breach of Privacy Issues of Paramount Concern.
against a prescriber, dispenser, pharmacy or patient relating to the matters contained in the database. Section 893.055 (1)(a), states,
Major concerns expressed by Florida Governor Rick Scott and those who want to repeal the database center around the invasion of patient privacy and
“All advisory reports are for informational purposes only and
possible compromise of sensitive patient information. Florida has a history
impose no obligations of any nature of any legal duty on a
of legally protecting its citizens’ right to privacy, even including a specific
prescriber, dispenser, pharmacy, or patient . . . the advisory reports
article in its State Constitution, Section 1, Article 23, Florida Constitution.
issued by the Department [Department of Health] are not subject to
This constitutional provision specifically guaranteeing citizens of Florida
discovery or introduction into evidence in any civil or administrative
the right to privacy has been interpreted by court decisions as extending to
action against a prescriber, dispenser, pharmacy, or patient arising
the right to die, the right to a patient and his or her family to make private
out of matters that are the subject of the report; and a person who
decisions regarding the patient’s care without State intrusion, the right to be
participates in preparing, reviewing, issuing, or any other activity
free from government access to the patient’s medical information, and many
related to an advisory report may not be permitted or required to
other corollary rights associated with privacy.
testify in any such civil action as to any findings, recommendations, evaluations, opinions or other actions taken in connection with the
Legal Uses of the PDMP Database.
preparing, reviewing, or issuing such a report.”
The PDMP was not intended to be used for criminal prosecution or law
This means the information in the PDMP database cannot be used in a
enforcement purposes. The legislative intent is clearly stated within the
medical malpractice case against a physician or a pharmacist relating to
statute itself. The purpose of the prescription database is to assist physicians
incorrect prescribing, over prescribing, overdoses of patients and related
in detecting patients who went to different physicians and obtained multiple
issues. It also means that information in the database cannot be used against
prescriptions for narcotics to feed their addiction or to sell on the street.
a physician, pharmacist or other health care practitioner in a Department
Under the terms of the Florida law, anyone who dispenses a “controlled substance” is required to report that to the Florida database. “Controlled
of Health (DOH) complaint investigation or other disciplinary proceeding against that health professional’s license.
substance” is defined as any medication listed in Schedule II, Schedule III
If you are a defense attorney defending a physician, pharmacist or other
or Schedule IV, contained in Section 893.03, Florida Statutes. See Section
health care practitioner against malpractice allegations, violation of the
893.055 (1)(b), Florida Statutes.
standard of care allegations or administrative charges against that person’s
Pharmacies and other dispensers of medications may check the PDMP prior to filling a prescription in order to determine if a patient already has a filled prescription for the same medication from another pharmacy or
license, you should bring a motion to exclude such evidence and test money pursuant to Section 893.055 (1)(a), Florida Statutes. Breaches of Privacy Surround History of Database.
another doctor. There is no requirement placed on a pharmacy or dispenser of a medication to check the PDMP first. However, it is mandatory for
20 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
There have been breaches of privacy of the information contained in the
MEDICAL/LEGAL
database since its implementation. These were attributed by the lawmakers
authorized by the statute. Section 893.0551 (7), Florida Statutes states, “A
using it and then seeking to do away with it after it had been implemented.
person who willfully and knowingly violates this section commits a felony of the third degree, punishable as provided in [Florida Statutes].”
Law Enforcement Agencies are Restricted in Accessing PDMP. If you are a physician, and you obtain information from the PDMP on a Law enforcement agencies are prohibited from direct access of the
person who is not your current patient or for uses other than treatment of
information in the PDMP. However, upon a valid, authorized request,
the patient, you have committed a felony. If you are a pharmacist, and you
certain information may be released by the PDMP program manager.
access or obtain information from the PDMP on someone for whom you
Additional disclosures of the information contained in the PDMP for law
are not currently filling a prescription or dispensing a medication, you are
enforcement purposes are set forth in Section 893.0551 (3), Florida Statutes.
committing a felony.
There are procedural safeguards that are required in order to ensure that the request is from a properly authorized official and is only used for appropriate
Just because you have access to the PDMP does not mean that you have the
purposes. See Section 893.055 (7), Florida Statutes.
right to snoop into it. You may not obtain information on your ex-spouse, ex-spouse’s current spouse or significant other, your significant other, your
Privacy Protections for PDMP Set Forth in Section 893.0551. A separate Florida Statute was enacted exempting the PDMP and its information from the public records. Florida has broad laws allowing the release of public records to requestors. These are set forth in Chapter 119, Florida Statutes, and Article I, Section 24(a), Florida Constitution. Accessing PDMP Information Without Proper Authorization is a Felony. It is illegal for any physician, pharmacist or other person to access or
neighbor or your business partners. There have been a number of cases since the implementation of the PDMP where these situations arose. Violation of the PDMP’s requirements for accessing and using its information can also be ground for discipline against a licensed health professional’s license, whether a physician, dentist, nurse practitioner, physician assistant or pharmacist. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit www.TheHealthLawFirm.com.
CMS
obtain any confidential information from the PDMP, except as specifically
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
21
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 after completion of their residencies. In 2014, $40,000 in scholarships were awarded to nine FSU College of Medicine students.
The mission of the Capital Medical Society Foundation is to support the charitable efforts of physicians and others, increase access to healthcare, promote education and serve the community’s health needs through innovative projects that are exemplary, affordable and dignified.
Gifts to Honor and in Memoriam: 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 to meet our mission. You can donate any time to one of CMS Foundation’s funds. 1) The CMSF Endowment 2) The We Care Network Endowment 3) The Scholarship Fund
Checks should be made payable to the CMS Foundation and indicate on the memo line of your check to which fund you would like to donate. Bring your check to the CMS Office or mail it: Capital Medical Society ~ 1204 Miccosukee Road ~ Tallahassee, FL 32308.
22 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
CMS FOUNDATION: WE CARE NETWORK
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.
THANK YOU! To our CMS members and We Care partners who saw new patients for the We Care Network in April 2015. Your generosity and support of the We Care Network makes a difference. PHYSICIANS Greg Albright, D.O. Dhananjay Bendre, M.D. Robert Bradford, M.D. Tim Broeseker, M.D. Stephen Carr, M.D. Raymond Cottrell, M.D. Jeffrey Crooms, M.D. David Dolson, M.D. Alberto Fernandez, M.D. Michael Ford, M.D. Spencer Gilleon, M.D. Sergio Ginaldi, M.D. Larry Harper, M.D. Celeste Hart, M.D. David Huang, M.D. James Hunt, D.O. Iman Imanirad, M.D. Amit Jain, M.D. Farhat Khairallah, M.D. Arjun Kaji, M.D. Maribel Lockwood, M.D. Kurt Luhmann, M.D. Michael Mangan, M.D. Winston Ortiz, M.D. Steven Ostrov, M.D. Rodolfo Oviedo, M.D. Michael Pentaleri, M.D. James Renehan, M.D. Adrian Roberts, M.D. Andres Rodriguez, M.D.
Philip Sharp, M.D. Gadi Silberman, M.D. Jeannine Silberman, M.D. Robert Snider, M.D. Joshua Somerset, M.D. Bob Soni, M.D. Jeremy Sunseri, M.D. Mary Swain, M.D. Timothy Sweeney, M.D. Jean Paul Tran, M.D. Ernesto Umaña, M.D. William Yaakob, M.D. DENTISTS Eric Amundson, D.D.S. Susan Byrne, D.M.D. Walter Colón, D.M.D. William McFatter, D.D.S. E. Lynn McLarty, D.D.S. Jim McSoley, D.M.D. Lawrence Pijut, 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
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 April 2015 and your name is omitted.
We thank our referring providers from April 2015: Anne Ananga, ARNP
Esaias Lee, M.D.
Aaron Appiah, M.D.
Damon McMillan, M.D.
Janelle Baker, ARNP
T. Adam Oliver, M.D.
Dhananjay Bendre, M.D.
Rose Origa, ARNP
Daniel Breivogel, ARNP
Dianne Pappachristou, D.O.
Kendall Campbell, M.D.
Stephen Quintero, M.D.
David Cardman, D.M.D.
Temple Robinson, M.D.
Lysmar Dinguis, M.D.
Mark Saunders, M.D.
Shirley English, ARNP
Terry Sherraden, M.D.
Anneka Gaffney, ARNP
Jeannine Silberman, M.D.
Judy Griffin, ARNP
Matthew Standridge, M.D.
Muhanad Hasan, M.D.
Tallahassee VA Clinic
Hantz Hercule, M.D.
Richard Thacker, D.O.
Susan Horton, ARNP
Leonard Tolley, D.D.S.
Iman Imanirad, M.D.
Marianne Towler, ARNP
Amit Jain, M.D.
Jean Paul Tran, M.D.
David Kahn, M.D.
Chris VanSickle, M.D.
William Kepper, M.D.
Jeffrey Wasserman, D.O.
Howard Kessler, M.D.
Richard Zorn, M.D.
Elaine Larkins, ARNP
DURING THE MONTH OF APRIL, THE WE CARE NETWORK: RECEIVED 77 REFERRALS, WITH 42 PATIENTS NEW TO THE PROGRAM
SCHEDULED 82 APPOINTMENTS WITH VOLUNTEER PHYSICIANS AND DENTISTS
$78,285 IN DONATED CARE WAS REPORTED BY WE CARE VOLUNTEERS
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 23 23
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