Cap Scan - June 2018 by Capital Medical Society

JUNE EDITION, VOLUME 2018, NO. 6

NEW MANDATORY REQUIREMENT FOR 2-HOUR PRESCRIBING CONTROLLED SUBSTANCES M.D.s

D.O.s

New Mandatory Requirement for 2-Hour Prescribing Controlled Substances (Opioid) CME Course must be taken by January 31, 2019. All DEA licensed physicians that are authorized to prescribe controlled substances MUST complete a 2-hour continuing education course on prescribing controlled substances offered by a statewide professional organization.

This 2-hour course MUST be completed by January 31, 2019 and at each subsequent renewal.

The Florida Medical Association is offering this course at: https://flmedical.inreachce.com/ Details?groupId=c64bbce1-c037-4008-b6bd1204fd149224.

The Florida Osteopathic Medical Association is offering this course at: https://www. mytablemesa.com/courses/prescribingcontrolled-substances-FOMA-board-approvedCME?utm_source=Educator%20campaign&utm_ medium=FOMA%20Prescribing.

FMA Member Price: $25.00 FMA Non-Member Price: $75.00

FOMA Members: Complimentary (The course is being offered complimentary to FOMA members for this initial cycle - ending 1/31/19. If you are a FOMA member, please call their office at 850-878-7364 to gain access to the FOMA member discount code.) Non-FOMA members: $75.00

CAPITAL MEDICAL SOCIETY 2018 MEETINGS CALENDAR August 25, 2018 Connect the Docs CMS/CMSA Family Picnic 11:00 am – 2:00 pm Maclay Gardens ($6 entrance fee)

September 18, 2018 CMS Membership & CME Meeting Addressing the Opioid Epidemic (2-Hour CME) Panel: Justin French, Tallahassee Police Department; E. Victoria “Tori” Penny, J.D., Henry Buchanan, P.A.; Celeste Philip, M.D., Florida Surgeon General; Matthew Standridge, M.D., TMH Physician Partners; and Sam Ashoo, M.D., Tallahassee Memorial Hospital, Bixler Emergency Center, Moderator 6:00 pm - Maguire Center for Lifelong Learning at Westminster Oaks CONTINUED ON PAGE 10

BOARD OF GOVERNORS David Dixon, D.O., President

I N T H I S I SS U E :

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

Maribel Lockwood, M.D., President-Elect

Professional Notes......................................................................3 Practice Management................................................................5 Announcements..........................................................................6 CMS Membership Meeting Minutes........................................7 Viewpoint......................................................................................9 Alliance Corner........................................................................... 11 Dean’s Corner............................................................................. 12 Medical/Legal............................................................................ 14 CMS Foundation........................................................................ 18

Kenneth Whithaus, M.D., Secretary/Treasurer

CMS Foundation: We Care Network.................................... 19

Tracey Hellgren, M.D., Immediate Past President Christie Alexander, M.D. Todd Hewitt, M.D. Sarah Ho, President, CMS Alliance Rohan Joseph, M.D.

HAPPY BIRTHDAY!

Sarah Ko, M.D. Narayanan Krishnamoorthy, M.D.

{JUNE BIRTHDAYS}

Paresh Patel, M.D. Laurence Rosenberg, M.D. Cody VanLandingham, M.D. Julia Weeks, M.D. Pam Irwin, Executive Director, Capital Medical Society Family Medicine Residents Meredith Maxwell, M.D./Alex Vanderby, M.D. Internal Medicine Residents Tahir Motiwala, M.D./Cristin Sampson, M.D. General Surgery Residents Aaron Hayson, M.D./Justin Lee, M.D.

PUBLICATION EDITOR Frank Skilling, M.D.

MANAGING EDITOR Shannon Boyle

GRAPHIC DESIGN Gandy Printers

EDITOR EMERITUS Charles E. Moore, M.D.

ARE YOU INTERESTED IN WRITING AN ARTICLE FOR CAP SCAN?

Please contact 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. 2

Melissa Martin, M.D. – 1st Scott Asher, M.D. – 2nd Connie Speer, M.D. – 2nd Christopher Sundstrom, M.D. – 2nd A. Lane Janney, M.D. – 3rd James Killius, M.D. – 3rd Kirk Mauro, M.D. – 3rd Hiren Joshi, M.D. – 4th Winston Ortiz, M.D. – 5th Robert Glickenberger, M.D. – 6th Robert Ashmore, M.D. – 8th Shane Rignanese, M.D. – 8th Okanta Jackson, M.D. – 10th Suzanne Morgan, M.D. – 10th Alexander Ramirez, M.D. – 11th David Saint, M.D. – 11th Scott Sellinger, M.D. – 11th Timothy Bolek, M.D. – 12th Leonard Leichus, M.D. – 13th Earl McKenzie, III, M.D. – 13th Nancy Loeffler, M.D. – 14th

Scottie Whiddon, M.D. – 15th Carlos Zapata, M.D. – 17th Deanna Louie, M.D. – 18th Whit Oliver, M.D. – 18th Barbara Williams, M.D. – 19th William Yaakob, M.D. – 19th Jitendra Padalia, M.D. – 20th Frederic Vroom, M.D. – 20th Kristin Harmon, M.D. – 23rd Jose Mendoza, M.D. – 23rd Sam Moorer, M.D. – 23rd Joseph Mazziotta, M.D. – 24th Myrle Grate, Jr., M.D. – 25th Kishor Muniyappa, M.D. – 25th Madhuri Sankuratri, M.D. – 25th Ronald Saff, M.D. – 27th Leslie Emhof, M.D. – 28th Russell Cole, M.D. – 29th Margarett Conklin Ellison, M.D. – 29th Amit Jain, M.D. – 29th Alexandra Nevett-Fernandez, M.D. – 30th

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!

PROFESSIONAL NOTES

PROFESSIONAL NOTES Shannon Boyle celebrated her ten-year anniversary with Capital Medical Society on May 1, 2018. Shannon’s tenure has seen many changes and growth opportunities. Shannon started her career as an intern from FSU working 15 hours a week. She was quickly moved to full-time staff as an Outreach and Support Assistant. Her position and job description have evolved over the years due to Shannon’s strong organizational and event planning skills. As Communications and Events Coordinator, Shannon wears many hats, providing leadership for Cap Scan publications, CMS directory and brochure publications, assisting with the recruitment and contracting of We Care Network donating providers, event planning for Capital Medical Society and Capital Medical Society Foundation. She provides strong support to the Capital Medical Society FMA delegation at the FMA Annual Meeting. She also is the liaison for all organizational IT issues. Shannon has become an invaluable part of the CMS team during her ten years. “Not only is she the consummate professional, but she is also that humble colleague that has become a true friend to staff and the medical community,” says Pam Irwin, Executive Director. Shannon graduated from FSU-College of Communication with a Bachelor’s degree in Public Relations. She is a Tallahassee native and married to Michael Boyle. Their four-legged child Lucia likely does not know she is a dog. Congratulations, Shannon! Dr. David Jones, tuba player with the Yellow Dog Jazz Band was on hand at Tallahassee Museum’s Jazz and Blues Festival on April 28. A crowd favorite was “Bugle Call Rag.” For more information about The Yellow Dog Jazz Band or to book them for a private, commercial, or public events, visit yellowdogjazz.com. Nice job, Dr. Jones!

Scott Tetreault, M.D. and Cristina Chiodi, FSU College of Medicine Class of 2022, presented “Atypical Hemolytic Uremic Syndrome Complicating Myeloma Treatment” at the annual meeting of the European Society for Translational Medicine in Vienna, Austria on April 21, 2018.

Richard R. Thacker, D.O., FACOI (’92), is retiring from 23 years of private practice this summer and has accepted the position of Assistant Dean of Clinical Sciences and Clinical Resources at the Alabama College of Osteopathic Medicine (ACOM) in Dothan, Alabama. “I am excited to have the opportunity to mentor the future generation of osteopathic physicians,” said Thacker, who was president of the Florida Osteopathic Medical Association in 2006–2007 and currently serves on the American Osteopathic Association Board of Trustees. 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 3

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Hettie Spooner Lindsay Elliott Calynne Hill

(850)509-4337 (850)545-2463 (850)545-6140

PRACTICE MANAGEMENT

Capital Medical Society (850) 877-9018

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

ANNOUNCEMENTS

CAPITAL MEDICAL SOCIETY LUNCH AND LEARN SEMINARS Time: 12 Noon to 1:30 PM (Seminars start at 12:30 PM) Place: CHP Auditorium, 2nd Floor, 1491 Governors Square Blvd. Cost: $10 per person, per seminar On April 18th, Bert Mitchell gave an excellent program on retaining good employees.

We thank Medical AR Revenue Solutions, LLC for sponsoring the April 18th Lunch and Learn. J.R. Blue and Sheila Erwin attended as representatives from Medical AR Revenue Solutions, LLC.

Seminars are held at the Capital Health Plan on Governors Square Blvd – and we thank them for providing this venue to us.

MARK YOUR CALENDARS FOR THE FALL 2018 LUNCH AND LEARN SEMINARS September 19, 2018 – Patient Compliance October 17, 2018 – Interviewing and Background Checks November 14, 2018 – Patient Collections

We will send out more information about these seminars as they get closer.

For more information or to RSVP, please contact Rosalie Carlin at (850) 877-9018 or rcarlin@capmed.org.

IN MEMORIAM

J. Richard Taylor, M.D. 1938 - 2018

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

ANYONE LOOKING TO PLAY CHESS? Call Joel Kramer (retired doc) 385-2095 or 556-8032

CMS MEMBERSHIP MEETING MINUTES

MINUTES: CMS MEMBERSHIP MEETING APRIL 13, 2018 The mission of the Capital Medical Society is to promote the practice of medicine for the ultimate benefit of the patient. I. Business Meeting – Capital Medical Society A. Welcome – Dr. David Dixon, President, called the meeting to order at 6:30 pm. Dr. Dixon thanked Westminster Oaks for use of their incredible facility. He invited Robyn Stevenson, RN, Nurse Liaison with Westminster Oaks to say a few words about their facility. B. Dr. Dixon welcomed and thanked our supporters for the evening:

Lucas Watkins, M.D., TMH Physician Partners, Surgical Specialists Chien-Yi Ruby Williams, M.D., TMHPP Pulmonary, Critical Care & Sleep Specialists Charles Yowell, M.D., TMHPP Urology Specialists Brian Zirgibel, M.D., Tallahassee Orthopedic Clinic b. Dr. Dixon introduced a new CMS Member and a visiting psychiatrist in attendance: Beverly A. Johnson, M.D., Dermatology Associates Allesa English, M.D., psychiatrist

Grantor MagMutual Foundation Presenting Sponsor Tallahassee Memorial HealthCare – Andrea Friall, M.D. Meeting Sponsor MagMutual – Staige Hoffman Displayers Bristol-Myers Squibb – Cynara Miller Novo Nordisk, Inc. – Michelle Glazier C. New Members a. Dr. Dixon announced 15 new members approved since the last membership meeting: Kenneth DeLay, M.D., Advanced Urology Institute Beverly A. Johnson, M.D., Dermatology Associates J. Lucas Koberda, M.D., Tallahassee Neurobalance Center Frank Lomagistro, M.D., Retired Nicky Nelson, M.D., TMH Physician Partners Hospitalists Mary Norton, M.D., FSU College of Medicine Chukwuma M. Okoroji, M.D., Nature Coast Women’s Care Mitchell Peabody, D.O., TMH Physician Partners, Cancer & Hematology Specialists Jorge Perez-De Armas, M.D., TMH Physician Partners, Cancer & Hematology Specialists Andras Schaffer, M.D., Dermatology Associates Eugene Wang, M.D., Tallahassee Neurology Specialists

c. Dr. Dixon recognized Dr. John Katopodis, FMA President and invited him to say a few words. Dr. Katopodis shared that the FMA just launched a resources page on their website dedicated solely to physician wellness. d. Dr. Dixon gave a brief overview of the new CMSF Physician Wellness Program. He recognized and thanked the Physician Wellness Committee: Faisal Munasifi, M.D., Chair Nicole Balmer, M.D. Alma Littles, M.D. Maribel Lockwood, M.D. John Mahoney, M.D. Julia Weeks, M.D. He also introduced one of the psychologists participating in the Physician Wellness Program: Tracey Morse, Ph.D. D. Mark Your Calendars Dr. Dixon announced the upcoming meetings/events: Tuesday, May 15 – 6:00 pm CME/Membership Meeting Maguire Center for Lifelong Learning Topic: “Advances in Minimally-Invasive Neurosurgery” Speaker: Narlin Beaty, M.D. Thursday, June 7 – 5:30-8:30 pm Doctor/Daughter Event Golden Eagle Country Club

CONTINUED ON NEXT PAGE

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 7

CMS MEMBERSHIP MEETING MINUTES

II. Tonight’s Program Topic: Stress in Medical Practice: Avoiding Risks of Burnout and Suicide Speaker: Stefan Pasternack, M.D. Dr. Pasternack gave an excellent and informative program on stress in the medical practice.

CME Proof of Attendance Forms will be sent to participants who stay for the entire CME program and fill out an evaluation form. Please turn completed evaluation forms in at the end of the program. III. Adjourn – Dr. Dixon adjourned the meeting at 7:45 pm.

4 Captions for above photos:

4 – Displayer, Novo Nordisk, Inc.: Michelle Glazier.

1 – Presenting Sponsor, Tallahassee Memorial HealthCare: Andrea Friall, M.D.

5 – (L-r) David Dixon, D.O., CMS President; Stefan Pasternack, M.D., Speaker; and John Katopodis, M.D., FMA President.

2 – Meeting Sponsor, MagMutual: Staige Hoffman. 3 – (L-r) Cyneetha Strong, M.D. with Displayer, Bristol-Myers Squibb: Cynara Miller.

6 – (L-r) Faisal Munasifi, M.D., Chair, CMSF Physician Wellness Committee with Stefan Pasternack, M.D., Speaker.

Please Thank Our Supporters for the April 13th CMS Membership Meeting Grantor Meeting Sponsor MagMutual Presenting Sponsor

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Displayers Bristol-Myers Squibb Novo Nordisk, Inc.

VIEWPOINT

THE DESCENT INTO DANTE’S INFERNO: SURVIVING A MALPRACTICE TRIAL By John P. Mahoney, M.D. I was sued several years ago by the family of a young woman who died of metastatic breast cancer. My professional association, another pathologist, and a treating physician were also defendants. My involvement was solely in the interpretation of laboratory tests on her offsite surgical specimen. The plaintiffs alleged that the patient could have survived had test results been properly reported allowing her to receive additional post-operative therapy. We received notice of intent to file the suit four years after the laboratory tests had been performed. I had absolutely no recognition of this case. After notifying our insurance carrier, a defense attorney contacted and informed me that my mind, memories, and communications would be indefinitely frozen. Although allowed to review my own reports and the test materials, there should be no discussions with anyone else including close friends, my partners, and even my wife. This physician was, in short, bound, gagged and thrown into a virtual dark closet by the attorney assigned to protect me from myself. In retrospect, this was done to protect all the defendants during the legal process of pre-trial discovery. Having testified many times in open court as a forensic pathologist, my experiences should have been an asset. The problem was that my previous testimonies as a witness for the deceased elucidated the manner and causes of death in criminal trials. I enjoyed the role of expert witness, having the luxury of explaining to the court and the jury in a manner that was explanatory and, if necessary, lengthy. This role avoided using short “yes” or “no” answers because such brevity might be misleading to a jury. During my deposition taken many months before the trial, I was transformed from being a confident, cooperative expert witness to a defendant. My attorney advised brief truthful answers and to avoid giving detailed explanations that might later be manipulated to impeach our testimony during the trial. However, my ingrained teaching role as a forensic pathologist broke through the deposition: explaining the “art of medicine” instead of succinctly answering questions. In short, I had

twenty-seven years’ experience as a pathologist and only one day as the defendant in a civil lawsuit. While depositions were being taken, attorneys for both sides were negotiating for an out of court settlement. Our side conceded that an important correlation between the surgical report and outside laboratory tests had not been performed, but the appropriate surgery and therapy had been done. The plaintiffs’ attorneys felt that they could secure a larger judgment by going to trial. Once it was clear that there would not be an out of court settlement, our attorney allowed preparatory talks with my wife and children. This physician did not anticipate the profound effect that this would have on our family and what this trial would ultimately do to me. I also came to realize the value of true friends, family and physician support through the crisis. By the time of the trial, I was prepared to testify before a jury justifying my decisions, often rehearsing my testimony in my long walks to and from the hospital every day. Although prepared, my behaviors changed: pacing constantly during leisure times, talking to myself, avoiding people, eating only one meal a day, and worst of all, sleeping only two to four hours a night. I did not sense depression but was obsessed with thinking about the trial with anger about the delay in testifying. I wanted to tell my story to the judge and jury, stopping this obsession and sleeping peacefully again. On the stand, I felt no anger or nervousness. I was anxious about not getting into my “teaching mode” and acting like a professor and not the defendant. Our expert witness for the defense agreed with my reports. Afterwards, leaving the court room, my wife and close friends went to dinner. I had two martinis, two beers, and a large glass of red wine. I was going to sleep that night for sure! But two hours after getting in bed, I awoke with a familiar pattern: mumbling, pacing and reviewing my testimony. My mind would not reboot and enter sleep mode. This was the first time I was aware of profound anxiety and the need for immediate help. Driving unannounced to my physician’s house for professional counselling, I was weeping as he opened the door. He asked if someone CONTINUED ON NEXT PAGE

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 9

VIEWPOINT

CONTINUED FROM PREVIOUS PAGE

had died in my family. My response, “They’re killing me. Can you help?” After talking with him for hours, there was overwhelming relief, later uninterrupted sleep. Although the trial lasted several more days, there was palpable relief during this period. The jury found that our professional association was at fault because of a processing error in a hospital employee’s laboratory protocol. The three physician defendants were not found negligent. The judgment given by the jury was for a lesser amount than what our side offered to settle for in pre-trial meetings. In short, the plaintiffs had not proved their case against me.

If you have the misfortune of being sued for professional malpractice, mentally prepare for the onslaught that you will face during the trial. All defense attorneys should have a heightened awareness of their client’s legal naiveté even if the physician has familiarity with the legal system. It may be advisable for defendants to consider pretrial mental health consultation in pending medical malpractice cases. We are mere babes in the woods in the legal system. The forces arrayed against us and our families are impressive and, at times, vicious and destructive. You are not invincible, and you should not go alone into this house of horrors.

Yet the anguish remained for a long time. The emotional toll of a malpractice trial should have prompted me to seek counseling earlier. Trapped in a dark closet, my mind was on the outer circle of an inferno of my own making. I should have discussed my burden with a healthcare professional, fallaciously believing that I, as a physician, should shoulder it alone.

CAPITAL MEDICAL SOCIETY 2018 MEETINGS CALENDAR CONT. FROM COVER

September 27, 2018 Connect the Docs Happy Hour sponsored by Capital City Bank 6:00 pm – 8:00 pm The Wine House (1355 Market Street, A1) October 16, 2018 CMS Membership & CME Meeting Domestic Violence & Human Trafficking (2-Hour CME) Suzanne Harrison, M.D., FSU College of Medicine and Terry Coonan, J.D., Center for the Advancement of Human Rights 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks

10 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

November 13, 2018 CMS Membership & CME Meeting Health Impact of Common Electronic Devices Alice Pomidor, M.D. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks December 6, 2018 CMS Foundation Holiday Auction 6:30 pm FSU University Center Club

ALLIANCE CORNER

ALLIANCE CORNER By Sarah Ho, CMSA President We hope everyone has a great summer, and look forward to the following events in the Fall. September 12, 2018 Fall Kickoff Social Welcoming New Members Location: Home of Melissa Inglese Time: 11:00 am (Lunch sponsored by Diana Cureton with Hancock Bank) September 26, 2018 Past Presidents Luncheon Location: Table 23 Time: 11:00 am - 1:00 pm Speaker: Dr. Linda Miles

The Alliance has had a busy couple of months. Our successful partnership in March with the CMS Foundation enabled us to present our community outreach partner, Hang Tough Foundation, with a check for over $450. In April, we had a beautiful day for our FMAA Walk for Wellness.

October 11, 2018 Wine & Whiskey Tasting Fundraiser Location: Home of Kelly and Hank Hutchinson Time: 6:30 pm - 8:30 pm Cost: $50/person October 24, 2018 Joanna Francis Living Well Foundation Location: TBD Time: 10:00 am Speaker: Jennifer Taylor, Chairman of the Board

In April, we also toured the FSU College of Nursing, and presented them with a scholarship check.

SAVE THE DATE Capital Medical Society and Capital Medical Society Alliance

Family Picnic Saturday, August 25, 2018 11am â€“ 2pm Maclay Gardens State Park ($6.00 entrance fee) Food Truck, Face Painting, Games, and Lots of Fun! Invitations will be emailed in late July. We hope to see you there! CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 11

DEAN'S CORNER

DEAN’S CORNER TOGETHER WE’RE INCREASING ACCESS TO CARE By John Fogarty, M.D., Dean, FSU College of Medicine Late this summer, 10 years will have passed since the first FSU College of Medicine graduates entered practice.

their teachers. Not counting those who will finish their GME work this summer, we now have 588 alumni in practice.

Of all the outcomes a medical school can share, likely none are more important than, “What kinds of physicians are you producing?”

This medical school’s roots are in Florida’s quest to provide more doctors for rural northwest Florida. Our mission grew from that original effort to produce physicians who would address needs in underserved communities throughout the state.

In what seems like the blink of an eye, we’ve collected a catalog full of data about how we’re doing in that regard. And this seems like a good time to share some of our numbers with you. Twenty-seven members of our inaugural Class of 2005 entered residency training, and 14 of those graduated to direct patient care in summer 2008 – eight in emergency medicine, four in family medicine and one each in pediatrics and internal medicine. Seven of those alumni physicians spent all four years of medical school in Tallahassee, meaning many of you in the local medical community taught them as both preceptors and clerkship faculty. Maybe that’s why so many of you expressed pride in seeing the first of our alumni transition to patient care. And it’s why I think you’ll share my pride in what we’ve accomplished together in such a short time. Today we have 1,255 alumni, all of whom began their clinical training here in Tallahassee with many of you as

Eighty-four of our alumni physicians are practicing in the Panhandle and border counties – from Perry to Pensacola. Thirty-seven are practicing in Tallahassee, and another 14 are nearby in Quincy, Thomasville, Cairo, Bainbridge, Marianna and Blountstown. While about 70 percent of our alumni leave Florida for residency training each year, nearly 60 percent are now in practice in Florida. That’s a strong indication that where (and how) they get their clinical education during medical school is influencing where they end up practicing. Another interesting fact about our alumni physicians is that almost 75 percent are practicing in one of six specialties: family medicine, emergency medicine, internal medicine, pediatrics, OB-GYN or general surgery. Thanks for the great teaching you provide our students. These numbers are one more indication of the healthy impact you’re having on patients throughout Florida – and beyond.

PHYSICIANS WHO ACCEPTED PAYMENTS FROM A PHARMACEUTICAL COMPANY RELATED TO A SPECIFIC OPIOID WERE 14.5 TIMES MORE LIKELY TO PRESCRIBE THAT DRUG OVER A SIMILAR ALTERNATIVE. SOURCE: CAREDASH.COM ANALYSIS OF 2014-2016 DATA FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND MEDICARE PART D PRESCRIPTIONS

12 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 5/9/18 8:37 AM13

MEDICAL/LEGAL

IMPROVING MEDICAL OFFICE COMMUNICATION AND SAFETY By David O. Hester, FASHRM, CPHRM, Director, Department of Patient Safety and Risk Management Each member of a medical care team plays an important role in reducing the number of incidents that can cause patient dissatisfaction, injury, and lawsuits. Communication with Hospitals, Labs, and Other Healthcare Providers Physicians and staff members interact with other health professionals and facilities regarding many aspects of patient care. It is vital to develop effective procedures for handling calls and test results received from outside departments—including nursing, laboratory, pathology, and radiology—and from any other consulting services. Include the following instructions in your procedures for staff members who handle calls and reports: • Document the details when receiving diagnostic results or information about a patient referral over the telephone, and read it back to verify accuracy. Verify the spelling of the caller’s name, and obtain the necessary information for a call back. • Obtain adequate information to allow the physician to make an appropriate evaluation of the call’s priority. For example, ask if the laboratory is reporting an urgent finding, a panic value, or a routine test result. • Note in the patient’s record the date, time, and degree of urgency of every call. • When calling another physician’s office to make an appointment, state the patient’s name and phone number, reason for the call, degree of urgency, and whether the patient is being sent for consultation or referral. Record in the patient’s chart the date, time, and name of the person who received the call. Request notification if the patient does not keep the appointment; document that information in the patient record, and inform the physician. Consideration should be given to obtaining an informed refusal attestation in follow-up. • Be particularly alert to laboratory, radiology, and pathology reports and to consultation letters from other physicians. Reports and letters should be reviewed, dated, and initialed by the ordering 14 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

physician and should not be filed without the physician’s initials. • Develop and use a tracking system for all tests, procedures, and consultations ordered to ensure that results are received in a timely manner, properly relayed to the patient, and follow-up is documented. Communication in the Medical Office Improve office communication and documentation by following these tips: • Establish communication procedures that promote efficient transmission of information and prevent messages from being overlooked or misinterpreted. • Schedule regular office staff meetings to improve communications, resolve problems, and develop a better understanding of each other’s job descriptions. • Document missed and canceled appointments in a patient’s chart, and always bring patient nonadherence to the physician’s attention. Establish a missed appointment protocol that outlines the appropriate follow-up action and is consistent with state and federal privacy laws. Document all efforts to contact the patient, including copies of letters sent. • Identify and update the patient’s allergy information during each encounter, and document it in a prominent and readily accessible location. Ensure that all physicians and staff know where to document and review allergy information. • Correct billing and collection errors promptly. If a dispute occurs, stop all billing action until the issue is resolved. The treating physician needs to review an account prior to pursuing collection action. Be sensitive to specific patient circumstances, and work with patients to resolve unpaid balances prior to pursuing collection action. • Establish collection protocols that are consistent with evolving state and federal laws. The protocols should be consistent with required standards and applicable payer contracts.

MEDICAL/LEGAL

Emergency Response

Summary

Prepare for emergency situations by following these tips:

All physicians and staff are responsible for improving office procedures and communications. By following the guidelines in this article, you can create a safer patient care environment.

• Have a written protocol for managing medical emergencies that defines the role of staff member responders. Perform regular practice drills. • Ensure that all staff who deal directly with patients are trained in cardiopulmonary resuscitation. • Make sure all relevant staff know the location and proper use of oxygen, resuscitative equipment, and drugs for emergent conditions. • Inspect emergency drugs periodically for expiration dates, and check emergency equipment and supplies to ensure readiness to respond. • Log all drug and equipment inspections and the corrective actions taken. The log entry needs to be dated and include the initials of the staff member conducting the activity. • Have written protocols for handling bomb threats, armed intruders, and individuals exhibiting threatening behaviors. Ensure staff training, perform regular practice drills, and document in human resource files. • Have written protocols for handling natural disasters. Ensure staff training, perform regular practice drills, and document in human resource files.

________________________________________ The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered. -------------------Contributed by The Doctors Company (thedoctors. com)

Equipment Safety These tips can help you and your staff provide a safe environment for patients: • Maintain a schedule for preventive maintenance of equipment. Log the activity with a reminder of when the next scheduled maintenance should take place. • Ensure new staff members with clinical responsibilities are trained in the correct use of equipment. Document all training in human resource files. • Ensure that all electrical equipment is properly grounded. • Report equipment malfunctions to the appropriate person in your organization or office. Stop using defective equipment until it is repaired, and mark it clearly that the equipment is out of service. CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 15

WE’VE MOVED! As of April 2nd, our new address is

2617 Mitcham Drive, Suite 102, Tallahassee, FL 32308 Reliable, comprehensive care for your patients with kidney disease and hypertension.

Avon Doll, Jr., MD

Hari Kolli, MD

Sayeed Khalillullah, MD

Kaushal Patel, MD

Serving Tallahassee and surrounding counties since 1975. (850) 878-1171 • (850) 942-1291 fax • nfnephrology.com

CAPITAL REGIONAL MEDICAL CENTER WELCOMES

SHAYIBU HARRUNA, MD Capital Regional’s Physician Network-of-Care is committed to delivering high quality and compassionate care. At Capital Regional Cardiology Associates, our cardiologists diagnose and treat cardiovascular disease. We provide expert care and use the latest technology to help our patients improve their overall heart health.

Our Cardiology Services Include: • Cardiovascular Disease • Clinical cardiology including management of high blood pressure and cholesterol • Cardiac Catheterization via femoral (leg) and radial (arm) approach • Interventional Cardiology

• Echocardiography • Nuclear Cardiology • Stress Testing

GO ONLINE OR CALL US TO SCHEDULE YOUR APPOINTMENT TODAY

2770 Capital Medical Blvd., Suite 109-C | Tallahassee, FL 32308 | (850) 877-0320 | capitalregionalca.com 16

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Tallahassee Neurology Specialists Welcomes

Dr. Eugene Wang! Dr. Wang is board certified in neurology, pain medicine and neuroimaging. He earned his medical degree from Pennsylvania State University College of Medicine after receiving honors from the Johns Hopkins Universityâ€™s five-year neuroscience program. Dr. Wang trained in Neurology residency at the prestigious University of Chicago Hospitals in Chicago, and subsequently underwent fellowship training in pain management at Thomas Jefferson University Hospitals in Philadelphia and in neuroimaging at the Dent Neurologic Institute in Buffalo, NY. Receiving many accolades throughout his career, he has had multiple research publications in major peer-reviewed pain journals.

Tallahassee Neurology Specialists and Dr. Roland Jones are very excited to welcome Dr. Eugene Wang to our practice.

He joins Tallahassee Neurology Specialists from Coastal Spine & Pain Center in Jacksonville Florida where he served as an interventional pain physician and neuroimager, and more recently served as Principal Investigator for several high profile clinical research studies at Coastal Clinical Research Specialists. Dr. Wang is a member of the American Society of Interventional Pain Physicians, American Interventional Headache Society, American Academy of Neurology, American Society of Neuroimaging, and the Spine Intervention Society. Dr. Wang is married to his wife Sing Your, who is an accomplished Ophthalmologist, and they have 3 beautiful children. Aside from being a busy father of 3 energetic children, Dr. Wang also enjoys classical music, racquetball, tennis, traveling, and trying new restaurants.

We are located at 1401 Oven Park Dr. Tallahassee Florida 32308. Office: 850-765-8623 ~ Fax: 850 765 0118 ~ tallahasseeneuro.com Tallahassee Neurology Specialists provides medical services for Neurology and Interventional & Multidisciplinary Pain Management. We accept most major insurances including CHP, Blue Cross, Cigna, Aetna, Medicare and Medicare Advantage Plans as well as others.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS FOUNDATION

The Impact of Private Support: Capital Medical Society Foundation’s community of donors strategically help fulfill its mission “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.”

➢ Access to healthcare is increased through gifts to We Care Network and the We

Donate to the CMS Foundation We Thank Our Donors We thank the following organizations who made a donation to the CMS Foundation this past month: We Care Network Charles A. Frueauff Foundation

Care Network Endowment Fund. More than $90 million in donated specialty medical and dental care has been provided to low-income, uninsured patients since the program was created in 1992. In fiscal year 2016-17, which ended June 30, 2017, more than $10.9 million in health care was donated. Gifts support the salaries and benefits of the case management team who coordinate donated care. ➢ To provide incentives to keep medical students trained at FSU College of Medicine in the Big Bend after completion of their residencies and help meet the growing demand for physicians in Florida, gifts to the Scholarship Fund provide scholarships to FSU College of Medicine students who have expressed an interest in returning to the Big Bend to practice after completion of their residencies. $47,000 was distributed to eight medical students in 2017. ➢ Gifts to Capital Medical Society Foundation help provide operation resources for Capital Medical Society Foundation. In addition, modest grants to area non-profits whose programs improve access to health care for the underserved. In 2017, CMSF awarded $10,000 in grants to Elder Care for their In-Home Services Program and to CMSF’s Physician Wellness Program. 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 Foundation will send an acknowledgement letter to those you memorialize and honor. How to Give: Through the generosity of donors, funds have been created in order to establish financial stability to meet our mission. You can donate at any time to one of CMS Foundation’s current funds: 1) Capital Medical Society Foundation-area of greatest need 2) The Capital Medical Society Foundation Endowment 3) We Care Network 4) We Care Network Endowment 5) Scholarship Fund 6) The Ronald G. Pickett Endowment 7) Physician Wellness Fund Checks should be made payable to the CMS Foundation and indicate on the memo line of your check to which designation you would like to donate. Bring your check to the CMS Office or mail it: Capital Medical Society ~ 1204 Miccosukee Road ~ Tallahassee, FL 32308. Donations may be made by credit card from the CMS website.

Your gifts to Capital Medical Society Foundation transform lives in the Big Bend.

If you would like to discuss a gift of appreciated securities, an insurance policy, designation of retirement plan assets, estate gift, or multi-year pledge, please contact: Pam Irwin Executive Director pirwin@capmed.org or (850) 877-9018

CMS FOUNDATION: WE CARE NETWORK

William Thompson, M.D. Ernesto Umana, M.D. David Vermess, M.D. Graham Whitaker, M.D. William Yaakob, M.D. Daniel Yang, M.D. FOUNDATION

We Care Network

THANK YOU To our CMS members and We Care partners who saw new patients for the We Care Network in April 2018. Your generosity and support of the We Care Network makes a difference. Physicians Gregg Alexander, M.D. Scott Asher, M.D. Emily Ashmore, M.D. Dhananjay Bendre, M.D. Acquinonette Bryant, M.D. Viet Bui, M.D. David Burns, M.D. Stephen Carr, M.D. Michael Cavallaro, M.D. George Cohen, M.D. Raymond Cottrell, M.D. Kenneth DeLay, M.D. William Dixon IV, M.D. Ray Dolly, M.D. David Dolson, M.D. David Durden, M.D. Margaret Ellison, M.D. Alberto Fernandez, M.D. Hong Gao, M.D. Gian-Carlo Giove, M.D. W. Harris Green, M.D. Aaron Guyer, M.D. Jerry Harris, M.D. Iman Imanirad, M.D. Barbara Jaeger, M.D. Amit Jain, M.D. Arjun Kaji, M.D. James Killius, M.D. Hari Kolli, M.D. Amulya Konda, M.D. Matthew Lee, M.D. Carey Linker, M.D. Maribel Lockwood, M.D. Deanna Louie, M.D. Kurt Luhmann, M.D. Michael Mangan, M.D. Ovidiu Marina, M.D. Hector Mejia, M.D. Jayan Nair, M.D. Kaushal Patel, M.D. Timothy Paulk, M.D. Jorge Perez de Armas, M.D. J. Daniell Rackley, M.D. Shawn Ramsey, D.O. Adrian Roberts, M.D. Andres Rodriguez, M.D. Laurence Rosenberg, M.D. Andras Schaffer, M.D. Philip Sharp, M.D. Eliot Sieloff, M.D. Gadi Silberman, M.D. Justin Simonds, M.D. Hardeep Singh, M.D. Francis Skilling, M.D. Robert Snider, M.D. Joshua Somerset, M.D. Christopher Sundstrom, M.D. Timothy Sweeney, M.D. John Thabes, M.D.

Dentists Jean-Pierre Bastien, D.M.D. Labon Bontrager, D.M.D. Heather Burch, D.M.D. Walter Colon, D.M.D. William McFatter, D.D.S. Jim McSoley, D.M.D. Ralph Montalvo, D.M.D. Russell Rainey, D.M.D. Frank Swerdzewski, D.D.S. Facilities Advanced Dental Care Advanced Urology Institute Apalachee Primary Care Anesthesiology Associates Bastien Dental Care Beachton Denture Clinic Bond Community Health Center Bristol Dental Clinic Capital Health Plan Capital Regional Cancer Center Capital Regional Medical Center Capital Regional Women’s Health Care Point Health & Wellness Center Dermatology Associates Desloge Home Oxygen Digestive Disease Clinic Eye Associates of Tallahassee Gadsden County Health Department Jasmine Womens Center Jessie Furlow Medical Center Ketchum, Wood, & Burgert Pathology Associates Madison Medical Center Neighborhood Medical Center North Florida Nephrology Associates North Florida Women’s Care Periodontal Associates Radiology Associates of Tallahassee Smile Connection at Bond Community Health Center Southeastern Plastic Surgery Southern Medical Group, P.A. Southern Vitreoretinal Associates Tallahassee Diagnostic Imaging Tallahassee Ear, Nose, and Throat Tallahassee Memorial HealthCare TMH Family Medicine Residency Program TMH Physician Partners Cancer & Hematology TMH Physician Partners Cardiology and Internal Medicine TMH Physician Partners Gynecologic Oncology Specialists TMH Physician Partners Pulmonary, Critical Care, and Sleep Specialists TMH Physician Partners Radiation Oncology Specialists TMH Physician Partners Surgical Specialists TMH Physician Partners Quincy TMH Physician Partners Urology Specialists TMH Rehabilitation TMH Transition Center Tallahassee Orthopedic Clinic Tallahassee Surgical Associates Tallahassee VA Clinic Wakulla County Health Department Wakulla Medical Center Walton & Cardman Dentistry Women’s Imaging Center

Please contact Diana Bixler at dbixler@capmed.org or 201-0130 if you are a We Care volunteer and you provided volunteer specialty care in the month of April 2018 and your name is omitted. 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. Also, up to five hours, per biennium, of CE credit may be fulfilled by performing pro bono medical and dental services to We Care Network patients, if we have received documentation of value of services. You can send your value of donated services via fax to Diana Bixler at (850) 201-0085 or mail to 1204 Miccosukee Road, Tallahassee, FL, 32308. Thank you!

We thank our referring providers from April 2018: Joy Ablordeppey, M.D. Ebonie Allen, ARNP Anne Ananga, ARNP Mary Jane Bailey, ARNP Joseph Baker, M.D. Karen Bartley, M.D. Megan Bassett, ARNP Dhananjay Bendre, M.D. Camille Blake, D.O. Jonna Bradley, ARNP Daniel Breivogel, ARNP Acquinonette Bryant, M.D. Viet Bui, M.D. David Cardman, D.M.D. Doris Carmichael, ARNP Lysmar Carrion-Dinguis, M.D. Jordan Cherkinsky, D.D.S. Jeffrey Crooms, M.D. David Dixon, D.O. William Dixon IV, M.D. Suma Dondapati, M.D. Margarett Ellison, M.D. Shirley English, ARNP Sharron Foster, M.D. Akash Ghai, M.D. Gian-Carlo Giove, M.D. Judy Griffin, ARNP Hantz Hercule, M.D. Dwight Hooper, M.D. David Huang, M.D. Amit Jain, M.D. David Khan, M.D. John Katopodis, M.D. Farhat Khairallah, M.D. Hari Kolli, M.D. Elaine Larkins, ARNP Damon McMillan, M.D. Hector Mejia, M.D.

Donald Michel, M.D. Kelly Miller, ARNP Marcia Morris, ARNP Jayan Nair, M.D. Rose Origa, ARNP Kaushal Patel, M.D. Kyara Paulk, ARNP Lisa Perkins, ARNP Jessica Proxmire, ARNP Charlie Richardson, M.D. Adrian Roberts, M.D. Andres Rodriguez, M.D. Laurence Rosenberg, M.D. Lucilita Salvador, PA Ryan Sanderson-Smith, M.D. Less Shrestha, M.D. Eliot Sieloff, M.D. Jeanine Silberman, M.D. Hardeep Singh, M.D. Joshua Somerset, M.D. Abisoye Somorin, ARNP Alanna Steaple, ARNP Christopher Sundstrom, M.D. John Thabes, M.D. Lacie Thompson, ARNP Faye Tinson, ARNP Leonard Tolley, D.D.S. Marianne Towler, ARNP Ernesto Umana, M.D. Dwanna Ward-Boahen, ARNP Jeffrey Wasserman, D.O. Lucas Watkins, M.D. Eula Weaver, ARNP Graham Whitaker, M.D. Chien-Yi Williams, M.D. Dianna Willis, ARNP

DURING THE MONTH OF APRIL, THE WE CARE NETWORK: RECEIVED 228 REFERRALS, WITH 33 PATIENTS NEW TO THE PROGRAM

SCHEDULED 210 APPOINTMENTS WITH VOLUNTEER PHYSICIANS AND DENTISTS

$268,213.71 IN DONATED CARE WAS REPORTED BY WE CARE VOLUNTEERS

Prsrt. Std. U.S. Postage

PAID Tallahassee, FL Permit 801

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