Cap Scan - August 2020

AUGUST EDITION, VOLUME 2020, NO. 8

Though the 2020 Celebration Awards Dinner was postponed due to COVID-19 concerns, we want to recognize our generous sponsors.

These are our colleagues and businesses who have made an investment in our medical community. We encourage you to thank them by supporting them.

A Heartfelt Thank You to our Sponsors for Re-Committing Their Support for our 2021 Celebration Awards Dinner TITLE SPONSOR

CAPITAL SPONSOR

PRESENTING SPONSORS

Ron Brafford, Broker

SUPPORTING SPONSORS

EVENT SPONSORS

Audiology Associates of North Florida Capital Regional Medical Center Dermatology Associates of Tallahassee Florida State University College of Medicine SunTrust Private Wealth and SunTrust Mortgage Tallahassee Ear, Nose, and Throat, P.A. TMH Federal Credit Union DISPLAYER

Hancock Whitney MagMutual Tallahassee Primary Care Associates Tallahassee Research Institute

IN KIND SPONSOR Novo Nordisk, Inc.

Betsy Barfield Photography

We look forward to celebrating Dr. Sergio Ginaldi and Dr. David Saint on March 25, 2021.

Please save the date for this well-deserved celebration!

CAPITAL MEDICAL SOCIETY 2020 MEETINGS CALENDAR October 20, 2020 Virtual CME Domestic Violence (2 Hours) Speaker: Suzanne Harrison, M.D. 6:30 pm

November 10, 2020 Virtual CME Human Trafficking (1 Hour) Speaker: Terry Coonan, J.D., Executive Director at the Florida State University Center for the Advancement of Human Rights 6:30 pm

November 24 - December 5, 2020 Virtual CMS Foundation Holiday Auction More details to follow - stay tuned!

BOARD OF GOVERNORS Ken Whithaus, M.D., 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

Rohan Joseph, M.D., President-Elect Paresh Patel, M.D., Secretary/Treasurer

Thank You to Celebration Awards Dinner Sponsors.......1 Professional Notes..................................................................4 CMS News.................................................................................6 Incoming Residents................................................................8 AMA Foundation Scholarship Opportunities...................9 Portraits in COVID-19........................................................... 10 Simpler Times........................................................................ 14 Viewpoint................................................................................ 16 CMS Foundation New Board Director............................. 17 Physician Wellness............................................................... 18 CMS Foundation Grant Recipients.................................. 20 Donate to the CMS Foundation......................................... 21 CMS Foundation: We Care Network................................22 Thank You to PPE Donors and Volunteers..................... 24

Maribel U. Lockwood, M.D., Immediate Past President Nicole Balmer, M.D. David Burns, M.D. Sybil Holt, CMS Alliance

HAPPY BIRTHDAY!

Sarah Ko, M.D. Amulya Konda, M.D.

{AUGUST BIRTHDAYS}

Matt Lee, M.D. Nancy Loeffler, M.D. Helen Paulson, M.D. Cody VanLandingham, M.D. Julia Weeks, M.D. Pam Irwin, Executive Director, Capital Medical Society Family Medicine Resident Mary Claire Smallwood, M.D. General Surgery Residents Hamzah Mansoura, M.D./SchMiyah Smith, 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.

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David Burns, M.D. – 1st Oliver Reyes, D.O. – 1st Cielo Rose, D.O. – 1st Katherine Mackenzie, M.D. – 1st Michael Douso, M.D. – 2nd Sangeeta Nair-Collins, M.D. – 2nd Ronald Ray, M.D. – 4th Stacia Groll, M.D. – 5th William Paul Sawyer, M.D. – 5th Bob Soni, M.D. – 6th Emily Ashmore, M.D. – 7th T. Adam Oliver, M.D. – 7th John L. Williams, Jr., M.D. – 7th T. Dean Dalrymple, M.D. – 8th Lisa Flannagan, M.D. – 8th Stanley Gwock, M.D. – 8th David Pascoe, M.D. – 8th Simon Lopez, M.D. – 9th Eugene Wang, M.D. – 9th Marc Inglese, M.D. – 11th Sergio Ginaldi, M.D. – 13th Alice Pomidor, M.D. – 13th SchMiyah Smith, M.D. – 13th

David Craig, M.D. – 15th Gadi Silberman, M.D. – 17th Joshua Fuhrmeister, M.D. – 18th Terence Reisman, M.D. – 18th Rachel Vanderby, M.D. – 19th Marie Becker, M.D. – 20th William Morse, M.D. – 20th Frank Walker, M.D. – 20th Michael Forsthoefel, M.D. – 22nd Shayla Gray, M.D. – 22nd Tracy Graham, M.D. – 25th P.S. Krishnamurthy, M.D. – 25th Thandi Walters, M.D. – 25th James Thomas, M.D. – 26th Charles Yowell, M.D. – 26th Jeffrey Ferraro, M.D. – 27th Richard Thacker, D.O. – 28th Stan Whitney, M.D. – 28th Camille Blake, D.O. – 29th Rick Damron, M.D. – 29th Ashton Byington, 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!

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PROFESSIONAL NOTES

PROFESSIONAL NOTES On July 15, 2020, Dr. Nancy Loeffler was elected by the Capital Medical Society Active members to fill the vacated seat on the Capital Medical Society Board of Governors. She will complete the remainder of the term, which ends on December 31, 2020. We are happy to have a Capital Medical Society past president offer her leadership and experience on the CMS Board of Governors during this challenging year. We welcome Dr. Nancy Loeffler and thank the entire CMS Board of Governors for their service.

Dr. Alma Littles and Dr. John Bailey will serve on Reference Committee II for the 2020 FMA Annual Meeting. The Speaker of the House of Delegates, Joshua Lenchus, D.O., Vice Speaker of the House of Delegates, Ashley Norse, M.D., President, Ronald Giffler, M.D., and President-Elect, Michael Patete, M.D. appointed the following physicians to Reference Committee II for the 2020 FMA Annual Meeting: • • • • • • •

Alma Littles, M.D., Chair John Armstrong, M.D. John Bailey, D.O. Elizabeth Devos, M.D. Vincent DeGennaro, M.D. Nitesh Paryani, M.D. Todd Smaka, M.D.

Reference Committee II is the only committee that will be convened for the 2020 Annual Meeting. This committee will make recommendations on 7 proposed amendments to the bylaws. The recommendations will be presented to the 2020 Virtual House of Delegates for their consideration. Capital Medical Society thanks Dr. Alma Littles and Dr. John Bailey for their service as members of the Capital Medical Society delegation to the 2020 FMA Annual Meeting and on Reference Committee II. Dr. Maribel Lockwood was appointed to the Credentials and Standing Rules Committee for the 2020 FMA Annual Meeting. The Speaker of the House of Delegates, Joshua Lenchus, D.O., Vice Speaker of the House of Delegates, Ashley Norse, M.D., President, Ronald Giffler, M.D., and President-Elect, Michael Patete, M.D. have appointed the following to the Credentials and Standing Rules Committee for the 2020 FMA Annual Meeting: • • • •

Daniel Thimann, M.D., Chair Maribel Lockwood, M.D. Joel Silverfield, M.D. Jason Wilson, M.D.

The charge for this committee is to ensure that the voting system is fair and accurate during the 2020 Virtual House of Delegates. The Capital Medical Society thanks Dr. Maribel Lockwood for her time and service as a CMS delegate and member of the FMA’s Credentials and Standing Rules Committee.

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

PROFESSIONAL NOTES

Dr. Madelyn Butler was named President of the Association of State Medical Society Presidents at the AMA and continues her years of serving the medical profession and helping to empower physician leaders throughout the US.

Myra M. Hurt, Ph.D. released her book, “Breaking The Mold: The Academic Pioneers Who Bucked Conventional Wisdom to Create the Florida State University College of Medicine” on the history of the Florida State University College of Medicine.

Senior Associate Dean Myra Hurt, founding faculty member of the FSU College of Medicine and its first acting dean, presented her new book to FSU President John Thrasher and FSU Provost Sally McRorie at a virtual event on June 19, 2020. The book recreates the unparalleled days when academic pioneers crafted a whole new approach to medical education. In its 20th year, the FSU College of Medicine’s successful launch and accreditation were in large part due to the tenacity and hard work of Dr. Hurt. We applaud Dr. Hurt, the “godmother” of the College of Medicine for her dedication, perseverance, and for compiling this meaningful history for others.

You may read the book online at https://med.fsu.edu/breakingthemold. The link will also advise how to acquire a printed copy.

Niharika Suchak, M.D. has been named Big Bend Hospice’s (BBH) new Medical Director. Dr. Suchak has served as BBH’s Associate Medical Director since February 2016.

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

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CMS NEWS

CAPITAL MEDICAL SOCIETY VIRTUAL LUNCHTIME LEARNING SEMINARS ~ These seminars will be virtual until further notice ~ Save the Date for the Fall 2020 Virtual Lunchtime Learning Seminars: September 16, 2020 Employee Law Updates With record litigation and a dramatic increase in governmental audits impacting local business, come join us for a fun interactive look at the areas that are most likely to create costly legal exposure at your company. Topics to be covered will include key points of risk throughout the employment life cycle, common mistakes involving employee leave, and preparing for coming changes to federal wage and hour laws. This is a cannot miss for small business owners, human resource professionals, and Chief Executive Officers alike!

Speaker: Bill Krizner, The Krizner Group Sponsor: Traci Poucher,

CAMPUS USA Credit Union (https://campuscu.com/)

October 21, 2020 No Ego: How Leaders Can Cut the Cost of Workplace Drama, End Entitlement, and Drive Big Results Speaker: Bert Mitchell Sponsors: Walt Haley,

FMI Printing & Distribution (https://fmibusiness.com/) Liz Thiele, TMH Federal Credit Union (https://www.tmhfcu.org/) November 18, 2020 Exploring Telemedicine Speakers: Paige Dixon and Eric Friall Sponsor: Liz Thiele,

TMH Federal Credit Union (https://www.tmhfcu.org/) Registration Required Time: 12:30 PM to 1:30 PM No Cost for these virtual seminars.

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

FEEDBACK ON RECENT CHANGES TO THE DISTRIBUTION OF CAP SCAN “Surprisingly, I still enjoyed reading it online and was so happy to see all the thank you letters from community physicians and administrators for all the hard work you and Pam have done to secure PPEs and keep everyone updated via communications. You all are priceless.”

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS NEWS

CMS MEMBERS: ARE YOU RETIRING? If you are planning to retire, please be sure to contact Rosalie Carlin at the Capital Medical Society office - (850) 877-9018 or rcarlin@capmed.org.

As a Retired CMS Member, your membership dues change to: Retired - $150.00 with meals (includes dinner at CME meetings) or Retired - $50.00 without meals (you are billed for dinner if you attend a CME meeting). It is your choice.

Do you plan to change the status of your Florida Medical License to Retired?

Visit this link: https://flboardofmedicine.gov/help-center/ how-do-i-change-the-status-of-my-license-to-retired/, or search online for: Florida Board of Medicine How do I change the status of my license to retired?

You must formally request Retired status with the Board of Medicine (BOM) for your medical licensure and pay a fee rather than just not renewing. The penalty for being late in requesting a Retired status change with the BOM can be $515.00.

Remember, be sure to let CMS know of your change in status.

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INCOMING RESIDENTS

CMS WELCOMES INCOMING RESIDENTS CMS President Dr. Ken Whithaus and Executive Director Pam Irwin hosted an orientation luncheon for new Family Medicine, General Surgery, and Internal Medicine Residents on June 17.

Many of the Residents shared harrowing stories about securing flights from their home countries to move to Tallahassee. The pandemic had an impact on their final year of medical school and launched some new hobbies like raised gardening and baking bread. One Resident was engaged in COVID-testing at her hometown ER. Dr. Whithaus and Pam shared the importance and benefits of local medical society membership. Please make them feel welcomed!

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

AMA FOUNDATION SCHOLARSHIP OPPORTUNITIES

AMA FOUNDATION ANNOUNCES SCHOLARSHIP OPPORTUNITIES FOR MEDICAL STUDENTS TO IMPROVE HEALTH EQUITY The new AMA Foundation President, Jacqueline A. Bello, MD, FACR, announced the creation of the DREAM MD Health Equity Scholarship (https://amafoundation.org/dream-md-equityscholarship/?bblinkid=232245044&bbemailid=22546217&bbejrid=1566594747), which will immediately award two $10,000 scholarships to Deferred Action for Childhood Arrivals (DACA) medical students.

As President, she is dedicated to continuing the Foundation’s long-standing commitment to improving the public health and further build upon our recent accomplishments. In addition to awarding two DREAM MD Health Equity Scholarships, the Vandenberg Health Equity Fund (https://amafoundation.org/vandenberg-health-equity/?bblinkid=232245045&bbemailid=22546 217&bbejrid=1566594747) will award two David Jones Peck, MD Health Equity Scholarships to medical students demonstrating commitment to addressing health disparities and promoting health equity in diverse, economically disadvantaged urban environments.

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PORTRAITS IN COVID-19

NEW CAP SCAN SERIES: "PORTRAITS IN COVID-19" – PLEASE SHARE YOUR EXPERIENCE

Capital Medical Society is accepting stories for its Cap Scan magazine from CMS and CMSA members as part of a new occasional series called “Portraits in COVID-19,” to capture the changes happening in healthcare and our personal lives due to COVID-19 as experienced by physicians and laypeople. These stories can be about your experiences treating COVIDpositive patients, supporting patients and coping

with families during “no visitation,” entering the world of telehealth, concerns about PPE shortages, distancing from your own families, family celebrations by social distancing, newfound time with family, newbie ZOOM meeting experiences worthy of an SNL skit, staycations extraordinaire, or schooling from home. You get the idea. Please try to stay within 800 words, include a photo if it makes sense, and be mindful of HIPAA, if writing about a patient experience. Please send by email to Shannon Boyle at sboyle@capmed.org. All submissions are reviewed by the Cap Scan editor prior to publication.

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It was eight years ago when Tallahassee Dentist Dr. James Walton realized the frustration of his patients not knowing what medications they were taking and why. He began working on materializing his concept of revolutionizing the way medical information is managed. So, he assembled a team of experts and together, they created a simple to use, secure, and HIPAA compliant software system that allows individuals to control their personal medical information. This solution is aptly named CONTROL Your Health Record®.

Having your personal medical information with you at all times is a concept supported by all medically related companies and associations. In May of 2019, the Federal Government announced they wanted individuals to take more control over their medical information.

Preventable medical errors are the third leading cause of death in the United States with as many as 440,000 per year. Dr. Walton’s solution has proven to save lives and reduce medical errors through technology.

In March of 2019, Dean Massey, the company’s president, was admitted to the hospital for a follow-up on his heart stint placement procedure. The surgeon responsible for his care needed to know which medications Dean was taking and was unable to retrieve the information from the hospital’s medical database. So, Dean, using the doctors cell phone, logged into his CONTROL® account, and the doctor was able to see Dean’s medications and move forward with the procedure.

Another case involved a Georgia high school band member with epilepsy who had a seizure while on a band trip to New York. Because the band director had a CONTROL® profile for each of the band members, he was able to inform the EMT’s of the young man’s condition and medications. Also, the director was able to forward this information to the hospital ahead of the young man’s arrival, so the medical team was able to provide appropriate care. These actions helped to save the young man’s life.

On another occasion, a man was having dinner in North Carolina when he activated the emergency alert feature on his app. A message was sent to a triage center in Miami which dispatched a locally based EMT team to the restaurant within minutes. This immediate action demonstrates the value of being able to get medical assistance wherever you are within or outside of the United States.

These are just three examples from the hundreds where CONTROL® has been instrumental in helping to save an individual’s life. CONTROL® has been beta tested in partnership with American Medical Response in a South Florida retirement community serving 14,000 residents where it has helped to save lives and improve the outcome of numerous medical emergencies. Currently it is being expanded to other communities in the region. In addition, over 5000 individuals have been testing CONTROL® with incredibly positive feedback. Presently, EMTeLINK, the parent company, is exploring expansion and launch with organizations and companies in the Southeast and across the country.

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PORTRAITS IN COVID-19

“I HAD NOT THOUGHT DEATH HAD UNDONE SO MANY…” AS SHARED BY FRANK SKILLING, M.D.: As the death toll from COVID-19 in the United States surpassed one-hundred-thirtythousand at the beginning of July, I have been remembering the words from T. S. Eliot’s poem, “The Waste Land,” in which he recalls the dead English youths after the Great War: “I had not thought death had undone so many.” He envisions them as a crowd that flows over London Bridge “and each man fixed his eyes before his feet.” I first read “The Waste Land” when I was eighteen and an English major at Spring Hill College. I had no knowledge of the Great War, London, or even Eliot, who died that year. Now as I follow the numbers of those stricken in our own pandemic, the words come back as if summoned by the toll of death. I confess that I had no conception of a pandemic, other than that it was an ordeal that scourged the world in the past, but I truly thought that we were more likely to be engaged in a nuclear war than see another pandemic occur in our lifetimes. Asia, I thought, would have one, but not us. I am disabused and chastened of that belief now. There is talk of “fighting the virus” or “engaging the unseen enemy” or “doing battle with the invisible,” but these are metaphors that don’t reflect what COVID-19 is doing to the entire world. I was as unacquainted with a pandemic as I was for understanding “The Waste Land” as an eighteen-year-old.

What is impressive to me is that the response of people today is reliably predicted by what has previously occurred. Initially for some, there is a denial that it is happening; then a fear of the unknown takes hold before a fatalism develops which is expressed in 12

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

frenetic social activity; and finally shaming of those who do or do not adhere to recommended preventive guidelines, especially wearing face masks. The search for a cause uncovers supernatural as well as natural reasons, most of them wrong. Daniel Defoe described these explanations in “Journal of a Year of the Plague” wherein he creates an account of the Great Plague of London in 1665-66. Then as now, an actual biological etiology seems unfathomable for the average mind: how can a thing be deadly if it’s not even living? Are we really being hunted by a microscopic entity? A lack of trust in neighbors leading to fear begins to spread incrementally. Our government shows mixed signals about concern for public health and restarting the economy. As the death toll mounts, a numbness with the anticipation of death sweeps in.

In reading “The Great Influenza of 1918”

by John Barry, I realize that the U.S. was enveloped in a matter of weeks before anyone in the medical profession or the government was able to respond. Because it was war time, the government suppressed all information about the pandemic in an attempt not to damage morale and support the war effort

by American citizens. Even with the current announcements emanating from the CDC and the Department of HHS, many are still denying the lethality of the disease. It’s as if human nature in its primitive state of denial takes over, and all the knowledge and preparation are thrown to the wayside.

Scientific explanations are suspect. Despite the constant barrage of TV coverage which documents its march across the world, many people are acting as if it’s not happening. And, unfortunately, it has now become a marker of

PORTRAITS IN COVID-19

the political divide which we are living with.

Those who wear masks in public must be of a certain tribe; those who don’t are of another.

“The best all lack conviction, and the worst are full of passionate intensity,” was W.B. Yeats assessment of the post-WWI landscape in “The Second Coming,” published in 1919. (His pregnant wife nearly died during the pandemic.) I see its echoes a hundred years later in our country’s reaction to our pandemic. Human nature doesn’t change, even in a “post-modern” society, and once we’re truly scared or desperately ill, we tend to regress in our behaviors. Only the survivors and their saviors truly know the human ordeal; statistics can’t express emotion.

As the child of parents who both served in uniform and met during World War II, I had always envisioned that conflict as the major defining event of their lives. But I now realize that they were both alive during the Great Influenza which may have been even more important. My father finished high school in 1918 in Baltimore, and had he been a year older, he most likely would have been drafted into the Army that summer.

When the pandemic occurred, the death rate in military cantonments and troop ships was astronomical because of the crowded living conditions. During his later studies, he received a master’s degree in bacteriology before entering Harvard Medical School, and I now wonder how much his choice of subject was influenced by living through the Great Influenza. That pandemic was an inspiration for many young men who pursued careers in microbiology and public health. At the same time my mother was living as a child in her native Italy, which suffered an exceedingly high mortality rate. Her arrival in the U.S. was

delayed at least several years until she finally disembarked at Ellis Island in 1921 at the age of ten.

My parents never talked about what it was like to be alive during the years of the socalled Spanish Flu, but I would love to hear their memories at a time when we are reliving the tragedy. Apparently, their silence on the pandemic was not unusual. After it was over, most people wanted to get on with their lives, and the memory of apocalyptic waves of death was too great to recount. And thus, we are condemned to repeat what we didn’t learn at that time. The last great pandemic claimed over fifty million lives worldwide.

The outcome of our century’s plague, while still uncertain, will certainly be tragic. Onehundred-thirty-thousand casualties in the USA will seem mild within the next year.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

13

SIMPLER TIMES

TRIBUTE TO MISS CARRIE

By Charles D. Williams, M.D., FACR, FAAP (“Pedro”) Miss Carrie was black. She had been good to me when I was a kid. She was a credit to her race.

The human race. She had a better character and was more forgiving than most of us. She loved the South and she loved Pedro.

I waited in the church yard until everybody had gone into the church. I didn’t want anybody to see me if I cried, so I sat down on the last pew. I’d git emotional at funerals, especially if it was somebody who had been good to me when I was a kid.

She always wore a bandana around her head and most of the time her apron pocket kept her snuff and some goodies for us younguns. She cared for my youngest sister when Mama got sick. One time she held my hand when I fell down and cried.

She didn’t have a husband or any close kin and was nearly 85. Living alone was hard for a black lady growing up in the South. All her life she lived in the country. Picking cotton in the hot summer months, tending her garden, milking her cow, feeding her chickens, churning and cooking. She loved to cook and she loved to eat and she loved her collard greens. Her country ham with red eye gravy was the best.

The upper part of her arms were four times bigger than the lower part of her arms and they shook when she laughed and she laughed at Pedro’s stories.

Her house was always clean as a whistle. Dirty rags never spent a night in Miss Carrie’s house. One time a neighbor said, “Miss Carrie, yore house shore is clean and I don’t know how you do that.” The neighbor was right. She didn’t know how Miss Carrie did that.

She always found time to wash clothes and boil them in a black wash pot on the outside. She sang hymns as she did her chores around the house. She also found time for us younguns.

She kept some dogs which were mixed breeds like most dogs in the South and when she called they came running with their tails up in the air. They loved Miss Carrie.

The preacher came in and my mind came back to the little white country church. My eyes noticed the casket.

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It was silver with white handles. She was dressed in a beautiful blue dress which was her favorite color. Her hair was as gray as an aluminum cooking pot and she seemed to be smiling. The preacher then said, “Now let us pray.”

The silver headed preacher said something about finding comfort and strength in the hope that there is life beyond what we know. He said something else about a home on the other side of the river and a home where the streets are paved with gold.

Some friends then carried her through the church doors and we made our way through the church yard to a tent that stood over an open grave. As I looked at the hole in the ground, I was reminded that life is only temporary. We know this early in life, but somehow we keep it to one side of our brains.

We then sang when the role is called up yonder, I’ll be there and the preacher said a final prayer. I felt a tear when the dirt made a loud thug on her casket.

All the people and all the cars left and I walked slowly to mine. The sun was setting behind the pine trees. I heard a noise and noticed two dogs running out of the corn fields with their tails up in the air. They headed straight to the fresh dirt and I shivered as the sun went down.

Miss Carrie, a new grave, Pedro and two lonely dogs.

The chapter closed on another wonderful life in South Georgia. She held my hand for a little while but she’ll hold my heart forever.

Reprinted with author permission from More Simpler Times.

Dr. Williams’ sequel book, More Simpler Times, can be purchased from the Capital Medical Society. All proceeds from the book are donated to the Capital Medical Society Foundation’s We Care Network program. The total sales from his books have raised over $39,000 for the CMS Foundation’s We Care Network.

Mind your health The new outpatient practice, FSU BehavioralHealthâ„¢ at Apalachee Center, combines the advantages of academic medicine with the leading provider of behavioral health care in this community for more than 50 years.

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The practice is part of the FSU Mood & Anxiety Center, a member of the National Network of Depression Centers, leveraging unparalleled expertise and resources to advance science in the field of mood disorders.

RESPONSIVE TO COMMUNITY NEEDS, ESPECIALLY THROUGH SERVICE TO ELDER, RURAL, MINORITY AND UNDERSERVED POPULATIONS HOURS & APPOINTMENTS Cente

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

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VIEWPOINT

THE BARRIERS TO AND BENEFITS OF EARLY DEMENTIA DIAGNOSIS

By Philip Nowicki, Ph.D. Older patients often come to see their primary care physician with a myriad of medical issues. If they don’t mention memory problems or cognitive decline, their physical health problems are likely to consume the entire visit. The caregiver might interpret the physician’s silence as a sign that there is nothing cognitively wrong with the care recipient. Furthermore, persons with early dementia don’t suddenly exhibit full-blown symptoms.

They initially appear gradually and sporadically. This dynamic is only one of many that explains why a timely diagnosis of dementia often fails to occur.

Currently, there is no cure for Alzheimer’s disease or other dementias. Not surprisingly, more than cancer or a stroke, Alzheimer’s disease or a related dementia (ADRD) is the condition that older people fear the most.

Consequently, caregivers or their loved ones are more inclined to dismiss cognitive changes and believe that everything is fine.

According to a 2014 caregiver survey by the Florida Department of Elder Affairs, more than three-fourths of care recipients did not receive an ADRD diagnosis until at least one year after their symptoms began. For over a third, it was more than three years. Nearly half of the caregivers delayed the diagnosis because they thought the condition was part of normal aging. Others indicated they did not want to know or think anything could be done. Some did not know where to find help.

Others reported they or the care recipient were in denial.

Some attributed the delay to family disagreement over how to respond to their loved one’s cognitive decline.

Interestingly, families’ uncertainty, fear, or denial of cognitive impairment mirror primary care physicians’ hesitancy to proceed with diagnostic evaluation. Most primary care physicians, physician assistants and nurse practitioners lack specific training on dementia care.

They may be blurred by what constitutes cognitive impairment and normal aging. They may not be familiar with the local dementia support services available.

Some primary care physicians (PCPs) may assume the caregiver does not want a diagnosis until the symptoms are more frequent and pronounced. Some may simply be uncomfortable administering the diagnosis or discussing the results with the family. Other PCPs may not want to risk a misdiagnosis or believe there is inadequate reimbursement for the time spent. In some communities, a diagnosis may not occur because there is insufficient support services or specialists to refer the person with dementia to.

Sometimes, there are attitudinal reasons why PCPs are reluctant to diagnose dementia. They may have doubts 16

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

about the usefulness of an early diagnosis. They may perceive there are limited treatment options. Given there is no cure, some may feel that an early diagnosis is pointless and can do more harm than good.

Missing from this equation are the benefits of an early diagnosis to the patient, caregiver and family which far outweigh the risks. Timely diagnosis enables the early initiation of treatment such as memory training, social stimulation, physical exercise and pharmacological intervention. These treatments can prolong the early phase of the disease, thus shortening the moderate to severe stages and their associated burdens. In turn, care recipient dependency time and admission to a care facility can be delayed.

Recent government actions are also helping to reduce the barriers to dementia diagnosis. In 2018, Medicare implemented code 99483. It reimburses physicians, physician assistants, and nurse practitioners for providing care planning services to individuals with cognitive impairment, including Alzheimer’s disease.

Last year, Florida became the only state to include in its State Health Improvement Plan (SHIP) a priority area dedicated to those living with ADRD and their families and caregivers. Among its goals is to strengthen the capacity of care organizations to assess, diagnose and treat individuals with ADRD and expand support for their caregivers.

An early diagnosis opens the door to future treatment and care. It helps people plan ahead while they are still able to make important decisions on their care and support needs. It allows them to obtain timely and often critical financial and legal advice. It affords caregivers more time to locate and utilize appropriate support mechanisms such as respite care, caregiver training, support groups, and counseling. Doing so makes it more likely that the person with ADRD can live longer in their home, and delay or possibly avoid placement in a care facility. Ultimately, these actions can dramatically reduce the financial burden and stress that caregivers and their family would otherwise experience.

About the Author: Philip Nowicki has a Ph.D. in Social Science from the Maxwell School of Citizenship & Public Affairs at Syracuse University. He is a former caregiver for his wife who had Alzheimer’s disease and passed away in 2017.

Since 2018, he has been a member of the Alzheimer’s Project Board of Directors. In 2019, he joined the Dementia Care and Cure Initiative (DCCI) taskforce for the Big Bend area. He currently serves on two ADRD subcommittees under Priority Area 9 of the State Health Improvement Plan.

CMS FOUNDATION NEW BOARD DIRECTOR

THE CAPITAL MEDICAL SOCIETY FOUNDATION BOARD OF DIRECTORS WELCOMES NEW BOARD DIRECTOR Yvonne T. Brown was elected to the Capital Medical Society Foundation Board of Directors in June 2020. Welcoming her are continuing board members, John P. Mahoney, M.D., President; Walt Colón, D.M.D., Vice President; Nancy Loeffler, M.D., Secretary; David Stewart, M.D., Treasurer; J. Alan Cox, Esq.; H. Avon Doll, M.D.; Marlisha Edwards, M.D.; Paula S. Fortunas, M.A.; Terreze Gamble, M.D.; Tracey Hellgren, M.D.; David Jones, M.D.; Rohan Joseph, M.D.; Maribel U. Lockwood, M.D.; Al McCully, M.D., Emeritus; Faisal Munasifi, M.D.; J. Brian Sheedy, M.D.; Joedrecka Brown Speights, M.D.; Jay Walton, D.D.S.; Kenneth R. Wasson, M.D.; Ken Whithaus, M.D.; Barbara Williams, M.D.; and Charles Williams, M.D., Emeritus.

Mrs. Brown moved to Tallahassee from South Florida with her husband Stephen Brown in 2012. Since her arrival, she has been invested in the community as a volunteer in many arenas, including in leadership roles with the FSU Foundation, the Tallahassee Memorial HealthCare Foundation, and Choose Tallahassee.

In 2017, despite being a University of Florida graduate, she was named an honorary Florida State University alum for her dedication to the community.

“We thank her for her willingness to serve on the CMS Foundation Board of Directors in support of its mission,” said Dr. John P. Mahoney, President, CMS Foundation.

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

17

PHYSICIAN WELLNESS

PHYSICIAN WELLNESS BURNOUT INVENTORY This is an adapted version of the Oldenburg Burnout Inventory, one of several such validated instruments used to assess the presence of burnout in many occupations. Each of these instruments, including this one, has its own unique advantages and limitations. This sample is provided not as a definitive measure of the presence or absence of burnout, but merely as one potential piece of data for you to consider as you explore issues related to physician wellness and resilience.

By answering the questions and tallying your score, you will be able to determine your score. Scores range from 16-64. Scores above 35 have been correlated with higher rates of burnout.

1. I always find new and interesting aspects in my work.

Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

4. After work, I tend to need more time than in the past in order to relax and feel better.

Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

2. There are days when I feel tired before I arrive at work.

Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

5. I can tolerate the pressure of my work well.

Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

3. It happens more and more often that I talk about my work in a negative way.

Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

6. Lately, I tend to think less at work and do my job almost mechanically.

Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

PHYSICIAN WELLNESS

7. I find my work to be a positive challenge.

Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4) 8. During my work, I often feel emotionally drained.

Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1) 9. Over time, one can become disconnected from this type of work.

Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

12. After my work, I usually feel worn out and weary.

Strongly agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1) 13. This is the only type of work that I can imagine myself doing.

Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4) 14. Usually, I can manage the amount of my work well.

Strongly agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

10. After working, I have enough energy for my leisure activities.

Strongly agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

15. I feel more and more engaged in my work.

Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

11. Sometimes I feel sickened by my work tasks.

Strongly agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

16. When I work, I usually feel energized.

Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

CALCULATE YOUR SCORE HERE:

If you are an Active or Associate member of the Capital Medical Society and would like to seek free wellness coaching services, please visit https://capmed.org/members-only/physician-wellness/. If you need help with your CMS login information, please email rcarlin@capmed.org.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

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CMS FOUNDATION GRANT RECIPIENTS

CAPITAL MEDICAL SOCIETY FOUNDATION PROVIDES GRANTS TO IMPROVE ACCESS TO HEALTH CARE On June 30, 2020, the Capital Medical Society Foundation Executive Director Pam Irwin presented a $5,000 check to the Big Bend Hospice Foundation President Dena Strickland in support of their bereavement services programs.

The Capital Medical Society Foundation’s mission 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. Pam Irwin shared, “We are happy to support these services. Big Bend Hospice offers grief support services to individuals and groups whether they used hospice services or have no prior hospice involvement.

They do great work in this community, especially with grieving children.”

On July 1, 2020, the Elder Care Services CEO Jocelyne Fliger, MSW was presented a check for $5,000 by Pam Irwin, Executive Director of the Capital Medical Society Foundation. The grant will provide In-Home Senior Services to this vulnerable population. In-Home Services directly supports seniors by providing comprehensive assessments and personal care plans that allow a senior to age in place. Care Managers visit the person and/or family needing help and decide what services are needed. It’s their ultimate goal to keep clients in their homes and as independent as possible while providing them and their families with the services they need to age with dignity. Capital Medical Society Foundation is a 501(c)(3) organization and provides limited grant funding to improve access to healthcare.

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DONATE TO THE CMS FOUNDATION

The Impact of Private Support:

Donate to the CMS Foundation – We Thank Our Donors We thank the following individual donors who made a donation to the CMS Foundation this past month: Capital Medical Society Foundation – included with their annual dues payment C. William Applegate, M.D. Donald C. Beeckler, M.D. Charles Deal, M.D. Celeste Paquette, M.D. Raleigh Rollins, M.D. James W. Stockwell, M.D. Michael B. Wilhoit, M.D. Capital Medical Society Foundation – Area of Greatest Need PhRMA Ron Saff, M.D. We Care Network Dr. and Mrs. Charles F. Manning – In Honor of James and Leila LaCrosse

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

The 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 the We Care Network and the We Care Network Endowment Fund. More than $112.1 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 2019-20, which ended June 30, 2020, more than $6.7 million in health care was donated. Gifts support the operational expenses of the program including salaries and benefits of the case management team who coordinate the donated care. ➢ To provide incentives to keep medical students trained at the 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. $50,000 was awarded in 2019. ➢ Gifts to the Capital Medical Society Foundation help provide operational resources for the Capital Medical Society Foundation. In addition, modest grants are awarded to area non-profits whose programs improve access to healthcare for the underserved. In 2020, the CMSF awarded a total of $10,000 in grants to Elder Care Services for their In-Home Services Program and the Big Bend Hospice Foundation for bereavement services.

Gifts to Honor and In Memoriam: You can make a gift 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. The 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 make a gift at any time to one of the 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 Gifts should be made payable to the CMS Foundation and indicate on the memo line of your check to which designation you would like to give. Bring your check to the CMS Office or mail it: Capital Medical Society Foundation ~ 1204 Miccosukee Road ~ Tallahassee, FL 32308.

Gifts may be made by credit card or direct debit from the CMS website.

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 or after hours at (850) 559-8611

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

21

CMS FOUNDATION: WE CARE NETWORK

FOUNDATION

We Care Network

THANK YOU To our CMS members and We Care Network partners who provided healthcare to new patients in June 2020.

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

Physicians Emily Ashmore, M.D. Christopher Babl, M.D. Venkata Bavikati, M.D. Dhananjay Bendre, M.D. Tim Broeseker, M.D. David Burns, M.D. Francisco Carpio, M.D. Gilbert Chandler, M.D. Alan Chen, M.D. George Cohen, M.D. Raymond Cottrell, M.D. Marilyn Cox, M.D. William Dixon IV, M.D. Margarett Ellison, M.D. Hong Gao, M.D. Gian-Carlo Giove, M.D. Todd Hewitt, M.D. Barbara Jaeger, M.D. Amit Jain, M.D. John Katopodis, M.D. James Killius, M.D. Amulya Konda, M.D. Matthew Lee, M.D. Carey Linker, M.D. Maribel Lockwood, M.D. Gordon Low, M.D. Kurt Luhmann, M.D. Michael Mangan, M.D. Ovidiu Marina, M.D. Jayan Nair, M.D. Chukwuma Okoroji, M.D. Thomas Park, M.D. Paresh Patel, M.D. Mitchell Peabody, D.O. Michael Pentaleri, M.D. Jorge Perez de Armas, M.D. Alexander Ramirez Valderrama, M.D. Hussein Rayatzadeh, M.D. Stephen Richardson, M.D. Davis Rierson, M.D. Adrian Roberts, M.D. Andres Rodriguez, M.D. Tim Ruark, M.D. Eliot Sieloff, M.D. Gadi Silberman, M.D. Hardeep Singh, M.D. Joshua Somerset, M.D. John Thabes, M.D.

William Thompson, M.D. David Vermess, M.D. Lucas Watkins, M.D. Tony Weaver, M.D. Graham Whitaker, M.D. Chien-Yi Williams, M.D. William Yaakob, M.D. Samuel Yu, M.D. Brian Zirgibel, M.D. Dentists Laban Bontrager, D.M.D. Walter Colón, D.M.D. Alan Dransfield, D.M.D. William McFatter, D.D.S. Jim McSoley, D.M.D. Lawrence Pijut, D.M.D. Barrett Tolley, D.D.S. Lawrence Weaver, D.D.S. Ronald Willis, D.M.D. Facilities Advanced Urology Institute Airway Works, LLC Allergy & Asthma Diagnostic Treatment Center Anesthesiology Associates Apalachee Primary Care Beachton Denture Clinic Bond Community Health Center Bristol Dental Clinic Capital Health Plan Capital Regional Cancer Center Capital Regional Surgical Associates Care Point Health & Wellness Center Centre Pointe Dental Group Dermatology Advanced Care Dermatology Associates Desloge Home Oxygen Digestive Disease Clinic Florida Cancer Specialists & Research Institute FSU PrimaryHealth Gadsden County Health Department Gynecologic Oncology of Tallahassee Jessie Furlow Medical Center Ketchum, Wood, & Burgert Pathology Associates Lawrence J. Pijut DMD PA Madison Medical Center Manocha, McSoley, Balan,

and Manocha Dentistry Neighborhood Medical Center Neuro-Ophthalmology & the Balance Disorders Clinic North Florida Women’s Care North Monroe Medical Center Oral & Facial Surgery Center

22 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Periodontal Associates of North Florida Radiology Associates of Tallahassee Red Hills Dental Associates Southern Medical Group, P.A. Southern Vitreoretinal Associates Tallahassee Diagnostic Imaging Tallahassee Memorial HealthCare TMH Family Medicine Residency Program TMH Physician Partners

Cancer & Hematology TMH Physician Partners Cardiology and Internal Medicine TMH Physician Partners Clinical Genetics Center TMH Physician Partners Gynecologic Oncology Specialists TMH Physician Partners Pulmonary, Critical Care, and Sleep Specialists TMH Physician Partners Quincy TMH Physician Partners Radiation Oncology Specialists TMH Physician Partners Surgical Specialists TMH Physician Partners Urology Specialists TMH Transition Center Tallahassee Orthopedic Clinic TOC Canopy Wakulla County Health Department Wakulla Medical Center Women’s Clinic 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 June 2020 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. In addition, 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) 2010085 or mail to 1204 Miccosukee Road, Tallahassee, FL, 32308. Thank you!

CMS FOUNDATION: WE CARE NETWORK

We thank our referring providers from June 2020: Ebonie Allen, APRN Anne Ananga, APRN Jonathan Appelbaum, M.D. Clifton Bailey, M.D. Katrina Ball, APRN Romaine Barrett, M.D. Karen Bartley, M.D. Dhananjay Bendre, M.D. Viralkumar Bhanderi, M.D. Kendra Brady, APRN Daniel Breivogel, APRN Alexander J. Brickler III, M.D. Tim Broeseker, M.D. Joseph Camps, M.D. Frances Carney, APRN Francisco Carpio, M.D. Lysmar Carrion-Dinguis, M.D. Jordan Cherkinsky, D.D.S. Melba Colon-Renta, M.D. Deborah Congdon, APRN Raymond Cottrell, M.D. Kenneth DeLay, M.D. Margarett Ellison, M.D. Cynthia Evans, APRN Michael Forsthoefel, M.D. Sharron Foster, M.D. Dale French, D.O. Anneka Gaffney, APRN Karin Gamery, APRN Hong Gao, M.D. Judy Griffin, APRN Hantz Hercule, M.D. Todd Hewitt, M.D. Jessica Hill, M.D. Amit Jain, M.D. Fang Sarah Ko, M.D. Amulya Konda, M.D. Stefanie Kreamer, M.D. Elaine Larkins, APRN Matthew Lee, M.D. Ian MacDonald, APRN Charles Maitland, M.D. Michael Mangan, M.D. Ashok Manocha, D.D.S.

Ovidiu Marina, M.D. William McFatter, D.D.S. Jonathan Melquist, M.D. Kelley Miller, APRN Marcia Morris, APRN Jayan Nair, M.D. Chukwuma Okoroji, M.D. Rose Origa, APRN Anthony Otekeiwebia, M.D. Paresh Patel, M.D. Mitchell Peabody, D.O. Jorge Perez de Armas, M.D. Lisa Perkins, APRN Jessica Proxmire, APRN Stephen Quintero, M.D. Alexander Ramirez Valderrama, M.D. Hussein Rayatzadeh, M.D. Charlie Richardson, M.D. Carla Robertson, APRN Tim Ruark, M.D. Ronald Saff, M.D. Lucilita Salvador, P.A. Benjamin Shivar, P.A. Gadi Silberman, M.D. Hardeep Singh, M.D. Spencer Smith, P.A. Joshua Somerset, M.D. Abisoye Somorin, APRN Alanna Steaple, APRN Kris Stowers, M.D. John Thabes, M.D. Briana Thompson, M.D. Faye Tinson, APRN Gregory Todd, M.D. Marianne Towler, APRN Jean-Paul Tran, M.D. Mary Tucker, M.D. Jeffrey Wasserman, D.O. Lucas Watkins, M.D. Robert Watson, M.D. Graham Whitaker, M.D. Ronald Willis, D.M.D. Shana Wood, APRN

DURING THE MONTH OF JUNE 2020, THE WE CARE NETWORK: RECEIVED 245 REFERRALS, WITH 139 PATIENTS NEW TO THE PROGRAM

SCHEDULED 99 APPOINTMENTS WITH VOLUNTEER PHYSICIANS AND DENTISTS

$195,389.03 IN DONATED CARE WAS REPORTED BY WE CARE VOLUNTEERS

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

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THANK YOU TO PPE DONORS AND VOLUNTEERS

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