OCTOBER EDITION, VOLUME 2019, NO. 10
-Capital Medical Society Celebrates National Breast Cancer Awareness MonthBREAST CANCER – A HEMATOLOGIST/ONCOLOGIST’S PERSPECTIVE By Tim Broeseker, M.D. Breast cancer remains a common cancer among women and a rare occurrence in men. Fortunately, the majority of patients are now diagnosed with early stage disease and cured with appropriate therapy, with a 10-year survival rate of about 80%. Breast cancer is the second leading cause of cancer deaths in women, far surpassed by lung cancer. Guidelines for screening mammography continue to evolve and differ from one professional group to another. For women ages 40 to 49, guidelines vary from recommending yearly mammography to individualizing the decision. For women ages 50 to 74, recommendations for mammography are split between yearly and every 2 years. For women older than 75, most recommend an individualized decision. While there is a role for screening MRI of the breast, the need for this is infrequent.
It may come as a surprise that there is no data to show a clear benefit for routine self-breast exams or exams by a health care professional, particularly in women who are getting routine screening mammograms. Nonetheless, this is a simple, low (or no) cost practice that is still thought to be worth educating and recommending to women. Breast cancer gene testing for BRCA1 and BRCA2 is important for women with breast cancer AND: 1) a strong family history of breast or ovarian cancer; 2) a personal history of triple negative breast cancer diagnosed under age 60; 3) a personal history of bilateral breast cancer; 4) a personal history of ovarian cancer; 5) under the age of 50 at time of diagnosis, plus several other less common scenarios. The presence of a breast cancer gene significantly increases the risk of ovarian cancer as well as breast cancer. Overall, however, only about 5% of all breast cancers are due to the presence of a breast cancer gene. There are other less common genes than BRCA 1 and BRCA 2, however, these do not CONTINUED ON PAGE 3
Capital Medical Society thanks the physicians and dentists in this community who provide care to breast cancer patients. CAPITAL MEDICAL SOCIETY 2019 MEETINGS CALENDAR October 15, 2019 CMS Membership & CME Meeting Prevention of Medical Errors Speakers: Julia Weeks, M.D. and Jesse Suber, Esq. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks
November 12, 2019 CMS Membership & CME Meeting Women are from Venus; Men are from Mars: Sexual Dysfunction on both Planets Speakers: Andrea Friall, M.D. and Kenneth DeLay, M.D. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks
December 5, 2019 CMS Foundation Holiday Auction 6:00 pm *NEW TIME* FSU University Center Club
BOARD OF GOVERNORS Maribel U. Lockwood, 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
Ken Whithaus, M.D., President-Elect Rohan Joseph, M.D., Secretary/Treasurer David Dixon, D.O., Immediate Past President
National Breast Cancer Awareness Month................................1 Professional Notes.........................................................................5 CMS Lunch and Learn...................................................................7 CMS/CMSA Connect the Docs Family Picnic..........................8 Military Service.............................................................................10 Reflections from the Editor........................................................ 11 Physician Burnout........................................................................ 14 Physician Wellness...................................................................... 16 More Simpler Times..................................................................... 18 Announcements........................................................................... 19 CMS Connect the Docs Happy Hour...................................... 20 2019 CMS Foundation Holiday Auction.................................. 21 Resident Perspective................................................................. 23 CMS Boards Welcome CMSF Development Director......... 24 CMS Foundation.......................................................................... 25 CMS Foundation: We Care Network...................................... 26
Christie Alexander, M.D. Todd Hewitt, M.D. Marc Inglese, M.D.
HAPPY BIRTHDAY!
Melissa Inglese, CMS Alliance Sarah Ko, M.D.
{OCTOBER BIRTHDAYS}
Matt Lee, M.D. Paresh Patel, M.D. Helen Paulson, M.D. Cody VanLandingham, M.D. Julia Weeks, M.D. Pam Irwin, Executive Director, Capital Medical Society Dermatology Residents Samantha Marrone, M.D./Shalini Thareja, M.D. Family Medicine Residents Tristan Brooks, D.O./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. 2
William Donnellan, Jr., M.D. – 2nd Roy Forman, M.D. – 4th Mary P. Norton, M.D. – 4th Chris VanSickle, M.D. – 4th Joseph Pagano, M.D. – 5th David Dolson, M.D. – 6th Kris Stowers, M.D. – 6th Windrik Lynch, M.D. – 8th J. Brian Sheedy, M.D. – 8th Rohan Joseph, M.D. – 10th L. Steve Sarbeck, M.D. – 10th Thomas Noel, M.D. – 12th Adrienne George, M.D. – 13th Tony Weaver, M.D. – 13th Sandeep Rahangdale, M.D. – 14th Eliot Sieloff, M.D. – 14th Pat Woodward, M.D. – 16th Garrett Chumney, M.D. – 18th Pam Irwin – 18th Mary Jane Tucker, M.D. – 19th Lori Rosenberg, M.D. – 21st Dennis Williams, M.D. – 21st
Scott Tetreault, M.D. – 22nd Patrice Bidwell, M.D. – 23rd Mark Fahey, M.D. – 23rd Michael Wilhoit, M.D. – 23rd Eric Chung, M.D. – 24th Alma Fe Houghton, M.D. – 24th Stephen Richardson, M.D. – 24th H. Logan Brooks, M.D. – 25th David Dixon, D.O. – 25th Andrea Venturini, M.D. – 25th Brewster Caldwell, D.O. – 26th Amanda Davis, M.D. – 26th Kathryn Davis, M.D. – 27th Zalika Paul, M.D. – 27th Simone J. Lescott, M.D. – 28th Judy St. Petery, M.D. – 29th Kenneth Wasson, M.D. – 29th Chien-Yi Ruby Williams, M.D. – 29th J.W. Richard Davis, M.D. – 30th D. Paul Robinson, M.D. – 30th Tom Hicks, M.D. – 31st John Streacker, M.D. – 31st
HAPPY BIRTHDAY! WE ARE SO GLAD YOU WERE BORN!
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DID WE MISS YOUR BIRTHDAY? IF SO, PLEASE EMAIL ROSALIE CARLIN AT RCARLIN@CAPMED.ORG!
NATIONAL BREAST CANCER AWARENESS MONTH
CONTINUED FROM COVER
increase the risk of breast cancer as much as BRCA 1 and 2.
HER2 positive patients in both the adjuvant and metastatic setting.
About thirty years ago, a paradigm shift occurred when lumpectomy plus radiation was shown to produce results equivalent to mastectomy in the majority of women with breast cancer. However, a trend has emerged over the past 15 years or so, where women are choosing, with increasing frequency, to treat unilateral breast cancer with bilateral mastectomies and immediate reconstruction even when breast conservation is an acceptable option for them. Most of these women are in the 40 to 50-year-old age group, and there is no strong data to support this as a better cancer treatment. It may be that since reconstruction results have become so acceptable, mastectomy is not seen as deforming as it once was. For women choosing breast conservation, the duration of radiation therapy for many patients can now be shortened from the traditional six and a half weeks to about five weeks.
Immunotherapy has made an impact in several other cancer types, though not as much currently in breast cancer. There is some benefit in the setting of metastatic triple negative (negative for estrogen receptor, progesterone receptor, and HER2) breast cancer, which is a subset where we still struggle to find more effective medications.
From my perspective as a medical oncologist, we have enjoyed an expansion of effective therapies over the past several years. Mutational analysis of breast cancer has allowed us to narrow our recommendation regarding who should receive adjuvant chemotherapy for node negative disease, thereby sparing many women unnecessary chemotherapy. Anti-estrogen therapy remains very effective for cancers that carry receptors for estrogen. For metastatic disease, we now routinely add a second drug from a class of drugs called CDK 4/6 inhibitors to the usual aromatase inhibitors, which substantially improves response rate and duration of response with minimal, or no, additional toxicity. About 25% of breast cancers are positive for a membrane protein called HER2. In these cancers, drugs that interfere with HER2 mediated metabolic pathways have proven very effective with low toxicity, and are used now routinely in
Number of New Cases and Death Rank
Common Types of Cancer
Estimated New Cases in 2019
Estimated Deaths 2019
1.
Breast Cancer (Female)
268,600
41,760
2.
Lung and Bronchus Cancer
228,150
142,670
3.
Prostate Cancer
174,650
31,620
4.
Colorectal Cancer
145,600
51,020
5.
Melanoma of the Skin
96,480
7,230
6.
Bladder Cancer
80,470
17,670
7.
Non-Hodgkin Lymphoma
74,200
19,970
8.
Kidney and Renal Pelvis Cancer
73,820
14,770
9.
Uterine Cancer
61,880
12,160
10.
Leukemia
61,780
22,840
15.2% Female breast cancer represents 15.2% of all new cancer cases in the U.S. Courtesy of National Cancer Institute
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
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CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
PROFESSIONAL NOTES
PROFESSIONAL NOTES As Bond Community Health Center celebrates its 35-year anniversary, the health center continues to strive to provide access to quality care to all. In June 2019, Bond achieved full accreditation from the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) and received Patient Centered Medical Home and Patient Centered Dental Home Recognition at all sites. The Bureau for Primary Health Care/Health Services and Resources Administration (BPHC/HRSA) awarded Bond $50,000 toward advancing quality improvement activities and maintenance of the patient-centered care model. Overall, BPHC/HRSA awarded quality improvement grant awards totaling $4,685,000 to 45 Florida health centers for such accomplishments as reducing disparities, advancement of health IT, controlling cost of care, and improving clinical quality measures.
CMS Members: If you receive accolades, please let us know so we can include you in this section! Email the details to Shannon Boyle at sboyle@capmed.org.
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7219_FL_CapitalCMS_DNA_Oct2019_0919_v1.indd 1 CAP SCAN - A CAPITAL MEDICAL SOCIETY
PUBLICATION
9/9/19 11:24 AM
CMS LUNCH AND LEARN
CAPITAL MEDICAL SOCIETY LUNCH AND LEARN SEMINARS BE SURE TO REGISTER FOR THE FALL 2019 LUNCH AND LEARN SEMINARS: October 16, 2019 Our Regional Health Information Exchange – What’s Next... Learn about our regional Health Information Exchange (or the RHIN as most users call it). Zach Finn, CEO of HIE Networks, will lead a presentation on the secure network covering new system features, who’s participating, and how to get connected if not already. A few specific topics include: • My EMR and interfacing - maybe it’s time? • Fax servers - is it time to rip-and-replace? • Fax Link - what is it and how do I use it? • Who in your organization is using the HIE and what other benefits are available? • Workflow Engineer - they are here to help! • Not connect - do you qualify to receive available funding? Speaker: Zach Finn, CEO, HIE Networks Sponsor: HIE Networks
November 13, 2019 Technology Roundtable Speaker: TBA Sponsor: TMH Federal Credit Union For more information or to RSVP, please contact Rosalie Carlin at (850) 877-9018 or rcarlin@capmed.org.
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
Seminars are held at the Capital Health Plan on Governors Square Blvd. – and we thank them for providing this venue to us.
WELCOME Amanda Stephens, DO Gynecologic Oncology Medical School: Lincoln Memorial University DeBusk College of Osteopathic Medicine Residency: Botsford Hospital (Beaumont Health) – Farmington Hills, MI Fellowship: Florida Hospital - Orlando, FL
TMH PHYSICIAN PARTNERS
Gynecologic Oncology 1775 One Healing Place Tallahassee, Florida 32308 850-431-4888
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CMS/CMSA CONNECT THE DOCS FAMILY PICNIC
THE CMS/CMSA CONNECT THE DOCS FAMILY PICNIC ON AUGUST 24TH AT MACLAY GARDENS STATE PARK WAS A HUGE SUCCESS! WE HAD 100 PEOPLE ENJOYING THE OUTDOORS WITH DELICIOUS FOOD, FUN GAMES AND ACTIVITIES, AND GREAT CONVERSATION.
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CMS/CMSA CONNECT THE DOCS FAMILY PICNIC
CONTINUED ON PAGE 12
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
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MILITARY SERVICE
CMS MEMBERS: HAVE YOU SERVED/ARE SERVING IN THE MILITARY? WE WOULD LIKE TO LIST ALL OF OUR CMS MEMBERS WHO SERVE/HAVE SERVED IN THE MILITARY IN OUR NOVEMBER 2019 CAP SCAN NEWSLETTER. IF YOU ARE SERVING OR HAVE SERVED, PLEASE CONTACT ROSALIE CARLIN AT (850) 877-9018 OR RCARLIN@CAPMED.ORG BY OCTOBER 8TH WITH YOUR BRANCH OF SERVICE AND RANK.
Elite Women’s Health and Dr. Stephanie Lee Welcome
KIM MORPHET, APRN back to Tallahassee! Same day appointments available! Call or Visit our website today to schedule your appointment! Phone: 850-320-7693 www.elitetallahassee.com
3217 Capital Medical Blvd. Tallahassee, FL 32308 10 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
REFLECTIONS FROM THE EDITOR
WHAT DID YOU JUST ASK ME? By Frank Skilling, M.D. The greatest problem in communication is the illusion that it has been accomplished. - G.B. Shaw (attributed) I have come to believe that one role of the first year in medical school is to learn the vocabulary of medicine well enough to follow whatever topic is being discussed on a rudimentary level. Early on I thought it meant memorizing a lot of “junk” that the medical students would only later find to be useful in the care of patients while on the hospital rotations. The challenge during the first year is to keep up with the terminology, which comes in unrelenting volumes. Despite one’s previous exposure to medical topics, learning the language of medicine is daunting, nonetheless. When I entered the University of Alabama at Birmingham School of Medicine in 1968, I was brought in with nearly one hundred other men and only two women. Our curriculum was packed with daily lectures and anatomy labs that took up a minimum of thirty-six hours a week with no exposure to patients or clinics. Our only free afternoon was Wednesday when we were released at noon after a biochemistry lecture. In an effort to keep the first year students from premature despair that they would never see a living patient, we were assigned to a third year medical student as a “big brother” who would take us under his wings to introduce us to clinical medicine in whatever rotation he happened to be on. I was assigned to Raymond Lyrene, a tall, quiet, gentle man from rural Alabama who was hopeful of becoming a pediatrician. (He is now a pediatric pulmonary specialist in Birmingham.) That fall he was taking an elective in pediatric cardiology with Lionel Bargeron, M.D., a famous clinician whose patients came from all over the south. I tagged along with Raymond one Wednesday afternoon wearing my new short white coat and carrying my brand new stethoscope. Dr. Bargeron’s clinic was held in a large exam room that could accommodate the patient, their family, Dr. Bargeron, his assistant, several fellows, pediatric residents, and a host of medical students. I was, naturally, the least important and most ignorant in the group. While I knew that the ear pieces of the stethoscope were supposed to fit into the external auditory canals, I hadn’t listened to a single chest at that time and had no earthly idea what hearts were supposed to sound like. As was the custom, I was the last person to listen to the patient’s chest.
After a bit of practice, I could use the stethoscope with enough proficiency to hear something, although I wasn’t sure what exactly it was. Throughout the afternoon Dr. Bargeron would diagram the child’s heart defect on a chalkboard and explain what sounds were generated by the various valvular anomalies. I felt like I was getting the hang of things because his diagrams correlated with the dissections we had been doing in the gross anatomy lab. As the afternoon wound down, the last patient and her parents were escorted into the exam room. She was a 16-yearold girl who was born with a ventricular septal defect that Dr. Bargeron had diagnosed and was following since infancy. This was the proverbial “hole in the heart” that sometimes closed spontaneously. He had opted not to recommend surgery since she was growing well and experiencing no physical limitations. Because she was well into puberty and had developed breasts, she had to remove her bra for the exam. While in another room, the nurse had put her in a gown backwards so that it fastened in front at the neck. This allowed the examiners to use their stethoscopes without exposing too much of her chest. Again the procession of examiners descended on the patient and, skipping direct visual examination, proceeded to perform auscultation to listen to the murmur. When it was my turn, Dr. Bargeron instructed me where to place my stethoscope on the chest wall and then told me to place my right hand along the lower left rib cage. I did as instructed, and he then turned to me and asked, “Did you feel a thrill?” I was both embarrassed and puzzled that he would ask me such a personal question, and in the presence of the patient and her parents. I didn’t know what to say, and kept my hand firmly placed on her ribcage. She seemed nonplussed after years of such exams. Sensing my embarrassment, Raymond leaned over the table and said to me, “A thrill is a murmur that is palpable.” Immediately I nodded at Dr. Bargeron and said, “Yes, I feel it.” My work with medical students has taught me that effective communication requires medical professionals to agree upon the language that they’re using to describe what they’re seeing and feeling clinically. It took me years to realize that my first year of medical school was essentially a language course in scientific description of the human body and its aliments. As I memorized volumes of material, the language of medicine slowly seeped into my consciousness so that I now have to compel myself NOT to think like a doctor. As an ophthalmologist I rarely think about cardiac murmurs anymore, but I know how to feel a thrill.
Dr. Bargeron was a courtly Southerner who talked to the patient’s family to evaluate the clinical status of the child, usually an infant or toddler, before carefully examining the child in the presence of the group. Then all the cardiology fellows, residents and students took turns in descending order of education and status to listen to the child’s heart sounds. CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 11
CMS/CMSA CONNECT THE DOCS FAMILY PICNIC
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12 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
CMS/CMSA CONNECT THE DOCS FAMILY PICNIC
A special thank you to our supporters for this event! Title Sponsor:
Event Sponsor: Maclay School
In-Kind Sponsors: Tami Frankland, Realtor with The Naumann Group Real Estate Seminole Sitters Games and tablecloths provided by: Hien Guyer and Amy Pagano
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
13
PHYSICIAN BURNOUT
REAL-WORLD STRATEGIES FOR PHYSICIAN BURNOUT By Robert D. Morton, CPHRM, CPPS, Assistant Vice President, Department of Patient Safety and Risk Management, The Doctors Company Throughout 2018, The Doctors Company’s patient safety risk managers provided hundreds of our members with live continuing medical education (CME) seminars that addressed burnout. The program evaluations asked members to tell us about actions they took as a result of participating in the seminars. The responses were wide-ranging, and some of them were understandably skeptical. Below is a synopsis of real-world actions taken by physicians and advanced practice providers to counteract burnout. The most common strategies provided by peers from their own experiences relate to scheduling or setting limits. Strategies include the following: • Allow more time for each patient visit, making visits more fulfilling. • Schedule adequate/more time off. • Provide more gaps in the schedule to allow for catch-up work or to make phone calls to patients. • Say no to more on your schedule. One CME participant offered an additional strategy related to setting limits: “Say no to overly complex cases.” Dr. Howard Marcus, an internal medicine physician in Austin, Texas, remarked, “Saying no to complex cases is in direct conflict with our obligations to take care of every patient to the best of our ability. People get old, sick, and complicated. It’s not their fault. That is the human condition. The solution is more time, not a refusal to see the patient. This is one area in which administrators should be willing to be more flexible so that physicians with the skill and the will to manage complex patients are provided adequate time and resources.” Other members recommended important first steps, such as being more aware of the signs of burnout in themselves and in colleagues. Suggested steps include the following: • Assess yourself for symptoms of burnout. • Provide mutual support so that all practice partners look for signs of extreme fatigue or burnout in each other. • Develop more awareness about the impact of job stresses on patient care. System and process changes implemented by members to address burnout often required collaboration with partners and staff. Suggested system changes include the following: • Review and revise electronic health record (EHR) templates. • Improve office systems for patient management. • Take steps to reduce nonclinical work that adds to daily burdens. • Improve workflow to streamline processes and outcomes. • Improve the patient intake and registration process. • Minimize administrative time. 14 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
• • •
Make documentation easier, allowing more time to focus on patients. Increase efficiency to provide patients with the best care possible. Facilitate timely review and action on lab results.
Staffing and delegation improvements also helped to reduce burnout. Members offer these options: • Provide extra office help to decrease physician frustration. • Assign a nurse practitioner or another clinician to address EHR usability issues with the vendor and provide staff education on EHR use. • Use a scribe. Members described and recommended individual and interpersonal efforts to advance well-being: • Take care of yourself so you can take better care of your patients. • Exercise regularly. • Start doing yoga. • Find comfort in spirituality and faith. • Seek counseling with local practitioners, such as psychologists, who are familiar with burnout. • Learn to be more tolerant of your patients and exhibit more patience with them. Rebuilding or Creating Community Members articulated a desire to create support groups or to find better ways for physicians to connect so they can support each other. It was a call for community. The theme of physician community and connectedness is strong. An article in NEJM Catalyst reported on an initiative to better understand the community of care. Among the findings: Those who simply gather for a meal can quickly move “from the complaints of the present to the possibilities of collective action. And in that experience, a community of peers and change agents was born.”1 Additional feedback from members expressed a need for interventions that combat burnout to begin at the earliest stage—even in medical school. Strategies for early interventions are in no short supply. One excellent resource is the National Academy of Medicine’s (NAM’s) Action Collaborative on Clinician Well-Being and Resilience. The Resource Center on the Clinician Well-Being Knowledge Hub website, which lists more than 100 resources on the topic of Learning Environment, is a comprehensive resource repository for those seeking to promote clinician well-being in their organizations and in their personal lives. As further evidence of its commitment to early intervention, the NAM Action Collaborative on Clinician Well-Being and Resilience
PHYSICIAN BURNOUT
hosted a live and web-streamed meeting titled “Redesigning the Clinical Learning Environment” in May 2019.2 Where to Begin It is clear that members identified a variety/combination of individual, structural, system, and organizational strategies that can help physicians reduce burnout and focus on what matters most to them. For anyone feeling paralyzed and not knowing where to begin, think globally and act locally. As a colleague shared: “Don’t wait for the perfect solution at the peril of not starting something.” Start somewhere; that’s how change begins. Resource The National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience, Clinician Well-Being Knowledge Hub. https://nam.edu/clinicianwellbeing/. ________________________________________ References 1. Métraux EL, Hiniker D, Kinner P. “Breaking bread” to combat burnout. NEJM Catalyst. March 14, 2019. https://catalyst.nejm.org/breaking-bread-burnoutcommunity/?utm_campaign=Connect%20Weekly&utm_ source=hs_email&utm_medium=email& utm_ content=70937477&_hsenc=p2ANqtz-8R3PXSW_je7p67ax4TkjQeOZhfTAxZzF39ASr_cpC7ARoEylKjz9htYUCedKn_
TRtxv0xo5Up6S09lQDh0BYCmxnL_Q&_hsmi=70937477. Accessed May 21, 2019. 2. Action Collaborative on Clinician Well-Being and Resilience. National Academy of Medicine website. https://nam.edu/event/establishing-clinician-well-beingas-a-national-priority-meeting-5/?utm_source=National +Academy+of+Medicine&utm_campaign=f74219fdffCR+July+meeting+registration_COPY_01&utm_ medium=email&utm_term=0_b8ba6f1aa1f74219fdff-146476909. Accessed May 21, 2019. ________________________________________ 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 considering the circumstances of 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)
OCTOBER 10 IS NATIONAL DEPRESSION SCREENING DAY Depression is common and treatable. About 10% of Americans suffer from depression each year. Symptoms to look out for include feelings of hopelessness and pessimism, decreased energy, insomnia or oversleeping, and significant changes in weight. If you feel you or a loved one may be depressed, share this with your primary care physician and see a licensed therapist. Anyone can take an anonymous depression screening at http://www.HelpYourselfHelpOthers.org.
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 15
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)
16 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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MORE SIMPLER TIMES
PEDRO, TICKS AND SURVIVAL By Charles D. “Pedro” Williams, M.D., FACR, FAAP Me and Pat upped and decided this past July to gather up our younguns and grand younguns and head up to North Carolina to the mountains to do some hikin’ and playin’ in the creek. On the eighth day I developed a flu-like syndrome except it wudn’t and decided to head back to Tallahassee. I was seeing little spots in my eyes and someone asked me if I had seen a doctor. I replied, “No, jest those little spots.” Later upon arrival in Dr. Judelle’s office he didn’t like the way I looked and called the EMT’s and sent me to the intensive care unit. My dad never liked the way I looked either but he never sent me to the hospital. Somebody said I was in septic shock and I could hear Dr. Judelle repeating, “Charles, Charles, speak to me, speak to me” and I cudn’t. However, I was thinkin’ my reputation is going to pot. They told me my blood pressure was 70/40 and my oxygen saturation was around 82. They started IV rocephin and gentamicin as well as IV dopamine. They said there were some EKG changes and that I needed a heart catheterization. I was wondering if I really needed that because they might find something. I could see the concern and caring in Dr. Judelle’s eyes and he called in Dr. Gredler who also showed the same concern and caring. I started wondering if I should have any say so or if a doctor’s doctor doctored according to the doctored doctor’s doctrine or if the doctor doing the doctoring doctored the other doctor according to his own doctoring doctrine. Since I was sort of out of it and I didn’t have a choice, they doctored according to their own doctoring. Dr. Gredler skillfully did the heart cath and told me it was still ticking and that my coronaries were clean. This pleased me greatly but I still didn’t want to die in such good health. Dr. Judelle called in Dr. Eric Nicholson who suspected a tick ailment called Erlichiosis which shares some features between Rocky Mountain Spotted Fever and Lymes Disease and has been fatal in some cases. IV tetracycline was started and within 24 hours there was a cleansing of the body and my vital signs stabilized as well as my rosacea. Five days in the ICU at TMH was 18 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
quite an experience and the physicians, allied health professionals and hospital personnel were wonderful. After discharge Dr. Bud Bailey told me that Erlichiosis wuz a status disease or an elite disease and that only rednecks got it. At least Pedro wuz in good company. At first Dr. Bailey seemed to be an authority on Erlichiosis but later I come to realize he was actually an authority on rednecks. He said that bathing on Saturday nights would help and Mama told me the same thing when I was a kid and she didn’t even go to medical school. I appreciated all the phone calls and folks who visited me and expressed concern. Dr. Ronald Ray was one who tried to visit me in the ICU and had difficulty getting in. I told them that he was my brother and they let him in. He actually is my brother at work and if I could have had a brother he would certainly have made a good one. When one is laying around in the ICU one has time to think and can learn some valuable lessons. Like salt is what you don’t notice until someone doesn’t put it in your grits. Like you may not recognize the real value of a true friend, your family and your wife until you are about to leave this ol’ world. Like you may not recognize fun in your life and work until it’s about to vanish from you. And like when you are not responding to medical therapy, you turn to a higher power. There was a whole lot I could say about survival. There was a whole lot I could say about the love of family and friends. There was much I could say about my doctors and care givers and there was so much I could say about spirituality, faith and higher beings. However, Pedro is just so happy to be alive and is so happy to find out that there were others who felt the same way.
Reprinted with author permission from More Simpler Times, Tales of a Southern Boy. Dr. Williams’ book, More Simpler Times, can be purchased from the Capital Medical Society. All proceeds from the book are donated to the We Care Network program.
ANNOUNCEMENTS
CMS ALLIANCE CHECK PRESENTATION The Capital Medical Society Alliance presented a $500 check to Pam Irwin for the Capital Medical Society Foundation Holiday Auction at their September 4, 2019 meeting.
MEDICAL SCHOOL DEBT Nearly two-thirds of actively practicing physicians still carry debt from medical school, according to a new national survey. Of those doctors, 32% had more than $250,000 in debt remaining, according to the study by Weatherby Healthcare, a locum tenens agency that places physicians, physician assistants, and nurse practitioners.
The company surveyed more than 500 actively practicing physicians in the U.S. and asked them about medical student debt, which has been an increasing problem garnering national attention. The high cost of medical school loans weighs heavily on doctors for many years following graduation, the survey found, as one-third of respondents (34%) expect to take at least 10 years to pay off their student loans. Source: FierceHealthcare, August 7, 2019, https://www.fiercehealthcare.com/practices/ nearly-two-thirds-physicians-carry-medicalschool-debt-survey-finds
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 19
CMS CONNECT THE DOCS HAPPY HOUR
OUR HAPPY H 5TH BER SEPTEM ON E HOUSE THE WIN STREET MARKET
A Good Time Was Enjoyed By All! A SPECIAL THANK YOU TO OUR SPONSOR FOR THIS EVENT:
20 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
2019 CMS FOUNDATION HOLIDAY AUCTION
Mark Your Calendars for This Year’s CMS Foundation Holiday Auction! Thursday, December 5, 2019 6:00 pm *NEW TIME* University Center Club at Florida State University 1 Champions Way (Doak Campbell Stadium) The Holiday Auction is the signature fundraising event of the Capital Medical Society physician community to fund the programs and initiatives of the Capital Medical Society Foundation, including the We Care Network, scholarships to medical students, and grants to programs that improve access to health care. The CMS Foundation gave $50,000 to ten deserving medical students this year. 2019 Scholarship Recipients: Blaire Scoles Cote Laura Ann Marie Davis Shelby De Cardenas Chase Forehand Jacqueline Hanners Laken Johnson Samantha Mahon Caneisaya Matthews Christopher Pope Lauryn Reid
Here is how you can help make the Holiday Auction even better than last year: 1. Plan to attend. Mark the Holiday Auction on your calendar. We want everyone to be there on December 5! The entrance fee is $100 per person. 2. Be an Individual Sponsor. Support the CMS Foundation with a $100 tax-deductible donation. We will publish the names of our individual sponsors in our event materials. 3. Donate an item for the auction. Do you have an item that you would like to donate? Call the CMS office at (850) 877-9018. 4. Give a Physician Group Sponsorship. If you belong to a large physician group practice, we encourage you to be a corporate sponsor. The donations and group practices will be listed in all our event materials, along with our local business sponsors. Your fellow physicians ask that your group become a sponsor at either the $500 or $1,000 level. These request letters have been mailed. Invitations to the Holiday Auction will be mailed in November. We hope to see you there! CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
21
2019 CMS FOUNDATION HOLIDAY AUCTION
FOUNDATION
SUPPORT YOUR FOUNDATION BE A HOLIDAY AUCTION SPONSOR! We Care Network
Capital Medical Society Foundation ~ Holiday Auction December 5, 2019 University Center Club at FSU FSU Doak Campbell Stadium – 1 Champions Way Sponsor Name:________________________________________________________________________ Address:___________________________________________________________________ Phone: ______________________________ Fax:__________________________________ E-mail:_____________________________________________Today’s Date:_______________________ Primary Contact:_____________________________________________________________ Contact Signature:___________________________________________________________ Please check your sponsorship level: _____ Title Sponsors: $5,000 • Invitation for eight (8) company representatives to the Holiday Auction • Logo on event materials • Recognition in articles/pictures in the newsletter, Cap Scan • One free full-page black & white ad in 2020 in the newsletter, Cap Scan • Logo on post-event Tallahassee Magazine advertisement
_____ Supporting Sponsors: $1,000 • Invitation for four (4) company representatives to the Holiday Auction • Listed as sponsor on event materials • Recognition in articles/pictures in the newsletter, Cap Scan • Listed as sponsor in post-event Tallahassee Magazine advertisement
_____ Presenting Sponsors: $2,500 • Invitation for six (6) company representatives to the Holiday Auction • Logo on event materials • Recognition in articles/pictures in the newsletter, Cap Scan • One free half-page black & white ad in 2019 in the newsletter, Cap Scan • Logo on post-event Tallahassee Magazine advertisement
_____ Event Sponsors: $500 • Invitation for two (2) company representatives to the Holiday Auction • Listed as sponsor on event materials • Recognition in articles/pictures in the newsletter, Cap Scan • Listed as sponsor in post-event Tallahassee Magazine advertisement
Donations payable to: Capital Medical Society Foundation The Capital Medical Society Foundation is a 501(c)(3) Corporation Federal Tax I.D. #: 59-2104510 COMPLETE AND FAX THIS FORM TO CMS: (850) 878-0218 QUESTIONS? CALL (850) 877-9018 22 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
RESIDENT PERSPECTIVE
WOULD YOU RATHER BE LOVED OR RESPECTED? By Alicia Billington, M.D., PhD, USF Health Morsani College of Medicine Five years ago I sat in a small room at a table across from an older gentleman whose face was expressionless and intense. He asked me a series of questions which I answered and have since forgotten. A handful of other people similarly interviewed me that day. Yet the only question I remember from this interview day for residency was the following, “As a doctor, would you rather be loved or respected, and why?” The first day of residency I asked myself the same question. Would I rather be loved or respected? A could hear the pattering of footsteps trailing me as the three medical students assigned to my service followed me from room to room and even to the bathroom till I remembered they were with me and I told them where I was going. What kind of a teacher should I be? What impression did I want to leave? What sort of future doctor did I want them to become? I looked around at the world of surgery and the answer for me was clear. There were a lot of tough folks in the surgery world. One person offering a little love couldn’t be a bad thing. Perhaps I would be perceived as being weak if I was nice to the medical students. Or perhaps I would be the one person that was kind to them and made them see how awesome the field of surgery was and why they should become a surgeon. I remembered being yelled at, embarrassed, and shamed as a medical student. So, I figured if I could hide it, it was better to be loved. Interactions with patients were a bit trickier. What would be my philosophy with the five-year-old boy who was beaten by his father versus the 25-year-old drug dealer with a fractured mandible? Human nature dictates that we behave differently in these situations. Yet here I am a fresh white coat. How did I get the mother to trust a young doctor? Shouldn’t I show authority so she knows I am in charge? And how do I get the prisoner to open up to me about risky behavior that could affect his safety and mine? Then there are the other residents. As I progressed through residency I thought about how I wanted to be perceived by the residents above me and below me. I wanted to residents above me to think I was tough and that I could handle the work. I wanted to residents below me to trust me and to not be afraid to approach me. Yet I didn’t want anyone to think that I was soft and could be walked over.
Each year at the start of a new level in residency I again ask myself this question to assess if my answer has changed. It has not. No matter the person, no matter the situation, I have remained steadfast in my answer. When the interviewer asked me this question I knew what I was supposed to say. The Machiavellian response to leadership is that fear overrules love. Always. But here is what I had to say. Lots of leaders are loved. Lots of leaders are respected. I would rather be loved. To me, love implies respect. It implies trust. It has a connotation of positivity. Respect does not mean that you are loved. It means you are accepted as the authority. But being a doctor is a partnership, not just a leadership. You have to get your patients to buy-in and open up about their deepest, darkest secrets. It requires medical students to let show their insecurities and ask questions. When you are a doctor your lower levels need to not fear you at 3AM when they don’t know what the next step is when a patient is sick so they can pick up the phone to ask for help. With the attendings, the most important component of our relationship is that they know I will be honest and work hard. I was told no one had ever answered the question that way before. I knew the right answer was supposed to be respected and not loved but that wasn’t the right answer for me. I figured if the program didn’t like my answer maybe it wasn’t the right program for me. On a day to day basis we face challenges in medicine. Situations annoy us. The correct instruments are missing. Someone doesn’t follow the post-op orders. We get called about stool softeners in the middle of the night not being ordered. We have two options: engage in a way that makes us respected or loved. While I don’t always get it right, I think the world can always use just a little more love. Originally published in Vol. 65, No. 2 – July/August 2019 of the Hillsborough County Medical Association publication, The Bulletin. Reprinted with permission.
As for my attendings, all I wanted when I started was to be accepted. I wanted to feel like they wanted me there and that I wasn’t a mistake. CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 23
CMS BOARDS WELCOME CMSF DEVELOPMENT DIRECTOR
JUDI WILLS’ GATHERING CAPITAL MEDICAL SOCIETY PRESIDENT, MARIBEL U. LOCKWOOD, M.D. HOSTED A WELCOMING PARTY AT HER HOME ON AUGUST 25, 2019 FOR THE BOARD DIRECTORS OF THE CAPITAL MEDICAL SOCIETY, THE CAPITAL MEDICAL SOCIETY FOUNDATION, AND THE CAPITAL MEDICAL SERVICES TO MEET JUDI WILLS, WHO RECENTLY JOINED CAPITAL MEDICAL SOCIETY FOUNDATION AS ITS DEVELOPMENT DIRECTOR. ALL THREE ORGANIZATIONS ENTHUSIASTICALLY SUPPORT THE CMS FOUNDATION’S EFFORTS TO INCREASE RESOURCES AVAILABLE TO INCREASE ACCESS TO HEALTHCARE IN OUR COMMUNITY.
24 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
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 – Area of Greatest Need Pam Irwin – In Memory of Edward Francis Zapert, D.M.D. Scholarship Fund Dr. and Mrs. J. Brian Sheedy – In Memory of LaSalle D. Leffall, Jr., M.D. We Care Network David Bellamy, M.D.
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 $105.8 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 2018-19, which ended June 30, 2019, more than $7.8 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 2019, the CMSF awarded a total of $10,000 in grants to Elder Care Services for their In-Home Services Program, the Big Bend Hospice for bereavement services, and the Lighthouse of the Big Bend to provide clients who have vision loss with the aids needed to manage their health and medical care independently. 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.
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: Judi Wills Development Director jwills@capmed.org or (850) 877-9018 or after hours at (850) 509-2058 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
25
CMS FOUNDATION: WE CARE NETWORK
FOUNDATION
We Care Network
THANK YOU To our CMS members and We Care partners who saw new patients for the We Care Network in August 2019. Your generosity and support of the We Care Network makes a difference.
Physicians Clifton Bailey, M.D. Venkata Bavikati, M.D. Marie Becker, M.D. Dhananjay Bendre, M.D. Tim Broeseker, M.D. Tony Bryant, M.D. David Burns, M.D. Carlos Campo, M.D. Joseph Camps, M.D. Stephen Carr, M.D. Gilbert Chandler, M.D. Alan Chen, M.D. George Cohen, M.D. Raymond Cottrell, M.D. Kenneth DeLay, M.D. William Dixon IV, M.D. Chesley Durgin, M.D. Mark Fahey, M.D. Akash Ghai, M.D. Spencer Gilleon, M.D. Gian-Carlo Giove, M.D. Aaron Guyer, M.D. Celeste Hart, M.D. Muhanad Hasan, M.D. Todd Hewitt, M.D. Brook Hill, M.D. Barbara Jaeger, M.D. Kenneth Kato, M.D. John Katopodis, M.D. James Killius, M.D. Amulya Konda, M.D. Gordon Low, M.D. Michael Mangan, M.D. Ovidiu Marina, M.D. Jayan Nair, M.D. Anthony Otekeiwebia, M.D. Michael Pentaleri, M.D. Jorge Perez de Armas, M.D. Cybelle Pfeifer, M.D. William Placilla, M.D. Davis Rierson, M.D. Andres Rodriguez, M.D. Stephen Sgan, M.D. Hardeep Singh, M.D. Francis Skilling, M.D.
Joshua Somerset, M.D. Bhavik Soni, M.D. Joseph Soto, M.D. David Stewart, M.D. Christopher Sundstrom, M.D. Mary Swain, M.D. Timothy Sweeney, M.D. William Thompson, M.D. Robert Thornberry, M.D. Ernesto Umana, M.D. Andrea Venturini, M.D. David Vermess, M.D. Kenneth Whithaus, M.D. Chien-Yi Williams, M.D. Daniel Yang, M.D. Samuel Yu, M.D. Brian Zirgibel, M.D. Dentists William Baldock, D.D.S. Labon Bontrager, D.M.D. Walter Colón, D.M.D. Brittney Craig, D.M.D. William McFatter, D.D.S. Lawrence Weaver, D.D.S. Facilities Advanced Urology Institute Anesthesiology Associates Apalachee Primary Care Bond Community Health Center Bristol Dental Clinic Brittney K Craig DMD Capital Periodontal Associates Capital Regional Surgical Associates Care Point Health & Wellness Center CESC Dental Clinic Dermatology Associates Desloge Home Oxygen Digestive Disease Clinic Eye Associates of Tallahassee Florida Cancer Specialists & Research Institute FSU PrimaryHealth Gadsden County Health Department Jessie Furlow Medical Center Ketchum, Wood, & Burgert Pathology Associates Kimble Family Center Lawrence E. Weaver DDS Madison Medical Center Neighborhood Medical Center North Florida Regional Thyroid Center North Florida Women’s Care North Monroe Medical Center Oral & Facial Surgery Center Periodontal Associates of North Florida
26 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION
Radiology Associates of Tallahassee Southern Medical Group, P.A. Tallahassee Dental Associates, PLLC Tallahassee Diagnostic Imaging Tallahassee Ear, Nose, & Throat Tallahassee Memorial HealthCare TMH Family Medicine Residency Program TMH Family Medicine - Wakulla 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 Rehabilitation Center TMH Transition Center TMH Wound Healing Center Tallahassee Orthopedic Clinic Tallahassee Outpatient Surgery Center Tallahassee Plastic Surgery Clinic Tallahassee Surgical Associates Tallahassee VA Clinic Wakulla County Health Department Wakulla Medical Center Women’s Imaging Center Tallahassee Orthopedic Clinic Tallahassee VA Clinic Wakulla County Health Department Wakulla Medical Center 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 August 2019 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) 2010085 or mail to 1204 Miccosukee Road, Tallahassee, FL, 32308. Thank you!
CMS FOUNDATION: WE CARE NETWORK
We thank our referring providers from August 2019:
Ebonie Allen, APRN David Alvarez, M.D. Anne Ananga, APRN Clifton Bailey, M.D. Karen Bartley, M.D. Marci Beck, D.M.D. John Bidwell, D.D.S. Kenara Blocker, APRN Jonna Bradley, APRN Sherry Bramblett, APRN Daniel Breivogel, APRN Tim Broeseker, M.D. Joedrecka Brown-Speights, M.D. LaToya Butler, D.D.S. Frances Carney, APRN Lysmar Carrion-Dinguis, M.D. Walter Colon, D.M.D. Melba Colon-Renta, M.D. Deborah Congdon, APRN Jeffrey Crooms, M.D. William Dixon IV, M.D. Wade Douglas, M.D. Margarett Ellison, M.D. Cynthia Evans, APRN Klive Forde, M.D. Sharron Foster, M.D. Anneka Gaffney, APRN Akash Ghai, M.D. Judy Griffin, APRN Muhanad Hasan, M.D. Hantz Hercule, M.D. Rohan Joseph, M.D. David Kahn, M.D. Arjun Kaji, M.D. Howard Kessler, M.D. Farhat Khairallah, M.D. Cynthia Kimble, M.D. Amulya Konda, M.D. Stefanie Kreamer, M.D.
Elaine Larkins, APRN Matthew Lee, M.D. Michael Mangan, M.D. Damon McMillan, M.D. Kelley Miller, APRN Marcia Morris, APRN Jayan Nair, M.D. Chukwuma Okoroji, M.D. Rose Origa, APRN Alfredo Paredes, M.D. Mitchell Peabody, D.O. Jorge Perez de Armas, M.D. Stephen Quintero, M.D. Alexander Ramirez-Valderrama, M.D. Brandi Richardson, APRN Charlie Richardson, M.D. Adrian Roberts, M.D. Andres Rodriguez, M.D. Lucilita Salvador, PA Sarah Skipper, PA David Smith, M.D. Joshua Somerset, M.D. Abisoye Somorin, APRN Anthony Speights, M.D. Alanna Steaple, APRN Christopher Sundstrom, M.D. John Thabes, M.D. Lacie Thompson, APRN Faye Tinson, APRN Barrett Tolley, D.D.S. Daniel Van Durme, M.D. Ramona Vossler, R.D.H. Dwanna Ward-Boahen, APRN Jeffrey Wasserman, D.O. Lucas Watkins, M.D. Eula Weaver, APRN Chien-Yi Williams, M.D. Brian Zirgibel, M.D.
DURING THE MONTH OF AUGUST, THE WE CARE NETWORK: RECEIVED 274 REFERRALS, WITH 179 PATIENTS NEW TO THE PROGRAM
SCHEDULED 125 APPOINTMENTS WITH VOLUNTEER PHYSICIANS AND DENTISTS
$315,402.46 IN DONATED CARE WAS REPORTED BY WE CARE VOLUNTEERS
CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 27
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