Cap Scan - December 2015

DECEMBER EDITION, VOLUME 2015, NO. 12

CAPITAL MEDICAL SOCIETY 2016 MEETINGS CALENDAR

January 21, 2016 Installation of New CMS President, J. Daniell Rackley, M.D. 6:00 pm FSU Alumni Center

March 24, 2016 Celebration Awards Dinner 6:30 pm FSU University Center Club

April 19, 2016 CMS Membership & CME Meeting 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks

BOARD OF GOVERNORS Joshua Somerset, M.D., President J. Daniell Rackley, M.D., President-Elect Tracey Hellgren, M.D., Secretary/Treasurer Alfredo Paredes, M.D., Immediate Past-President Shelby Blank, M.D. Garrett Chumney, M.D. David Dixon, D.O. Shakra Junejo, M.D. Maribel Lockwood, M.D. Amy Pagano, CMS Alliance President Paresh Patel, M.D. Philip Sharp, M.D. Ernesto Umaña, M.D. Kenneth Whithaus, M.D. Pam Wilson, Executive Director Family Medicine Resident Todd Hewitt, M.D. Internal Medicine Residents Sura Jermanus, M.D./Jose Martinez, D.O.

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

2015 CMS Meeting/Event Sponsors …

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New CMS Members …

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2016 CMS Presidential Installation …

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Announcements …

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CMS Lunch and Learn …

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CMS Membership Meeting Minutes …

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Reflections from the Editor …

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Viewpoint …

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CMS Happy Hour …

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Alliance Corner …

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Medical/Legal …

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CMS Foundation …

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CMS Foundation: We Care Network …

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HAPPY BIRTHDAY! {DECEMBER BIRTHDAYS}

Stephen Duncan, M.D. – 1st

Julie Kelch, M.D. – 14th

Terry Sherraden, M.D. – 1st

Milagros Pescador, M.D. – 15th

Chaowen Chen, M.D. – 2nd

Gary Winchester, M.D. – 15th

J. Orson Smith, Jr., M.D. – 3rd

Michele Hoggatt, M.D. – 16th

Dorothy White, M.D. – 3rd

Praful Patel, M.D. – 17th

Raul Fernandez, M.D. – 4th

Cristina Rodriguez, M.D. – 18th

C. William Applegate, M.D. – 5th

Arthur Clements, M.D. – 20th

Jeffrey Kirk, M.D. – 5th

Cynthia Tie, M.D. – 20th

Jonathan Appelbaum, M.D. – 8th

David Jones, M.D. – 21st

Arjun Kaji, M.D. – 8th

Dale Wickstrum, M.D. – 23rd

Kendall Campbell, M.D. – 9th

Angelo Ayar, M.D. – 25th

Elizabeth Curci, M.D. – 9th

Isaac Moore, M.D. – 25th

ARE YOU INTERESTED IN WRITING AN ARTICLE FOR CAP SCAN?

Joshua Somerset, M.D. – 9th

Efren Baltazar, M.D. – 28th

Larry Taylor, M.D. – 9th

Robert Watson, M.D. – 28th

Please contact Shannon Boyle at sboyle@capmed.org. All articles submitted will be reviewed by your peers prior to publishing.

Nighat Ahmed, M.D. – 11th

Bobby Abraham, M.D. – 29th

Charles Kent, M.D. – 11th

Tim Broeseker, M.D. – 31st

Thomas Lawrence, M.D. – 11th

Iman Imanirad, M.D. – 31st

William F. Lindsey, M.D. – 11th

Matthew Lee, M.D. – 31st

Paul Katz, M.D. – 13th

Gregory Todd, M.D. – 31st

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

MANAGING EDITOR Shannon Boyle

GRAPHIC DESIGN Gandy Printers

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.

W. Brad Stephens, M.D. – 13th

HAPPY BIRTHDAY! WE ARE SO GLAD YOU WERE BORN!

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

Thank you.

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

2015 CMS MEETING/EVENT SPONSORS

We thank the following businesses and organizations for sponsoring CMS Meetings/Events in 2015: Aargus Facility Services Big Bend Hospice Boehringer-Ingelheim Pharmaceuticals, Inc. Boys Town Bristol-Myers Squibb Capital City Bank Capital Health Plan Capital Regional Medical Center Centennial Bank Dermatology Associates of Tallahassee Digestive Disease Clinic and Tallahassee Endoscopy Center Express Printing FD Insurance Florida Blue Florida Medical Association FSU College of Medicine FSU College of Nursing Gilead Hancock Bank Hayes Computer Systems HealthSouth Rehabilitation Hospital of Tallahassee

Horizon Pharma Janssen Pharmaceuticals MagMutual Office Depot Pfizer Physicians Indemnity Risk Retention Group Prime Meridian Bank Prudential Financial Radiology Associates of Tallahassee Sanofi Southeastern Urological Center SunTrust Tallahassee Memorial HealthCare Tallahassee Memorial HealthCare Foundation Tallahassee State Bank/Synovus The Krizner Group Thomas Howell Ferguson P.A. CPAs TMH Federal Credit Union United Way of the Big Bend Westminster Oaks Active Living Community

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NEW CMS MEMBERS

CAPITAL MEDICAL SOCIETY IS PLEASED TO WELCOME THE FOLLOWING NEW MEMBERS:

Moses deGraft-Johnson, M.D. Medical School: Ross University Internship/Residency: Albert Einstein Long Island Jewish Medical Center Specialty: Vascular Surgery Practice: THORVASC, P.A.

Tracy Graham, M.D. Medical School: Florida State University Internship/Residency: University of Florida Specialty: Emergency Medicine Practice: Bixler Emergency Center, TMH

Katherine Guthrie, D.O. Medical School: Lake Erie College of Osteopathic Medicine Internship/Residency: University of South Florida Specialty: Pediatrics Practice: Pediatrix Medical Group of Florida Gregory Hartlage, M.D. Medical School: University of South Florida Internship/Residency: Emory Fellowship: University of South Florida Specialty: Cardiology Practice: Southern Medical Group 4

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

Jeffrey Kirk, M.D. Medical School: American University of the Caribbean Internship: New York Medical College, Our Lady of Mercy Residency: Albert Einstein College of Medicine Fellowship: Grand Rapid Medical Education Partners/Michigan State University Specialty: Vascular Surgery Practice: Capital Regional Vascular Surgery

Helen Paulson, M.D. Medical School: Florida State University Internship/Residency: Mountain Area Health Education Center, Asheville, NC Specialty: Family Medicine Practice: TMH Physician Partners, Quincy

Resident: Kristen Baker, M.D. Medical School: American University of the Caribbean Practice: TMH Family Medicine Residency Program

2016 CMS PRESIDENTIAL INSTALLATION

ATE D E H T SAVE 2016 CMS Presidential Installation Honoring J. Daniell Rackley, M.D. Insert photo 15

Thursday, January 21, 2016 at 6:00 pm FSU Alumni Center - 1030 West Tennessee Street CMS Members and their Spouse/Guest are invited

Keynote Speaker Ralph J. Nobo, Jr., M.D., Florida Medical Association President

Also Honoring Outgoing CMS President – Joshua Somerset, M.D. Outgoing CMS Board Members – Garrett Chumney, M.D., Alfredo Paredes, M.D., and Philip Sharp, M.D. Outgoing CMS Foundation Board Members – Katrina Rolle, J.D., Joshua Somerset, M.D., and Hugh VanLandingham, M.D. Outgoing CMS Alliance President – Amy Pagano Invitations will be mailed in mid-December.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

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ANNOUNCEMENTS

PROFESSIONAL NOTES

Jay Walton, D.D.S. represented The Florida Dental Association in receiving a check for $25,000 from the Walmart Foundation for a grant to pay for its Mission to Mercy program that will bring dentists from around the state to Jacksonville in April, 2016 with the goal of treating 3,000 people who can’t afford to go to the dentist. Dr. Walton serves on the Capital Medical Society Foundation Board of Directors and the We Care Network Dental Advisory Committee.

Ed Zapert, D.M.D., Executive Dental Director, Public Health Dental Program, Florida Department of Health and Katrina Rolle, UWBB President/ CEO, and Pam Wilson, UWBB Board member represented United Way of the Big Bend in receiving a check for $35,000 from the Walmart Foundation for a grant to support its SMILE UNITED initiative.

The United Way dental program is a collaborative effort between the Leon County Health Department Center for Dental Care and Prevention and Leon County Schools to provide students with services such as dental exams, cleanings, dental sealants, fluoride varnish, oral health instructions, personal dental kits, and referrals to further dental work when needed.

Dr. Zapert serves on the We Care Network Advisory Committee and the We Care Network Dental Advisory Committee.

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CELEBRATIONS

Attendees in photo: Dr. Al McCully, Robert McCully, Patti Trudeau, Mari McCully, Brian Shoemaker, Lauren Shoemaker, Dean Judith McFetridge-Durdle, PhD, RN

Dean Judith McFetridge-Durdle, PhD, RN, of FSU College of Nursing unveiled a memorial tribute for Mrs. Imogene “Jean” McCully on October 29, 2015 at the Vivian M. Duxbury Hall, FSU College of Nursing. The bronze memorial that captures the image of Mrs. McCully as a young nurse includes one of her favorite quotations from Aristotle, “Where the needs of the world and your talents cross, there lies your vocation.”

Family, friends and beneficiaries of Mrs. McCully community advocacy were on hand for the celebration. Dean McFetridge-Durdle shared the impact Mrs. McCully had for many years in advocating for funding for nursing scholarships from the Charles A. Frueauff Foundation. However, Mrs. McCully also had a tradition of extending hospitality to incoming faculty and students to welcome them to the community. She was a friend, an organizer, and a doer. She understood the importance of nursing to improve access to care.

CMS LUNCH AND LEARN

CAPITAL MEDICAL SOCIETY LUNCH & LEARN Capital Health Plan, 1491 Governors Square Boulevard On October 28th, Bill Krizner gave an excellent program on the areas that are most likely to create costly legal exposure at your company.

You can reach Mr. Krizner at (850) 3863747 or bkrizner@ thekriznergroup. com.

Hayes Computer Systems sponsored the October 28th Lunch and Learn. Jeff Chaffin and Colin Stephens were in attendance as representatives of Hayes Computer Systems. You can reach Mr. Chaffin at (941) 404-9151 or jchaffin@hcs.net or Mr. Stephens at (850) 766-3998 or cstephens@hcs.net.

Mark Your Calendars for the Spring 2016 Lunch & Learn Seminars: February 17, 2016 • March 16, 2016 • April 20, 2016 • May 18, 2016 Seminars are held at the Capital Health Plan on Governors Square Boulevard and we thank them for providing this lovely venue.

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Email for Full Details on these medical properties or to discuss your specific needs.

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CMS MEMBERSHIP MEETING MINUTES

MINUTES CMS MEMBERSHIP MEETING, OCTOBER 20, 2015 The mission of the Capital Medical Society is to promote the practice of medicine for the ultimate benefit of the patient.

Supporting Sponsor, Janssen Pharmaceuticals: (l-r) Shaina Jackson and Tracy Blandino.

I. Business Meeting – Capital Medical Society A. Welcome – Dr. Joshua Somerset, President, called the meeting to order at 6:20 pm. Dr. Somerset thanked Westminster Oaks for use of their incredible facility and Mr. Don Wilson, Executive Director at Westminster Oaks, spoke to the members about their facility.

B. Dr. Somerset welcomed and thanked our sponsors for the evening: Presenting Sponsor Florida Blue – Barbara Cox and Renard Head

Presenting Sponsor, Florida Blue: (l-r) Barbara Cox and Renard Head.

Supporting Sponsors Janssen Pharmaceuticals – Tracy Blandino and Shaina Jackson Physicians Indemnity Risk Retention Group – Kriston Kent, M.D.

Supporting Sponsor, Physicians Indemnity Risk Retention Group: Kriston Kent, M.D.

Meeting Sponsors Boehringer Ingelheim – Cori Bennett and Samantha Oven Bristol-Myers Squibb/Pfizer – Cynara Miller and Debra Placilla Centennial Bank – Steve Mitchell and Khanty Xayabouth Florida Medical Association – Chandra Prine HealthSouth Rehabilitation Hospital of Tallahassee – Jimmy Clark, PA and Valerie Sullivan MagMutual – Angela Ross Prudential Financial – Randall Rust and Ed Laurenzio Sanofi – Gavin Boone Meeting Sponsor, Boehringer Ingelheim: (l-r) Cori Bennett and Samantha Oven.

CONTINUED ON NEXT PAGE

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CMS MEMBERSHIP MEETING MINUTES

Meeting Sponsor, MagMutual: Angela Ross.

Meeting Sponsor, Bristol-Myers Squibb/Pfizer: (l-r) Debra Placilla and Cynara Miller.

Meeting Sponsor, Centennial Bank: (l-r) Steve Mitchell and Khanty Xayabouth.

Meeting Sponsor, Prudential Financial: (l-r) Ed Laurenzio and Randall Rust.

Meeting Sponsor, Florida Medical Association: Chandra Prine.

Meeting Sponsor, Sanofi: Gavin Boone.

C. New Members

a.

Dr. Somerset introduced new CMS Members in attendance: Kalil Al-Nassir, M.D., Tallahassee Pulmonary Clinic Michael Psikogios, M.D., TMH Physician Partners, Southwood Alexander Ramirez, M.D., TMH Physician Partners, Surgical Specialists

b. Dr. Somerset also introduced a new CMS Member applicant in attendance:

Helen Paulson, M.D., TMH Physician Partners, Quincy

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D. Mark Your Calendars

Dr. Somerset announced the upcoming meetings/events: November 10, 2015 Annual CMS Membership & CME Meeting- to vote on our 2016 slate of officers, board members and FMA delegates “Advanced Cardiac Imaging-Cardiac MRI” Greg Hartlage, M.D. and Ernesto Umaña, M.D. 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks

CMS MEMBERSHIP MEETING MINUTES

December 3, 2015 CMS Foundation Holiday Auction 6:30 pm University Center Club at Florida State University

II. Tonight’s CME Program – this is a 2 Hour Category One Program Topic: Prevention of Medical Errors Speaker: Scott Sellinger, M.D. and Jesse Suber, Esq.

Physician CME Proof of Attendance Forms will be sent to participants who attend the entire CME program.

III. Adjourn – Dr. Somerset adjourned the meeting at 8:10 pm.

Please Thank Our Sponsors for the October 20th CMS Membership Meeting Presenting Sponsor

Supporting Sponsors Janssen Pharmaceuticals Physicians Indemnity Risk Retention Group

(L-r) Jesse Suber, Esq., speaker for the evening; Dr. Joshua Somerset, CMS President; and Dr. Scott Sellinger, speaker for the evening.

Dr. Sellinger and Mr. Suber gave an excellent and informative program on the prevention of medical errors.

Meeting Sponsors Boehringer Ingelheim Bristol-Myers Squibb/Pfizer Centennial Bank Florida Medical Association HealthSouth Rehabilitation Hospital of Tallahassee MagMutual Prudential Financial Sanofi

CAPITAL MEDICAL SOCIETY 2016 MEETINGS CALENDAR

(continued from page 1)

April 23, 2016 Family Fun Day Picnic 11:00 am – 2:00 pm Maclay Gardens ($6 entrance fee)

September 20, 2016 CMS Membership & CME Meeting 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks

May 17, 2016 CMS Membership & CME Meeting 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks

October 18, 2016 CMS Membership & CME Meeting 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks

May/June 2016 CMS Doctor/Son Banquet Time & Location: TBA

November 15, 2016 CMS Membership & CME Meeting 6:00 pm Maguire Center for Lifelong Learning at Westminster Oaks

August/September 2016 CMS Meet the Candidates Forum Time & Location: TBA

December 1, 2016 CMS Foundation Holiday Auction 6:30 pm Location: TBA

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REFLECTIONS FROM THE EDITOR

SEE YOU AROUND

By Charles Moore, M.D.

“Yippee-Yi-Yo,” and, as I noted in my last month’s column quoting Mr. Boehner, “Zi-PiDee-Do-Dah”… for with this issue I submit my retirement from the Editorship of Cap Scan.

It’s not all that easy. Old habits are hard to relinquish. You know: Life, Children, Work, and of course, now, even bacon and hotdogs. The latter two, I am glad to say, I have decided to treat like a martini, and carry on in the face of every threat of cirrhosis and cancer of the colon. Having lived so moderately I must, like all other old duffers, simply counsel “moderation,” except when it comes to your wife and, when they are behaving, your children. Then you can do somersaults and “Zi-Pi-Dee-DoDahs” too.

I have penned this and that for these fleeting years: Diane Pickett, Mollie Hill, Karen Wendland, Sue Conte, and most recently Pam Wilson. As much as any, however, I thank Dr. Jim Conn, famous in days of yore as the compleat surgeon of the old school, who wrote seriously brilliant essays on the state of man and medicine. It was he who asked me to take up the pen for Cap Scan before it had a name, and was but two sides of a single sheet of mimeographed paper.

I have no idea, myself, whom I might in turn approach to ask, and who would enjoy being, the new Editor. Notice that the position comes with a capital “E” and other perks that may exist, but I am not sure of. And anyway, come to think of it, it is

But look, I much appreciate having had the opportunity to write for Cap Scan. And while I am at it, let me thank for their oversight and tolerance those CEOs of CMS under whom 12

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

equally true that we do not need an Editor whatsoever. Cap Scan is famous for demanding no particular style of its writers; we have been happy with wherever you want to put your commas, and only draw the line at just some few of the four letter words. It will be easy for Ms. Wilson, with the very pleasant assistance of Shannon Boyle, to see to that.

The future sails on, after all, inevitably.

So “Yippee-Yi-Yo,” and why not a round of “Zi-Pi-Dee-DoDahs” indeed, not to forget the bluebird on your shoulder, either!

And, by all means, Merry Christmas, too! CMS

VIEWPOINT

STANDING ON SHOULDERS

By A.D. Brickler, M.D. went into the power plant, and after 4 hours there was light. I wanted to be an engineer.

Editor’s Note: Never did a physician less inclined to be one become a better one!

My son, A.J. Brickler, wrote in these pages recently about inspiration. I also have a story to tell.

My dad was a national class distance runner who, with the aid of athletic scholarships and construction jobs, graduated from the University of Colorado with a degree in mechanical engineering. He subsequently became a professor at a small college in central Ohio. In addition to teaching internal combustion engine design and air frame stress, he was on call to the college President for any complex equipment problems.

Complete restoration of a Ford Model T fire engine, and the rebuilding of an old Allison aircraft engine represented the type of magic he accomplished.

He taught me to drive the fire engine. I was eleven years old.

We were inseparable. One winter night the steam generator that supplied power to the entire campus went down. My father and some of his senior students

World War II resulted in a critical need for engineers. This resulted in the relocation of our family to New Jersey. My father worked in the signal corps squire labs.

The war ended as I finished high school. Engineering schools were only accepting war veterans. My fall back was a double major in math and physics. The war was ended by two atomic bombs which vaulted physicists to rock star status. As a consequence, the MCAT were weighted heavily with physics. My college advisor, aware of this change, suggested that I take advantage of this situation and go to medical school. I entered medical school at the end of my junior year. No essay on my love of people or desire for rural practice required. Good, I did not have to lie.

I hated the first two years of med school. It was an unnecessary exercise in memorization as opposed to defining and solving problems.

Regurgitating the Krebs cycle or knowing the number of bones in the human body did not move me. The clinical years were better.

Then came the Korean War.

Now a medical officer in the USAF, I reported for duty at Lockbourne AFB, Columbus, Ohio. The hospital commander told me that I was to be his obstetrician. I was to work days with every other night call. We were affiliated with Ohio State Medical Center so I was to receive training credit. Two of my very close boyhood friends who were infantry officers died in Korea. We did everything together except going to med school.

My father in law was right up there with my Dad. He put himself through the University of Pittsburgh working in the steel mills. He graduated with a PhD in genetics, and subsequently earned a MD. He was professor of biology at FAMU with a huge primary care practice on the side. He asked me to help.

I was met with the massive social unrest associated with the civil rights transition, desperate medical need, and crushing poverty. I witnessed courage that was awesome. I cared for patients who could neither read nor write, but whose philosophical approach to life was inspiring. The work was backbreaking. The privilege of being involved was priceless.

I finally knew that I wanted to be a physician. CMS

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VIEWPOINT

DISINTERMEDIATION

By Frank Skilling, M.D.

Few Americans under sixty can recall the hassle of making a long distance call before direct distance dialing (DDD). First you had to have an open line, then dial zero for the operator, then tell her what number you wanted in whichever city, then you were put on hold on a “dead” line before the other party was connected through.

In the meanwhile the local operator contacted the long distance operator who then tried to patch through to the other local operator at the call destination. If the call was from a pay phone (remember them?) and you didn’t have any coins, you had to wait for the operator to “reverse the charges” before proceeding. Jim Croce in 1972 had a hit song called “Operator” that ended with the singer telling his phone operator “you can keep the dime.”

Thankfully, those days are long gone.

One of my current favorite words is disintermediation.

Originally used to describe financial transactions, it has now been adapted to other fields where an end user has direct access to a final product or service without the “mediation” of a middle man or intermediary. The examples are so numerous that it’s a bit hard to remember times when we needed skilled employees to perform tasks we routinely do for ourselves today.

My mother came from a small immigrant Italian family, and one of her cousins, Jenny George, started working as a telephone switchboard operator during high school. In her long career she became a supervisor and occasionally worked on Sundays when the long distance lines in the northeast were not busy. My Aunt Josephine lived near Jenny, and Jenny knew that Josephine was usually at home with my uncle Carmen on Sundays in Pennsylvania.

My mother Leona had moved far away from her family’s Hazelton, PA home to Miami when she married my father at the end of World War II.

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When our families were all at home, and Jenny was working, I would sometimes answer the phone on a Sunday to hear, “Please hold for long distance” before the line went silent. I was supposed to immediately notify my mother who grabbed the phone and waited until Aunt Jo was patched through to start a conversation that lasted at least an hour. I’m sure that Ma Bell, the behemoth American Telephone and Telegraph Company or ATT, provided our family with generous long distance service courtesy of Cousin Jenny.

The phone company in the 1950s needed a supervisor to keep track of long distance charges. Today we talk on satellite phones, smart phones, and land lines and never give a thought to contacting an operator except for directory assistance. This is one concept of disintermediation: no long distance operators needed, please don’t apply for a job that doesn’t exist anymore.

And, by the way, the same applies to milk men, ice cutters, lamplighters, rat catchers, and bowling pin setters.

VIEWPOINT

In my medical practice I now have to field inquiries or concerns from patients about perceived medical conditions that they have diagnosed themselves. Not a week goes by now without someone coming in for an “emergency” appointment to follow up on a symptom that they’ve been advised might be a serious eye problem. Seniors, adults, and children have access to sites like WebMD, Google Scholar, and various medical schools that caution them to seek immediate medical attention for: flashes, floaters, blurred vision, red eyes, irritation, contact lens problems, etc. While I’m grateful for the patient referrals, the anxiety that such unfiltered information creates is often the worst part of the visit for the patient or the parents. Everybody assumes the worst diagnosis is the correct one. The situation reminds me of one of my medical school roommates who developed every symptom when we studied pathophysiology in our second year. He practiced palpating his own liver so he could determine if he was developing fatty infiltration and needed to cut back on his beer consumption. Now everyone’s a self-diagnostician because of the internet.

Disintermediation has allowed the pharmaceutical

companies to directly advertise to consumers, and the evening network news, with lots of viewing seniors, is prime time for Viagra, Aleve, Xarelto, Claritin, etc. I remember when soft contact lenses were first advertised on television or popular magazines in the 1970s: it was the breakthrough product that heretofore had only been advertised to ophthalmologists.

The eye care community was a bit surprised to have their long term patients calling in to get the new Soflens product.

One of the older contact lens company representatives even apologized to me at the time for his company’s audacity to approach patients directly.

Today no one gives the ads a second thought. It’s assumed that viewers are also consumers and driving the demand to their physicians’ offices.

The social status of physicians has been changed by disintermediation. When I was a medical student in the 1970s, Ellen Balthrop, who was married to my physician mentor Ed Balthrop, a general practitioner in Pensacola, gave me a copy of The Young Princes. This was an essay by a distinguished medical historian who wrote for the then popular MD Magazine, a publication targeted at physicians and their leisure time (and NOT

Mad Magazine, the satirical publication). In the book he likened the medical students of the era to the young princes who were heirs to the throne but not yet entitled to rule on their own. He extolled the virtues of being a physician, and Ellen Balthrop inscribed the end page with a quote from the book. It read simply, “To be a doctor is to be an intermediary between God and Man.” If that essay was written today, the quote would have to be rewritten as, “To be a doctor is to be an intermediary between the patient and, please make a selection, the pharmaceutical industry, the hospital industry, the insurance industry, or the government bureau of your choice.” The physician still practices medicine, but disintermediation has removed the influence he or she once possessed to intercede with God in the once hallowed doctorpatient relationship. CMS

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CMS HAPPY HOUR

Thank You For another wonderful Capital Medical Society Happy Hour on October 15th at Liberty Bar & Restaurant. The evening was filled with food, drinks, and lots of great conversation.

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Let us help you with that difficult conversation.

Planning Early About Care at the End

a Program of Big Bend Hospice

Counseling a patient about the end-of-life can be challenging.

Planning Early About Care at the End

a Program of Big Bend Hospice

For more information about Big Bend Hospice’s PEACE Program and FIVE WISHES contact Candace McKibben at (850) 878-5310 or candace@bigbendhospice.org

That’s where we can help.

The Big Bend Hospice PEACE (Planning Early About Care at the End) program is designed to assist people in understanding, discussing, and communicating their advance directives through one-on-one conversation with a trained Big Bend Hospice PEACE program facilitator. Physicians may also choose to have someone on their staff receive training, to facilitate discussions with patients within their own practice.

Contact us today, and also ask about FIVE WISHES, an advance care planning document published by Aging with Dignity, which focuses on addressing a patient’s healthcare wishes in the event that they cannot advocate for themself. Big Bend Hospice distributes them at no-charge to any person residing in the Big Bend region.

Call Big Bend Hospice, we’re here to share the journey.

1723 Mahan Center Blvd., Tallahassee, FL 32308 • 850.878.5310 • www.bigbendhospice.org CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

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ALLIANCE CORNER

takes over the reigns as of January 1st, 2016. The Installation meeting will be held on January 27, 2016 at the home of Tami Frankland. Be on the lookout for more information about this meeting.

It has been a great year for the Capital Medical Society Alliance. I’m excited to share some of the amazing things we have accomplished this year.

We donated $1,200 to FAMU School of Nursing for scholarships, supported Capital Area Healthy Start with their annual fundraiser, printed the 2015 Directory, and we continued to support and build our relationships with many in the health care community.

This could not have been done without team work.

Thank you to everyone in the CMSA and especially to my Board and committee chairs. We still have several social events this year and hope to see you all there.

It is bittersweet to see my year as President ending but I look forward to the coming year when Hien Guyer

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The 2016 CMSA Board will be President, Hien Guyer; President-Elect, Ida Thompson; VP Membership, Cynara Miller; Treasurer, Sarah Ho; Treasurer-Elect, Lisa UmaĂąa; and Immediate Past President, Amy Pagano. Hien has been busy working to get her schedule ready for the 2016 year and will include it in the December issue of the Capillary.

Thank you again for your support and helping to make 2015 another successful year for the CMSA. Warm regards, Amy Pagano, 2015 CMSA President

MEDICAL/LEGAL

THOSE PESKY CREDITORS: HOW TO AVOID THEM

By Tyler Huston, CFP®, AEP®, CLU®, ChFC®, CASL®, Pyxis Advisors, 850-629-7220 or THuston@financialguide.com One of the key issues I’ve come across working with physicians is their desire to protect their assets from creditors.

Fortunately, in our great State of Florida, we have a lot of options in addition to what’s offered through our federal government regarding asset protection.

As with most financial planning, there’s more than one way to carve this Thanksgiving Turkey. Also, there are benefits and disadvantages as with any strategy. As always, please consult your personal advisor(s) to understand more fully how these strategies could help improve your situation.

In addition to these statute-protected assets, how you title your accounts plays a significant role. While not in state statute and only if you’re married, titling your account Joint Tenants by the Entirety has case precedent for asset protection. This is a great strategy if concerned with a malpractice lawsuit: The monies in this account are owned 100% by the physician AND by their spouse. The case precedent is that if the physician gets sued for malpractice, you can’t technically take the spouse’s money as he/she had nothing to do with the malpractice.

Let’s start with some state specific options - Florida Statute Title XV, Chapter 222: (http://www.leg.state.fl.us/statutes/index. cfm?App_mode=Display_Index&Title_ Request=XV#TitleXV) This statute outlines a few items that are protected outright from creditors, if utilized properly.

Quick Tip: Check with your investment advisor and banker. The default for joint accounts is to set them up as Joint with Rights of Survivorship. NOT THE SAME PROTECTION! JTWROS only protects you from having these assets go through probate at death, not from creditors. Don’t assume your accounts were set up JTE (even if your statements say Joint) unless you specifically asked.

The larger assets named are: • Homesteaded primary residence Which house you decide within the state of Florida to place your homestead exemption

These are the easiest and least expensive ways to get asset protection here in Florida. They don’t require the use of an attorney/CPA to create the accounts as they’re protected by their own identity.

• Qualified retirement plans - 401(k), IRA, ROTH IRA, 403(b), SIMPLE IRA, etc.

In addition to these strategies, there are avenues regarding trusts and business entities.

• Life insurance cash values - The cash values inside of a whole or universal life insurance contract on your life

With these next strategies, please consult an expert attorney and/or CPA in these matters before creating the trusts or business entities. These are much more complex in scope and require expertise to navigate all the options and their benefits/disadvantages.

• Annuities - The value of assets inside of your annuity Also listed are educational savings accounts and health savings accounts, though, typically, these are smaller-sized accounts than the aforementioned. If appropriate for your planning, with only the four major assets listed above, you can protect millions of dollars in assets.

•

There are a multitude of types all varying in complexity and utility.

The primary goal must be to fit your comprehensive financial plan with a secondary goal of asset protection.

•

Business Entities - You can purchase a business or create your own business such as an S-Corp, C-Corp or LLC. By doing so, you can mitigate any losses to only the assets within that entity, hopefully. Depending on the circumstances, the corporate veil can be pierced, and again why talking with an expert is essential.

•

Giving Assets Away - Depending on your overall plan, perhaps a strategy is to simply start giving pieces of your wealth away. Certainly, you can’t lose what you no longer own. Gift tax and estate tax issues apply here as well, in addition to making sure you have enough to live your life how you want to live it with your family.

•

Advanced Estate Planning Techniques There are myriad other avenues regarding charitable giving, other types of trusts and family partnership planning that can help protect assets.

These are the most complicated and require the most expertise to make certain they fit your plan.

As mentioned earlier, there are a lot of techniques to utilize for asset protection.

When looking into options, remember the primary goal should be making your plan work for you and secondarily build in asset protection within that framework. Lastly, always consult an expert in these matters, and for these strategies, it usually requires more than one.

Irrevocable Trusts - These types of trusts typically give your assets away, where you no longer own them (per se).

There are gift tax, estate tax and access to capital issues here, which is cause for the caution to speak with an appropriate advisor/expert before engaging in these.

CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 19

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21

CMS FOUNDATION

The Impact of Private Support: Capital Medical Society Foundation’s community of donors strategically help fulfill its mission “to support the charitable efforts of physicians and others, increase access to healthcare, promote education and serve the community’s health needs through innovative projects that are exemplary, affordable and dignified.”

DONATE TO THE CMS FOUNDATION

WE THANK OUR DONORS

We thank the following people who made a donation to the CMS Foundation this past month: For the CMS Foundation-Area of Greatest Need - Stanley Gwock, M.D. For the CMS Foundation Endowment Mark and Debbie Dent - In Memory of Jyotsna Dalal, M.D. For the We Care Network The Perkins Charitable Foundation Year-End Appeal for the CMS Foundation-Area of Greatest Need J. Brian Sheedy, M.D. - In Honor of Nelson Kraeft, M.D., Fred Lindsey, M.D. and Al McCully, M.D. Year-End Appeal for the Scholarship Fund - Curtis Stine, M.D. - In Memory of Linda Stine Your gifts to Capital Medical Society Foundation transform lives in the Big Bend

• Access to healthcare is increased through gifts to We Care Network and the We Care Network Endowment Fund. $60 million in donated specialty medical and dental care has been provided to low income, uninsured patients since the program was created in 1992. Gifts support the salaries and benefits of the case management team who coordinate donated care.

• To provide incentives to keep medical students trained at FSU College of Medicine in the Big Bend after completion of their residencies and help meet the growing demand for physicians in Florida, gifts to the Scholarship Fund provide scholarships to FSU College of Medicine students who have expressed an interest in returning to the Big Bend to practice after completion of their residencies. $50,000 was distributed to seven medical students in 2015.

• Gifts to Capital Medical Society Foundation help provide operational resources for Capital Medical Society Foundation, including building maintenance, computer upgrades, as well as, modest grants to area non-profits whose programs improve access to health care for the underserved. In 2014, CMSF was able to repave its parking lot after 17 years, install a front door security and intercom system to improve the safety of staff, and purchase a new computer server. $11,000 in grants were awarded for Big Bend Hospice’s Bereavement Services Program, Elder Care’s In-Home Services Program, and FSU College of Medicine’s Chapman Community Health Program.

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

How to Give: Through the generosity of donors, funds have been created in order to establish financial stability to meet our mission. You can donate at any time to one of CMS Foundation’s current funds: 1) Capital Medical Society Foundation-area of greatest need 2) The Capital Medical Society Foundation Endowment 3) We Care Network 4) We Care Network Endowment 5) Scholarship Fund Checks should be made payable to the CMS Foundation and indicate on the memo line of your check to which designation you would like to donate. Bring your check to the CMS Office or mail it: Capital Medical Society ~ 1204 Miccosukee Road ~ Tallahassee, FL 32308.

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:

The Capital Medical Society Alliance presented a $500 check to Pam Wilson for the Capital Medical Society Foundation Holiday Auction at their October 28, 2015 meeting.

Pam Wilson, Executive Director pwilson@capmed.org or (850) 877-9018

22 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION

CMS FOUNDATION: WE CARE NETWORK

Robert Snider, M.D. Joshua Somerset, M.D. Timothy Sweeney, M.D. Jean Paul Tran, M.D. David Vermess, M.D. Daniel Yang, M.D. FOUNDATION

We Care Network

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

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

Physicians Kalil Al-Nassir, M.D. J. Galt Allee, M.D. Venkata Bavikati, M.D. Marie Becker, M.D. Raj Bendre, M.D. Timothy Bolek, M.D. Tim Broeseker, M.D. Viet Bui, M.D. Stephen Carr, M.D. Michael Cavallaro, M.D. Marilyn Cox, M.D. William Dixon, IV, M.D. Michael Douso, M.D. Akash Ghai, M.D. Spencer Gilleon, M.D. Celeste Hart, M.D. David Huang, M.D. Iman Imanirad, M.D. Simha Jagadeesh, M.D. Amit Jain, M.D. Rohan Joseph, M.D. Farhat Khairallah, M.D. Maribel Lockwood, M.D. Michael Mangan, M.D. Ovidiu Marina, M.D. Steven Ostrov, M.D. Rodolfo Oviedo, M.D. Praful Patel, M.D. J. Daniell Rackley, M.D. James Renehan, M.D. Adrian Roberts, M.D. Karen Russell, M.D. Gadi Silberman, M.D. Jeannine Silberman, M.D. Hardeep Singh, M.D.

Dentists Eric Amundson, D.D.S. William T. Baldock, D.D.S. Brian Beck, D.M.D. Steven Bryan, D.M.D. Darrh Bryant, D.M.D. Susan Byrne, D.M.D. David Cardman, D.M.D. Walter Colón, D.M.D. John S. Dozier, D.M.D. Michael Hartley, D.M.D. Susanne Lumpp, D.M.D. William McFatter, D.D.S. E. Lynn McLarty, D.D.S. Jim McSoley, D.M.D. Lawrence Pijut, D.M.D. Frank Swerdzewski, D.D.S. James Sykes, D.M.D. Jay Walton, D.D.S. Lawrence Weaver, D.D.S. Ed Zapert, D.M.D. Facilities Affordable Dentures Anesthesiology Associates Beachton Denture Clinic Capital Regional Medical Center Dermatology Associates Desloge Home Oxygen Leon County Dental Clinic Pathology Associates Radiology Associates Seven Hills Surgery Center Southeastern Surgery Center Tallahassee Diagnostic Imaging Tallahassee Endoscopy Center Tallahassee Health Imaging Tallahassee Memorial HealthCare Tallahassee Orthopedic and Sports Physical Therapy Tallahassee Outpatient Surgery Center TMH Family Medicine Residency Program Women’s Imaging Center

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

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

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

We thank our referring providers from October 2015: J. Galt Allee, M.D. Eboni Allen, ARNP Anne Ananga, ARNP Scott Asher, M.D. Erin Ayers, ARNP Marie Becker, M.D. Raj Bendre, M.D. Viralkumar Bhanderi, M.D. Timothy Bolek, M.D. Jonna Bradley, ARNP Sherry Bramblett, ARNP Daniel Breivogel, ARNP Kendall Campbell, M.D. Lysmar Dinguis, M.D. Mignon Emenike, M.D. Shirley English, ARNP Cynthia Evans, ARNP Elizabeth Fajer, M.D. Sharron Foster, M.D. Anneka Gaffney, ARNP Judy Griffin, ARNP Hantz Hercule, M.D. Brian Hoh, M.D. Dwight Hooper, M.D. Susan Horton, ARNP James Hunt, D.O. Iman Imanirad, M.D. Marc Inglese, M.D. Simha Jagadeesh, M.D. Amit Jain, M.D. Rohan Joseph, M.D. Howard Kessler, M.D. Elaine Larkins, ARNP Janice Lawson, M.D.

Esaias Lee, M.D. Damon McMillan, M.D. Kelley Miller, ARNP Rodolfo Oviedo, M.D. Paresh Patel, M.D. Praful Patel, M.D. Lisa Perkins, ARNP Marlaine Registe, ARNP Charlie Richardson, M.D. Adrian Roberts, M.D. Jose Rodriguez, M.D. Karen Russell, M.D. Tamara Sealy, M.D. Gadi Silberman, M.D. Hardeep Singh, M.D. Alanna Steaple, ARNP Christopher Sundstrom, M.D. Tallahassee VA Clinic TMH Family Medicine Residency Program Barrett Tolley, D.D.S. Leonard Tolley, D.D.S. Marianne Towler, ARNP Dwanna Ward-Boahen, ARNP Jeffrey Wasserman, D.O. Franklin Watson, D.D.S. Dorothy White, M.D. Dale Wickstrum, M.D. Karen Young, M.D.

DURING THE MONTH OF OCTOBER, THE WE CARE NETWORK: RECEIVED 186 REFERRALS, WITH 113 PATIENTS NEW TO THE PROGRAM

SCHEDULED 110 APPOINTMENTS WITH VOLUNTEER PHYSICIANS AND DENTISTS

$105,215 IN DONATED CARE WAS REPORTED BY WE CARE VOLUNTEERS

23 CAP SCAN - A CAPITAL MEDICAL SOCIETY PUBLICATION 23

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