Vol. 2 Issue 3 | 2020
C
MANA ONNECTION
United in Faith. Bonded in Service. One in Purpose.
THE OFFICIAL NEWSLETTER FOR THE STUDENT CHAPTER OF THE COPTIC MEDICAL ASSOCIATION
TABLE OF
CONTENTS
03
06
HOW TO DEAL WITH BEING A BIG DEAL: MAINTAINING HUMILITY IN SUCCESS
Stephen M. Meawad, Ph.D.
BOOK REVIEW: FERVENT BY PRICILLA SHIRER
Miriam Saleh
THE RESILIENCE OF THE
08
10
12
COPTIC PEOPLE
Nardin Derias UPWARD TREND IN PRIVATE EQUITY INVESTMENT IN PROFESSIONAL PRACTICES
Ayman Soliman, Esq.
2019 TESTIMONIAL: BOLIVIA HEALTH EDUCATION TRIP
15
CMANA Connection
Mariam Elias
CONFERENCE 2019 RECAP: ARE YOU SEEING 2020?
Ameer Halim
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HOW TO DEAL WITH BEING A BIG DEAL: MAINTAINING HUMILITY IN SUCCESS
Stephen M. Meawad, Ph.D.
I
suspect that when one hears “maintain humility in success,” it is often conflated with “do not boast about your this-worldly achievements.” After all, the wise King Solomon and our father St. James tell us not to boast about tomorrow. Yet, our lack of humility seems to be a deep-seated issue that is not resolved by merely sweeping our achievements to the side and pretending we are not inflated with the pomp that never fails to accompany them. Typically, a “successful” person may feel she must bring herself down from the high and mighty status she holds. This hubris is hardly ever overt but is usually internalized or subconscious, manifested only when challenged or disrespected. In this regard, I suggest reimagining what maintaining humility in success might mean. It is “being right-sized in the graced pursuit of godliness.” To be “right-sized” is to have a relatively accurate estimation of my limits, weaknesses, and sinfulness, on one hand, and my worthiness as a son and daughter of God, on the other hand. To realize that the journey is “graced” is to defer glory to the One to whom it is due. To conceive of one’s journey as a “pursuit of godliness” places God as telos of that journey while acknowledging a person’s synergistic, exertive participation in the process.
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Redefining these terms requires a shift in perspective that in turn remedies three main causes of lack of humility—
SELF-CENTEREDNESS, LACK OF INTROSPECTION, AND DENIAL OF GOD'S GRACE.
How many of our issues begin and end with our self-centeredness! Social anxieties often take root in a focus on self-image. Marital and parental instabilities often come about when selfishness trumps self-sacrifice. Socioeconomic, psychological, emotional, and spiritual issues all find their places in rampant selfcenteredness in one way or another. Beyond these issues that arise from selfcenteredness, infatuation with the self is toxic to the soul, to the inner human being out of which is supposed to arise tranquility, joy, and all good things. Pride, part of the primordial sin of Adam and Eve and even of angels like Lucifer son of the morning, creates barriers between humans and God, the Author of Peace, Joy, Love, and all Goodness and the spiritual Creator of the human being.
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HOW TO DEAL WITH BEING A BIG DEAL CONTINUED
Similarly and ironically, one who is self-centered can at the same time lack introspection. We all fall into these issues to some degree. We are unaware of ourselves, hesitant to face our true selves in the darkness of silence. I recall asking hundreds of my undergraduate students what they thought about silence and its potential benefits. I certainly was not expecting many to observe any meditative practices, but at the very least I thought the question would make sense to them! Many responded in ways I never would have imagined: “Professor, do you mean silence in the political arena?” “What do you mean by silence? Why would a person sit in silence? What would you even do?” These characterize some of the more worrisome responses. Others were able to understand the implications a little more clearly: “Professor, that might be really scary and depressing,” presumably due to the self-realization that might ensue. This is precisely the consequence of introspective, silent, self-reflection. One’s flaws are exposed, requisite to self-improvement and the acquisition of humility.
Lastly, pride results from a denial of God’s grace. The one who believes that all success results from one’s own doing can never attain humility. God’s grace is initiator, sustainer, and consummator; it is in all places at all times. Even those who deny God’s very existence are carried by His grace. One can only be right-sized, then, when she acknowledges the Person who makes all things possible in her life. To deny God’s grace is to deny the underlying component of success. “The Lord was with Joseph, and he was a successful man” (Gen. 39:2). Success is being with God, not a worldly accomplishment that is otherwise attained.
THE ONE WHO BELIEVES THAT ALL SUCCESS RESULTS FROM ONE'S OWN DOING CAN NEVER ATTAIN HUMILITY.
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HOW TO DEAL WITH BEING A BIG DEAL CONTINUED
In all of this, the solution is simple but requires a sustained shift of perspective, out of which will spring all of a person’s actions. Overcoming these causes of pride requires a Christcentered worldview, one in which our Lord Jesus Christ becomes the singular goal, the Person who structures life and the Person from whom my life’s narrative gains meaning, direction, and fulfillment. When Jesus Christ is the One I am pursuing, this-worldly success is an occasion to glorify God, not an occasion to boast in my successes. All my work is done for my God, as a light-filled witness to the transformation He ensued in me despite my sinfulness. Ambition is good; it is natural to human beings, a drive instilled by God. Yet, the singular measure of success is not what the world might define as success; it is an increasing unity with my God, manifested in love of God and
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neighbor. This remedies the first cause of pride noted above. Pursuit of unity with God, a perpetual ascent, requires a focused exertion of graced spiritual struggle away from evil and towards good in the community of the Church. The Church provides the tools necessary to center oneself, combatting the lack of introspection noted above. At the same time, the community of the sacramental Church emphasizes living a Eucharistic life of perpetual thanksgiving for God’s grace and goodness, effectively remedying the third cause of pride. It is all too easy to get wrapped up in our smaller day-to-day goals and to lose focus on the mission, our Lord Jesus Christ, the Paragon of humility and all virtue. Yet, it is only when I make it an unceasing habit to tell God that this life is for Him and His people that I will ever maintain the humility that quietly and powerfully transforms all it encounters.
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BOOK REVIEW:
Fervent
By Pricilla Shirer Review By Miriam Saleh
D
eliberate and intentional. To me, those are the two best words
to describe Shirer’s writings. The entire theme of Fervent is an explanation of how our prayer lives are a war ground but there is a victory that is waiting for us... once we start to pray powerfully and strategically, that is. One of the first things she explains is that if each of us only pray for the things on our small, limited heart we’re putting our spiritual lives at risk because in order to win this battle we must pray with the desires of God’s heart, not our own. She challenges us by asking: is the enemy fighting against us because we have a bigger mission to accomplish? A passion and zeal for His plans? Or perhaps, is the enemy combating against our heart and our purity? She teaches that once you learn how to identify what the enemy is after is when you’ll then learn which weapon in prayer to pick up. Simply put: each of the ten chapters are their own ‘weapons’ against ‘the wiles of the devil’. Although the enemy fights against us in more than these ten ways in prayer, these ten strategies to use in prayer cover many hidden areas in each of us. We all need to need to learn that prayer is the place we purify the passions of the inward man to then enrich the actions of the outward man; this is a war we’re all battling. We’ve all heard in lectures that the strongest/most common weapon the enemy uses is psychological, but Shirer redeems this powerfully into her own personal how and why statements.
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Fervent
BOOK REVIEW
CONT.
By Pricilla Shirer
She often times starts with “If I were your enemy I’d remind you of...” or “If I were your enemy I’d never let you forget about the time of...”
and
then
explains
why
the
enemy
uses
the
tactic.
Understanding why/how the enemy uses the devices he does helps tremendously in our warfare. I mean, could we really set foot in a battlefield if we didn’t have a battle plan? Or better yet, could we really win a battle if we didn’t have the right weapon? Shirer then pairs the “If I were your enemy” statements with biblical victories of those who have fought some of our modern battles. Purposeful prayer only begins to explain Shirer’s writings. Although the battleground prayer theme is one of the stronger themes in the book, so is the reminder of grace. Her book is filled with several testimonies that explain our worth, our glory in Him, and why we’re all worthy of His divine interventions. Her book overflows with the abundance of His love. Between her own close friends, her own stories, and of course victory stories from the Bible, Shirer explains how prayer is the ultimate weapon to rise in His strength. What I love about her skill as a storyteller is how personable she makes each of our prayer lives; these victories were told in a way where you can see yourself in them. To me, this shows how even in our prayers we’re all in communion. It’s even in our warfare in prayer that we can learn from and experience His grace as a whole.
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THE
RESILIENCE
OF THE
Coptic People
By Nardin Derias
I
f there is one thing that strikes me constantly, it is the unwavering faith of the Coptic Orthodox people. The church is known as a “Church of Martyrs” and since its inception has been marred by persecution. As recently as this year, people have lost their lives simply for practicing their faith. This piece is a reflection on what I saw this past summer when I visited some of Egypt’s holy sites.
The building was huge, towering over me. I could see the Coptic Cross at the top of it: it was the St. Mark Coptic Orthodox Cathedral (the seat of the Patriarch). The chapel neighboring this cathedral was the site of a bombing that took 29 lives. I walked into the museum they built dedicated to not only these martyrs, but others who lost their lives in other tragedies as well. The walls were lined with little cubes, in these cubes mementos from the martyrs; their clothing at the time of the bombing, blood-stained, torn, and all. Every direction I turned my head, another photo. I remember walking into another room and seeing a few empty cubes and turning to my mother and saying, “the sad part is, these will probably be filled the next time we’re here.”
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THE RESILIENCE OF THE
Coptic People
CONTINUED
A bible verse comes to mind: “Blessed are those who are
persecuted for righteousness' sake,
for theirs is the kingdom of heaven”
Matthew 5:10 This remains true today. The persecution our ancestors, our brethren in countries abroad face on a regular basis is humbling. I found myself feeling guilty a lot of times, why is it that I can go to church without fear, but my family in Egypt could not? I have to remind myself that even though I do not face the same hardships they might, that persecution can manifest itself in different ways. This could manifest itself in our day-to-day: we make conscience decisions as Christians every day, in the workplace, at school, and in our personal lives.
There are many times when Coptic people, especially young professionals, feel like they do not fit in. Sometimes it is hard to find people with the same ideals, the same interests. Learning to stand up for your beliefs, in spite of what others may think or say, that takes a certain level of courage. Not backing down and giving into peer pressure in the face of ridicule, that’s combatting persecution in a small important way. Another verse I think about often is:
“These things I have spoken to you, that in
Me you may have peace. In the world
you will have tribulation; but be of good
cheer, I have overcome the world”
John 16:33. My trip to that cathedral, to that church, seeing the remnants of the bombing on the church columns, that was all a reminder to me, a testament to the unshakeable faith, the resilience of the Coptic people throughout the years.
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UPWARD TREND IN PRIVATE EQUITY INVESTMENT
IN PROFESSIONAL PRACTICES Ayman Soliman, Esq.
T
he last decade has seen a steady increase of infusion of private equity investment in the healthcare sector, a trend that continues to grow each year, both in the quantity and types of transactions.
One of the foremost areas of investment is in the management of physician and dental practices which is fueled by (i) the highly fragmented markets served by these providers that promise to be more efficient and profitable with consolidation and upgraded management, (ii) the perceived ability of the health care sector to withstand economic downturns and (iii) a progressively aging population in need of increased services.
The availability of investment dollars is attractive to physicians who not only wish to expand their practices and increase profitability and bargaining power with insurers, but also want to spend more time involved in patient care instead of administrative, compliance and IT matters.
This intersection of interests has resulted in successful private equity investment in certain specialties such as dermatology, pain management, ophthalmology and certain types of dental practices. The profitability experienced in these ventures has led to an expansion of such investment into other specialties such as urology, gastroenterology, radiology and orthopedics, and in the last few years, to primary care practices.
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UPWARD TREND IN PRIVATE EQUITY INVESTMENT
CONTINUTED
There are, of course, potential drawbacks for either party in entering into this type of transaction. The unpredictability of reimbursement rates is an obvious risk. In addition, private equity firms usually enter into these transactions with the goal of achieving high returns in a fairly short time frame, which might conflict with the quality of care that the professional practice is accustomed to providing. Failure to meet expected economic goals might result in the private equity firm being contractually allowed to assume a greater ownership stake in the venture and the practitioners having less control of their practice than they anticipated. There may also be an inherent conflict between the fast track financial expectations of private equity firms and the ongoing shift from fee-for-service reimbursement to a model based on quality of care and treatment outcomes.
When entering into and structuring transactions of this type, both parties must be mindful of, and careful to comply with, state and federal fraud and abuse statutes and regulations, including the prohibition of kickbacks and self-referral of patients. Another concern is compliance with New York’s prohibition against the corporate practice of medicine, a limitation that some investors from states that allow ownership of medical practices by nonlicensed persons may not be familiar. Failure to comply with applicable law may result in significant civil, and in the case of the federal Antikickback Statute, criminal penalties. Licensed practitioners have an even greater concern because a violation of these laws may be deemed to be unprofessional conduct which can result in suspension or revocation of their license to practice.
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In addition, the Federal Government has stepped up its enforcement efforts. In a closely watched Florida case, United States ex rel. Medrano and Lopez v. Diabetic Care Rx LLC d/b/a Patient Care America, et. al. the Department of Justice bringing an action under the False Claims Act against a private equity firm based on that firm’s alleged involvement in decisions to drive up the value of the pharmacy business in which it had invested, including the payment of commissions to contractors to generate business, that resulted in improper government reimbursement. Investors and practitioners considering a private equity transaction are best served by early and thorough due diligence. Consultation with knowledgeable legal, accounting and financial advisors early in the negotiation process is advisable.
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T E S T I M O N I A L :
HEALTH EDUCATION TRIP BOLIVIA 2019 Mariam Elias
G
oing on this trip a second time, I thought I knew exactly what to expect in terms of preparation and execution. Before actually arriving to Bolivia, I ran into every obstacle imaginable. From trying to place the correct prescription orders to worrying about getting past customs in Santa Cruz. I kept praying, reassuring myself that God must have a plan. Little did I know, God not only had a plan but he ALWAYS has the means to provide when we fall short.
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Our itinerary began from arrival day as we embarked to our first village. Most of the trip was spent treating patients and praying services at the main church Sayedna built. We traveled from village to village all with each specialty carrying their equipment in suitcases. I was fortunate enough to scribe and aid two amazing eye doctors. My job entailed doing the pre-screening which entailed taking visual acuity, optical history & chief complaint. It still amazes me how we were able to provide aid and do God’s work with such little equipment and resources. I kept thinking to myself how a regular eye exam or dental exam is supposed to go and how much harder it was for the doctors to preform their jobs without having the machinery needed to aid them.
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HEALTH ED BOLIVIA 2019 T E S T I M O N I A L :
I recall visiting a village that had nothing. People were surviving without indoor plumbing and with a makeshift roof over their heads. Sayedna had begun to build a church in this area along with a bathroom that included indoor plumbing. We walked into the building, that only consisted of 4 walls and an empty bathroom, and divided into our given medical specialties. After having set up the designated area, the doctor I was working with realized he could not perform the eye exam due to the great amount of natural light peaking in. Eye exams must be done in the dark so the pupils can dilate when the doctor shines the light and it allows for optimal view of the back of the eye. Without skipping a beat, the doctor relocated to the darkest place we could find: the one person, unfinished bathroom. Not only was it a tight space, it was pitch black! I completed the prescreening and then would lead the patients into the room using the flashlight from my phone.
CONTINUTED
Dr. Calvin using the portable auto refracting machine
On another occasion, there was a young man who had a case of tooth decay that had progressed. The dentist on the trip kept trying to extract the tooth and every time, it would crumble a little bit more. The case really needed to be completed with better equipment and possibly general sedation. After over three hours of the dentist leaning into the boy’s mouth, the tooth was fully extracted.
Dr. G prepping for an extraction
The Optometry Team (left to right) Dr. Mina, Dr. Calvin, Mariam, Jessica
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HEALTH ED BOLIVIA 2019 T E S T I M O N I A L :
The kindness, generosity, and humility these doctors portrayed will leave a lasting effect on me for the rest of my life. In the face of adversity, they didn’t fear. They trusted in God and did their due diligence. Everything that was done was done in love. Prior to going on this trip, I was always so quick to panic, in fear of a bad outcome. I learned firsthand that there’s no way of knowing what kind of work God is doing behind the scenes so we must always pair our faith with trust because He will never abandon us.
CONTINUTED
I am forever grateful for my experience, for getting to serve alongside the most wonderful people I have ever met and for meeting those who are the true embodiment of our savior.
“FOR WE WALK BY FAITH,
NOT BY SIGHT”
2 CORINTHIANS 5:7
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O
n December 22, 2019, the CMANA Student Chapter celebrated the start of its 7th annual conference in Boston. This was the largest conference to date with 300 students and young professionals from all over the Continental US and Canada. We were blessed with an awesome panel of speakers who all spoke to us about having “2020 Vision,� and how to reorient our studies and careers as a chance to witness for Christ. His Grace Bishop Angaelos blessed us from the United Kingdom and encouraged us to see every patient as a blessing and someone to be thankful for. Dr. Haidy Marzouk challenged us to overcome preconceived biases regarding our patients and their stories, and instead to practice true empathy. Finally, Dr. Craig Story spoke to us about the interplay between science and our faith, and challenged the false narrative of a dichotomy between the two. Workshops throughout the conference also brought some hot topics to the forefront, including bioethics, mental health, and how to start an effective non-profit organization. These are issues that the Church does not have official teachings on, and it was an excellent opportunity to get us all thinking and praying for guidance as we will undoubtedly face some of these challenges in our careers. Overall, it was an exciting and fruitful weekend but there is much work that needs to be done. By God’s grace we hope that this weekend planted the seeds for the desire to serve in our students and young professionals.
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C
MANA ONNECTION
NEWSLETTER
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