COLORADO MEDICINE ADVOCATING EXCELLENCE IN THE PROFESSION OF MEDICINE VOLUME 119 NO. 3 AUG-OCT 2022 COLORADO MEDICAL SOCIETY ANNUAL MEETING Breckenridge YOU’RE INVITED TO THE 2022 CMS ANNUAL MEETING Networking, professional developing and fun for the whole family; don't miss the signature event for Colorado physicians!
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7 MILE-HIGH ENDOWMENT FUND
AMA President Jack Resneck Jr, MD, presents the urgent need to reform the way Medicare pays physicians and outlines how the AMA is leading in this effort.
8 MEET THE CANDIDATES FOR 2022 ELECTION
The CMS Education Foundation is proud to name five recipients of scholarships that support students who want to care for rural and underserved populations in their future careers.
PHYSICIAN PAYMENT SYSTEM
14 PRESENTING THE 2022 GILCHRIST SCHOLARS
The Gilchrist Scholarship Committee has named three excellent student leaders for the 2022 awards.
In his final President's Letter, Dr. Johnson reflects on change, politics and the need to be involved.
10 CMS EDUCATION FOUNDATION NAMES SCHOLARS
We hope you’ll join the Colorado Medical Society and your colleagues around the state for our 2022 Annual Meeting in Breckenridge, Sept. 16-17. We have built a robust program of education and social events, plus plenty of free time to enjoy Breckenridge. PAGE 4 ⊲ 16 COPIC Comment: COPIC’s educational resources 18 Introspections: Oppressed and depressed 20 Reflections: Breath 21 Reflections: Tobacco scented candle 22 Medical News: Colorado Medical Society honors young scientists at the Colorado state science fair
24 FINAL WORD: REFORM THE MEDICARE
The Mile-High Medical Society created an endowment fund named for Dr. Charles Blackwood, the first African American graduate of the University of Colorado School of Medicine. They gave their first awards and need your help to fully fund the scholarship in perpetuity.
12 IT’S GREAT TO BE TOGETHER! See photos from in-person social events around the state, hosted by your state and local component societies.
The CMS leadership election is held in August. Meet the two candidates for CMS president-elect, plus the candidates for AMA delegation. Your vote matters!
Our Colorado delegation to the American Medical Association represented our state at the AMA Annual Meeting in June, advocating for policy and moving into leadership positions.
YOU’RE INVITED TO THE 2022 CMS ANNUAL MEETING CONTENTS FEATURES INSIDECMS DEPARTMENTS
3 TROUBLESOME TIMES
6 COLORADO LEADS AT THE AMA
COLORADO MEDICAL SOCIETY STAFF Dean Holzkamp Acting Chief Executive Dean_Holzkamp@cms.orgOfficer Kate Alfano Director of Communications and Kate_Alfano@cms.orgMarketing Amy Berenbaum Goodman, JD, MBE Senior Director of Amy_Goodman@cms.orgPolicy Dianna Fetter Senior Director of Business Development Dianna_Fetter@cms.org Crystal Goodman Executive Director, Northern Colorado Medical Crystal@nocomedsoc.orgSociety Ms. Gene Richer, M Ed, CHCP™ Director of Continuing Medical Gene_Richer@cms.orgEducation Mihal Sabar Accounting Mihal_Sabar@cms.orgManager Chet Seward Chief Strategy Chet_Seward@cms.orgOfficer Debra Will Assistant Director of Continuing Medical Education and Recognized Accreditor Debra_Will@cms.orgPrograms Tim Yanetta Manager of Tim_Yanetta@cms.orgIT/Membership 7351 Lowry Boulevard, Suite 110 • Denver, Colorado 80230-6902 720.859.1001 • fax 720.859.7509 • www.cms.org COLORADO MEDICAL SOCIETY BOARD OF DIRECTORS Brittany Carver, DO Amy Duckro, DO Enno F. Heuscher, MD, FAAFP, FACS Rachelle M. Klammer, MD Marc Labovich, MD Chris Linares, MD Michael Moore, MD Edward Norman, MD Courtney Olson, MS Lynn Parry, MD Leto Quarles, MD Hap Young, MD AMA DELGATION David Downs, MD, FACP Carolynn Francavilla, MD Rachelle Klammer, MD Katie Lozano, MD, FACR A. "Lee" Morgan, MD Jan Kief, MD Tamaan Osbourne-Roberts, MD Lynn Parry, MD Brigitta J. Robinson, MD Michael Volz, MD AMA PAST PRESIDENT Jeremy A. Lazarus, MD 2021-2022 OFFICERS Mark B. Johnson, MD, MPH President Patrick Pevoto, MD, RPh, MBA President-elect Hap Young, MD Treasurer Sami Diab, MD Immediate Past President Dean Holzkamp Acting Chief Executive Officer
Dean Holzkamp, Executive Editor, and Kate Alfano, Managing Editor. Design by Scribner Creative.
OFFICERS, BOARD MEMBERS, AMA DELEGATES, and STAFF
COLORADO MEDICINE (ISSN-0199-7343) is published bimonthly as the official journal of the Colorado Medical Society, 7351 Lowry Boulevard, Suite 110, Denver, CO 80230-6902. Telephone 720-859-1001; outside Denver area, call 1-800-654-5653. Periodicals postage paid at Denver, Colo., and at additional mailing offices. POSTMASTER, send address changes to COLORADO MEDICINE, P. O. Box 17550, Denver, CO 80217-0550. Address all correspondence relating to subscriptions, advertising or address changes, manuscripts, organizational and other news items regarding the editorial content to the editorial and business office. Subscriptions are available for $36 per year, paid in advance. COLORADO MEDICINE magazine is the official journal of the Colorado Medical Society, and as such is also authorized to carry general advertising. COLORADO MEDICINE is copyrighted 2006 by the Colorado Medical Society. All material subject to this copyright appearing in COLORADO MEDICINE may be photocopied for the non-commercial purpose of education and scienti fic advancement. Publication of any advertisement in COLORADO MEDICINE does not imply an endorsement or sponsorship by the Colorado Medical Society of the product or service advertised. Published articles represent the opinions of the authors and do not necessarily reflect the official policy of the Colorado Medical Society unless clearly specified.
INSIDE CMS PRESIDENT’S LETTER
While we physicians strongly believe that science supports the current way medicine is being practiced, every year we fight bills that are filed by legislators who apparently either don’t understand the science, don’t believe the science, or don’t care about it. In my experience, however, most elected officials do believe in science and base most of their decisions and votes on the evidence presented to them. But there are some whose voting record seems to be based on other motivators. Some appear to vote based on campaign contributions, (although all deny it). Some vote based on personal relationships or experiences – a brother who is a physician, a partner who is a naturopath, or a missed or misdiag nosed case of cancer. And some seem to base their votes merely on whom they like or dislike. These motivations should not surprise us; they clearly align with human nature. But they ought to alert, and even alarm, us. As Martin Niemöller pointed out in his famous statement, there is a time to speak out, and a time when speaking out becomes too late. We also know that the voices of many speaking loudly together are politically much more powerful than are the voices of a few. One of the reasons the Colorado Medical Society was established was to be your industry advocate to ensure that physicians have the necessary clinical protections and autonomy to do what’s in the best inter ests of their patients. The more physician members we have, the more powerful we can be as that advocate. We also need our members to be speaking in unison, and not focusing only on their own special interests and practices. We need to be wise in playing the “game” of politics. We need to help elected offi cials understand the science, education and experience on which our practices are based. Especially in this election year, we need to have the resources to help those who support us fairly compete in their campaigns. We need to ensure that our care of patients is excellent and our “bedside manner” is winsome. We have seen what can happen when we do not work together. As Dr. Will Mayo, one much wiser than I, said, "Attend your medical societies." ■
Dr. Will Mayo
President’s Letter: Troublesome times Mark B. Johnson, MD, MPH of medical practice, the social and political bases of medical practice are now being threatened, challenged and changed underneath us. The legitimate practice of medicine hangs by a very fine thread, and that thread is being buffeted by legal, social, religious, ethical, political and economic interests. Most of us know that there are big changes occurring in American society and in Colorado that impact the way we practice, but many physicians either are unaware of, or haven’t spent much time thinking about, the fact that every legal right that has been granted to us, every limit or expansion on scopes of our practices, every regulatory function or requirement that has been put in place to protect the safety of our patients and to limit those who can prescribe medications or perform procedures, can be suddenly changed at the whims of elected officials or their political ambitions. Up until the early 20th century in Colo rado, anyone could hang a shingle on an office door and open a “medical” prac tice. There was an oversupply of folks claiming to be doctors in the state. And then one day, the state began to regulate the practice of medicine. The power of government established the parameters within which medicine must be practiced.
F irst they came for the ophthalmol ogists, and I did not speak out— because I was not an ophthalmologist. Then they came for the obstetri cians and gynecologists, and I did not speak out—because I was not an obstetrician or gynecologist. Then they came for the anesthesi ologists, and I did not speak out— because I was not an anesthesiologist. Then they came for me—and there was no one left to speak for me. With apologies to Pastor Martin Niemöller, whose well-known statement inspired my reimagining I used to walk through a beautiful neigh borhood near my home almost every day. It was situated on a hill that overlooks the small valley in which I live, and walking up and through it gave me a bit of the cardio workout I was trying to achieve. I walked there so often that some of the neighbors began to recognize me and would wave or say hello as I walked past. And then one day…it was gone. The homes, the neighbors, the complete neighborhood. Gone. Burned to the ground in less than a day. We Americans are famous for frequent change. It’s one of the hallmarks of democracy that defines our culture. But although change is constantly occurring, it is usually so incremental that we don’t recognize it immediately. Sometimes, though, it happens in a single day. Or at least you can identify a day when all those small, incremental changes finally came to a point where everything was different. Physicians are very familiar with change. Our work is based on science, and scientific evidence is constantly being reviewed, challenged and transformed. But even more than the changing bases “Attend your medical societies.”
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11:45 a.m. - 1 p.m. COMPAC Lunch COMPAC hosts lunch on Saturday featuring speaker Mariann Goodland, a veteran reporter with Colorado Politics, who will give a bipartisan outlook of the 2022 November elections and the 2023 Colorado legislative session. 1-1:30 p.m. Exhibit break and dessert 1:45-2:45 p.m. Health care value session with AMA President Jack Resneck Jr, MD, and Kyle Leggott, MD 2:45-3:45 p.m. Buprenorphine for Pain Management with Josh Blum, MD 3:45-4:30 p.m. Exhibit break and presentation of poster competition awards 4:30-6 p.m. Wellness break Take a break from a busy day to hike, bike or rest, and rejoin the fun for our evening activities. Mini (30-minute) photo sessions with a professional photographer are available Saturday afternoon and Sunday morning for family photos in the fall foli age. Sign up on our event webpage. 6-6:30 p.m. President's Reception Enjoy a cocktail reception with friends old and new before the President’s Gala. 6:30-10 p.m. President’s Gala The President’s Gala is the highlight of the weekend, featuring the passing of the gavel from outgoing CMS President Mark Johnson, MD, MPH, to incoming SATURDAY, SEPT. 17 7-8 a.m. Breakfast 7-4:30 p.m. Poster contest CMS is proud to host our first-ever poster contest! All CMS members, especially medical students and residents, are invited to present your research through poster-panel displays in three catego ries: primary research, case report and evidence-based review. Awards will be given in various categories. More infor mation and link to poster contest registra tion form on the event webpage, or email, or email membership@cms.org 8 a.m. - 9 p.m. Children’s camp ages 0-2, 2-12 Kids will have another day of fun with professional childcare providers, ending with a movie night during the Saturday evening Gala. Advance registration required. 8-10 a.m., 10:30-11:30 a.m. The path forward: Understanding, connecting and flourishing in a multicultural context Our morning education session features renowned speaker Effley Brooks, MBA, who will train you on how to navigate indi vidual and cultural identities to connect and communicate better. 10-10:30 a.m. Exhibit break and poster discussions
8:30-9:30 p.m. Medical student trackMeet and greet/networking
12-8 p.m. Children's camp ages 0-2, 2-12 Bring the kids to enjoy arts and crafts, snacks and other activities while you participate in the meeting. Advance registration required.
This is the final quarterly meeting of the CMS Board of Directors in 2022, and will be offered as a hybrid meeting for in-per son or virtual participation. All meetings are open to all CMS members to attend.
6-7:30 p.m. Welcome Reception with Exhibitors Don’t miss our opening reception to pick up your registration materials, meet and greet old and new friends, and visit with our exhibitors who keep the confer ence fees low and offer great products and services.
See the full agenda on CMS.org; subject to change FRIDAY, SEPT. 16 12-5 p.m. Board of Directors lunch and meeting
When was the last time you had social time with your peers outside of the classroom? Enjoy a meet and greet to put faces to names beyond the Zoom screen. Active physicians are invited, too – especially those willing to mentor the next generation of physicians.
of Communications and Marketing IN-PERSON EVENT: Friday, Sept. 16 - Saturday, Sept. 17 5 AMA PRA Category 1 Credits™ Registration is open at CMS.org Your registration fee gives you access to excellent programming, networking, our President's
COVER COLORADO MEDICAL SOCIETY ANNUAL MEETING BreckenridgeYou’re invited 2022 Colorado Medical Society Annual Meeting A CELEBRATION OF CMS MEMBERS, LEADERS AND SUPPORTERS
more. Physicians will have the opportunity to sponsor a medical student if you choose. CMS Member Physician, Fellow, Resident | $125 CMS Guest | $100 CMS Student | $50 CMS Student Guest | $35 Children’s Camp: 0-2 years old | $35 per day per child 2-12 years old | $50 per day per child AGENDA, 4 COLORADOABBREVIATEDMEDICINE
Kate Alfano, CMS Director Gala and
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SUNDAY, SEPT. 18
Open time for fun around Breckenridge Optional events
Professional fall photos with Emily Davis Photography Add on a 30-minute photo session in the mountains with professional photographer Emily Davis of Emily Davis Photography, based in Firestone, Colo. The discounted cost of $175 for Annual Meeting registrants includes a set of 25+ edited digital photos; you own the rights to print copies through any venue. Timeslots are available Saturday after noon or Sunday morning; sign up on the event webpage. Poster contest Encourage research in medicine as CMS members display the latest in research and teaching through poster-panel displays in three categories: primary research, case report and evidence-based review. Awards will be given in various cate gories. Researchers will be available Saturday during the day to discuss their projects. Find more information and the link to register for the poster contest on the event webpage. We need judges! Contact kate_alfano@cms.org if you are interested in judging the poster contest! Childcare Bring the kids to enjoy arts and crafts, snacks and other activities while you participate in the meeting. $35 per day per child age 0-2; $50 per day per child age 2-12. CMS will host guests at two locations, The Village at Breckenridge and the DoubleTree Breckenridge. All conference activities will be held on the first floor of The Village at Breckenridge. The Village at Breckenridge 535 S. Park Ave, Breckenridge CO The Village at Breckenridge Resort is located at the base of Peak 9, close to boutique shops and award-winning restaurants along Main Street. It is comprised of suites ranging in size from studios to four-bedroom units. All have full kitchens, breakfast bars and dining areas.
CMS wants to make the Annual Meeting a wonderful event for CMS members and your guests; consider participating in one of the following options. Additional cost may apply.
DoubleTree by Hilton Hotel Breckenridge 550 Village Rd, Breckenridge, CO 80424 The DoubleTree Breckenridge is also located at the base of Peak 9, just two blocks up the hill from The Village at Breckenridge. Their free shuttle connects you to downtown Breckenridge and Main Street for shopping and dining. Pets are allowed for an additional fee. Go to our events page for links to make your room reservations. Thank you to our sponsors The Colorado Medical Society thanks these sponsors and exhibitors for their support of the CMS Annual Meeting: COPIC, Abyde, ARCAM, Cruise Planners, Mines & Associates, The Center for Personalized Education for Profession als (CPEP), Colorado Physician Health Program (CPHP), Huntington National Bank, Armed Forces, Panacea, and SHJ Wealth
CMS President Patrick Pevoto, MD, MBA. Don a cowboy hat and boots for this country-chic semi-formal event. Enjoy food stations around the room, the COPIC dessert bar, music and dancing.
TheAdvisors.Colorado Medical Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for webpage.onbeobjectivesLearningphysicians.canfoundtheevent■
AMA leaders unveiled the AMA Recov ery Plan for America’s Physicians, which aims to critical components of the profession by:
• Michael Volz, MD
Left photo, from left: Colorado delegate Carolynn Francavilla Brown, MD, CMS President Mark B. Johnson, MD, MPH, and Elias Brown at the Inaugural Dinner.
Kate Alfano, CMS Director of Communications and Marketing
• Lynn Parry MSc, MD
Your Colorado delegation encourages all CMS members to get involved. Join the American Medical Association at member.ama-assn.org/join-renew. Plan to attend an upcoming AMA careideastimeorgationAttendwww.ama-assn.org/about/events.meeting;ameetingoftheColoradoDeletotheAMAreachoutanytodiscussyourforfederalhealthpolicy;contact dianna_fetter@cms.org All are welcome! ■
Jack Resneck, Jr, MD, who will be the special guest at the Colorado Medical Society’s Annual Meeting in Brecken ridge, was inaugurated president of the AMA during the AMA Annual Meeting. In his inaugural address he acknowl edged the immense COVID-19-related challenges that are still ongoing. “While it would be easy to get overwhelmed by despair, as I begin this new role, I’ve never been prouder of my physician colleagues. I've never been prouder to be part of this profession. And I've never been prouder of our AMA.”
• Lee Morgan, MD, delegation chair
Colorado leaders influence AMA policy, rise to leadership positions at the AMA Annual Meeting
• Supporting telehealth, and • Reducing physician burnout.
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• David Downs, MD, FACP
Francavilla Brown was elected vice chair for the private practice physician section. New to the delegation and representing Colorado in the Young Physicians Section are Kamran Dastoury, MD, and Erin Schwab, FollowingMD.persistent advocacy and lead ership by CMS member Michael A. Puente Jr, MD, and Rocky Vista University student Jimmy Rager, a resolution was adopted by the House of Delegates to reverse an outdated policy banning blood and tissue donation based on sexuality. Because of their action, the AMA will lobby the U.S. Food and Drug Administration to use modern medical knowledge to revise its decades-old deferral criteria for donors of corneas and other tissues. Francavilla Brown testified against a policy that would discourage informal breast milk sharing. Especially in the middle of a formula shortage, she spoke in support of milk that is being shared. Francavilla Brown was quoted in MedPage Today : “It is milk that is good enough for their own baby. There is no reason it wouldn't be good enough for someone else's baby.” She asked delegates to examine why they feel uncomfortable with this prac tice, suggesting the problem is a form of cultural bias. Among other policies passed by the AMA HOD were measures to stop misinforma tion in public health, seek legal protec tions for patients seeking and physicians providing reproductive health services, support additional steps to prevent gun violence, stop insurance coverage losses when the COVID-19 public health emer gency ends and help private practices as they navigate new payment models.
O ur Colorado delegation to the American Medical Association were part of nearly 700 physicians, residents and medical students who gathered in Chicago for the 2022 AMA Annual Meeting to consider a wide array of proposals to help fulfill the AMA’s core mission of promoting medicine and improving public health. This was the first in-person meeting of the AMA House of Delegates since the emergence of COVID-19 and physicians enjoyed being back together for the first time in three years. Thank you to these leaders on the Colorado Delegation to the AMA!
• Tamaan Osbourne-Roberts, MD
Right photo, from left: Lee Morgan, MD, Dave Downs, MD, and Rachelle Klammer, MD, serve Colorado wines at the PacWest Candidate Wine Reception.
• Brigitta Robinson, MD, FACS
• Fixing prior authorization, • Leading the charge to reform Medi care pay, • Fighting scope creep,
FEATURE AMA REPORT
• Jan Kief, MD
• Rachelle Klammer, MD • Katie Lozano, MD, FACR
• Carolynn Francavilla Brown, MD
• Karima Osman • Tyler (Benji) Benjamin • Codi Hortsman • Mohamoud Ahmed MHMS originally established a scholar ship in 2016 and, after a successful fund raising effort, named Marcus Marable the first recipient of the scholarship in 2017. Recognizing the need to to create new opportunities in medical education; help develop a more diverse, inclusive health care workforce for Colorado’s under-served communities; and support students historically underrepresented in health care, MHMS started an endowed fund. It is named for Charles J. Blackwood, MD, who in 1947 became the first African American graduate of CUSOM. He would have been 100 years old in 2021.
There are two years left to raise the remaining funds. Donations may be made online with a credit card, ACH transfer, or by written check. Find more information or donate online at endowed-scholarship-fundfund/mile-high-medical-society-https://giving.cu.edu/
FEATURE MHMS names first Blackwood Scholars COLORADO PHYSICIANS CAN HELP SOCIETY REACH SECOND FUNDRAISING GOAL Kate Alfano, CMS Director of Communications and Marketing Call Today 303.317.6669 www.yourcruisedoctor.com Celebrity Cruises Sail in Modern Luxury from ultra-luxury Celebrity Flora, Celebrity’s 100-passenger purpose-built ship perfect for exploring the Galapagos, to the New state-of-the-art Beyond with amazing itineraries and innovative spaces. Gourmet cuisine and the exclusive Retreat— a ship within a ship luxury suite. Call us today for exclusive savings on your land or cruise dream vacation! T he Mile-High Medical Society (MHMS) named its first official recipients of the Charles J. Blackwood, MD, Endowed Memorial Scholarship Fund in September 2021. COLORADO MEDICINE 7
Congratulations to the Blackwood Schol ars, class of 2025:
Unfortunately, there is still lack of trust in Black communities due to things that happened in the past.”
The Blackwood Endowed Memorial Scholarship Fund provides full scholar ships to one or more students each year pursuing a medical degree at the Univer sity of Colorado School of Medicine (CUSOM). But there is still work to do. CUSOM Dean John J. Reilly Jr. pledged to support the endowment dollar for dollar up to $2 million. The first $1 million milestone was reached in February 2021, allowing for the first awards. “This was such a daunting task for a small medical society, but we weren’t willing to give up,” said Terri Richardson, MD, lead of the endowment committee. "We felt it was important to do something and leave a lasting legacy for the organization and the community; a legacy to support the next generation of doctors." She is joined on the endowment committee by Johnny Johnson, MD, MHMS president; Henry Frazier, MD; Nia Mitchell, MD; and Regina Richards, PhD, MSW. They are guided by CU development director Travis Leiker, MPA. Even in present day there are disparities,” Richardson said. “We receive calls from patients requesting referrals to Black physicians, but we don’t have enough medical providers to meet this need.
PAGEELECTIONTHE
AMA DELEGATION (four candidates running for four positions; listed alphabetically) VISIT Omar Mubarak, MD, MBA Hap Young, MD Dave Downs, MD, FACP incumbent AMA Delegation Rachelle M. Klammer, MD incumbent AMA Delegation Kay Lozano, MD incumbent AMA Delegation Lee Morgan, MD incumbent AMA Delegation
PRESIDENT-ELECT (two candidates running for one position; listed alphabetically)
Get to know the candidates running for CMS leadership positions by reading their candidate statements in this magazine. See their CVs on the CMS election page, cms.org/articles/2022-cms-election.
The election will be held in August and all ballots will be cast electronically. Do you receive CMS e-newsletters and email blasts? If not, you may need to update your contact information to receive a ballot. Email membership@cms.org with any new information. All CMS members are encouraged to use this opportunity to vote. We also ask you to consider seeking a leadership position next year. More details on the 2023 nomination period will be available in September. Taking the opportunity to vote affirms the commitment of our organization to engage all members in the governance process. Do you have questions about voting, nominations or leadership opportunities? Don’t hesitate to reach out to membership@cms.org
THE FOLLOWING CMS PHYSICIANS ARE RUNNING FOR OFFICE.
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I was born and raised in the state of Colorado and attended both college and medical school at the University of Colorado. I did my general surgery resi dency at Michigan State University and fellowship in vascular surgery at Henry Ford Hospital in Detroit. When I finished fellowship in 2006, I knew I wanted to come home to Colorado. My father was a private practice physician in the Metro area. I am very proud of him, and I wanted a similar life. Plus, the active lifestyle of Colorado suits me. My wife got accepted to the University of Colorado for rheumatology fellowship, and I got a job at Vascular Institute of the Rockies (VIR). I have stayed with that same prac tice and been very proud of its reputation and the services we provide across the state of Colorado. I can’t explain my motives for running for president of CMS without touching on the story of VIR and my partners. Being a part of VIR is one of the greatest privileges of my life. The group originally consisted of three vascular surgeons; I was the fourth. All the partners delivered the best vascu lar surgical care and the group functioned as a family. We originally just had a clinic on Presbyterian St. Luke’s campus and covered that hospital and St. Joseph’s. Over time the economics of health care pushed us to become a larger and more aggressive corporation. We added part ners. We created outreach clinics across the state in Grand Junction, Alamosa, Edwards, Steamboat, and even in Colby, Kan. Our group has always done well but the marketplace got much harder to navi gate for private practice groups. In 2015 I felt that I needed to better understand some aspects of the busi ness of medicine in order to help my prac tice adapt. I went back to the University of Colorado and got an MBA, and then became the managing partner in my group. We made many other advance ments as a corporation. We purchased our own building, created our own inter ventional labs at our Denver office and in Grand Junction, created a Locums corpo ration, and adapted in many other ways. I am proud of what VIR has achieved – we deliver world-class vascular care and try to do so at the lowest cost to Coloradans. What I have recently realized is the business of medicine in Colorado is no longer about hard work and low-cost quality care. There are multiple variables at play that can stress the best physician whether private practice or employed. I have met multiple practitioners who say FOR PRESIDENT-ELECT OMAR MUBARAK, MD, FACS, FSVS, MBA, RVT
INSIDE CMS 2022 CMS leadership election
CANDIDATE
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their practice may not survive the next five to 10 years, or they’ve lost all negoti ating power with their employer. Admin istrators encourage financial sacrifices from employees but are unwilling to make any themselves. Many Colorado physi cians that I encounter say they would no longer recommend the field to their own children. I want to work with CMS and the legislature to change that dynamic and restore some balance of power back to Colorado’s physicians. My passion is and has been my involve ment in patient health care, and as a radiologist nothing has given me more pleasure than helping determine the diagnosis of and aiding in the care of patients. However, I have never lost sight of the importance of the interaction with others in accomplishing this. The input, knowledge, and experience of fellow health care providers is an exceptional “tool” not to be ignored. It is this engagement with my peers that has inspired me to bring their stories and experience to help shape the Colorado Medical Society policy these past 16 years as an active member of the CMS Board of Directors, the Executive Committee, and member and now chair of the Finance ItCommittee.iswiththis same passion that I ask for your support to serve the needs of all physicians, independent practice or employed, as president of the Colorado Medical Society. Over the past three decades in clinical practice, I have had both opportunities as well as the occa sional roadblock. Some, by choice or otherwise, I have dealt with on my own. Yet many issues were open to, and some required, the help of others working together to achieve the goal. I have a unique perspective having spent the last 20 years in a rural Colorado practice. Physicians, and in my expe rience especially rural physicians, can feel a long way from and disconnected from the Colorado Medical Society and other professional organizations. Many don’t realize, or lose sight of, the effort and time spent by CMS to help provide a stable and positive environment within the state to practice medicine. There is a sense that, “As long as things are going well, why worry?” That’s where a strong CMS position comes into play. I want to emphasize and reintroduce the benefits, and the efforts behind them, which CMS provides to doctors across the state, regardless of where they practice. I want to engage more physicians in the realization that CMS helps provide the backdrop for a safe, fair, and secure practice environ ment, allowing physicians to do what they do best – care for their patients! Right now, with the time afforded me with the changes in my own practice, I feel I have an exceptional opportunity to take advantage of my accumulated knowl edge and experience to enhance and help other Colorado physicians in their quest for a satisfying and secure health care practice. I stand ready to listen to fellow physicians about their concerns, hopes and plans related to their practices, to assimilate that information and their concerns, and to use my years of experience in orga nized medicine to help the Colorado Medical Society develop and implement plans of action to improve the practice environment for all physicians, whether they work in small practices, large groups, or health care systems. ■ CMS is pleased to announce ARCAM as our newest Partner in Medicine. ARCAM is the Annual Wellness solution. They provide comprehensive and innovative solutions for physicians and medical practices by performing the Annual Wellness Visit, allowing providers to enhance patient care while creating a more efficient and profitable practice.
Contact ARCAM today to see how they can assist in creating a healthier patient population and a more profitable practice!
Contact: Brittany Sloan, Operations Director 800-801-9672 | Direct: www.arcamhealth.com407-797-8980 FOR PRESIDENT-ELECT HAP D. YOUNG, MD COLORADO
CANDIDATE
Awardees are Carly Forest, Joseph Melius and Nicholas Slaboden.
SCHOLARSHIP2022-2023
C
INSIDE CMS CMS Education Foundation: Helping first-year medical students pursue rural medicine
Thank you to the members of the CMS Education Foundation Board of Directors
ongratulations to first-year students from the University of Colorado School of Medicine and Rocky Vista University College of Osteopathic Medicine who were each awarded $4,000 scholarships from the Colorado Medical Society Education Foundation (CMS EF).
Kate Alfano, CMS Director of Communications and Marketing
Jack L. Berry, MD (Chair) Mark Deutchman, MD Dave Downs, MD, FACP Mark Levine, MD Patrick Pevoto, MD, RPh, MBA William G. Rainer Jr, MD James R. Regan, MD David Ross, DO, FACEP CMS EF, a 501(c)(3) private foundation, has a mission to render financial support to select first-year medical students at UCSOM and RVU. Student scholarships are based on criteria such as the student’s financial status, academic achievement and desire to practice in rural or under served areas upon graduation. The CMS EF Board is thankful for the generous financial contributions and support from CMS members and others who make these education scholar ships possible. You can contribute to the CMS Education Foundation at www.cms.org/contribute
Theresa Tafoya is in the rural training track at CUSOM and aims to practice in Montrose County. “I cannot tell you where or how I will do things in the future, but I can tell you what I hope for,” Tafoya wrote in her application letter. “I hope to love fiercely, strive for excellence, and challenge disparities. I hope to become a kind, compassionate, just, and honest person and physician.” ■
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Gabrielle Coleman is the recipient of the Maribeth and Jack Berry Scholarship and Theresa Tafoya is the recipient of the William Gerald Rainer Scholarship.
Joseph Melius is in the rural and wilder ness medicine track at RVU and aims to return to rural Yampa Valley to practice full-spectrum medicine including obstet rics, mental health care and emergency medicine. “The people of rural Colorado need and deserve health care profes sionals who know their culture and care about their individual community’s well being,” Melius wrote in his application letter. “I’ve identified a task that needs doing and it ‘ain’t gonna’ do it itself. It’s time to make myself useful.”
RECIPIENTS Gabrielle Coleman is in the rural training track at CUSOM and aims to practice in rural Colorado. “I view rural medicine as the best of career and personal life,” Coleman wrote in her application letter. “These opportunities for creativity, problem solving, and enduring relation ships are far and away the most alluring aspects of medicine to me. Then, when the workday is done, there exists a closeknit community to engage with, a special way to know and be known by others.” Carly Forest is also in the rural training track at CUSOM and aims to practice in rural Colorado. She will complete a rural clerkship in Salida, Colo., this year and is the current president of the Family Medicine Interest Group. “Over and over again, I am reminded of the great diversity of family medicine,” Forest wrote in her application letter.” However, there is no place where that diversity is so appar ent as in rural medicine. In this setting, a physician’s scope of practice is only dependent upon personal limits. I love this aspect of rural medicine. You can have a broad scope and still be a primary care physician – after all, there’s a reason primary medicine is primary.”
Nicholas Slaboden is also in the rural and wilderness medicine track at RVU. In addition to pursuing a DO, he has a master’s degree in biomedical sciences. “I grew up in an underserved health care community and I understand the struggle of having to travel long distances to get the most basic of care,” Slaboden wrote in his application letter. “I can empathize with my future rural Colorado commu nity. I have every intent on becoming a rural-worthy physician, able to bring patients better access to health care.”
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Physicians are starting to gather in person again for social events.
Metro area physicians, residents and medical students gathered on May 11 at Ursula Brewing in Aurora for Beers with Peers.
PourUrsulaBreckenridgetogetherbeBreweryBrewingBrothersCommunity Tavern
Located on the University of Colorado Anschutz Medical Campus, this social event was co-hosted by the Colorado Medical Society, CU Alumni Association and CU Housestaff Association, and sponsored by Huntington National Bank.
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Northern Colorado physicians enjoyed snacks, beverages and great conversation at Beers with Peers on July 14. This event was hosted by the Northern Colorado Medical Society and sponsored by Canyon Home Care and Hospice.
View photos below from events held at Beers with Peers at Pour Brothers Community Tavern in Fort Collins, Beers with Peers at Ursula Brewing in Aurora, tri-component social at Breckenridge Brewery in Littleton, and MHMS-CMS social Ocean Prime in Denver.
INSIDE CMS
ADEMS, Aurora-Adams Medical Society and Denver Medical Society hosted a family-friendly social at Breckenridge Brewery in Littleton on June 4. Great food, drinks, lawn games and a brewery tour delighted attendees.
It’s great to
The Colorado Medical Society and Mile-High Medical Society co-hosted a no-agenda mixer at Ocean Prime DTC in Denver on June 1. MHMS is a Denver organization of Black health professionals that is committed to ensuring the development, sustain ability, and viability of African American physicians and students, colleagues, and the Denver metropolitan community they serve. This event brought together CMS and MHMS members to engage and find synergy in our shared goals.
Ocean Prime DTC COLORADO MEDICINE 13
“This project and my time with CMS taught me how to leverage with people and create compromise to meet a goal,” Leary said. “We serve and represent all in Colorado and public policy won’t always be a linear process.”
All three awardees served on the CMS Board of Directors and as CMS Medical Student Component leaders for their medical schools.
Jimmy Rager is a fourth-year medical student at Rocky Vista University College of Osteopathic Medicine. He worked with Monica on the opt-out policy to increase medical student memberships in CMS and has seen great gains in CMS member ships and memberships in the American Medical Association: 100 percent RVU
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From left: Jimmy Rager, Monica Patten and Jacob Leary receive their award checks from scholarship committee member Aris Sophocles, MD. Jacob Leary receives his award check from Dr. Sophocles.
Kate Alfano, CMS Director of Communications and Marketing
INSIDE CMS
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T he Gilchrist Scholarship Committee has named three scholars for 2022: Monica Patten, Jacob Leary and Jimmy Rager. In recognition of their outstanding achieve ments, they received unrestricted monetary awards to aid them in their medical education.
Monica Patten is a fourth-year medical student at the University of Colorado School of Medicine. She helped increase student membership at CU by advocating for membership to be “opt out” instead of “opt in.” Monica has done considerable work in voter registration and wrote an article for Colorado Medicine about the importance of voting. She was also active in engaging medical students in main taining confidentiality in peer assistance counseling. Monica established the first LGBTQ+ group at CU and was part of the board that started the educational hub that reaches the entire campus. She also completed a research project in suicide among LGBTQ+ persons. “I was interested in CMS as soon as I began my first year because I wanted to be involved in anything to do with advo cacy and policy related to physicians,” Patten said. “I’ve realized throughout medical school that advocacy and policy are important to me and, surprising to some people, it’s one of the things that helps me prevent burnout. Through my experience at CMS, I have a clear understanding of how to be an effective advocate and how to continue advocacy in my future career, whereas before I didn’t know how policy and practice would overlap. CMS has connected me with many physicians who have done that successfully.”
Jacob Leary was awarded his medical degree by the University of Colorado School of Medicine in May and began his internal medicine residency at the University of Washington in June. Jacob has a special interest in suicide preven tion and during his medical school years completed a special media project on the importance of firearm awareness for the CU Colorado Springs Branch. He successfully navigated the political sensi tivity of the issue, met with stakeholders and wrote a video script that rose above politics to emphasize the public health need for firearm safety.
Congratulations to the 2022 Gilchrist scholars
COLORADO MEDICINE 15 Thank
Alfred Gilchrist (Chair) Curtis Hagedorn, MD Jan Kief, MD
Mark Laitos, MD Lee Morgan, MD
Thank You
Dr. Sophocles talks with the scholarship recipients about their future career goals. you to the members of the Gilchrist Scholarship Committee
Patrick Pevoto, MD Aris Sophocles, MD
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Robert Yakely, MD Gerald Zarlengo, MD
membership in CMS and 80 percent membership in the AMA. Jimmy authored evidence-based guidelines for cornea donations and managed to affect the policy at the Food and Drug Administra tion and the AMA. He also led a COVID-19 vaccination drive in 2021 among medical students. He’s currently advocating on behalf of DO students who do rotations through CUSOM, working to change poli cies he feels are discriminatory. “CMS has been amazing,” Rager said. “It has taught me leadership skills and helped me forge connections in Colorado. I’ve learned about policy and legislation and through the big projects I’ve done with CMS. It has been a very valuable experience that I am grateful for.”
The Alfred D. Gilchrist Student Leader Scholarship Foundation was established in 2020 to honor former CMS CEO Alfred Gilchrist’s 40-year career of physician advocacy. This is the second year of distri bution of awards. It is open to third- and fourth-year medical students who have demonstrated a significant leadership contribution to organized medicine. Pref erence is given to students who are active with CMS or a CMS component medical society. Contribute to the Gilchrist Scholar Fund at www.cms.org/contribute
Gerald Zarlengo, MD, Chairman & CEO COPIC Insurance Company Professional education is a critical aspect of health care. When COPIC was founded, we recognized that we could play a vital role in providing timely, relevant educa tion for physicians that focuses on current issues in medicine. Our Patient Safety and Risk Management team collaborates with our Legal team to develop educational content based on insight drawn from claim reviews, input from our staff, recent trends in health care, feedback from insureds, and current medical literature.
COPIC’S educational resources GAIN VALUABLE KNOWLEDGE, EARN CME CREDITS/COPIC POINTS
COPIC has a catalog
DEPARTMENTS COMMENT
COPIC’s role as an educational resource is backed by us being accredited as a provider of Continuing Medical Education (CME) by the Accreditation Council for Continuing Medical Education (ACCME). We are also accredited as a provider of Continuing Nursing Education (CNE) by the American Nurses Credentialing Center Commission on Accreditation Each(ANCC).year, we offer an array of activi ties that include on-demand courses, virtual and in-person seminars, and other programs designed to meet the needs of physicians and other medical providers. These activities often qualify for CME credit and participants can also earn COPIC points which apply toward a premium discount. The following high lights some of the educational opportuni ties available through COPIC. ON-DEMAND COURSES THROUGH COPIC’S WEBSITE
of 40+ on-de mand courses that can be accessed at www.callcopic.com/education These courses generally take an hour to complete and cover a wide range of topics that include: • Against Medical Advice and Informed Refusal • Everything You Wanted to Know About the Colorado Candor Act • Emerging Risks in Procedural Specialties • Maximizing Effective Practice Among Physicians, PAs and APNs • Understanding Common Cancers and Syndromes In addition, our online catalog includes several courses focused on the nuances and unique scenarios for specific medical specialties. These are based on feed back and requests from insured medical providers and the courses address risks specific to a certain specialty. They include the following: • Current and Emerging Risks in Obstet rics and Gynecology, Internal Medi cine, Emergency Medicine, Surgery, and Pediatrics • Patient Safety Pearls for Hospitalists, Anesthesia, Gastroenterology, Lapa roscopic Cholecystectomy, Obstetrics, Radiology, and Urology VIRTUAL AND IN-PERSON SEMINARS The COPIC Education Catalog, which can be downloaded at com/professional-educationwww.callcopic. , highlights seminars that cover topics in areas such as patient/staff communications, clinical risk management, legal risk management, and physician support. Here are exam ples of some seminars that are popular among our insureds: Patient/Staff Communications • Check Your Spam Folder: Communi cating Electronically with Colleagues and Patients • The Empathy Effect: The Secret Sauce in Medicine • The Upset Patient: How to Manage Difficult Interactions • Telehealth Basics Clinical Risk Management • Creating a Safer Office Practice: Preventing Errors in the Office Setting • Informed Consent: Best Practices for You and Your Patient • Medication Errors in the Electronic Age • Opioid Management: A Practical Approach to a National Crisis Legal Risk Management • HIPAA Basics: What Every Provider Should Know (and Understand) • If You Knew EMTALA Like I Know EMTALA : Common Pitfalls and Compliance Issues • The Hidden Dangers of Minors and Legal Risk • EHRs: Expected and Unexpected Dangers That Emerge in Lawsuits If you are interested in scheduling a seminar at your facility or practice, please contact Carmenlita Byrd at cbyrd@copic.com or (720) 858-6131 ■16 COLORADOASCHEDULINGSEMINARMEDICINE
WITHIN NORMAL LIMITS—COPIC'S PODCAST Another newer form of education that COPIC offers is our podcast—Within Normal Limits: Navigating Medical Risks. It is hosted by Eric Zacharias, MD, COPIC’s director of medical education, and there are more than 40 episodes available. Each episode is around 20-30 minutes and features a discussion with physician leaders and/or medical experts that offers insights to improve care and avoid medical liability issues. Recent episodes include: • Navigating Conversations with Patients About Guns • Helping Kids Cope with Anxieties Around Medical Care and Pain Management • A Return to Discussing Spinal Epidural Abscess • Using Ketamine to Treat Depression Within Normal Limits is available on popu lar platforms such as Apple Podcasts, Google Podcasts, Spotify, and Amazon. You can also go to www.callcopic.com/ wnlpodcast for more information. COLORADO MEDICINE 17
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Oppressed and depressed
My story isn’t unique; there are many others like me. The biggest lesson my third-year rotations have taught me is that everyone needs a voice and a place at the table. I was standing in the corner of the exam room when my preceptor was talking to a patient about cutting rice out of her diet if she doesn’t want to end up losing her legs due to diabetes. The preceptor left after saying that, and the patient sat there stunned and mumbled something under her breath. I asked if I could clarify anything for her, and she asked me how she was supposed to cut out rice, which is an integral part of her Filipino Anothercuisine?patient on an M1 hold was handed a list of medica tions, told that it would help her psychiatric condition, and left alone. She refused on multiple occasions, barely talked to anyone and just sat on the bathroom floor instead. Later, I sat down next to her on the floor and asked her why she didn’t want to take her medications. She looked at me with a surprised face and made a remark that no one had asked her why she didn’t want to take the medications. They just kept telling her she needed it and never explained why. She apprehensively shared her Haitian family culture of viewing medications as a disability, and that she was conflicted because she grew up being taught something else and felt that she was betraying her family. It is easier to label “non-compliant,” “med student,” “diabetic” than it is to give someone the voice they need. There is usually more than what meets the eye behind every person, especially a person who lacks basic privileges. Whether it is the medical student who is standing in the corner trying to just survive given the immense burden on their shoulders, the patient who can’t give up an integral part of her culture, or the patient for whom taking medications would mean going against her own family, a voice that is heard is the first and foremost step toward more inclusive and equitable health care. ■
Dikchhya Karki Critical reflective writing holds a prominent place in the Medical Humanities curric ulum at Rocky Vista University College of Osteopathic Medicine. Beginning in the first semester of Medical Ethics, students engage in critical reflection to explore their own assumptions and biases and how their values impact their practice. This submission is selected and edited by Nicole Michels, PhD, chair of the Department of Medical Humanities, and Alexis Horst, MA, writing center instructor. Dikchhya Karki is a fourth-year medical student at Rocky Vista University College of Medicine. She was born and raised in Nepal until she was 10 years old when she moved to Longmont, Colo. Dikchhya completed her B.S in Business Administration/Pre Med at Union College in Lincoln, Neb. She loves spending time with her family and friends, experiencing new food and, if the weather permits, trying hard to not fall while hiking.
There is a saying that the most oppressed and depressed person is the eldest daughter. I wouldn’t say that is completely true in my case but comes very close to it. Being born the first daughter of a South Asian household wasn’t my choice.
DEPARTMENTS INTROSPECTIONS
It comes with a lot of unspoken expectations and rules; add barriers of being a first-generation immigrant to that and it is as sticky as it gets. Belonging to a heavily patriarchal culture, I had to shine my way out of being married off by the age of 25. Daughters are still considered someone else’s prop erty. One of the rituals in our wedding ceremonies is to give Kanyadan (kun-yea-daan), which is essentially the bride’s parents giving over their daughter to the groom’s parents and saying, "she is your responsibility now."
Trying to escape the fate of being handed off like an object, I worked my way to medical school. Now I was playing the role of a medical student, daughter, sister, mentor and a role model all while being groomed to be an “ideal” wife and daughter-in-law. It is why I began cooking when I was in the 6th grade, helping my parents with household chores and their small business, taking care of my little brother so that he didn’t have to struggle as much, and helping anyone else in the community who was also trying to go into medicine. While my responsibility was being given to my future family, I was responsible for everyone else around me. I learned early on to put others before me but, eventually, I grew weary, felt unhappiness surrounding me, dreaded having to wake up in the morning. It wasn’t until my therapist asked me, “well what about you?” that echoed in my head for days. What about me? I was fulfilling my duties, I was doing “the right thing,” doing what I saw my mother doing, and she seemed content. It is what she learned and was teaching me. Who am I to start questioning? Why do I get a voice?
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“My mom used to make us boiled half-cut potatoes. That’s what I’m used to. I’m not used to much spice,” he said. He paused. “My mom was a lovely woman. She raised all eight of us,” he continued. From there, he detailed his upbringing on a small farm in rural southern Colorado and reminisced about the antics that he and his siblings used to get into.
It was one of those rare days on my Inter nal Medicine rotation where I had finished my work early. I was wrapping up my notes for the day, and the admissions pager remained uncharacteristically silent. I signed my last note to my resident and excused myself to check on my patients for the afternoon before I left for the day.
The next morning, my intern and I approached the night resident for signout. She ruffled through her patient list before settling on our patients.
The irony is not lost on me that as I sit here typing this, my body is currently fighting off the same virus that Mr. B passed away from. When I told my family and peers that I had contracted COVID-19, the response was laid-back reassurance: “It’s okay, you’re young and vaccinated!” After seeing COVID-19 derail the lives of so many, this casual confidence feels almost naïve. Watching Mr. B’s course from the sidelines has shown me that COVID-19 is fickle and unpredictable, spanning the spectrum of improvement to deterioration within a few hours. The confidence that I will survive a virus that has taken the lives of so many is a privilege that has been thrust upon me by virtue of being young, healthy and vaccinated. During my time in quarantine, I have been grappling with this privilege – it is a privilege that I did not necessarily work for but has been granted to me. Plenty of people, like Mr. B, did their part to shelter-in-place and triple vaccinate; nevertheless, their evasive efforts were unfruitful and eventually succumbed to underlying conditions. As I left Mr. B’s room that evening, I couldn’t help but reflect on his fears about breath ing. I marveled at the mechanics that kept air moving through my lungs without a thought. What a privilege to not have to worry about something that I once took for granted. The enormity of this privilege is not lost on me, and for this privilege I am grateful. ■
DEPARTMENTS REFLECTIONS Breath Vall Vinaithirthan
He continued to talk about his wife and his kids, and the sun had started to set. Our conversation came to a close. “I’ll be back in bright and early tomorrow and we can chat more,” I said as I placed the PPE into the trash bin.
“Mr. B was intubated and transferred to the ICU last night,” she said. As I presented him on ICU rounds later that morning, my mind was still reel ing from the news as I reported “now intubated.” Over the next few days, my one-liner grew longer – “… now intubated, sedated, proned and paralyzed.”
Vall Vinaithirthan is a fourth-year medical student at the University of Colorado School of Medicine. She is applying this residency cycle as an aspiring Internal Medicine physician, and is undecided (and excited) about where the specialty will take her. Originally from the San Francisco Bay area, she migrated to the southern California coast to complete her bachelor’s in Biology. She is grateful that medicine brought her to Denver and enjoys all that Colorado has to offer.
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One of my patients was Mr. B, a kindhearted, elderly, immunocompromised man admitted for COVID-19 pneumonia. I gowned up in the pale-yellow PPE, adjusted my N95 so that it did not fog up my glasses, and headed into the room. After exchanging the usual pleasantries, I asked him how his lunch was.
“It’s good. It’s kind of spicy,” he paused, “I’m not used to spices.” He looked at me for a moment before proceeding, as though asking permission.
“The thing I’m most nervous about is my lungs. I want to breathe. My wife is very worried. She says I don’t speak up enough about what’s bothering me. But I just want to be able to breathe,” he said.
“I want the same thing for you. We’re reassured that you’ve been going down on your oxygen over the past few days,” I responded.
When we broke the news to Mrs. B, she refused to believe it. “I need to talk to your seniors! You guys have no idea what you are talking about,” she Initially,yelled.I was taken aback by her response; it was not characteristic of my prior interactions nor Mr. B’s stories of her. I quickly realized that her response was not a reflection of her character, but of grief. I recognized that grief bleeds – beyond the boundaries of profession alism and character. Not long after our conversation, Mr. B was transitioned to end-of-life care. His wife and kids were able to say goodbye, and he was palli atively extubated. During his veteran’s salute, I reflected on our last conversa tion, and how I was likely the last person he got to share his life’s moments with. I was grateful that he was able to reflect on his life shortly before he passed. I wondered if he knew.
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Not enough sleep Out of energy drinks I walk into the familiar room Log on, start my pre-charting No longer a room number next to his name IDeceasedthinkabout the day prior The kindest he’d been to me Asked me for a hug I wondered about boundaries I decided why not, and gave one Goodbye, get some rest, I’ll see you tomorrow Speak to his right ear Talk slow but not too slow Loud but not too loud Be patient with him “MyScaredbrain doesn’t work anymore because of the stroke” Hold his Spoutinghandconspiracy theories Bite my tongue TellPausehim, “I hear that you’re anxious The hospital noises are not soothing I know your roommate likes to yell I’ll grab you earplugs And we can practice calming breathing Cannottogether”take a deep breath Produce shallow gasps As peaceful as he can “When I pass I hope I return to a magical spot I used to ride my motorcycle there I want my ashes to live there But I know no one will bring them I have no one left” “You’re not alone I’m Disappointedhere” in myself now Can’t remember the name of his magical spot But know that if I stumble across it He will come back Gasping for air Chest heaving Smile missing teeth Living in the leaves on the trees he told me of Crisp fall OfReminderswindtheSeptember we shared Unlikely companions in an unfamiliar place Goodbye, R See you next time Get some rest ■
Madelyn Mendlen is a medical student at the University of Colorado School of Medicine, currently completing a research year before embarking on her fourth year. Originally from Seattle, Wash., she has a passion for computer science, everything brain-related and humanism in medicine. Madelyn has a tradition of lighting a candle in honor of her patients when they pass. She will be applying to neurosurgery residency programs in the 2024 Match cycle.
Madelyn
DEPARTMENTS REFLECTIONS Tobacco
Thank you to Cory Carroll, MD, and Donna Sullivan, MD, for serving as CMS judges. Interested in judging in 2023? Contact crystal_goodman@cms.org ■
The 2022 Colorado Science and Engi neering Fair (CSEF) was held April 7-8. than 200 projects were on display from students in grades 6 through 12 at the Lory Student Center on the Colorado State University – Fort Collins campus and roughly 350 individual grand and special awards were handed out. The Colorado Medical Society Educa tion Foundation is honored to present a special award for the top students in the health and medical category. The students below received a certificate, a $100 prize and an invitation to present their project at the 2022 CMS Annual Meeting in Breckenridge. Congratulations! Chloë Pennington, 8th grade (junior level) Friends School, Boulder Project: TATAA Celiac! A Proposed Model of Celiac DNA Isolation, Intervention and Cure Gitanjali Rao, 11th grade (senior level) STEM School, Highlands Ranch Project: A Novel Approach to Early Direc tional Diagnosis for Prescription Opioid Addiction - Phase II
DEPARTMENTS MEDICAL NEWS Colorado Medical Society honors young scientists at the Colorado state science fair
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From left: Chloe Pennington presents her junior-level project to science fair judge Carroll.
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From left: Gitanjali Rao explains her senior-level project to Cory Carroll, MD, a family physician in Fort Collins and CMS judge of the 2022 Colorado Science and Engineering Fair.
Additionally, CMS was asked to award the Wojtaszek Family’s Paul Wojtaszek Memorial Award, a $200 prize to a presenter in the senior medicine and health category. Congratulations to this special award winner. Aditi Avinash, 10th grade (senior level) Rock Canyon High School, Highlands Ranch Project: Quantitative Methods to Analyze the Synergism of Digestive Enzymes for Gluten Breakdown
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FEATURE FINAL WORD Why we must reform the Medicare physician payment system
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The need for change is clear. Taking prac tice cost inflation into account, Medicare physician payment rates plunged 20 percent from 2001 to 2021. In the last decade, as spending per enrollee for other parts of Medicare jumped by 3.6 percent to 42.1 percent, spending on physician services per enrollee retreated by 1 percent. With inflation soaring to 40-year highs this year, statutory payment cuts looming, and many physician prac tices still dealing with pandemic-related financial issues, next year’s proposed cuts from the Centers for Medicare and Medicaid Services (federal CMS) undermine the long-term sustainability of physician practices while threatening patient access to physicians participating in LeadingMedicare.the charge to reform Medicare physician payment is a core element of the AMA’s Recovery Plan for America’s Physicians, along with fixing prior autho rization, supporting telehealth, reducing physician burnout and stopping scope of practice creep. Physicians put their lives on the line responding to the COVID-19 pandemic and holding together a health care system stretched far too thin. It’s time our nation supports doctors and removes obstacles that interfere with what drew us all to medicine in the first place – caring for First,patients.physicians need predictable, auto matic, positive payment updates tied to practice costs – just like hospitals, skilled nursing facilities, and others already have in place. Annual payment rate adjustments should be tied to a measure of inflation, such as the medical economic index. We also must eliminate or replace the budget neutrality rules that penalize physicians for changes beyond their control, while offering no credit for cost savings that physician-led quality improvements have generated in other parts of the system, such as reduced hospitalizations. Rather than layering on burdensome reporting requirements for measures that seldom feel relevant, physicians also deserve access to timely, actionable data, and incentives tailored to the distinct characteristics of different specialties and practice settings. While maintaining a financially viable fee-for-service model, we also need a diversity of voluntary alternatives that invest in practice trans formation. Alternative payment models designed by physicians can remove barri ers to the innovation required to address the multiple chronic disease epidemics our nation faces.
Jack Resneck Jr, MD President, American Medical Association T wo decades of stagnant physician payment rates in the face of rising practice costs, as well as proliferating administrative burdens, have put the Medicare program on an unsustainable path that threatens patient access to quality care. The American Medical Association (AMA) and multiple state and national medical societies – includ ing the Colorado Medical Society – have outlined a practical, commonsense approach to reform based on the principles of simplicity, relevance, alignment and predictability.
Payment reform must also be undertaken with a lens on health equity. Physicians need support as they care for historically marginalized and minoritized populations, address upstream and social determi nants of health, and combat discrimina tory practices in health care delivery. Quality and value measures should be risk-adjusted and reflect the ongoing contributions of physicians to dismantle health disparities. Ensuring that payment reform and innovations equip physicians to reduce inequities, rather than penaliz ing that work, will improve our health care system and the health of our nation. Just as we didn’t get where we are overnight, we are unlikely to secure the massive, badly needed overhaul of the Medicare physician payment system in a day. The good news is that we are laying the groundwork for reform, and we can get there through single-minded determination and the collective efforts of physicians, the AMA, and our counter parts in the Federation like the Colorado Medical WorkingSociety.together, we can place the Medicare payment system back on a sustainable path and ensure that our patients continue to receive the quality care they deserve.
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Hear more from Dr. Resneck at the CMS Annual Meeting in Breckenridge. He will be joined by Colorado leader Kyle Leggott, MD, to present a session Saturday, Sept. 17, 1:45-2:45 p.m., on efforts to increase health care value on the federal and state levels. for the CMS Annual Meeting on our website, www.cms.org ■
Commit somethingto greater Optum Colorado delivers health care through New West Physicians in Denver as well as the Optum and Mountain View Medical Groups in Colorado Springs. We invite you to be part of our incredible momentum in medicine. The research, growth, and emphasis on technology make this a place where you can have a real impact—and spend more time treating your patients, too. And you’re always backed by the stability of a nationwide health care leader. Practice medicine the way it was meant to be practiced. Join the Optum team. Contact Chad Smith at 763-361-5975 or chad_smith@optum.com See the difference you can make at optumcareersco.com Optum Colorado is hiring internal & family medicine physicians Competitive signing bonus ©2022 Optum, Inc. All rights reserved. Dr. Christopher McNulty Joined in 2015
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