ECMS March/April Bulletin 2020

Page 1

Editors: Kacey Montgomery, M.D. | Erica Huffman, Executive Director



Just what is “physician burnout”? Do I have it? Am I going to get it? How will I know if I get it and what do I do about it if I do get it? I had never heard the term “physician burnout” until two years ago at an ECMS meeting and honestly didn’t know anything about the subject until I began reading articles and information for this newsletter. In 2019 Medscape surveyed more than 15,000 physicians across 29 specialties and found that 44% of all physicians reported feeling burned out. Fifty percent of women physicians surveyed reported feeling burnout and 39% of the men physicians reported feeling burned out. The top six specialties reporting burnout were urology, neurology, physical medicine and rehabilitation, internal medicine, emergency medicine and family medicine. When asked about the biggest contributors to burnout, 59% of doctors blamed it on too many bureaucratic tasks and 34% blamed it on too many hours spent at work. Many physicians reported struggling with their EMR (electronic medical record) and felt they spent too much time practicing “desktop medicine” and spent twice the amount of time staring at their computer screen than interacting with the patient. This is not what most of us envisioned when we signed up for this job. Dr. Dike Drummond, author of Burnout Prevention Matrix, believes that burnout originates from a disorder of energy and compares burnout to an energy bank account. Our bank accounts store our physical, emotional and spiritual energy that we use every single day. When we are at work, there are withdrawals from out energy accounts. Unless we are able to replenish our energy accounts, we will eventually have a negative balance in our accounts which is the definition of burnout. Our energy bank account is different from a battery, because when batteries run out, they stop working. When physicians’ batteries run out, they often don’t stop working and continue to operate in a negative balance. So why should we care if a physician has burnout? Burnout is directly linked to many undesirable consequences including lower patient satisfaction, lower quality of patient care, higher medical errors, higher malpractice risk, higher physician and staff turnover, physician substance abuse, and physician suicide. That’s right… burnout can be deadly! Suicide rates for both men and women are higher in physicians than the general population. If burnout is such a serious subject, then why is it just now being recognized

Page 4 - President’s Letter Ctd. Page 6 - Practice Mgmt. Page 8 - Medical/Legal Page 13 - Foundation Page 15 - Community

Save the Date April April 23rd Wahoo Baseball Game June June 23rd Physician Speed Networking *calendar is subject to change


Founded in 1873


1 | ECMS

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E.C.M.S. Bulletin

The Bulletin is a publication for and by the members of the Escambia County Medical Society. The Bulletin publishes six times a year: Jan/Feb, Mar/Apr, May/Jun, Jul/Aug, Sept/Oct, Nov/Dec. We will consider for publication articles relating to medical science, photos, book reviews, memorials, medical/legal articles, and practice management.

Vision for the Bulletin:

Appeal to the family of medicine in Escambia and Santa Rosa County and to the world beyond. A powerful instrument to attract and induct members to organized medicine.


Advancing physicians’ practice of medicine in our community.

New Members Beasley, Jenna, M.D., FAAD Dermatology NPI: 1992063267 Vital Dermatology 6202 N 9th Avenue, Suite 2 Pensacola, FL 32504 (850) 888-2424 Fax: 620-7107703 Biery Jr., John, D.O. FSM/OMT NPI: 1033198924 Southeast Health ACOM- Ashford Clinic 445 Health Sciences Boulevard Dothan, AL 36303 (334) 699-2266 Fax: (334) 699-2268 Cahill, Joseph, M.D. N NPI: 1427346766 West Florida Specialty Groups- Neurology 8383 North Davis Highway Pensacola, FL 32514 (850) 494-3954 Fax: (850) 494-3960 www.westfloridamedicalgroup. com Boyd, Marc, D.O., M.D. GYN NPI: 1770581456 Baptist Medical Group-Ladies First OB/GYN 3417 North 12th Avenue Pensacola, FL 32503 (850) 432-7310

Ad placement Contact Erica Huffman at 478-0706 Ad rates 1/2 page: $350 · 1/4 page: $200 · 1/8 page: $150

View and opinions expressed in the Bulletin are those of the authors and are not necessarily those of the board of directors, staff or advertisers. The editorial staff reserves the right to edit or reject any submission.

Foust, Joseph M.D. FM NPI: 1407837438 Baptist Medical Group Family Medicine & Walk-In Care – Navarre 8888 Navarre Parkway Navarre, FL 32566 (850) 437-8800 Hlavacek, James, M.D. ORS NPI: 1659506798 Andrews Institute –Ortho Trauma Baptist Medical Towers 1717 North “E” Street, Suite


208 Pensacola, FL 32501 (850) 916-8700 Garrison, Carrie, M.D. Pediatric Critical Care NPI: 1639383359 Ascension Medical Group Sacred Heart 5153 N. Ninth Avenue Pensacola, FL 32504 (850) 416-4325 Fax: (850) 416-7677 https://healthcare.ascension. org/ Gierdimas, Evaldas, M.D. Electrophysiology NPI: 1881878080 Baptist Health Care 1717 North “E” Street, Suite 434 Pensacola, FL 32501 (850) 434-4011 Fax: (850) 434-4011 Jonnalagadda, Sweata, M.D. HEM/ONC NPI: 1851667109 Baptist Medical Group- Hematology and Oncology 1717 North E Street, Suite 231 Pensacola, FL 32501 (850) 469-7975 McBride, Suzanne, M.D. FM NPI: 1881682144 Baptist Medical Group Primary CareNorth Hill 1717 North “E” Street, Suite 222A Pensacola, FL 32501 (850) 437-8637 Manis, Peter, M.D. Sr. Health NPI: 1164485926 Baptist Medical Group- Senior Health 1000 West Moreno Street Pensacola FL, 32501 (850) 469-7406

Kohler, Nathan Diagnostic Neuroradiologist/ Neurointerventional Radiologist NPI: 1902033566 Ascension Sacred Heart 5153 North 9th Avenue Pensacola, FL 32504 (850) 416-2250 Fax: (850) 416-2536 Presley, James, M.D. FSM NPI: 1336403393 Andrews Institute – Non-Surgical Sports Medicine Baptist Medical Park – Navarre 8880 Navarre Parkway Gulf Breeze, FL 325 (850) 916-8700 Redick, Guinevere, M.D. OBGYN NPI 1932482775 The Women’s Group 2114 Airport Blvd Suite 1000 Pensacola, FL 32504 (850) 476-3696 Fax: (850) 477-3573 Ripps, M.D., Lorraine AP/CP NPI: 1649470238 Gastroenterology Associates of Pensacola, P.A. 517 Selina Street Pensacola, FL 32503 (850) 969-0767 Fax: (850) 969-0761 Rosenberg, Brian, M.D. APM NPI: 1174744031 Andrews Institute – Interventional Pain Medicine Baptist Medical Group – Nine Mile 9400 University Parkway 101B Pensacola, FL 32514 (850) 916-8700

3 | ECMS

Samuels, Richard, M.D. Diagnostic RAD NPI: 1700995693 Radiology Associates of Pensacola 1717 North “E” Street, Suite 300 Pensacola, FL 32501 (850) 432-6851 Fax: (850) 438-6821 Sharma, Amit, M.D. Colorectal Surgeon NPI: 1629210836 West Florida Hospital 2130 E. Johnson Ave, Suite 130 Pensacola, Fl 32514 (850) 494-3749 Fax:850-494-3974 Sherrell, Victor, M.D. P NPI: 1134488455 West Florida Behavioral Health 2191 Eat Johnson Ave. Pensacola, FL 32514 (850) 494-3953 Fax: (850) 434-3960 Sully, Keziah, M.D. PM&R/Pain Management NPI: 1689963027 Veterans Administration 790 Veterans Way Pensacola, FL 32507 (850) 855-7929 Wilsdorf, Terry T., M.D. CD NPI: 1841236619 Cardiology Consultants 1717 North “E” Street, Ste. 331 Pensacola, FL 32501

(850) 484-6500 Fax: (850) 444-1755

Move/ Changes

Henson, Roger, M.D. (life) FP NPI: 1396819124 Baptist Medical Group Family Medicine-Nine Mile 9400 University Parkway, 4th Fl., Suite 409 Pensacola, FL 32514 (850) 208-6160 Jones, Cheryl S., M.D. D NPI: 1588600795 Cheryl S. Jones, M.D., P.A. 4624 N. Davis Highway Pensacola, FL 32503 (850) 494-0940 Fax: (850) 696-2613 Kasabian, Michael, D.O. FM NPI: 1275527293 West Florida Medical Group W Street 6431 North “W” Street Pensacola, FL 32505 (850) 494-4600 Fax: (855) 901-2936 Konnell, Benjamin, M.D. FM NPI: 1164512224 West Florida Primary Care 4910 N. 12th Avenue Pensacola, FL 32504 (850) 494-4600 Fax: (850) 456-7222

Lauro, Francis, D.O. CD NPI: 1952367567 Cardiology Consultants 1717 North “E” Street, Ste. 331 Pensacola, FL 32501 (850) 484-6500 Fax: (850) 444-1755 Morris, Carol, M.D. Gastro NPI: 1295972206 Baptist Medical Group 1717 North “E” Street, Ste. 401 Pensacola, FL 32501 (850) 626-9626 Fax: (850) 626-9606 Ryan, Mark, M.D. FM NPI: 1659513919 Woodlands Medical Specialist 2114 Creighton Road, Ste. A Pensacola, FL 32504 (850) 696-4000 Fax: (850) 637-1747 Sauer, Samual Wade, M.D., MPH IM NPI: 1023019536 Covenant Care 5041 N 12th Ave. Pensacola, FL 32504 (850) 433-2155 Fax: (850) 202-1170 Ullman, Saul, M.D. OPH NPI: 1881690253 Ullman Eye Consultants 5528 North Davis Highway Pensacola, FL 32503 (850) 208-1900 Fax: (850) 208-1950

President’s Letter Continued and addressed? Unfortunately, is still remains a taboo subject in the medical workplace. There is also a lack of training in medical schools and residency programs on how to deal with stress management and burnout prevention. The medical profession as a whole still supports two key principles which are “the patient comes first” and “never show weakness”. These principles combined with our belief that we should work as hard as we can, be perfect and be a superhero is the perfect recipe for a burnout disaster. So how do we recognize burnout in ourselves or our colleagues? Dr. Drummond describes three cardinal symptoms of burnout which include exhaustion, cynicism, and doubt. Exhaustion Is when you run out of physical, emotional, or spiritual energy. You withdraw from your energy bank account and have a negative balance. Cynicism is when you lose your ability to care for, empathize or connect with patients, staff and coworkers. Doubt is when you begin to question the quality and importance of your work. Other symptoms attributed to burnout include fatigue that doesn’t respond to adequate rest, feeling sick a lot due to a lowered immune system, musculoskeletal pain, changes in appetite and changes in sleep habits. How can we prevent burnout? There is no one formula for preventing burnout, because there are many factors that contribute to burnout and will be different for each person. First doctors must identify the aspects of their job that predispose to burnout. We need to be examining our work flow and processes to make them more efficient and less stressful. We need to find ways to remain calm, focused and compassionate at work. We must create boundaries between our work life and our private life and defend those boundaries. We need colleagues that we can depend on for advice and support and we need to interact with them on a regular basis. We need to learn to ask for help. We need to recharge our batteries and make healthy deposits in our energy bank accounts. What do we do if we have already become burned out? We must turn to our colleagues and ask for help and support. We must seek treatment programs that address physician burnout. We need to be educated on how to manage stress in our jobs and prevent burnout early on in our medical training. We need effective wellness programs for physicians that teach us how to prevent and treat burnout in ourselves. The ECMS members are lucky to have a physician wellness program through the ECMA foundation. And last but not least, we must keep talking about the “taboo” subject and get rid of the negative stigma associated with acknowledging our weaknesses and asking for help. ECMS | 4


Save The Date


5 | ECMS

Medicine never wavered in fight against scope expansion In a major setback for patient safety and despite vigorous opposition from organized medicine, the Florida Legislature yesterday sent two pieces of legislation to Gov. Ron DeSantis, HB 389 and HB 607, which will allow nurse practitioners to practice independently without any physician supervision and will allow pharmacists to treat certain medical conditions. In an unusual move, the Legislature sent both bills to the Governor immediately after passage, and he signed them into law within hours of receipt. The FMA, along with the FAFP, FOMA, and every county medical and specialty society, fought hard and did everything within our power to defeat this bad legislation. As your President, I was in Tallahassee on a regular basis throughout the 60-day session, along with many other physician leaders meeting with lawmakers and providing committee testimony. Every week, a group of physicians representing county medical and/or specialty societies was at the state Capitol fighting for patient safety and quality care. The FMA created a coalition made up of more than 50 medical societies that was fully engaged in advocacy efforts. In addition, the FMA was active on all social media platforms educating the public and legislators on the benefits of physician-led, team-based care and the dangers of allowing nurse practitioners to practice without any supervision. Your FMA Executive Committee met regularly by conference call during the legislative session. As a group, we made the decision to stand on principle and not compromise on this issue. In our view, no compromise would have made this legislation acceptable. The FMA believes that medical school and residency training are essential to quality patient care, and we would never support any efforts that would undermine the value of our medical degrees and training programs. While it would be easy to view this issue as a fight between physicians and nurse practitioners, it is much more complicated. House Speaker Jose Oliva was able to engage a broad coalition that included the business community, labor unions, the hospital association, and the powerful health insurance industry in pushing for the passage of this legislation. The following groups lobbied heavily in favor of allowing nurse practitioners to practice independently: • Florida Chamber of Commerce • Florida Blue • Florida Association of Health Plans • Florida Hospital Association • Florida Insurance Council • Americans for Prosperity (Koch Brothers) • Associated Industries of Florida While we are profoundly disappointed in the outcome, I know we did all that we could under very challenging circumstances to stop this bill from passing. I am proud of the fact that the FMA, along with the county medical and specialty societies, stood up for our patients and never wavered on our principles. There will be more legislative battles in the future, and your FMA is focused on unifying the medical community and building better relationships. We can’t allow this legislative setback to define us. We will use the lessons learned from this process to become a stronger organization. The FMA will maintain its focus over the next few years on the myriad of issues impacting physicians, including narrow health plan networks, fair payment for our services, regulating PBMs and reforming the prior authorization process. It is critical that physicians stay unified as we continue advocating for policy initiatives that will improve the practice of medicine in Florida. Sincerely,

Ronald F. Giffler, MD, JD, MBA President, Florida Medical Association

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2019 Novel Coronavirus and Patient Safety in the Medical Office Debbie Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company The 2019 novel coronavirus (COVID-19) continues to spread across multiple continents, infecting tens of thousands of individuals worldwide, with thousands of deaths. On Tuesday, February 25th, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, urged the U.S. public to begin making preparations for the possibility of a U.S. pandemic with “the expectation that this could be bad.” Given that outbreaks are expected to occur at a community level, medical offices will undoubtedly experience an influx of patients seeking assistance. The question is: Are medical offices doing enough to prepare? Most medical offices have, for the most part, learned from experience and are paying closer attention to widespread outbreaks of disease. One lesson learned from Ebola, measles, and other recent outbreaks—when many healthcare organizations were unprepared—is that all medical offices should have an infection control and emergency preparedness plan in place. The CDC has been responsive in its role to gather data and advise clinicians on COVID-19; however, it is up to physicians and all healthcare facilities to take necessary steps to provide effective screening for the public, followed by recommended protocols. Preparedness Matters A well-constructed infection control preparedness plan for COVID-19 is essential for facilities where patients receive care, such as physician offices, dental offices, long-term care facilities, and ambulatory care centers. Leading into the Ebola crisis, nearly 80 percent of hospitals in the U.S. acknowledged that they were unprepared to deal with patients who might present with Ebola symptoms. That led to avoidable early mistakes when clinicians encountered cases they had not anticipated seeing. Unlike Ebola, patients with a COVID-19 infection may look a lot like patients with fairly routine cold and flu symptoms, or they may be infectious without any presenting symptoms at all. But by following best practices, facilities where patients receive care can make great strides in identifying and treating the coronavirus early. Careful screening with a bias for suspicion that a patient might have the coronavirus will serve healthcare providers well in this situation. The following are some recommendations in the event a patient with suspected COVID-19 seeks care:

· Follow the CDC’s patient assessment protocol for early

disease detection. If a patient calls to schedule an appointment for an acute respiratory illness (e.g., fever, cough, and difficulty breathing), he or she should be screened using the Flowchart to identify and Assess 2019 Novel Coronavirus.

ECMS | 8

· If presenting symptoms, travel history, or patient contacts

are suspicious, immediately isolate patients coming into the office (segregate them from other patients in the facility) in a designated exam room with dedicated patient care equipment. A back entrance may be utilized, if available. Since most medical offices don’t have negative pressure airflow, a spare bathroom with negative exhaust fans may be an option in the medical office setting instead of a regular exam room. The CDC provides guidelines for environmental infection control in healthcare facilities. Be aware that it is unknown how long the virus remains airborne once a room is vacated, and there are currently no CDC instructions on length of time before the room may be used again.

· Once suspected patients are inside the facility, instruct

them to put on a face mask, utilize tissues, practice good hand hygiene, and dispose properly of any contaminated protective equipment/tissues in a designated waste receptacle. Educational resources, including posters for use in the medical office, are available from the World Health Organization (WHO).

· Follow Standard, Contact, and Airborne precautions

including gloves, gowns, protective eyewear, and NIOSHcertified N95 respirators that have been properly fittested. This applies to all healthcare staff interacting with patients.

· Limit staff exposure to suspected patients, with the exam room door kept closed.

· When there is a reasonable presumption that a patient

may have been exposed to COVID-19, contact the local or state health department to determine if the patient needs to be tested.

· Maintain records of staff-patient contact, i.e., who was

assigned to work with the patient, either in a log or in the medical record.

· Once the patient exits the room, conduct surface

disinfection while staff continues to wear personal protective equipment (PPE).

· Provide up-to-date, factual information on the virus to

the patient and close contacts, including how to follow infection-control practices at home, such as in-home isolation, hand hygiene, cough etiquette, waste disposal, and the use of face masks.

Practice Management · Remind patients and their families to access information about the virus through reputable sources such as the CDC, not social media.

· Check with your local public health authorities for

locations designated to triage suspected patients so exposure is limited in general medical offices. Emergency preparedness plans most likely will be activated so that parties are coordinating efforts to deliver effective public health intervention.

Suspected cases must be reported to applicable local and state health departments. The CDC provides instruction on their website for reporting requirements by medical offices to state and local health departments, who, in turn, report “persons under investigation” (PUI) to the CDC for further evaluation and testing. Also, any unprotected occupational exposure by staff members should be assessed and monitored.

We recommend that when in doubt, healthcare providers should adopt a clinical suspicion of COVID-19 to protect the patient and others. The dynamics surrounding the virus will continue to change in the days and weeks ahead. What must not change is that physicians and care teams should remain vigilant and careful. They should be exceptionally proactive in asking the right questions, documenting interactions, following rigorous protocol, and keeping abreast of emerging insights and data as they become available from the CDC. The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

Consider Legal Risks When the Ebola virus was new to the U.S., there was one wellreported case where a patient who came to the hospital with Ebola was sent home without treatment. Such situations not only put the patients and others at risk, but also put healthcare providers and hospitals at risk for litigation.

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9 | ECMS

Ron DeSantis Governor

Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.

Scott A. Rivkees, MD State Surgeon General Vision: To be the Healthiest State in the Nation

March 5, 2020 TO LICENSED HEALTH CARE PROVIDERS Re: Communicable Disease Investigation and Reporting All practitioners, hospitals, and laboratories in Florida are required to notify the Florida Department of Health (FDOH) of diseases or conditions of public health significance under section 381.0031, Florida Statutes, and Florida Administrative Code, Chapter 64D-3. FDOH maintains a Table of Reportable Diseases or Conditions to Be Reported in Florida Administrative Code Rule 64D-3.029, which is updated periodically. It is important that the requirements imposed by the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA) be understood and followed, especially regarding disease reporting responsibilities and protections. Review or Inspection of Medical Records: The disclosure of protected health information from patient records for communicable disease investigation is permitted without patient consent to a public health authority that is authorized to collect such information for the purpose of preventing or controlling disease. See 45 C.F.R. 164.512(b)(1)(i). Furthermore, subsection 381.0031(7), Florida Statutes, affirmatively requires licensed health care providers to allow FDOH personnel access to communicable disease information in patient medical records and specifically provides: “Health care practitioners, licensed health care facilities, and laboratories shall allow the department to inspect and obtain copies of such medical records and medical-related information, notwithstanding any other law to the contrary.” This same section creates an exception to confidentiality laws and provides security to the practitioner by stating: “A health care practitioner…may not be held liable in any manner for damages and is not subject to criminal penalties for providing patient records to the department as authorized by this section.” Reporting Cases of Communicable Disease: HIPAA does not change the obligation of health care providers, laboratories, and hospitals to report cases of disease listed in Florida Administrative Code Rule 64D-3.029, or the obligation to cooperate with FDOH's epidemiology investigations. HIPAA Section 45 CFR 160.203(c) specifically defers to state law with respect to "reporting of disease or injury, child abuse, birth, or death, or for the conduct of public health surveillance, investigation, or intervention." Also, health care providers are permitted to report these and other matters that contain protected health information to the public health authority without notice to your patient [45 CFR 164.512(b)]. In fact, subsection 381.0031(2), Florida Statutes, requires licensed health care practitioners to report diseases of public significance to FDOH. Florida Administrative Code Rule 64D-3.029 specifies the diseases required to be reported. These state requirements are not modified by federal law.

ECMS | 10 Florida Department of Health

Foundation ESCAMBIA COUNTY MEDICAL SOCIETY FOUNDATION Dear Physicians; Spring greetings form your Foundation! This is NOT your grandmother’s Spring! I hope that everyone is healthy and maintaining some semblance of a regular schedule. The Foundation’s schedule is maintaining and progressing and has included the following! If you missed the last Society meeting, you missed a real treat in the presentation by Dr. Greer. Thanks to the Mag Mutual grant for the Foundation’s PWP, we were able to bring in this guest speaker. We were entertained, but most importantly reminded of what being a physician entails. Hopefully we can bring in other speakers of his caliber. Physician Wellness Program; our PWP continues to expand to address physician stress issues. In addition to the above talk, we have our continued service by the Drs. Spencers, which enables three free visits that are completely confidential. And we are in the planning stages to initiate wellness classes to ECMS members. Stay tuned! Blood Pressure Cuff Program; the BP Cuff program has supplied 500 blood pressure cuffs to indigent patients. This has been expanded to include distribution through some Primary Care offices as well as the charity clinics. We hope to expand this further. We Care Program; the We Care Program continues to provide indigent care to patients through participating Medical Society physicians. If you are able, please consider participating. Go Seniors Program: the Go Seniors Program travel vouchers subsidize almost $600 per month in taxi charges! This helps indigent patients make their doctors’ appointments. If your office manager needs help in participating, please have them contact Erica. FSU Medical Student Scholarships; your Foundation yearly awards a 4th year medical student a scholarship to further enable their studies. As you know, this program is now fully endowed, and will facilitate some to return to this area to practice after studies are completed. Pensacola State College Endowment; this endowment facilitates students at PSC to pursue health related fields of study, and likewise promotes them to stay in the area. The 1873 Society; this society commemorates the founding date of ECMS. Donations enable our programs to grow - consider becoming a member! Thanks to all who support our community by supporting the Foundation. Stay Healthy! Kurt A. Krueger, MD Pres., ECMS Foundation


11 | ECMS

Physician Wellness Burnout Inventory This is an adapted version of the Oldenburg Burnout Inventory, one of several such validated instruments used to assess the presence of burnout in many occupations. Each of these instruments, including this one, has its own unique advantages and limitations. This sample is provided not as a definitive measure of the presence or absence of burnout, but merely as one potential piece of data for you to consider as you explore issues related to physician wellness and resilience. By answering the questions and tallying your score, you will be able to determine your score. Scores range from 16-64. Scores above 35 have been correlated with higher rates of burnout. If you are an Active member of Escambia/Santa Rosa County Medical Society and would like to seek free wellness coaching services, please visit Physician-Wellness

Agree (+2) Disagree (+3) Strongly Disagree (+4) 8. During my work, I often feel emotionally drained. Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1) 9. Over time, one can become disconnected from this type of work. Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

1. I always find new and interesting aspects in my work. Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

10. After working, I have enough energy for my leisure activities. Strongly agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

2. There are days when I feel tired before I arrive at work. Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

11. Sometimes I feel sickened by my work tasks. Strongly agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

3. It happens more and more often that I talk about my work in a negative way. Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

12. After my work, I usually feel worn out and weary. Strongly agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1)

4. After work, I tend to need more time than in the past in order to relax and feel better. Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1) 5. I can tolerate the pressure of my work well. Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4) 6. Lately, I tend to think less at work and do my job almost mechanically. Strongly Agree (+4) Agree (+3) Disagree (+2) Strongly Disagree (+1) 7. I find my work to be a positive challenge. Strongly Agree (+1) ECMS | 12

13. This is the only type of work that I can imagine myself doing. Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4) 14. Usually, I can manage the amount of my work well. Strongly agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4) 15. I feel more and more engaged in my work. Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4) 16. When I work, I usually feel energized. Strongly Agree (+1) Agree (+2) Disagree (+3) Strongly Disagree (+4)

Foundation The Physician Wellness Program (PWP) provides a safe harbor for physicians to receive wellness coaching to address normal life difficulties in a confidential and professional environment. Why was the program created?

PWP benefits • This program is a membership benefit for ECMS Active Members • Member relatives may attend coaching sessions with members in attendance

A physician’s life can be difficult. Problems with the current health care delivery system, maintaining a healthy work/ life/family balance, and dealing with the normal stresses of everyday life do take their toll on physicians.

• Three free in-person wellness coaching sessions each calendar year

Often our patients turn to us for counseling and guidance, but who can we turn to when we need to talk through an issue or get some coaching on how to handle the stresses in our lives? Too often the answer is “no one,” and that is regrettable, because it is important that we be as healthy as possible in our roles as physicians.

• Program is funded by donations and grants

It is important that we function at our best in all areas of our lives. By addressing areas of difficulty, we can decrease our stress levels and increase our level of resilience and effectiveness. Some examples of those difficulties include: • Burnout • Work-related issues • Difficulty Managing Stress • Family Issues • Marriage/Relationship Problems • Depression and Anxiety • Mood Swings

• Complete confidentiality • Convenient location

Rick Spencer, Ph.D., Psy.D. is a licensed psychologist and a partner at Psychological Associates with over three decades of clinical experience in the Pensacola area. Dr. Spencer treats teens and adults with individual, family and couple’s (marriage) counseling and has specialized training in marital treatment, such as Imago therapy. Paige Spencer, Psy.D., licensed psychologist, provides individual, couples, family, and group psychotherapy services to preteens, adolescents and adults. Dr. Spencer enjoys helping patients utilize their individual strengths to overcome obstacles in their lives and promote personal growth. She works with patients with a variety of concerns including depression, anxiety, relationship difficulties, grief, sexual abuse and PTSD. In addition, she has an extensive history of working with Veterans and with patients who have a chronic medical illness (e.g. chronic pain, CFS, diabetes, obesity, multiple sclerosis) to manage the psychological symptoms and improve quality of life.

• Suicidal Thoughts

Office hours Monday 8:00 am - 5:15 pm

How PWP works

Tuesday 8:00 am - 5:15 pm

The Escambia County Medical Society Foundation board has hired licensed clinical psychologist Dr. Rick Spencer and Dr. Paige Spencer. They will provide wellness coaching to the Escambia/Santa Rosa County Medical Society Active Members, for up to three visits percalendar year.

Thursday 8:00 am - 6:00 pm

These providers will maintain a minimal confidential paper file for each physician, but no insurance will be billed and ECMS and the ECMS Foundation, Inc. will not be given any information that would identify those who utilize the program. As such, the program is completely confidential. ECMS Foundation will pay a monthly invoice to our psychologist based on the total number of sessions provided. ECMS membership will be verified through a monthly log provided to Psychological Associates, P.A.


Wednesday 8:00 am - 5:15 pm Friday 8:00 am - 4:00 pm Donate to PWP The Physician Wellness Program (PWP) is made possible with your tax deductible donation. To donate to the PWP and make a difference for our local physicians, please mail your check made payable to the: ECMS Foundation 4771 Bayou Blvd. #157 Pensacola, Fl 32504 Please put “PWP” on the memo line.

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THE 1873 SOCIETY Since 1873, Escambia and Santa Rosa County Medical Society physicians have dedicated themselves to their patients and the people of Escambia/Santa Rosa County. To further our mission and build on the loyal support of our members, the Board of Directors approved the formation of The 1873 Society, a special recognition opportunity to formally honor physicians who contribute to our organization and have demonstrated a long-term commitment to the quality of health care and well-being of our community. As a member of The 1873 Society your good name as a physician will be honored in our community forever--entwined with the good works of the medical society in a cherished legacy. Membership in The 1873 Society is for physicians who have chosen to pledge $3,000 to Escambia County Medical Society Foundation, Inc. This can be accomplished through a single gift or a recurring gift of $1,000 over three years, THREE IN THREE! The 1873 Society members are recognized and awarded with their names permanently engraved on a traveling Wall of Honor to be displayed in the ECMS office and at ECMS and ECMSF events.

THE 1873 SOCIETY MEMBERS The individuals listed below are both founding members as well as others who have joined The 1873 Society since its founding. We thank you for joining their distinguished ranks. Joanne Bujnoski, D.O. Kurt Krueger, M.D. Ken Long, M.D. Ellen W. McKnight, M.D. Jennifer Miley, M.D. Jack Kotlarz, M.D.

Hillary Hultstrand, M.D. Brett Parra, M.D. Robert Sackheim, M.D. Michelle Brandhorst, M.D. Steve Ziller, M.D.

Who is the Escambia County Medical Society Foundation? The Escambia County Medical Society Foundation is a non-profit organization dedicated to providing healthcare services on a volunteer and funding basis through its members. The Foundation was created in 1994. The primary goal is to assure access to adequate healthcare for the medically indigent citizens of the area, to study and promote improved methods and facilities for healthcare, to pursue the protection of public health, implement the means of financing healthcare at reasonable costs to cooperate with other organizations and institutions interested in pursuing these goals, and disseminate information concerning healthcare in general. Current Foundation programs include “We Care” and “Go Seniors!” Contact the ECMS Foundation for more information | 850.478.0706 or ECMS | 14

In the Community Ascension Sacred Heart The Studer Family Children’s Hospital at Ascension Sacred Heart Pensacola has opened a Pediatric Sleep Center that provides diagnostic testing and a comprehensive team of caregivers. Dr. Gulnur Com serves as the center’s medical director. The hospital also collaborates with providers in psychiatry, psychology, obesity medicine and craniofacial surgery to treat children with a variety of sleep conditions. For more information, call 850-416-2190. On March 2, Ascension Sacred Heart (ASH) opened a new Rehabilitation Center at 4925 Grande Drive in Pensacola (behind Cordova Square). The $9.5 million facility offers physical, occupational and speech therapies and houses ASH Occupational Health Strategies. The new building includes state-of-the-art equipment, such as the Zero G Gait and Balance System, a robotic body-weight support system that is the only one of its kind in the Pensacola area. Construction is underway on a freestanding ER at the intersection of Nine Mile Road and Stefani Road in Pensacola. The 14,700 square-foot facility should be completed by the end of this year. The new facility will be located within a mile of the Ascension Sacred Heart Health Center at Milestone, an outpatient medical facility that opened last year. The ER will be supported by the Level II Trauma Center at ASH Pensacola, and the specialists in the Pediatric Trauma Center at the Studer Family Children’s Hospital at Sacred Heart.

Baptist Hospital Like hospitals and physician offices all across the nation, Baptist Health Care is busy with the demands of meeting the many challenges presented by the COVID-19 pandemic. We have been on high alert for several weeks and leaders are meeting daily to provide the highest quality care to patients. We’re evaluating all operations daily. We’ve made modifications to our ERs to expand our isolation areas and initiated other measures to protect the health and safety of our patients, visitors and team members. We’re creating additional testing sites to make them easily accessible throughout the community, and we’re exploring alternative methods of patient assessment. While this is a challenging situation, the fact is that we care for people with infectious diseases every day. We have the training, the knowledge, the skills. This is what we do. As a community, we can all overcome the mighty challenges that lie ahead.


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