Knoxville Medicine Magazine Spring 2024

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ACADEMY OF MEDICINE

Academy Officers

David Harris, MD

PRESIDENT

Greg Curtin, MD

PRESIDENT ELECT

Melissa Chiles, MD

SECRETARY

Jeff Gilbert, MD

TREASURER

Briam Daley, MD

IMMEDIATE PAST PRESIDENT

Kimberly Weaver, PhD CEO

Board of Trustees

Matt Doppelt, MD

Carley Fowler, MD

Darinka Mileusnic-Polcan, MD

Greg Phelps, MD

Jordan Lakin, DO

Patrick McConville, MD

Ex- Officio Board Members

Richard Briggs, MD

Debbie Christiansen, MD

Randal Dabbs, MD

Richard DePersio, MD

Robert Page, MD

Donna Brunson -KAMA

Publisher

Kim Weaver, PhD

Editor

Jonathan Weaver

Production/Advertising

David Caudill

ADVERTISING: For advertising information, call the Academy offices at (865) 531-2766. The magazine is published four times per year by the Knoxville Academy of Medicine (KAM). All rights reserved. This publication or any part thereof may not be reproduced without the expressed written consent of the KAM. The appearance of advertising in KAM publications is not a KAM guarantee/endorsement of the product or the claims made for the product by the manufacturer. The fact that an advertisement for a product, service, or company has appeared in a KAM publication shall not be referred to in collateral advertising. The KAM reserves the right to accept or reject any advertising in the publication.

PRESIDENT'S MESSAGE

2024 is upon us, and the Knoxville Academy of Medicine owes a great debt of gratitude to Brian Daley for leading our organization for the past two years. In order to build on the work that he, the board of trustees, and their predecessors have done over the years, I would propose that we ask ourselves exactly how does a local physician organization like the Knoxville Academy of Medicine justify its existence in 2024? I firmly believe that caring for the suffering remains the greatest job in the world, and that we doctors need to help each other sustain and improve our ability to do that job. So do we band together locally, at the state level, nationally, by specialty, or some combination of these? Physicians’ organizations typically: a) advocate for physicians and patients in the political arena, b) facilitate health care for disadvantaged patients, c) provide physician-support services, d) provide continuing medical education, e) promote a favorable public face of medicine, and e) provide opportunities for physicians and their families to interact socially. Let’s first ask ourselves which of these functions lend themselves best to action by a local or regional association, as opposed to a national, state, or specialty organization. My ultimate goal is for the KAM to function so meaningfully that a large majority of local physicians, even while disagreeing with each other on certain points, choose to join it, support it, mold it for the future, and make it their own.

ment for healthcare for disadvantaged patients is partially covered by the government at the county, state, and national level, provision of purely charity care is not. A local physicians’ organization may attempt to provide charity care directly. Alternatively, it can help organize the sometimes chaotic and fragmented charity care donated by physicians, hospitals, faithbased institutions, and others. If reported in the local media, this work can also positively influence the public’s view of our profession. Social events can also serve as fund-raisers for charity care (see below).

Physician services. While there are state and federal entities that support physicians’ health and well-being, these may not function well on a personal level. On the other hand, doctors suffering from stress, family problems, or burn-out may hesitate to seek help locally because of privacy concerns. Accordingly, a local medical society must provide confidential mechanisms to help its members in need. These needs may vary greatly among student, resident, practicing, and retired members. A local society can also help members with job placement or help them save money on medical equipment, recreational activities, and advertising. It may enlist experienced physicians to provide personal mentoring services for student, resident, or younger practicing physicians.

Politics. The truism, “all politics is local,” may not apply to us. With some exceptions, such as in the recent COVID pandemic, local lawmakers have not usually delved into issues that affect our ability to take care of patients. State law, on the other hand, greatly influences issues such as who is insured, medical liability, and who may practice surgery and medicine. The current combined membership in the KAM and the Tennessee Medical Association allows us to weigh in to the legislature on these issues, but forcing members to join both may make dues cost-prohibitive for some. Physician pay, on the other hand, is always on the agenda at the national level, chiefly due to Medicare, so this issue is usually addressed by national organizations such as the AMA and specialty societies. Charity care. While provision of and pay-

Medical education. In a midsized city such as Knoxville, most continuing medical education is best handled by local academic institutions and specialty societies. A local medical association might serve to collect and distribute information on upcoming local CME activities, while not actually producing such programs.

Public Face of Medicine. Since we don’t really have many “natural enemies” other than the child who sees us approach with something sharp, presenting a favorable image of physicians has not been very difficult, at least until recently. The COVID pandemic brought out a politicized view of medicine, rooted in attacks on science itself. We saw personal threats directed at physicians and other healthcare personnel for the “crime” of treating a disease many wanted to deny. Physicians were shouted down at public meetings because they advocated transmission-mitigating behaviors. There was widespread public misunderstanding of

CONTINUED ON PAGE 7

ACADEMY

New Members

A big welcome to our newest members! We are excited that you have decided to join KAM.

RUTH BALDRIDGE, MD FAMILY MEDICINE

Summit - Strawberry Plains Pike Family Practice

MATTHEW BLAIR, MD PEDIATRICS

Summit - Pediatric Clinic Hardin Valley

CHRISTIE CARRINGER, MD INTERNAL MEDICINE

Summit Medical Group on Park West

PHILIP CATO, MD ANESTHESIOLOGY

University Anesthesiologists

MAKSIM GUSEV, MD VASCULAR SURGERY

Premier Surgical Associates PLLC

JESSICA IVEY, MD INTERNAL MEDICINE

Summit Medical Group on Park West

CHRISTINE KENNEDY, MD NUCLEAR RADIOLOGY

Abercrombie Radiology

SANJEEV KHANNA, MD DIAGNOSTIC RADIOLOGY

Abercrombie Radiology

REBECCA LONG, MD FAMILY MEDICINE

Summit Medical Group Halls Family Physicians

ANDREW MASTERS, MD INTERNAL MEDICINE

Summit Medical Group at Middlebrook

CHARLES MORRIS, MD INTERNAL MEDICINE

Summit - Internal Medicine Associates

MARY NELSON, MD INTERNAL MEDICINE

Summit Medical Group At Fort Sanders

ROBERT ROBINSON, MD DIAGNOSTIC RADIOLOGY

Abercrombie Radiology

DUSTIN SMITH, MD ANESTHESIOLOGY

University Anesthesiologists

GUY SMOAK, MD FAMILY MEDICINE

Summit Medical Group at Middlebrook

STEVEN BINDRIM, MD GASTROENTEROLOGY

Gastrointestinal Associates

JAMES BRUMIT, MD RADIOLOGY

Vista Radiology

SARKIS CHOBANIAN, MD

GASTROENTEROLOGY

Gastrointestinal Associates

KAMRY CLARK, MD ANESTHESIOLOGY

Covenant Anesthesiology Group

ZACHARY DICKSON, MD GASTROENTEROLOGY

Gastrointestinal Associates

MEADE EDMUNDS, MD OTOLARYNGOLOGY

Ear, Nose, and Throat Consultants of East TN

WILLIAM ERGEN, MD GASTROENTEROLOGY

Gastrointestinal Associates

KELLI GREEN, MD INTERNAL MEDICINE VA Outpatient

ANDREW HARRIS, MD ORTHOPEDIC SURGERY University Orthopedic Surgeons

First Column: Ruth Baldridge, MD; Matthew Blair, MD; Christie Carringer, MD; Philip Cato, MD; Maksim Gusev, MD; Jessica Ivey, MD; Christine Kennedy, MD; Sanjeev Khanna, MD.

Second Column: Rebecca Long, MD; Andrew Masters, MD; Charles Morris, MD; Marry Nelson, MD; Robert Robinson, MD; Dustin Smith, MD; Guy Smoak, MD; Steven Bindrim, MD.

Third Column: James Brumit, MD; Sarkis Chobanian, MD; Kamry Clark, MD; Zachary Dickson, MD; Meade Edmunds, MD; William Ergen, MD; Kelli Green, MD; Andrew Harris, MD.

JOHN HAYDEK, MD GASTROENTEROLOGY

Gastrointestinal Associates

JASON HUFFMAN, MD GASTROENTEROLOGY

Gastrointestinal Associates

ROBIN HUSKEY, MD FAMILY MEDICINE Well Key Urgent Care

TREVOR INGENERI, MD GASTROENTEROLOGY

Gastrointestinal Associates

SARAH KORTEBEIN, MD OTOLARYNGOLOGY

Greater Knox Ear Nose & Throat Associates

KEVIN MEYERS, MD GASTROENTEROLOGY

Gastrointestinal Associates

TEJAL MISTRY, MD GASTROENTEROLOGY

Gastrointestinal Associates

JOHN MOORE, MD GASTROENTEROLOGY

Gastrointestinal Associates

RAJ NARAYANI, MD GASTROENTEROLOGY

Gastrointestinal Associates

DANIEL NEVIN, MD GASTROENTEROLOGY

Gastrointestinal Associates

FRANK OSBORN, MD

GASTROENTEROLOGY

Gastrointestinal Associates

CORNELL OVERBEEKE, MD

DIAGNOSTIC RADIOLOGY Vista Radiology

CEDRIC PALMER, MD FAMILY MEDICINE Well Key Urgent Care

RAMANUJAN SAMAVEDY, MD

GASTROENTEROLOGY

Gastrointestinal Associates

KATHRYN SCHOTT, MD

ANESTHESIOLOGY & PAIN MED

Pain Consultants of East Tennessee

JORDAN SWEARINGEN, MD ANESTHESIOLOGY

Covenant Anesthesiology Group

QUOC-BAO (BRIAN) TO, MD DIAGNOSTIC RADIOLOGY Vista Radiology

MATTHEW ZACHARY, MD ANESTHESIOLOGY

Covenant Anesthesiology Group

MADISON COMPTON, DO FAMILY MEDICINE Valley View Family Physicians

KRISTEN LILLY, MD OBSTETRICS AND GYNECOLOGY Generations Obstetrics & Gynecology

JOSHUA PICKETT, DO INTERNAL MEDICINE Faculty Internal Medicine at Turkey Creek

First Column: John Haydek, MD; Jason Huffman, Md; Robin Huskey, MD; Trevor Ingeneri, MD; Sarah Kortebein, MD; Kevin Meyers, MD; Tejal Mistry, MD.

Second Column: John Moore, MD; Raj Narayani, MD; Daniel Nevin, MD; Frank Osborn, MD; Cornell Overbeeke, MD; Cedric Palmer, MD; Ramanujan Samavedy, MD.

Third Column: Kathryn Schott, MD; Jordan Swearingen, MD; Quoc-Bao (Brian) To, MD; Matthew Zachary, MD; Madison Compton, DO; Kristen Lilly, MD; Joshua Pickett, DO.

ACADEMY NEWS

New Resident Members

Jonathan Crump, MD

Mary Katherine Herndon ,MD Andrew

New Student Members

Railey Abel

Creighton Adams

Kaylee Airola

Adam Alamah

Alex Aliscio

Nathanial Amey

Madeline Amos

Zeeshan Ayub

Vincent Bartolomei

Sydney Bates

Roman Batista Jr.

Bridget Baur

Angeles Bautistu

Matthew Baynard

Jacqueline Beaudrie

Ashley Belcher

Adrian Belli

Dornu Biragbara

Alexis Boling

Sydney Bostic

Elizabeth Bowers

Jessica Boyer

Katelyn Brackney

Emma Bradley

Hunter Brady

Rahi Brahmbhatt

Maggie Bratton

Cooper Brett

Sierra Brock

Amanda Brown

Charles Brown

Nathan Brown

Hannah Caldwell

Joseph Callaghan

Madison Calloway

Tyler Cameron

Preston Capener

Nicholas Carbone

Cody Carr

Braxton Chafin

David Clark II

Makayla Clark

Amanda Clavijo

Elizabeth Cole

Mackenzie Cole

Savanah Collier

Michael Compagnere

Emily Conte

Aaron Cook

Christiana Coonradt

Shelby Cox

Lizbeth Cruz

Karina Del Monte

Kevin Diaz

Sajana Dumre

Kropilak,MD Isairis Peralta Valerio, MD

Linley Dunn

Eint Ei

Samaria Elder

Carolyn Elliott

Hannah Fairfloth

Caylee Farmer

Shawn Ferris

Bethany Fields

Alexa Filion

Megan Finch

Brooke Fishman

Elizabeth Fleming

Serena Fleming-Dittenber

Grayson Fleshman

Kimberly Flores

Christopher Forsyth

Laura Fortune

Paul Freedman

Byron Freeman

Bailey Gaddis

Kayla Garcia

Jake Gibson

Jensen Glass

Bailey Goodwin

Gregory Gosdigian

Elizabeth Gray

Evan Grider

Gabriella Grund

Lanette Guerra

Clair Gunter

Amberlika Guruvadoo

Bradon Hammer

Caitlyn Hannah

Jordan Harrell

Kyle Hart

Shannon Hayes

Noah Heatherly

Joshua Henschel

Juilan Hernandez

Karynne Hernandez

Lily Hertel

Kennedy Hess

Cameron Holmes

Emily Hoskins

Marli Howard

Ethan Hubbard

Russell Hubbard

Adara Hubert

Matt Hudson

Lauren Huelson

Hannah Jackson

Dylan Jarrett

Alyssa Jeffries

Brady Jennings

Taylor Jennings

Tyler Jensen

Morgan Johnson

Grace Jones

Maria Jones

Andrea Jorratt

Neha Joshi

Vasilea Karageorge

Shilpi Karan

Sridivya Kavuru

John Keck

Brittney Keys

Shannon Kirkland

Shaili Kothari

Meryl Kovacs

Kyle Larsen

John Leatherman

Michael Lee

Olivia Lee

Rachel Legiec

Alexander Levin

Tyler Lock

Alexis Luka

Michael Lynch

Sitara Mahmoodi

Rea Mansuknani

Christopher Marizer

Aziz Martha

Hector Martinez

Maggie Maze

Katherine McCoy

Ryan McManus

Stephen McNichol

Myra Meade

Gianna Meckler

Clayton Medrum

Kaleigh Mehlhorn

Celeena Memon

Jacob Mendez

Richard Merus

Colin Mesa

Robert Metcalfe

Makanna Meyers

Sierrah Miley

Ashlyn Miller

Alexandra Miranda

Azza Mohammed

Brianna Morgan

Ellis Morgan

Betzubet Moryado

Joseph Motilal

Andrew Muca

Sam Mullins

Nina Musgrove

Savannah Mutchler

Kaytlyn Naffziger-Bruce

Kim Steward, MD

Simeon Nelson

Arman Nessar

Caddie Nguyen

Catherine Nobles

Kamryn Noe

Rebekah O’Bryan

Autumn O’Neal

Bolaji Olusanya

Brooke Ommert

David Orozco

Emily Parker

Lucia Pastore

Deneil Patel

Jay Patel

Benjamin Perdomo

Jackelyn Philip

John Philo

Dahlia Pierre

Prachee Pingle

Kaitlin Pisani

Jamarquis Poore

Hannah Poorman

Thomas Powell

Taylor Procter

Grayson Proulex

Ashley Quisler

Brittney Ramsey

Michael Ricado

Peter Richards

Shelby Robinson

Benjamin Rodell

Melissa Rodriguez

Mario Rodriquez

Christopher Root

Mason Rucinski

Rachael Ruggles

Trevor Russo

Sarah Ruston

Karen Ruttlen

Kathryn Ryan

Adrianna Salah

Sayf Saleem

Refeeah Samad

Amber Sanders

Angelika Santaliz

Isaac Schoutko

Burke Schramel

Felicia Sedwick

Sulagna Sensarma

Jennifer Shabrach

Mariam Shakir

Juhi Sharma

Cory Shields

Laynee Shipp

Caitlyn Simtion

Alexis Skolaris

Rebecca Slay

Lindsey Smiley

Austen Smith

Cameron Smith

Clayton Smith

Hannah Smith

Austin Snyder

Taylor Sokolovic

Joslynn Soria

Gregory Speleotes

Michael Sriffes

Rebecca Stark

Eric Stickles

Devan Struab

JoAnna Sumber

Joseph Summers

Elizabeth Sutton

Morgan Sweeney

Haley Sykes

Kaley Sykes

Nathaniel Tamez

Purity Tanui

Olivia Thiagg

Breanna Thomas

Rachel Thomas

Janae Thompson

Vivian To

Jay Toland

Alexandra Tracy

Alyssa Trivus

Andrew Tucker

Bethany Umloff

Alexis VanBuren-Young

Davis Vazquez

Katherine Veiez

Karthika Venugopalan

Zoe Verostek

Lindsay Walden

Abigail Walters

Lauren Ware

Lindsay Weber

Michael Wendershi

Abigail White

Destiny White

Ozias Williams

Seanna Williams

Madison Willis

Zana Wingate

Noah Woford

Mason Wolk

Mina Yakoub

Patient Satisfaction

just filled out my umpteenth survey this month on a recent store purchase. We get asked everything these days from hotel stays, flights, to how our restaurant meal was. academia, this is the new research tool that is convenient, and low-cost. all have a feeling that we affecting a beneficial change we respond, and having voices heard. IS this really case?

PRESIDENT'S MESSAGE CONTINUED

how the scientific approach to a new disease necessitates constant re-evaluation of and sometimes changes to medical recommendations. Increased visibility of a local medical society through reassuring and non-political press-releases and media interviews may have a role in reducing public mistrust and hysteria in the future.

pitals and the government. Such ratings, and the folks who use the ratings, are not face to face with the patient. The surveys are not timely, and they are often used to decide remuneration. We feel powerless because many of the things that impact our patients, and their responses, are system-related and beyond our ability to change.

Everyone should read the Viewpoint in the December issue of JAMA about PaSatisfaction Instruments.

(JAMA 328(22): 2209-10). In it spells out the exact reasons such surare not only not efficacious in determining improving care but detrimental to physicians.

Social interaction. Is it important for physicians and their families to interact socially? When I joined the KAM in 1989, there were fewer local physicians, but I believe that a larger percentage of them belonged to the KAM. There were well-attended general KAM member meetings at the old downtown facility, as well as popular family social functions. I also noted that the members were a fairly homogeneous group: overwhelmingly white, male, US-trained allopathic physicians in private practice, affiliated with (but not employed by) one or more local hospitals. Nowadays, we Knox docs are not only more diverse, but we may work for hospitals, staffing companies, academic institutions, private equity, or ourselves. Therefore now, more than ever, I feel the need to meet and befriend my

Quoting Edward Demming himself – such rat“build fear, demolishes teamwork and nourishes rivalry and politics “(ibid). It’s not so much the asking patients for their opinions, but rather the way it is asked, and importantly, the way it is used by our hos-

KAM

patients’ other physicians, many of whom have completely different backgrounds from me, and therefore have much to offer. Meeting other doctors and their families allows us to find common ground in taking care of our patients and integrating the practice of medicine into our personal lives. This unites us as Knoxville-area docs, no matter where we came from or how we practice medicine.

We all agree communication is the key and could be improved by all practitioners. A former mayor of New York City, Ed Koch, was known for walking the streets and asking “How’m I doin’?” It was personal, actionable, and very much point of care. It encourages communication and conversation at the person level. For the sake of our patients, and for our sake, let’s not worry about the surveys, but rather how we’re seen in that moment by that patient. We need to act to make changes at the individual level and ask “How’m I doin’?

The foregoing has been a brief, and certainly not exhaustive, overview of what I think organized medicine can do for our patients and us at the local level. In the next issues, I will review the KAM’s current programs and ask what’s working and what isn’t, and what programs could be deleted, modified, or added. During my two years at the helm, I am very interested in hearing from physicians both in and out of the KAM as to their thoughts on the direction of the KAM going forward, specifically what keeps them in or out of the KAM.

David J. Harris, Jr., MD, FACS President, Board of Trustees,

Knoxville Academy of Medicine

THE BLOUNT COUNTY MEDICAL SOCIETY UPDATE

The Blount County Medical Society held its annual Holiday Party at the Blue Tick Tavern on November 30, 2023. The special guest was

- Brian J. Daley, MD, MBA, FACS

Like sending your rug to the Spa!

and beauty of your rug.

Blount Memorial Acting CEO Jonathan Smith who was available to answer any questions that the physicians may have regarding the transition in leadership in the hospital. The band “Reflections” played as attendees enjoyed music and food. The outgoing BCMS President Jenifer Winbigler, MD shared the medical societies accomplishments during the 2023 year. These included: An increase in BCMS members, support for the Blount Foundation through support of the Golf Tournament and the 2023 Pork and Cork, support Knoxville Area Project Access (KAPA) through the Boot Scootin’ Ball, supported Blount physicians by providing wellbeing services through the Vitality Initiative Project (VIP) Program, annual BCMS Tailgate and Pig Roast, Day at the Smokies, Summer Picnic, Legislative Dinner, Day on the Hill, participation in the Annual House of Delegates, having the physicians of Blount County representing issues impacting the House of Medicine and gaining an extra delegate seat! Dr. Winbigler also shared how it was an honor to have been born in Blount Memorial Hospital and return to serve there as a physician. She spoke of what it meant to her to have been the first female president of the BCMS and her love for the community. Dr. Winbigler also encouraged membership of colleagues and to be active in events. She spoke of the plans to increase support of our area physicians through the VIP well-being program and assisting our community through a stronger relationship with KAPA. The 2023 Board members were recognized and thanked for their service. Vice President – Travis Groth, DO, Secretary - Aaron Bussey, MD, Treasurer – Marvin Beard, MD, and the Board of Trustees – Wally Werner, MD, Peter Scott, MD and James Brad Ray, MD. Elections were held and the 2024 slate of officers were elected: President – James Ray, MD, Vice- President – Jennifer Winbigler, MD, Secretary – Laura Yount, MD, Treasurer – Marvin Beard, MD and the Board of Trustees - Peter Scott, MD, Bryan Tigner, MD, and Kim Ballard, MD.

TCRN UPDATE ACADEMY NEWS

The Tennessee Community Resource Network (TCRN) is a program of the Knoxville Academy of Medicine Foundation and is a partnership with the East Tennessee Health Information Network (etHIN). TCRN is a web based, closed loop referral platform which connects clients to necessary services in the medical, behavioral, and social service domains. Since serving our first clients in February 2023, TCRN has collected much community data.

TCRN Platform Statistics

• Over 600 clients have been added

• 3,200 appointments have been entered

• 250+ programs are listed within the TCRN resource directory

• 860 referrals have been sent to agencies throughout our community with the top service categories below

Why is this important to physicians and hospitals?

• As of January 2024, CMS has released new Z codes which specifically address social determinants of health (SDoH) which are now reimbursable.

• Hospitals and providers will be required to complete SDoH screenings and refer patients to resources as a standard for both CMS and Joint Commission.

• The development of G codes by CMS allows for reimbursement for SDoH screening and coordination of care.

• TCRN has developed a revenue sharing model in which providers can send TCRN a list of patients needing assessments via PRAPARE and SDoH referrals and TCRN will coordinate appropriate care and report back to the provider for reimbursement.

For more information about TCRN, the revenue sharing model, or TCRN license, contact Danielle Sims at tcrn@knoxvillemedicine.org.

KAMA Corner

By: Jen Ollis, KAMA President

Hello all!

Wow, what a wild start to 2024 - Snowmagadden, KAMA’s Doc Rock for Health, and the KAMA Philanthropic Board Takeover of our February Meeting!

Doc Rock was again a great event, with fantastic bands, exciting energy, and successful fundraising. A special thank you to Kirstin Kropilak and Mary Weiss for their leadership and to all of those who served on the planning committee and evening volunteers.

The first-ever Philanthropic Takeover Meeting was so much fun and a great success, helping raise funding for the KAPA Kitchen! Donna, Rachel, and Liz put together a phenomenal experience, and I appreciate their efforts and time dedicated to planning and hosting this event.

Later this spring, the Philanthropic Board will share the overall impact of these events - so stay tuned!

KAMA Retreat is just around the corner at the amazing Dancing Bear Lodge, and our President-Elect Maria Jernigan will begin setting the groundwork for the 2024-2025 KAMA year. She has an exciting program and a vision I can’t wait for her to share.

Here's a brief on what’s going on:

Juliann Chavez & Tom Walker are still hosting our monthly KAMA First Hand, where members cook a from-scratch meal for those staying at the Ronald McDonald House.

Sheila Barnett & Robyn Doiron continue collecting items from KAMA members for donations to Vine School Health Center.

Lili Vincent and KAMA Book Club have selected many great books this year, with many more titles and discussions this spring.

Nancy Sewell graciously hosts KAMA Lunch Bunch once a month for a time of friendship and a meal at one of Knoxville’s many great local restaurants.

Be on the lookout for any KAMA Klimbers hikes to be announced so you can enjoy the warming temperatures and pleasant company.

I'm looking forward to a beautiful spring with lots going on! Please email kamalliance@gmail.com with any questions about our events and programs.

Jen Ollis KAMA President

LEGAL NEWS

Responding to Subpoenas and Court Orders

BY: Eliza Jones, London Amburn

Your practice may receive a subpoena for testimony or records, or be ordered by a court to provide information. If you automatically comply, you may unintentionally create legal exposure for your practice.

Many judges and litigators, by necessity, become specialists in one or more areas of the law, but may not have a detailed understanding of practice areas that are not part of their daily work. So, healthcare Providers should not assume that all subpoenas or court orders they receive are compliant with various healthcare laws and regulations.

State and Local Rules

Each jurisdiction has rules about how subpoenas must be “served,” which is a fancy way of saying “how they must be delivered to you.” For example, in Tennessee, subpoenas for witnesses in civil matters must be served by “delivering or offering to deliver a copy thereof to the person to whom it is directed.” Tenn. R. Civ. P. 45.03. Depending on the circumstances, you may want to object to a subpoena received by email or fax.

specified patient notification or a qualified protective order. Sometimes, litigators will take the additional step to obtain patient consent, for the sake of efficiency. However, it is still the Provider’s responsibility to ensure that consent is sufficient under HIPAA and that the subpoena or court order is “HIPAA compliant.”

There are also local rules governing the timing of subpoenas, how long you may take to respond, etc. which vary by the type of matter (civil, criminal, or juvenile).

Federal and State Regulations

Providers also need to consider their obligations under the Health Insurance Portability and Accountability Act and its corresponding regulations (“HIPAA”) when responding to subpoenas and orders. For example, providers may disclose protected health information in response to a compliant court order or subpoena if it is provided along with a compliant patient consent or certain “satisfactory assurances.” See 45 C.F.R. § 164.512(e). These satisfactory assurances may take the form of

Providers who run substance treatment programs should also consider the federal substance use disorder regulations codified in 42 Code of Federal Regulations Part 2 (Part 2). Barring certain exceptions, Part 2 programs may not disclose substance use information in response to any subpoena that is unaccompanied by a compliant court order. The Part 2 regulations dictate when a hearing must be held, judicial findings, and what must be included in orders for civil and criminal matters. Likewise, there are state statutes and regulations that also must be complied with in certain circumstances before furnishing records in response to a subpoena or court order.

So, How Should I Respond?

It depends. Your options are to comply, object (or move to quash), or ignore it. There are risks associated with each approach that need to be considered. Automatic compliance is not without risk and may be a violation of HIPAA, Part 2, state mental health record requirements, etc. The judge or issuing attorney will likely expect compliance with an otherwise valid order/subpoena. However, violations of healthcare laws/regulations may result in civil or criminal penalties. So, it is important to seek counsel and know how to object and refuse to comply in a respectful and informative manner, when needed.

Calendar of Events

“What if?”- Happy 18th Anniversary KAPA ACADEMY NEWS

The year is 2005 and from July through September approximately 170,000 adults were disenrolled from TennCare, the Tennessee Medicaid program, following a change in eligibility rules. This severely affected the health and wellbeing of many of our very own here in the greater Knoxville community. Something had to be done to address this crisis. And in times like these are when leaders step up. To meet this crisis head-on, forwardthinking leaders of the Knoxville Academy of Medicine (KAM) responded by asking “What if?”. What if we created a new Knoxville Academy of Medicine Foundation (KAMF) program that would serve as a broad-based community charity so that access to healthcare could happen through medical professionals who would agree to donate services to patients in need? About 200 generous medical professionals responded and late in 2005, the program went from “What if?” to “What is” and Knoxville Area Project Access (KAPA) was formed as a broad-based community charity to provide access to a full continuum of health care by removing structural barriers for low-income, uninsured individuals.

open heart surgery. Due to financial constraints and lack of insurance, they were unable to afford this procedure and because of this, they were referred to KAPA by their primary care provider. Once the patient was screened and met KAPA enrollment guidelines, KAPA was able to connect them to one of our partner specialty care organizations who generously donated their services. With the skilled hands of the surgeons and the support of the medical team, the patient underwent successful open-heart surgery. This procedure was performed with precision and care, ensuring the patient's safety and well-being throughout the entire process. Thanks to our partners, this patient was able to receive the treatment they desperately needed and now look forward to a healthier future.

In March 2006 KAPA screened, enrolled, and provided access to its first applying and qualifying uninsured patient in need of healthcare. That person along with now over 35,0000 uninsured others residing in our 23 surrounding counties that KAPA has assisted to date are grateful for the KAM leaders that asked, “What if?” and the generosity of now over 2900 physicians, physician extenders, and all area hospitals that have answered this question over the past 18 years with a resounding over $409 million in donated care. Happy 18th Anniversary KAPA!

Here is just one of many stories of how KAPA and our medical partners continue to meet the needs of those we serve: This patient needed life-saving

Medical Student Article

BY: AUSTIN THOMAS, 2nd year LMU DCOM

I struggled for a while thinking of what to write. I reached out to friends, colleagues, and family. I could not imagine there was anything of value that I could offer to the primary audience of this publication, attending physicians. Then it hit me, this is exactly what I need to talk about.

Imposter syndrome is all the rage on medical school campuses these days. I lost count of how many times I heard it mentioned during first year orientation. For those unfamiliar, imposter syndrome is a feeling of unworthiness and self-doubt encountered by many who find themselves in situations they do not feel they deserve. A typical presentation of imposter syndrome in a medical student can best be summarized with the phrase “I don’t belong.” It makes sense that medical trainees are apt candidates for imposter syndrome. From highly selective admissions processes, to long and arduous years of training, to strict hierarchal structures defining seniority and authority, it is no wonder why medical students might not feel like they belong. With the vast numbers of applicants to medical school, it would not be so far-fetched to convince one’s self that one’s admission was nothing more than statistical happenstance, or to put it less eloquently, “my name was just drawn out of a hat and now I’m here.” Medical students often must remind themselves that the above statement is false. Someone, somewhere thought we would be a good doctor. Having only just started our medical training, medical students often feel

By KAM never being too satisfied with “What is” and continuing to ask, “What if?”, you have grown to be one of the largest project access programs in the nation that constantly seeks to live out the KAMF Vision – “We exist to lift up our community, so that every person has an opportunity for a healthy life”.

Some of you may be wondering what’s the next big thing for KAMF since adding KAPA, the TN Community Resource Network (TCRN), the Vitality Initiative Project (VIP), Doc Talk, a Community Health Worker to KAPA, and launching the KAPA Kitchen Food Pantry.

Well….“What if a new Restorative Health Program could be established to address the overwhelming and devastating OPIOID epidemic that is impacting over 50% of our families living in our greater Knoxville community?” This program could possibly include a Recovery Program which would offer counseling such as substance and opioid misuse, grief counseling, family support, etc. “What if?”….To be continued….

like we have nothing to contribute. We certainly aren’t the smartest in the room by any stretch of the imagination. Even among our colleagues, someone else always scored one point higher on the MCAT or has a CV overflowing with publications. Perhaps this is the problem. In our eyes, our measure of how to be a good doctor has been reduced to numbers. Board scores, hours of community service, number of publications, numbers which will continue to shape our forward trajectories. Maybe this is ok; it is, after all, preparing us for a world where our lives will be defined by RVUs, utilization, and patient satisfaction scores.

Maybe, it isn’t. Good doctoring isn’t quantifiable. How does one quantify the calm and solace imparted upon a patient with a simple holding of the hand and the utterance “I am here for you. It is going to be ok.” It doesn’t take a standardized test taking master to notice that the patient in front of you has been struggling to open her applesauce for the last 20 minutes and do something about it, no matter how below your station you may believe opening it to be.

If you are reading this, no matter your stage in training, you earned it. A career in medicine does not happen by accident. Every day that you open a chart, practice with a suture kit, or try to cram all 1000 pages of First Aid into your brain; you are working to become that doctor your six-year-old self-imagined. Never forget how far you have come.

KAPA CHW Spring Fling Event

KAPA’s first annual Community Health Worker (CHW) event called “Spring Fling” happened on Saturday, March 23rd, from 10am to 1pm. Our CHW, KAPA staff, and our partners were able to connect with families in the greater community surrounding KAPA, Cedar Bluff and Middlebrook. We had music, free donuts, hotdogs, and fun stuff for kids like Easter egg hunts, face painting, games, and a Mandalorian. Many thanks

VIP Update

The KAM Vitality Initiative Project (VIP) program continues to grow to meet the needs of membership. The program was designed with the understanding that we would be addressing 3 crucial points in addressing physician well-being. 1.) Build better awareness through education to reduce the stigma of physician burnout. 2.) Provide a safe environment and means for non-disclosable counseling sessions. 3.) Create more opportunities for physicians and their families to build community and collegiality.

THE KAMF has made great progress in all the outlined areas and has been focused on caring for our area physicians and their families. This year you will find an increased concentration on our VIP programming and events that are designed to build community and expand the mentorships between members. This year you will see events designed to intentionally bring members together to better all involved. We will be combining our Student and Resident Tacos & Tequila and Pizza & Poli-

Wine Tasting Fundraiser

The Knoxville Academy of Medicine Alliance (KAMA) hosted a wine tasting event at the KAM Conference Center to benefit the KAPA Kitchen. Attendees were able to enjoy time together as they “Raised a Glass” to help the KAPA Kitchen better serve our community. The event was well attended and KAMA members along with event organizer, KAMA Past President Donna Brunson, did an outstanding job. $7221.00 much-needed

to our partners who came out to join us in this effort to provide health education and resources to our patients and their families. Partners present were Boys and Girls Club, UT Hospital, Bob Bell with Joy FM, Faith Promise Church, Migrant Education, American Heart Association, St. Mary’s Legacy Clinic, the Vol Bus, and KARM. The event was sponsored by Beaver Dough Joe and Faith Promise Church.

tics events to further encourage communication and engagement between these groups. Additionally, we have launched our new Speed Dating Your Specialty event that features various specialties throughout the year and allows medical students to come and ask questions from our KAM physician members. The feedback from this event has been incredible. The students have enjoyed learning, and the physician members stressed how they wished this program was available when they were students. Our Upcoming Day at the Smokies event is also a perfect example of how we continue to bring all membership (students, residents, active and emeritus) and their families together to strengthen the medical community. Last year UTGSM used the event as a wellness opportunity for their well-being efforts.

We encourage all our members to take advantage of the many opportunities to engage. For more information on upcoming events please contact Olivia Jones at ojones@knoxvillemedicine.org.

funding was raised and will be applied to providing items for our KAPA patients to help address food insecurities and household staple items. A special thank you to KAMA and all that attended the event and helped to build awareness of the KAM Foundation’s latest efforts to serve our patients!

SaTurday, auguST 17, 2024 5:00 pm The miLL & miNe

Its KAPA’s Boot Scootin’ Ball…Island Style!!! Featuring The Caribbean Chillers “Florida’s FAVORITE Jimmy Buffett Tribute Show”. Calling all Parrotheads and Beach Lovers! Enjoy our Silent Auction, Margarita Tiki Bar, Great Music and Special “Island” Menu! Hawaiian Shirts and Flip Flops Encouraged! All proceeds benefit Knoxville Area Project Access! Advance Tickets and Corporate Tables on Sale Now! Don’t Miss this Event! Tickets Sold Out Last Year, So Make Your Reservations Now! FOR TICKETS VISIT KAPABOOTSCOOTIN.COM! FOR CORPORATE TABLES CALL DAVID CAUDILL AT (865) 531-2766, EXT 2280 It’ll Be Five O’clock Somewhere... HERE!