MACOMB COUNTY MEDICAL SOCIETY - January/February/March 2025

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Editor Adrian J. Christie, MD

Managing Editor

Heidi L. Leach

Graphic Designer

Lori Krygier

2025

President Narendra D. Gohel, MD

President-Elect

Lawrence F. Handler, MD

Treasurer & Secretary

Daniel M. Ryan, MD

Delegates

Terrence P. Brennan, MD

Adrian J. Christie, MD

Narendra D. Gohel, MD

Lawrence F. Handler, MD

Jareer S. Hmoud, MD

Khaled M. Ismail, MD

Carolann Kinner, DO

Cheryl D. Lerchin, MD

Akash R. Sheth, MD

MSMS Region 2 Director

Daniel M. Ryan, MD

Executive Director

Heidi L. Leach

In This Issue

Macomb Medicus Journal is published quarterly by the Macomb County Medical Society. Winter: Jan/Feb/ Mar, Spring: Apr/May/Jun, Summer: Jul/ Aug/Sep, Fall: Oct/Nov/Dec. Subscription to the Macomb Medicus is included in the society’s annual membership dues.

Statements and opinions expressed in articles published in the Macomb Medicus are those of the authors and not necessarily those of the Macomb County Medical Society. Advertisements do not represent approval or recommendation of the Macomb County Medical Society.

Address changes and all communications relative to articles and advertising in the Macomb Medicus should be addressed to: Editor, Macomb County Medical Society, P.O. Box 551, Lexington, Michigan 48450-0551 or email HLeach@macombcms.org

All material for publication, including advertisements, must reach the Society office no later than the 10th (business) day of the month preceding the date of issue, e.g. December 10 for the Winter issue. Thank you. No portion of the Macomb Medicus may be used for publication elsewhere without permission from the publisher.

Tragic Murder of UHC CEO Unveils Deeper Cracks in the Healthcare System

Iwish you and your loved ones a New Year filled with health, happiness, and prosperity. However, as we celebrate, we cannot forget the heartbreaking brutal murder of United Healthcare CEO Brian Thompson by Luigi Mangione. Our thoughts are with his family during this difficult time. The overwhelming majority of the public would likely condemn the act of violence itself, recognizing that murder is never an acceptable solution to any social or political issue. Regardless of any grievances individuals may have with the healthcare system or corporate practices, most would agree that violence should never be used as a means of protest or expression. On the other side, Luigi Mangione who has been charged with murder has had thousands of donations pour into an online fundraiser for his legal defense, with messages supporting him and even celebrating his crime. The crime he is accused of has been broadly condemned, but the Ivy League educated, photogenic 26-year old has become an unsettling mixture of folk hero, celebrity, and online crush in certain circles.

1. High Costs and Inefficiency

The U.S. spends significantly more on healthcare than other developed nations, yet the outcomes often do not match the expenditure. Administration costs, billing complexity, and the high cost of medical treatments, pharmaceuticals, and insurance premiums create financial burdens for both individuals and the system as a whole.

2. Lack of Universal Coverage

Unlike many other developed countries, the U.S. does no have a system that guarantees healthcare for all its citizens. While programs like Medicare and Medicaid serve some populations, millions remain uninsured or underinsured, leading to disparities in access to care and health outcomes.

3. Healthcare Inequality

There are deep disparities in healthcare access and quality, often tied to race, socioeconomic status, and geography. Low-income communities, rural areas, and people of color frequently face barriers to accessing the same level of care as wealthier or urban populations.

It is understandable to use a tragic event like this as a lens through which we can reflect on the broader societal issues. When we talk about underlying problems in the U.S. healthcare system, there are several key areas that contribute to its challenges that we witness on a daily basis. However, our patients, hospitals, insurance companies, pharmaceutical companies, and politicians all have different points of view which influence their mindset related to the issues at hand. I, too, have my own perspective given my background and experiences.

As someone who embraces technology and is in the constant pursuit of knowledge, I wanted to educate myself on what to consider when it comes to the state of healthcare in this country. With the help of ChapGTP, I described the brutal murder of the UHC CEO and then asked ChatGPT on New Year’s Day “What are the issues with our healthcare system?” ChatGPT provided the following ten issues. Of course it can provide many more issues and can dig deeper into each one. While we may not agree with the solutions mentioned below, it is worth acknowledging this is yet another perspective to consider as we, as a community, continue to work within this complex and diverse healthcare matrix.

Again this is the list generated by ChatGPT.

4. Fragmented System

The U.S. healthcare system is fragmented, with multiple providers, insurance companies, and government programs. This can result in lack of coordination between care providers, inefficacies, and difficulties for patients navigating the system, leading to poor continuity of care and higher costs.

5. Profit Motive

Many healthcare providers, including insurance companies and pharmaceutical firms, operate for profit, which can lead to prioritizing financial gains over patient care. This profitdriven model often results in higher prices for essential services, medications and insurance premiums.

6. Preventative Care and Public Health

The U.S. healthcare system tends to be more reactive than preventative. Focus is often placed on treating illnesses after they occur, rather than investing in prevention and early intervention, which could reduce long-term healthcare costs and improve public health.

7. Mental Health Care Gaps

Mental health services in the U.S. are often underfunded and harder to access, despite the rising demand. Stigma, lack of insurance coverage, and shortage of mental health

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professionals contribute to significant challenges in addressing mental health needs.

8. Pharmaceutical Industry Issues

The high cost of prescription drugs, coupled with limited regulation and transparency in drug pricing, creates significant financial strain for individuals. This, combined with the influence of pharmaceutical companies in policymaking, often complicates efforts to reduce healthcare costs.

9. Healthcare Workforce Shortages

The U.S. faces a shortage of healthcare professionals in several key areas, including primary care, nursing, and mental health services. This shortage, exacerbated by burnout and underfunding, affects the quality and accessibility of care.

10. Health Insurance System Flaws

Even with reforms like the Affordable Care Act (ACA), many Americans still face difficulties affording coverage. Health insurance premiums, co-pays, and out-of-pocket expenses remain a significant financial burden, especially for those who are self-employed or work in low-wage jobs that do not provide insurance. F

Thank You for Your Generosity!

2024 MCMS Foundation

Holiday Sharing Card Project Raised $4,030

We would like to thank the Macomb County Medical Society members who participated in this year’s Holiday Sharing Card Project. Your generous donations enabled us to raise $1,920 for the Macomb Food Program which feeds hungry families throughout Macomb County and $2,110 for Turning Point which assists victims/survivors of domestic violence, sexual assault, and human trafficking.

Winter Fun in Macomb County!

Achieving and maintaining mental wellness is the foundation for keeping the entire body healthy.

To support that effort, Macomb County Community Mental Health is proud to offer a great on-line, personalized program, My Strength.

“The health club for your mind,” MyStrength provides programs and support for many types of emotional and physical challenges, including:

• Reducing stress

• Improving sleep

• Managing depression

• Managing anxiety

• Mindfulness & meditation

• Balancing intense emotions

• Pregnancy & early parenting

• Managing chronic pain

MyStrength offers daily tips for the mind, body and spirit, and:

• Is Safe, Secure, and Confidential—Your privacy is our top priority, and MyStrength maintains the highest level of security available to create a completely confidential and safe environment.

• Has Proven Resources—based on the latest research and professional advice from best-selling authors.

• Is Packed with Tools — MyStrength offers many resources to improve mental health, with the latest research and professional advice.

It’s easy to get started; Go to mystrength.com and enter access code MCCMHComm and begin your journey to stronger overhall health!

MyStrength has helped many people across the country from the comfort and privacy of their homes.

There is no cost to join, and it is simple to get started. Go to www.mystrength.com. Select “Sign Up” and enter the access code: MCCMHComm. Complete the Wellness Assessment (it takes about ten minutes) and be on your way with personalized tools and supports.

Go Mobile! Using the access code, get the myStrength app for IOS and Android devices at www.mystrength.com/mobile

CHILDREN’S SPECIAL HEALTH CARE SERVICES EXPANSION AND IMPROVEMENTS

Our program is growing! Children’s Special Health Care Services (CSHCS) recently expanded coverage from age 21 up to age 26. Macomb County’s program added over 500 new clients this year, for a total of 3,788 clients and families enrolled as of September 2024. To continue providing exceptional service, CSHCS hired a new Registered Nurse and an additional Client Representative. New and existing clients can check out the new staff assignments on the CSHCS staff webpage.

In addition to new staff, the CSHCS website is being updated to provide even more helpful information. Visit macombgov.org/ cshcs to download forms, make payments, and read the latest newsletter. A new Frequently Asked Questions page is also available to help families navigate program requirements and take advantage of available services. CSHCS has plans to add new training and conference resources for families soon.

CSHCS covers specialty medical care for over 2,700 qualifying diagnoses. This includes specialist visits, medications, medical equipment, therapies, and mileage reimbursement or transportation assistance. Program eligibility is not income limited. Families with or without health insurance are eligible to join; we work with both Medicaid and commercial insurance.

For additional information, call the main CSHCS line at 586-4666855, visit macombgov.org/cshcs, or email Program Supervisor, Karla Anderson, RN, at karla.anderson@macombgov.org

COMMUNITY HEALTH IMPROVEMENT PLAN UPDATE: BEHAVIORAL HEALTH & SUBSTANCE USE

In 2023, the Macomb County Health Department, along with over 25 partner organizations completed a comprehensive Community Health Assessment (CHA). The CHA was then used to create the 2024-2028 Community Health Improvement Plan (CHIP), which identified three priority areas that would be addressed by the CHIP:

• Behavioral Health & Substance Use

• Social Determinants & Built Environment

• Chronic Disease & Healthy Lifestyle

Workgroups for each priority area were established to help develop local level strategies and activation.

Here is an update on the Behavioral Health and Substance Use workgroup:

The Behavioral Health Workgroup, composed of 14 local organizations, has made great progress in helping people in Macomb County get the care they need. Currently, the workgroup is updating a Behavioral Health Services Map to make it easier for the community to find and access mental health help, including resources for veterans, people with disabilities, and the LGBTQ+ community. In February, the workgroup will launch social media campaigns featuring posters made by Center Line High School students to spread the word about mental health, with more partnerships on the horizon.

The Behavioral Health Workgroup will continue to collaborate to improve services, share information, and ensure that everyone in the community can access the support they need. For more details, visit our website

PARTNER SPOTLIGHT: MYCARE HEALTH CENTER

This month, we are proud to spotlight MyCare Health Center, a vital partner serving the Macomb County community. MyCare Health Center is dedicated to providing highquality, affordable healthcare services to ALL people. Their comprehensive care model ensures that every patient, regardless of age, income or insurance status, receives needed, quality medical attention. Key services provided by MyCare Health Center:

• Primary and Preventive Care - Offering everything from routine check-ups to managing chronic conditions.

• Dental Services - Ensuring the community has access to comprehensive oral health care.

• Behavioral Health Support - Integrating mental health services and specialized treatment for substance use disorders.

MyCare Health Center’s commitment to accessible healthcare makes a profound impact in Macomb County. By addressing both immediate and long-term needs, MyCare plays a crucial role in strengthening the social safety net in Macomb County! They continue to be a cornerstone of health and wellness for individuals and families in need.

For more information, please visit Who We Are | MyCare Health Center | Michigan F

The MCMS would like to wish the following members a very Happy Birthday!

JANUARY

Nikhil Ambulgekar, MD

Kenneth Andrews, MD

Joshua Apple, MD

Shadi Bashour, DO

Adrian Christie, MD

Donald Cucchi, DO

Laura Dalla Vecchia, MD

Anna Demos, MD

Rudyard Dimson, MD

Robyn Garcia, MD

Thomas Giancarlo, DO

Theodore Golden, MD

Steven Grekin, DO

Lawrence Handler, MD

Michael Hoff, DO

Orest Horodysky, MD

Cynthia Housel, DO

Steven Hudock, MD

Amy Kopp, MD

Walter Lang, DO

Stephen Lemos, MD

Zachary Liss, MD

Joseph Lucido, DO

Leah Ludwig, DO

Robert Moore, MD

George Nassif, MD

Omokayode Osobamiro, MD

Vinay Pampati, DO

Harold Papson, MD

Sara Pulito, DO

David Reed, MD

Maria Repolski, MD

Dawn Severson, MD

Leo Toomajian, DO

Firas Yazigi, MD

H. Jay Zeskind, MD

John Zinkel, MD

FEBRUARY

Omr Abuzahrieh, MD

Mohamad Ajjour, MD

Edward Alpert, MD

Aneela Aman, MD

David Benaderet, MD

Christina Blake, DO

Kirk Cleland, MD

Anthony Colucci, DO

Peter Francis, MD

David Ginnebaugh, MD

William Goldstein, MD

Kristen Herman, MD

Maurilio Hernandez, MD

Angela Iacobelli, MD

Eli Isaacs, MD

Harjeet Jhajj, DO

Mark Karchon, DO

Sameera Khan, MD

Mun Kim, MD

Stephen Levy, MD

Kim Lie, MD

John Lim, MD

Michael Maceroni, DO

Bryan Mazey, DO

Glenn Minster, MD

Dariouche Mohammadi, MD

Donald Muir, MD

Sujini Palaniswamy, MD

Prameela Patel, MD

Ronald Pierskalla, MD

Nina Rehman, DO

Jennifer Rivard, MD

Daniel Ryan, MD

Joyanta Saha, MD

Fremont Scott, DO

Geoffrey Seidel, MD

Saadia Siddiqui, MD

Kenneth Smith, MD

Steven Taormina, DO

Julie Thompson, DO

Lacey Walke, MD

Mary Watts, MD

Zenon Zarewych, MD

MARCH

Anthony Affatato, DO

Majid Al-Zagoum, MD

Ghazwan Atto, MD

Valda Byrd, MD

Steven Cusick, MD

Mark Deprez, MD

Steven Ferrucci, MD

Rene Franco Elizondo, MD

Anna Fraymovich, MD

Valal George, MD

Mohammad Ghaffarloo, MD

Thomas Gignac, MD

Vamshidhar Guduguntla, MD

Marko Gudziak, MD

Bal Gupta, MD

Katherine Hartman, MD

Violette Henein, MD

Eddie Idrees, MD

Pallavi Jasti, MD

Kathleen Joyce, MD

Shabbir Khambati, MD

Mubina Khan, MD

Arsenia Koh-Guevarra, MD

Marcus Koss, MD

Peter Kowynia, MD

Sang Lee, MD

Ruben Legaspi, MD

Alicia Lumley, MD

George Maristela, MD

Nayna Nagrecha, MD

Abdullah Rathur, DO

Michael Raad, DO

Jennifer Rimmke, MD

Ariston Sandoval, MD

Jagmohan Sharma, MD

Scott Sircus, MD

Akemi Takekoshi, MD

We would like to welcome the following New Members!

Anthony J. Affatato, DO

Emergency Medicine – Board Certified Medical School: Midwestern University Chicago College of Osteopathic Medicine (IL), 1987. Post Graduate Education: Midwestern University Chicago College of Osteopath, Medicine (IL), completed in 1988; Henry Ford Macomb Hospital, completed in 1991. Hospital Affiliations: Henry Ford Macomb. Currently practicing at Henry Ford Macomb –Emergency Dept., 15855 19 Mile Rd., Clinton Twp., MI 48038, ph. 586-263-2940.

Shawkat Ahmed, DO

Internal Medicine – Board Certified Medical School: Lake Erie College of Osteopathic Medicine (PA), 2011. Post Graduate Education: Ascension Macomb-Oakland Hospital, completed in 2014. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb, Henry Ford St. John, McLaren Macomb. Currently practicing at Great Lakes Medicine, 50505 Schoenherr Rd., Ste. 340, Shelby Twp., MI 48315 ph. 586-731-8400, fx. 586-731-8406.

Mohamad K. Ajjour, MD

Interventional Cardiology, Cardiovascular Disease, Internal Medicine – Board Certified All Medical School: Universidad Autonoma De Guadalajara (Mexico), 1981. Post Graduate Education: Wayne State University School of Medicine, completed in 1985; St. John Hospital, completed in 1988. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb, Henry Ford St. John, Henry Ford Warren. Currently practicing at Cardiovascular Institute of Michigan, 18303 E. 10 Mile Rd., Ste. 100, Roseville, MI 48066, ph. 586-776-8877, fx. 586-776-3092, www.cvi-mi.com.

Fadi R. Al-Qas Hanna, MD

Interventional Cardiology, Cardiovascular Disease, Internal Medicine – Board Certified All Medical School: University of Baghdad (Iraq), 2003 Post Graduate Education: University of Baghdad College of Medicine, completed in 2005; Ascension St. John Hospital, completed in 2012, 2015, 2016. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb, Henry Ford Warren. Currently practicing at Advanced Cardiovascular Associates, 49050 Schoenherr Rd., Ste. 100, Shelby Twp., MI 48315, ph. 586-731-700, www.acaoffice.com.

Majid M. Al-Zagoum, MD

Interventional Cardiology, Cardiovascular Disease, Internal Medicine – Board Certified All Medical School: Al-Mustansiriyah University College of Medicine (Iraq), 1991. Post Graduate Education: Henry Ford Hospital, completed in 1997, 2002; St. John Hospital, completed in 2003. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Corewell Beaumont Troy, Henry Ford Macomb, Henry Ford St. John, Henry Ford Warren. Currently practicing at Cardiovascular Institute of Michigan, 18303 E. 10 Mile Rd., Ste. 100, Roseville, MI 48066, ph. 586-776-8877, fx. 586-776-3092, www.cvi-mi.com

Aneela Aman, MD

Internal Medicine – Board Certified Medical School: Khyber Medical College (Pakistan), 2000. Post Graduate Education: Ascension Providence Hospital, completed in 2011. Hospital Affiliations: Henry Ford Macomb. Currently practicing at Sterling Internal Medicine PLC Hospital Medicine Specialists, 43475 Dalcoma Dr., Clinton Twp., MI 48038, ph. 586-399-1157.

Robert E. Aquino, DO

Internal Medicine – Board Certified Medical School: Michigan State University College of Osteopathic Medicine, 1998. Post Graduate Education: McLaren Macomb, completed in 2001. Currently Practicing at Aquino Integrative Internal Medicine, 30695 Little Mack Ave., Ste. 500, Roseville, MI 48066, ph. 313-401-0256, fx. 877-871-1373, www.aquinomedicine.com.

Mariana D. Atanasovski, MD

Dermatology – Board Certified Medical School: Wayne State University School of Medicine, 2010. Post Graduate Education: Wayne State University, completed in 2014. Hospital Affiliations: Henry Ford Warren. Currently practicing at Modern Dermatology, 58851 Van Dyke Ave., Ste. 100, Washington, MI 48094, ph. 248-375-4033, fx. 248-375-4034, www.moderndermmi.com

Brian A. Barbish, MD

Interventional Cardiology, Cardiovascular Disease, Internal Medicine – Board Certified All Medical School: Wayne State University School of Medicine, 1985. Post Graduate Education: St. Joseph Mercy Oakland Hospital, completed in 1988; Detroit Medical Center, completed in 1993. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb, Henry Ford St. John, Henry Ford Warren. Currently practicing at Cardiovascular Institute of Michigan, 18303 E. 10 Mile Rd., Ste. 100, Roseville, MI 48066, ph. 586-776-8877, fx. 586-776-3092, www.cvi-mi.com

Mark A. Bergin, MD

Orthopedic Surgery – Board Certified, Orthopedic Sports Medicine – Board Certified Medical School: Wayne State University School of Medicine, 2006. Post Graduate Education: Northwestern Memorial Hospital (IL), completed in 2007; Robert Wood Johnson University Hospital (NJ), completed in 2009; University of Chicago School of Medicine (IL), completed in 2012; University of Pittsburgh School of Medicine (PA), completed in 2013. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Corewell Beaumont Troy, Henry Ford Detroit, Henry Ford Macomb. Currently practicing at St. Clair Orthopaedics & Sports Medicine, 23829 Little Mack Ave., Ste. 100, St. Clair Shores, MI 48080, ph. 586-773-1300, fx. 586-773-1600, www.stclairortho.com

Kirk G. Cleland, MD

Orthopedic Surgery – Board Certified Medical School: Wayne State University School of Medicine, 2008. Post Graduate Education: Henry Ford Hospital, completed in 2013; Indiana University School of Medicine, completed in 2014. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Detroit, Henry Ford Macomb. Currently practicing at St. Clair Orthopaedics & Sports Medicine, 23829 Little Mack Ave., Ste. 100, St. Clair Shores, MI 48080, ph. 586-773-1300, fx. 586-773-1600, www.stclairortho.com.

Anthony J. Colucci, DO

Emergency Medicine – Board Certified Medical School: Des Moines University College of Osteopathic Medicine (IA), 1989. Post Graduate Education: Detroit Osteopathic Hospital, completed in 1990; Bi-County Community Hospital, completed in 1993; Botsford Hospital, completed in 1995. Hospital Affiliations: Henry Ford Macomb. Currently practicing at Henry Ford Macomb Hospital – Emergency Dept., 15855 19 Mile Rd., Clinton Twp., MI 48038, ph. 248-237-3226.

Victor I. Corondan, MD

Family Medicine – Board Certified Medical School: Wayne State University School of Medicine, 1992. Post Graduate Education: Ascension Providence, completed in 1995. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb, Henry Ford St. John, Henry Ford Warren. Currently practicing at Corondan Medical, 14050 E. 14 Mile Rd., Warren, MI 48088, ph. 586-920-2249, fx. 586-920-2281.

Donald D. Cucchi, DO

Family Medicine – Board Certified, Emergency Medicine – Board Certified Medical School: Midwestern University Chicago College of Osteopathic Medicine (IL), 1966. Post Graduate Education: McLaren Oakland Hospital, completed in 1967. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb, Henry Ford Warren. Currently practicing at Sterling Heights Medical Center, 11600 15 Mile Rd., Sterling Heights, MI 48312, ph. 586-939-3020, fx. 586-939-2191.

James J. Dietz, MD

Orthopedic Surgery – Board Certified Medical School: Wayne State University School of Medicine, 1992. Post Graduate Education: Henry Ford Hospital, completed in 1997; State University of New York at Buffalo, completed in 1998. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Detroit, Henry Ford Macomb. Currently practicing at St. Clair Orthopaedics & Sports Medicine, 23829 Little Mack Ave., Ste. 100, St. Clair Shores, MI 48080, ph. 586-773-1300,fx. 586-773-1600, www.stclairortho.com.

Vijayalakshmi Donthireddy, MD

Hematology & Oncology – Board Certified, Internal Medicine – Board Certified Medical School: Government Mohan Kumaramangalam Medical College (India), 1998. Post Graduate Education: Presence St. Francis Hospital (IL), completed in 2000; Henry Ford Hospital, completed in 2006. Hospital Affiliations: Henry Ford Detroit, Henry Ford Macomb, Henry Ford W. Bloomfield. Currently practicing at Henry Ford Cancer Center - Detroit, 2800 W. Grand Blvd., Detroit, MI 48202, ph. 888-246-6424.

Adam G. Feinstein, DO

Neuromusculoskeletal Medicine – Board Certified Medical School: Michigan State University College of Osteopathic Medicine, 2007. Post Graduate Education: Michigan State University, completed in 2010. Hospital Affiliations: McLaren Macomb. Currently practicing at A. Feinstein OMM Institute, 37040 Garfield Rd., Ste. C-2, Clinton Twp., MI 48036, ph. 586-840-7599, fx. 586-840-7597.

Katherine Foley Cuello La O, DO

Vascular Surgery – Board Certified, General Surgery – Board Certified Medical School: A.T. Still University School of Osteopathic Medicine (AZ), 2012. Post Graduate Education: Affinity Medical Center (OH), completed in 2017; McLaren Macomb Hospital, completed in 2019. Hospital Affiliations: Henry Ford Macomb, McLaren Macomb, McLaren Port Huron. Currently practicing at Macomb Surgical Associates, 37400 Garfield Rd., Ste. 120, Clinton Twp., MI 48036, ph. 586-228-3800, fx. 586-228-9800.

Judy H. Fontana, MD

Dermatology – Board Certified Medical School: Wayne State University School of Medicine, 2008. Post Graduate Education: Beaumont Royal Oak Hospital, completed in 2009; Northwestern Memorial Hospital, completed in 2011; Detroit Medical Center, completed in 2014. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb. Currently practicing at Dermatology Specialists of Shelby, 50505 Schoenherr Rd., Ste. 325, Shelby Twp., MI 48315, ph. 586-580-1001, fx. 586-580-9289, www.dermatologyspecialistsofshelby.com

Matthew S. Forcina, MD

Cardiovascular Disease, Cardiac Electrophysiology, Internal Medicine – Board Certified All Medical School: Temple University Lewis Katz School of Medicine (PA), 2001. Post Graduate Education: Duke University Medical Center (NC), completed in 2004; Beaumont Royal Oak Hospital, completed in 2007; Medical University of South Carolina, completed in 2009. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb, Henry Ford Warren. Currently practicing at Advanced Cardiovascular Associates, 44850 Mound Rd., Sterling Heights, MI 48314, ph. 586-7317000, fx. 586-731-8610, www.acaoffice.com

Hamsa J. Gabbara, MD

Internal Medicine

Medical School: American University of Antigua College of Medicine, 2016. Post Graduate Education: Wayne State University School of Medicine, completed in 2024. Hospital Affiliations: Henry Ford Wyandotte. Currently practicing at Downriver Medical Associates, 2300 Biddle Ave., Ste. 100, Wyandotte, MI 48192, ph. 734-246-5705, www.downrivermedicalassociates.com

Pamela A. Georgeson, DO

Allergy and Immunology – Board Certified Medical School: Midwestern University Chicago College of Osteopathic Medicine (IL), 1983. Post Graduate Education: Botsford Hospital, completed in 1984; Children’s Hospital of MI, completed in 1987; Henry Ford Hospital, completed in 1989. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb, Henry Ford St. John. Currently practicing at Kenwood Allergy & Asthma Center, 30170 23 Mile Rd., Chesterfield, MI 48047,ph. 586-949-5900, fx. 586-949-5922, www.kenwoodallergy.com.

Wearing a white coat doesn't mean they're a doctor. ASK if a PHYSICIAN is part of your CARE TEAM. MIHowWhiteCoatsWork.org

Thomas Giancarlo, DO

Neurology – Board Certified, Sleep Medicine – Board Certified

Medical School: Michigan State University College of Osteopathic Medicine, 1983. Post Graduate Education: Botsford Hospital, completed 1986; Wayne State University School of Medicine, completed in 1988. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb, McLaren Macomb. Currently practicing at Michigan Neurology Associates & Pain Consultants, 34025Harper Ave., Clinton Twp., MI 48035, ph. 586-445-9900, fx. 586-791-0649, www.michiganneurologyassociates.com.

James J. Giliberto, DO

Vascular Surgery – Board Certified, General Surgery – Board Certified Medical School: Philadelphia College of Osteopathic Medicine (PA), 1983. Post Graduate Education: McLaren Macomb Hospital, completed in 1988; Ascension St John Hospital, completed in 1989. Hospital Affiliations: Henry Ford Macomb, McLaren Macomb. Currently practicing at Macomb Surgical Associates, 37400 Garfield Rd., Ste. 120, Clinton Twp., MI 48036, ph. 586-228-3800, fx. 586-228-9800.

Sheldon L. Gonte, MD

Ophthalmology – Board Certified

Medical School: Wayne State University School of Medicine, 1987. Post Graduate Education: Sinai/Grace Hospital, completed in 1991. Hospital Affiliations: Corewell Beaumont Royal Oak, Henry Ford Macomb, Henry Ford Warren, McLaren Macomb. Currently practicing at Lasik/ Cataract Eye Specialist, 43928 Mound Rd., Ste. 100, Sterling Heights, MI 48314, ph. 586-268-4400, fx. 586-268-2182, www.sheldongontemd.wixsite.com

Steven Grekin, DO

Dermatology – Board Certified Medical School: Des Moines University of Osteopathic Medicine & Health Sciences (IA), 1989. Post Graduate Education: Bi-County Community Hospital, completed in 1994. Hospital Affiliations: Corewell Trenton, Henry Ford Macomb, Henry Ford Warren, Henry Ford Wyandotte. Currently practicing at Grekin Skin Institute – Warren, 13450 E. 12 Mile Rd., Warren, MI 48088, ph. 586-759-5525, fx. 586-759-4022, www.advancedderm.com.

MEDICAL RECORDS OF RETIRED PHYSICIANS

Patients looking for their medical records from retired physicians frequently contact the MCMS. If you are retired or will be retiring shortly, please contact the MCMS at 877-264-6592 or email HLeach@macombcms.org and let us know how patients can retrieve their records. If the records have been destroyed, please inform us of that also so we can note our database accordingly. Thank you!

Vamshidhar D. Guduguntla, MD

Cardiovascular Disease, Interventional Cardiology, Internal Medicine – Board Certified All Medical School: Guntur Medical College (India), 1987. Post Graduate Education: St. John Hospital, completed in 2002. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Corewell Beaumont Troy, Henry Ford Macomb, Henry Ford St. John, Henry Ford Warren. Currently practicing at Eastside Cardiovascular Medicine, 25195 Kelly Rd., Ste. A, Roseville, MI 48066, ph. 586-775-4594, fx. 586-775-4506.

Dorothy M. Halperin, MD

Anatomic & Clinical Pathology – Board Certified Medical School: University of Illinois College of Medicine, 1988. Post Graduate Education: University of Michigan Health System, completed in 1989; Ascension St. John Hospital, completed in 1991; Detroit Medical Center/Wayne State University, completed in 1993; Corewell Beaumont Royal Oak, completed in 1996. Hospital Affiliations: McLaren Macomb. Currently practicing at McLaren Macomb, 1000 Harrington St., Mt. Clemens, MI 4843, ph. 586-493-8000, fx. 586-493-8721.

Katherine M. Hartman, MD

Family Medicine – Board Certified Medical School: Michigan State University College of Human Medicine, 2020. Post Graduate Education: Corewell Troy Beaumont, completed in 2023. Hospital Affiliations: Henry Ford Macomb, Henry Ford St. John. Currently practicing at Bay Area Family Physicians, 34301 23 Mile Rd., Ste. 100, Chesterfield, MI 48047, ph. 586-725-1770, fx. 586-7254080, www.bayareafp.com.

Derek L. Hill, DO

Orthopedic Surgery – Board Certified Medical School: Midwestern University Chicago College of Osteopathic Medicine (IL), 2002. Post Graduate Education: Botsford Hospital, completed in 2003; Philadelphia College of Osteopathic Medicine, completed in 2007; University of Pennsylvania Hospital, completed in 2008. Hospital Affiliations: Corewell Trenton, Henry Ford Macomb, Henry Ford St. John, Henry Ford Warren. Currently practicing at Hill Orthopedics, 928 E. 10 Mile Rd., Ste. 400, Ferndale, MI 48220, ph. 248-268-4299, fx. 888-850-3877, www.drhill.com

Jareer S. Hmoud, MD

Infectious Diseases – Board Certified, Internal Medicine – Board Certified Medical School: University of Damascus Faculty of Medicine (Syria), 1995. Post Graduate Education: Al-Bashir Hospital (Jordan); University of Toledo College of Medicine (OH), completed in 2001; University of MI Hospitals, completed in 2003. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb, Henry Ford Providence, Henry Ford Warren, McLaren Macomb. Currently practicing at MI Infectious Disease Associates, 13430 E. 13 Mile Rd., Warren, MI 48088, ph. 248-8548999, fx. 248-429-1506.

Angela M. Iacobelli, MD

Allergy & Immunology – Board Certified Medical School: Wayne State University School of Medicine, 1986. Post Graduate Education: Beaumont Royal Oak Hospital, completed in 1990; Henry Ford Hospital, completed in 1993. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb. Currently practicing at Allergy and Asthma Specialists of MI, 43417 Schoenherr Rd., Sterling Heights, MI 48313, ph. 586-981-0390, fx. 586-803-3512, www.aasmich.com.

Ghaith M. Ibrahim, MD

Gastroenterology – Board Certified Medical School: University of Aleppo Faculty of Medicine, 1990. Post Graduate Education: Northeastern Ohio University College of Medicine, completed in 1997; Ascension Providence Hospital, competed in 2000. Hospital Affiliations: Henry Ford Macomb, Henry Ford Warren. Currently practicing at Pioneer Medical Associates, 27560 Hoover Rd., Warren, MI 48093, ph. 586-757-6400, fx, 586-757-8400.

Harpal S. Jande, MD

Internal Medicine, Hospitalist

Medical School: Rajasthan University Sardar Patel Medical College (India), 1988. Post Graduate Education: Sparrow Hospital, completed in 1996. Currently practicing at Great Lakes Medicine, 50505 Schoenherr Rd., Ste.

Elena N. Jdanova, MD

Internal Medicine – Board Certified, Hospitalist Medical School: Yaroslavl State Medical Academy (Russia), 1985. Post Graduate Education: Sinai Grace Hospital, completed in 2010. Hospital Affiliations: Corewell

Beaumont Royal Oak, Henry Ford Macomb. Currently practicing at Academic Internal Medicine Specialists, 26677 W. 12 Mile Rd., Ste. B6, Southfield, MI 48034, ph. 248-354-4709, fx. 248-354-4807.

Ajith K. Kadakol, MD

Vascular Surgery – Board Certified Medical School: Bangalore Medical College (India), 1993. Post Graduate Education: Einstein Medical Center Philadelphia (PA), completed in 2001; Carney Hospital (MA), completed in 2002; Boston University Medical Center (MA), completed in 2008; Henry Ford Hospital, completed in 2010. Hospital Affiliations: Henry Ford Macomb, Henry Ford W. Bloomfield. Currently practicing at Henry Ford West Bloomfield Hospital, 6777 W. Maple Rd., W. Bloomfield, MI 48322, ph. 800-436-7936.

Amin R. Khan, MD

Anesthesiology – Board Certified Medical School: Khyber Medical College (Pakistan), 1983. Post Graduate Education: Lady Reading Hospital (Pakistan), Completed in 1985; Provincial Health Services (Pakistan), completed in 1988; Royal Preston Hospital (England), completed in 1990; Warrington General Hospital (England), completed in 1991; Broadgreen Hospital (England), completed in 1992; Alderhey Children's Hospital (England), completed in 1993; Medical College of Wisconsin, completed in 1998; Cleveland Clinic (OH), completed in 1999; University of Toronto (Canada), completed in 2000. Hospital Affiliations: Henry Ford Macomb. Currently practicing at Macomb Anesthesia, 15855 19 Mile Rd., Clinton Twp., MI 48038, ph. 586-263-2371.

Marcus E. Koss, MD

Family Medicine – Board Certified Medical School: Wayne State University School of Medicine, 1999. Post Graduate Education: Beaumont Hospital, completed in 2002. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb. Currently practicing at Essential Care Family Medicine, 21603 E. 11 Mile Rd., St. Clair Shores, MI 48081, ph. 586-280-2100, fx. 833-496-1920, www.essentialcare-familymedicine.com.

ACTIVATE YOUR POLITICAL VOICE

The Michigan Doctors’ Political Action Committee (MDPAC) is the political arm of the Michigan State Medical Society. MDPAC supports pro-medicine candidates running for the State legislature, Michigan Supreme Court and other statewide positions. Join today!

Vijaya G. Kotha, MD

Psychiatry – Board Certified, Addiction Medicine – Board Certified

Medical School: Gandhi Medical College (India), 1983. Post Graduate Education: Henry Ford Hospital, completed in 1992; Sinai Grace Hospital, completed in 1995. Hospital Affiliations: Henry Ford Macomb, Henry Ford Warren. Currently practicing at 11900 E. 12 Mile, Ste. 111, Warren, MI 48093, ph. 586-5735000, fx. 586- 573-5304.

Peter D. Kowynia, MD

General Surgery – Board Certified Medical School: Wayne State University School of Medicine, 1987. Post Graduate Education: St. John Hospital, completed in 1992. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb, Henry Ford St. John. Currently practicing at Northeast Surgical Specialists, 43211 Dalcoma Dr., Ste. 4, Clinton Twp., MI 48038, ph. 586-286-8800, fx. 586-286-8068, www.northeastsurgicalspecialists.com.

Walter C. Lang, DO

Internal Medicine – Board Certified

Medical School: Des Moines University College of Osteopathic Medicine, 1989. Post Graduate Education: St. John Hospital. Currently practicing at Shores Primary Care, 28001 Harper Ave., St. Clair Shores, MI 48081, Ph. 586-772-7180.

Rakesh Lattupalli, MD

Nephrology – Board Certified, Internal Medicine – Board Certified Medical School: Osmania Medical College (India), 1998. Post Graduate Education: St. John hospital, completed in 2008. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb, Henry Ford Providence, Henry Ford St. John, Henry Ford Warren. Currently practicing at Metro Detroit Renal Doctor, 1349 S. Rochester Rd., Ste. 115, Rochester Hills, MI 48307, ph. 248-759-4852, fx. 248-759-4854.

Christopher L. Lee, MD

Orthopedic Surgery – Board Certified Medical School: Wayne State University School of Medicine, 1972. Post Graduate Education: Wayne State University Hospital, completed in 1976; Stanford University Hospital (CA), completed in 1977. Hospital Affiliations: Henry Ford St. John. Currently practicing at St. Clair Orthopaedics & Sports Medicine, 23829 Little Mack Ave., Ste. 100, St. Clair Shores, MI 48080, ph. 586 773-1300, fx. 586 773-1600, www.stclairortho.com

your audience with a print and digital publication. Your digital ad will be

Contact Heidi Leach at HLeach@macombcms.org for

Stephen E. Lemos, MD

Orthopedic Surgery – Board Certified Medical School: University of Wisconsin-Madison, 1994. Post Graduate Education: Fletcher Allen Health Care University of Vermont Medical Center, completed in 1999; Kerlan-Jobe Orthopedic Clinic (CA), completed in 2000. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb, McLaren Macomb. Currently practicing at Associated Orthopedists of Detroit, 24715 Little Mack Ave., Ste. 100, St. Clair Shores, MI 48080, ph. 586-779-7970, fx. 586-779-7748, www.associatedortho.org

Joseph G. Lucido, DO

Family Medicine – Board Certified Medical School: Michigan State University College of Osteopathic Medicine, 2019. Post Graduate ducation: Henry Ford Macomb, completed in 2022. Hospital Affiliations: Corewell Beaumont Grosse, Henry Ford Macomb, Henry Ford St. John. Currently practicing at Bay Area Family Physicians, 34301 23 Mile Rd., Ste. 100, Chesterfield, MI 48047, ph. 586-725-1770, fx. 586-725-4080, https://bayareafp.com/.

Alicia G. Lumley, MD

Neurology – Board Certified Medical School: National Autonomous University of Mexico School of Medicine, 1979. Post Graduate Education: Westchester Medical Center (NY), completed in 2000; New York Medical College St. Vincent’s Hospital, completed in 2003; Henry Ford Hospital, completed in 2004. Currently practicing at Lakeside Neurology, 25195 Kelly Rd., Ste. B, Roseville, MI 48066, ph. 586-777-3370, fx. 586-777-3380.

Bryan J. Mazey, DO

Ophthalmology – Board Certified Medical School: Kirksville College of Osteopathic Medicine (MO), 1991. Post Graduate Education: Detroit Osteopathic Hospital, completed in 1992; Bi-County Community Hospital, completed in 1995. Hospital Affiliations: Henry Ford Macomb, Henry Ford St. John, McLaren Macomb. Currently practicing at Great Lakes Ophthalmology, 36821 Green St., New Baltimore, MI 48047, ph. 586-716-4959, fx. 586-716-2936.

Glenn J. Minster, MD

Orthopedic Surgery – Board Certified Medical School: Wayne State University School of Medicine, 1990. Post Graduate Education: Wayne State University Hospital, completed in 1995; Tulane Medical Center (LA), completed in 1996. Hospital Affiliations: Henry Ford Detroit, Henry Ford Macomb, Henry Ford Wyandotte. Currently practicing at Henry Ford Lakeside, 14500 Hall Rd., Sterling Heights, MI 48313, ph. 586-247-2750.

Shyam S. Moudgil, MD

Neurology, Clinical Neurophysiology, Vascular Neurology, Internal Medicine – Board Certified All Medical School: P.T. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences (India), 1978. Post Graduate Education: Kingsbrook Jewish Medical Center (NY), completed in 1996; St. John Hospital, completed in 1998; West Virginia University School of Medicine, completed in 2001; Henry Ford Hospital, completed in 2002. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford Macomb, Henry Henry Ford St. John, Ford Warren. Currently practicing at Lakeside Neurology, 28573 Schoenherr Rd., Warren, MI 48088, ph. 586-777-3370, fx. 586-777-3380.

Nayna S. Nagrecha, MD

Nephrology – Board Certified, Internal Medicine – Board Certified Medical School: Indira Gandhi Medical College (India), 1992. Post Graduate Education: Wayne State University School of Medicine, completed in 2003; St. John Hospital, completed in 2005. Hospital Affiliations: Corewell Beaumont Grosse Pointe, Henry Ford St. John. Currently practicing at Metro Detroit Kidney Associates, 23995 Greater Mack Ave., Ste. 102, St. Clair Shores, MI 48080, ph. 586-585-9727, fx. 586-933-2353.

George H. Nassif, MD

Geriatric Medicine – Board Certified, Internal Medicine – Board Certified Medical School: University of Cairo Faculty of Medicine (Egypt), 1982. Post Graduate Education: University of Cairo Faculty of Medicine (Egypt), completed in 1987 & 1997; Wayne State University, completed in 2006, 2009, 2010. Hospital Affiliations: Corewell Beaumont Troy, Henry Ford Macomb. Currently practicing at 42621 Garfield Rd., Ste. 108, Clinton Twp., MI 48038, ph. 586-263-3312, fx. 586-263-5311.

M Learning History Through Watch Collecting

y story begins in a flea market in Johannesburg in 1985, when visiting family in South Africa.

My wife, Mynetta’s Uncle Jake, had been in the British army during WWII and stationed there where he met his wife and settled, instead of returning to the UK. His daughter, Penny, and Mynetta were looking at items most appealing to women, and I further explored stalls until I came across a couple of rather ‘sleazy- looking’ young men selling old pocket watches. Most looked badly used but one gold watch caught my eye and miraculously began ticking after a few winds. The dial had the London maker’s name and address. I surmised that it likely dated from the turn of the 20th century and was enthralled to have almost a living object in my hand still performing this valuable function of keeping time. Moreover, those guys took American Express! My interest in horology has expanded since then, although on my return to the USA I noticed that the timepiece had stopped running and lost one of its hands. Despite this, I had been inspired to become a watch collector and over the years have acquired examples of watches dating from the 17th century to more recent examples with complications such as perpetual calendars, chronographs, alarm watches and dual time zones (also known as GMT’s).

Development of mechanical devices, no matter how complicated or functional, could not occur without the inventiveness and resourcefulness of individuals, and their stories have often been inspirational. This is not more so than the centuries of progress in timekeeping. The industrial revolution or even space travel would not have become possible without it.

A few names in particular stand out to me as heroes of their age and brilliant innovators. These include Galileo, who at 19 years of age in 1610 noticed that a swinging chandelier in a cathedral took the same time to complete a swing no matter how big the swing was (the Law of Isochronism).

Many years ago, before the internet became ubiquitous, I waited for three months after sending money, to hear from a Frenchman about a purchase of a so-called ‘onion watch’ dated 1719 (Fig.1) with the maker’s name in a reference book called “Baillie’s” - the maker’s father, Louis Lallemand had made the turret clock on a tower at Blois near Paris in the 1600’s; the seller had fled the summer heat of Paris to sail his yacht on the French Riviera. He claimed that the watch had been inherited from his aristocratic mother’s family, specifically his great grandfather Sir Barbellion du chateau de Nancay.

Pendlum clocks became the first accurate timekeepers. In the 18th century, King George III was enamored by scientific discoveries; one clockmaker to the king, Thomas Mudge, invented the detached-lever escapement used still today in billions of mechanical watches. This century also saw John Harrison, a British carpenter, who went from making wooden clocks to amazing timepieces which can still be seen working at the Royal Naval Museum in Greenwich, London. His watch H4 (Fig. 2) completed in 1759, kept time to within three minutes for a sailing ship’s threemonth journey from England to Jamaica. His innovations for accurate timekeeping enabled determination of longitude at sea, so that a Royal Navy ship could calculate its exact location and avoid shipwreck.

This allowed Britain to acquire an empire encompassing almost a third of the known world. The idea for the first automatic wristwatch came to John Harwood, the son of a British watchmaker, while serving at the front as a soldier in WWI. Under the extreme conditions of trench warfare, his watch stopped frequently. If the cause was not penetrating dust or water, then it was forgetting to wind the watch by hand. He eliminated the crown and used a turning bezel instead to set the hands (Fig 3). Though a good first step, the first really successful automatic wristwatch was the Rolex oyster perpetual

continued on page 14

FIG. 1" Onion Watch" circa 1719
John Harrison
John Harwood
FIG. 2. H4 clock (watch) circa 1759
FIG. 3. My Harwood Wristwatch

chronometer from a company founded in London in 1905 by the 24-year-old Hans Wilsdorf, a German who became a British citizen after taking an English bride. He was a marketing genius and during the boom years of the 1920’s he popularized the Rolex Oyster watches with their water-resistant cases. Earlier versions were known as “bubble backs” as the movement was encased in a dome-shaped cover on the back of the case (see Fig. 4). When Mercedes Gleitz, a London stenographer, swam the English Channel with a wristwatch strapped to her wrist, Wilsdorf achieved a marketing coup and purchased a full page advertisement in the Daily Mail newspaper (Fig.5). Rolex watches also successfully made their way to the top of Mount Everest, to the deepest dive into the ocean attached to a diving bell, and on the wrist of Donald Campbell during his attempts to break land speed records.

On October 7, 1927 Mercedes Gleitze, a young London stenographer, swam the English Channel in 15 hours 15 minutes with her “Rolex–Oyster”. Imagine the surprise of the reporters present at her landing, when they found that the watch was still running as perfectly as if it had never left dry land. The event caused a sensation at the time, for the waterproof watch was still unknown to the general public. On November 27, 1927, Wilsdorf reserved the front page of the “Daily Mail” (at a cost of 1600 British Pounds) for an advertisement proclaiming the success of the first waterproof watch. This was the first step in the triumphant rise to fame of the “Rolex-Oyster".

Watch collecting has also given me an insight into historical events. Britain’s long connection with India from earlier colonial days to the recent British Prime Minister Rishi Sunak (20222024) has been recorded on the faces and the movements of pocket watches of the late 19th and early 20th Century. I acquired a watch with a portrait of a General Rudra Shumsher (Fig. 6), who accompanied the Maharajah (Great King) of Nepal, Chandra Shumsher (Fig. 7),

on a much ballyhooed state visit to Britain in 1908, where he met with King Edward VII and Prime Minister Asquith, during a turbulent period in which British Indian governance was undergoing much criticism by leadership of both countries. Chandra praised the British rule, which greatly increased his popularity with his host.

The Chandra dynasty, beginning in the mid-19th century, amassed a fortune by making deals with the British over the recruitment of Gurkha soldiers who helped suppress the Indian mutiny of 1857 and later fought for the British in two World Wars. Chandra Shumsher himself was educated in Kolkata and thus became the first Nepalese Prime Minister who had passed matriculation examination. In the convocation address of 1884, the then Vice Chancellor of Calcutta University praised him as “a gentleman who has shown he can handle pen as efficiently as sword”.

Chandra was the second Nepalese prime minister to visit Britain and tour Europe after Jung Bahadur Rana. In Britain, he stayed in Mortimer House and was entertained by his Majesty Edward VII. He also observed naval exercises of British Royal Navy and in one of the warships he met the French President. On 24 June, the University of Oxford conferred the honoris causa degree of Doctor of Civil Laws on him.

After Chandra's return from the European tour, he instituted some noteworthy reforms in his own country. He abolished “Sati custom” ritual suicide by widows, banned slavery, made it illegal for a person to be killed for witchcraft, and founded the first college of Nepal, Tri-Chandra College. He established hospitals throughout Nepal and started the first railway service, Nepal Government Railway from Raxaul to Amlekhgani in his tenure. Altogether, a remarkable man and great leader of his country he was unknown to me prior to a single watch acquisition. F

FIG. 4. My Rolex Oyster "bubble-back"
FIG. 5
Hans Wilsdorf
Fig 6. My watch with a portrait of General Rudra Shumsher
Fig 7. Maharajah Chandra Shumsher visiting Great Britain in 1908

Henry Ford Macomb Hospital

HENRY FORD HEALTH’S FIRST ROBOTIC MITRAL VALVE REPAIR SURGERY AT HENRY FORD MACOMB HOSPITAL

Congratulations to Dr. Raed Alnajjar and his team, who performed Henry Ford Health’s first robotic mitral valve repair surgery at Henry Ford Macomb Hospital in November. It was the first in the tri-county area of Wayne, Oakland and Macomb. The robotic procedure, available at only a small percentage of hospitals in the country, is done through 5 small incisions and provides the patient with a shorter hospital stay, much quicker recovery, less pain, lower chance of complications and improved cosmetics.

FIRST PULSE FIELD ABLATION IN MACOMB COUNTY TO TREAT ATRIAL FIBRILLATION

In October, Dr. Ali Shakir and the electrophysiology team performed the first pulse field ablation in Macomb County to treat atrial fibrillation.

Pulse field ablation is significantly safer than traditional methods like burning or freezing tissue. It uses electrical pulsations to isolate the areas of the atrium that trigger atrial fibrillation, all while minimizing structural damage. “Atrial fibrillation ablation has been around for many years. This is one of the greatest advancements we’ve had in a long time,” said Dr. Shakir. Congrats to all involved! F

Cost: No cost for MCMS Members (included in membership)

Non-members $50 payable in advance

Registration: HLeach@macombcms.org

OBJECTIVES:

1. E-cigarette and Novel Tobacco Product Education for the Healthcare Provider due to their ingredients and components relating

2. Tobacco usage trends and risk factors

3. Different approaches to addressing tobacco use and cessation treatments for tobacco use disorder in adolescents and adults

4. Review and evaluate methods used to combat vaping in adolescents

MDHHS DIRECTOR HERTEL VISITS MACOMB COUNTY TO HIGHLIGHT SUCCESS OF FAMILY IMPACT TEAMS AIMED AT KEEPING KIDS SAFE IN THEIR HOMES

Michigan Department of Health and Human Services (MDHHS)

Director Elizabeth Hertel recently joined MDHHS staff and clients for a roundtable discussion on the department’s ongoing efforts to improve the safety and well-being of Michigan children through its Family Impact Teams (FIT).

Launched in August 2023 as part of the Keep Kids Safe Action Agenda, FIT is an innovative program that keeps children at risk of neglect safely in their homes by delivering services and assistance to families such as food and housing assistance, Medicaid programs and gas cards.

“I’m proud of the work MDHHS is doing to ensure families are connected to department programs that can help meet their basic needs,” said Elizabeth Hertel, director of MDHHS. “The right economic supports increase the potential for children to remain at home with their parents instead of being placed in foster care. And for those in foster care, providing these economic supports can result in a safer, more stable home environment as we work to reunify children with their parents.”

The FIT approach strengthens collaboration between MDHHS’s Economic Stability Administration – which provides public benefits such as food assistance and Medicaid – and its Children’s Services Administration, which protects children and provides services to their families.

Through FIT, MDHHS family resource specialists engage with families face-to-face, determine their eligibility for assistance programs offered by MDHHS, and refer them to other local agencies that can provide them with resources to meet the families’ needs.

The FIT project has delivered services to more than 4,100 families in 23 counties since its launch in August 2023. In Macomb County, over 215 families have been served through FIT.

The first phase of the project began in August 2023 in Allegan, Barry, Chippewa, Grand Traverse, Kalkaska, Leelanau, Luce,

Mackinac, Oakland, Sanilac, St. Clair and Wayne counties. The second phase of the project began in May 2024 in Berrien, Clare, Delta, Dickinson, Isabella, Macomb, Menominee, Ogemaw, Ottawa, Roscommon and Saginaw counties.

MICHIGAN SELECTED BY CMS AS ONE OF FOUR STATES TO PARTICIPATE IN INNOVATIVE BEHAVIORAL HEALTH MODEL THAT SEEKS TO IMPROVE QUALITY OF CARE, ACCESS AND OUTCOMES

As part of its continuing commitment to improving behavioral health access to care and outcomes, the Michigan Department of Health and Human Services (MDHHS) is participating in the Innovation in Behavioral Health (IBH) Model.

The IBH Model focuses on improving quality of care and behavioral and physical health outcomes for adults enrolled in Medicaid and Medicare with moderate to severe mental health conditions and substance use disorder (SUD). The model will support aligning payment between Medicaid and Medicare for integrated services and improving quality reporting and data sharing. Michigan is one of four states selected by the Centers for Medicare & Medicaid Services (CMS) to participate in the model.

“We are excited to have been chosen by CMS to offer this enhanced level of care to Medicaid beneficiaries seeking treatment for behavioral health issues and substance use disorder,” said Elizabeth Hertel, MDHHS director. “Michigan residents will receive more personalized and integrated care through this model designed to reduce visits to the emergency department, improve behavioral and physical health outcomes and address quality of life needs such as housing, food and transportation.”

Medicaid and Medicare populations experience disproportionately high rates of mental health conditions or SUDs, or both. As a result, they are more likely to experience poor health outcomes such as frequent visits to the emergency department and hospitalizations or premature death. In FY2022, Michigan’s Community Mental Health Service Programs served 178,837 individuals for behavioral health issues; with 12,806 of those individuals receiving substance use services only. An additional 62,691 admissions for SUD services were administered by the state’s 10 Pre-Paid Inpatient Health Plans.

February 12 ~ YesRx – Michigan’s Statewide Cancer Drug Repository Network

MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75

AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/ Retired/Life members.

February 12 ~ Overcome Payer Denials with Successful Appeals

MSMS Practice Management Series, Live Webinar, 1 pm – 2 pm, 1 AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/ Retired/Life members.

March 12 ~ CKD: Nephrologists Perspectives for the PCP

MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75

AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/ Retired/Life members.

March 19 ~ MSMS Advocacy Day: Strengthening the Voice of MI Physicians

In-Person Event, 9 am – 4 pm, Heritage Hall in Lansing. Join MSMS and meet directly with legislators at the Capitol.

March 19 ~ E-Cigarette & Novel Tobacco Product Education for the Healthcare Provider Multi-County Live Webinar, 7 pm – 9 pm, 2 AMA/PRA Category 1 CME Credits. FREE for MCMS members. Register online or email HLeach@macombcms.org

April 9 ~ Peer Review: An Opportunity to Celebrate Quality and Lift Physician Practices

MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75 AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/ Retired/Life members.

May 3 ~ MSMS House of Delegates

In-Person Meeting, 10 am – 5 pm, Crown Plaza Lansing in Lansing.

May 14 ~ A Plethora of New Avenues for Chronic Head and Neck Pain

MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75

AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/ Retired/Life members.

May 16 ~ A Day of Board of Medicine Renewal Requirements

MSMS In-Person Meeting, 8:30 am – 4:45 pm, Holiday & Suites in Troy. Earn the mandated Michigan Board of Medicine CME - all in one day! Conference fulfills: 3-hrs Pain Management, 1-hr. Controlled Substances, 3-hrs DEA MATE Act, 1-hr Medical Ethics, 3-hrs Implicit Bias. 7 AMA/PRA Category 1 CME Credits. Cost: FREE for Active, Active Emeritus, & Resident members; $180 Retired/Emeritus/Life members; $350 for non-members.

June 11 ~ From Pathogen to Patient: A Deep Dive into Gastrointestinal Tract Infectious Disorders

MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75 AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/ Retired/Life members.

continued from page 17

Michigan plans to implement the IBH Model in multiple locations throughout the state in both urban and rural areas, including the Upper Peninsula. Sites will be chosen from among providers who are currently participating in the Certified Community Behavioral Health Clinic demonstration or as a Health Home.

“Michigan’s receipt of this award from CMS underscores and will strengthen Michigan’s innovative community-based approaches to meeting the behavioral health needs of Michiganders. Building on Michigan’s network of Certified Community Behavioral Health Clinics and Behavioral Health Homes – two initiatives led by MDHHS - this newly funded initiative will foster even greater access to and coordination of behavioral health care and other community health and human services for Michiganders enrolled in Medicaid or Medicare,” said Robert Sheehan, Community Mental Health Association of Michigan CEO. “CMHA applauds MDHHS for expanding its partnership with CMS, the latest in a long list of leading-edge behavioral health initiatives.”

Specialty behavioral health providers will screen and assess patients for priority health conditions as well as behavioral health conditions and SUD. Providers will lead an interprofessional care team and be responsible for coordinating with other members of the care team to address patients’ behavioral and physical health and health-related social needs such as housing, food and transportation. Providers will be compensated based on the quality of care provided and improved patient outcomes.

The eight-year model period began Jan. 1, 2025, and consists of a three-year pre-implementation period prior to services starting. MDHHS was awarded $7.5 million by CMS for planning and implementation. F

I N M E M O R I A M

Ralph Alexander Babcock September 25, 1946 – June 14, 2024

Dr. Ralph Alexander Babcock, age 77, passed away on June 14, 2024, in Bluffton, South Carolina. He was born on September 25, 1946. Dr. Babcock, a dedicated physician, served the community as a physician at St. Joseph's Mercy Macomb in Clinton Township, MI before retiring and moving to the Low Country in 2005.

He is survived by his loving wife, Katie Babcock, his children Tobin, Tiffany, Alexandra, Brandon, stepchildren Shelly Ferrelli, Benjamin Neveau, and Heather Segale, and he was a cherished grandfather to six.

A graduate of Wayne State University School of Medicine, Dr. Babcock joined the Macomb County Medical Society and the Michigan State Medical Society in 1991. A Pulmonary Disease specialist, Dr. Babcock touched the lives of many through his medical practice. May he rest in peace. F

Congress Fails to Stop Medicare Payment Cut for Physicians

Despite early reports that an end of year stopgap funding bill would lessen the amount of the Medicare physician reimbursement reduction to 0.3 percent, the final version of the continuing resolution (CR), American Relief Act of 2025 (HR 105450), approved by Congress did not include this adjustment. Therefore, the originally scheduled 2.8 percent cut approved in the 2025 Medicare Physician Fee Schedule (PFS) Final Rule took effect on January 1, 2025.

By failing to address this issue, Congress has, for the fifth consecutive year, allowed physicians’ reimbursement under Medicare to be cut. Inclusive of this current reduction, Medicare rates have fallen 33 percent over the past two decades when adjusted for inflation in practice costs.

The impact of these cuts doesn’t only affect physicians’ Medicare business. As Michigan State Medical Society (MSMS) Chief Executive Officer Tom M. George, MD, stated in MSMS’s comments on the 2025 Medicare PFS proposed rule, “It is also important to note that this negative impact has a broader impact as many states like Michigan use Medicare as the benchmark for reimbursement in other areas such as worker’s compensation, motor vehicle injuries, surprise billing, etc. Therefore, when Medicare payments continue to decline, so do payments in other areas of practice.”

Of note, the final CR includes a temporary extension of telehealth flexibilities through March 31, 2025. They include the following:

• Allowing all Medicare beneficiaries to receive telehealth services from any location, including the beneficiary’s home.

• Extending telehealth services for federally qualified health centers and rural health centers.

• Delaying in-person requirements for mental health telehealth.

• Allowing audio-only telehealth services.

Advocating for Congress to make long-term meaningful reforms to the Medicare payment system has been and will continue to be a top priority in 2025. There are several solutions such as annual inflationary increases that have gained traction with many legislators. It will be critical to broaden this support in the new year and stop the annual payment cuts, financial uncertainties, and end-of-year negotiations for temporary fixes.

Because the American Relief Act of 2025 only provides fiscal year 2025 appropriations to Federal agencies through March 14, 2025, Congress will have to act during the next couple of months to avert a government shutdown. MSMS and MCMS will be advocating that a reversal of the Medicare cut, longterm payment relief, and a permanent extension of the current telehealth flexibilities be included in the next spending bill. F

CME Requirements for Licensure

Every three years physicians are required to complete the following continuing education for license renewal.

150 hr. Continuing Medical Education

75 hr. of which must be Category 1 CME credits for MDs

60 hr. of which must be Category 1 CME credits for DOs

3 hr. Pain & Symptom Management

with 1 hr. Controlled Substance Prescribing

1 hr. Medical Ethics

3 hr. Implicit Bias for renewals after June 1, 2024

Separate from CME

One time – training for Identifying Human Trafficking Victims

One time – training for Opioids & Controlled Substances Awareness for Prescribers

One time – the Medication Access and Training Expansion (MATE) Act, requires DEA registered prescribers to have 8 hrs. training in opioid use disorders

EXCITING NEW MSMS MEMBER BENEFIT – FREE CME

The Michigan State Medical Society is excited to announce a significant enhancement to the benefits of membership. Beginning December 2, 2024, the Michigan State Medical Society (MSMS) will offer FREE Continuing Medical Education (CME) to all active members*.

MSMS aims to support the professional development of all Michigan physicians and ensure access to the latest medical knowledge and practices. MSMS offers a diverse range of educational offerings to help physicians stay informed and compliant with all licensure requirements in an ever-evolving health care landscape. This new membership benefit provides a value of more than $8,000. MSMS invites you to deepen your impact and become engaged in the dynamic changes taking place in Michigan's medical landscape by becoming a member of MSMS.

“MSMS has always prioritized physician growth and education, I encourage you to take advantage of this opportunity for FREE CME. Whether you are a long-time member or considering membership, MSMS is here to support your journey as a physician.”

– Tom George, MD and Chief Executive Officer of MSMS

Every physician in Michigan can make the most of this exciting new benefit by joining the Michigan State Medical Society today!

Click here or Call 517-336-5716 to enjoy the privileges of membership in the Michigan State Medical Society.

*Free CME began 12/2/24, no refunds on any CME, including webinars, courses, training, online or in-person events registered for prior to 12/2/2024.

SPECIAL MESSAGE FROM MSMS PRESIDENT MARK C. KOMOROWSKI, MD

Yes, Virginia, there is a Santa Claus, but the miracle was not on 34th Street; rather, it was at 1305 Abbott Road, East Lansing, Michigan. Despite having downsized our staff, what did not diminish was the intensity of our advocacy efforts. MSMS, led by CEO Tom George, MD, along with his dedicated staff, successfully thwarted last-minute attempts by both Chambers of the

Michigan Legislature to increase the caps on non-economic tort damages during the time-limited lame-duck session.

Between mid-November to mid-December, MSMS spearheaded a coalition of like-minded partner organizations and orchestrated a winning strategy to defeat HB 6085 and SB 1158. MSMS analyzed the bills, activated its grassroots network of physician members through legislative alerts, and coordinated outreach to key legislators. Despite being limited to only three minutes of testimony against the bills in committee, MSMS successfully coordinated the submission of over 100 opposition cards, compared to only five cards in support.

County Medical Societies, Physician Organizations, and hospital medical staff sections rose to the occasion. They recirculated the MSMS alerts, contextualizing them for their own members, further amplifying legislative outreach efforts.

The common thread driving this success can be summarized in one word, “engagement.” These engagement efforts resulted in the legislation’s demise as the session ended.

Have you asked yourself what would have been the consequences if the bills had passed? According to the Doctors Company, which insures 5,500 Michigan physicians, liability insurance premiums were estimated to increase by 37%. Could your practice sustain such an increase?

In contrast, MSMS membership and contributions to MDPAC represent a small yet critical investment. Much like homeowners or life insurance, these investments protect our ability to practice medicine. We need a strong MSMS to defend us against ongoing assaults on our profession.

The trial attorneys’ super PAC, Justice for All, has raised and spent over $10 million on Michigan Supreme Court races alone since 2020. Meanwhile, MDPAC raises less than $50,000 annually from our members.

A spectacular way to start the new year would be to urge a non-member colleague to join MSMS and to encourage every member to contribute $300 to MDPAC. The results MSMS achieves clearly demonstrate that this investment is money well spent.

MSMS HAS A NEW PREFERRED PARTNER PROGRAM

The Preferred Partner Program was created to identify and partner with high-quality,innovative organizations that are committed to providing value and resources to physicians in Michigan.

The mission is to provide high-quality, cost-effective solutions for our membership. Preferred Partners must be committed to MSMS members, meet high-quality standards, and offer products or services that help achieve the following: increase revenue; reduce operating/capital costs; improve quality; increase productivity and continued on page 21

continued from page 20

resources, and/or deliver new strategies and technology for health care in Michigan.

Below you will find the categories of products and services MSMS has or is currently pursuing partnership with for MSMS members.

· Accounting · Legal Services

· Actuarial Services

· Behavioral Health

· Billing

· Chronic Care Management

· Coding/Charting

· Electronic Medical Record

· Human Resources

· Insurance & Sub-Insurance

· Patient Engagement

· Peer Review

· Pharmacy Solutions

· Remote Patient Monitoring

· Revenue Cycle

· Telehealth

· Venture Capital

· Workforce Solutions

For more information or help in any of these areas, please contact Rebecca Blake at rblake@msms.org or 517-336-5729.

2025 MSMS HOUSE OF DELEGATES MEETING

The House of Delegates is the official policy-making body of the Michigan State Medical Society. Resolutions and Board Action Reports are the vehicles used to debate and determine the policies, priorities, and direction of MSMS during the ensuing 12 months and beyond. This year’s meeting will be held on Saturday, May 3, 2025, from 10:00 am – 4:00 pm, at the Crowne Plaza, in Lansing. Resolutions are due by March 3, 2025. The Reference Committee Meetings will be held virtually in the weeks leading up to the House of Delegates meeting. They will each be held on a different evening during the weeks of April 14 and April 21, from 6 pm – 8 pm, allowing you to attend more

than one if you choose. If you are interested in serving on a Reference Committee, please email Carrie Wheeler at cwheeler@msms.org

For more information on the House of Delegates, please visit www.msms.org/hod or contact Rebecca Blake at rblake@msms.org or 517-336-5729 or Carrie Wheeler at cwheeler@msms.org or 517-336-5723.

Stay tuned for additional updates regarding the House.

MSMS PHYSICIANS INSURANCE AGENCY (PIA) NOW OFFERS OTHER MAJOR HEALTH INSURANCE OPTIONS

MSMS Physicians Insurance Agency is ready to assist physician practices with group health insurance in 2025. Practices have been experiencing double digit increases with some group health insurance carriers.

Physicians Insurance Agency can provide competitive rates for all major health insurance companies in Michigan, let us quote you several options. PIA has decades of experience; our agents can provide counsel on how to maximize coverage and save on premiums. Plus, PIA will provide assistance with billing, service, and coverage needs.

Like your Current Policies? Through an “Agent of Record” change, you can keep the same policy and allow PIA to service your group. Receive MSMS level customer service while supporting the work of MSMS.

To request a quote contact Angela Criswell at 517-336-5734 or acriswell@msms.org F

We appreciate you continued support and want to remind you to pay your dues before March 1 to prevent a lapse in membership.

Why Membership Matters

Whether you’re a solo practitioner, member of a group practice, or employed by a health care system, the Macomb County Medical Society is focused exclusively on advocating for our local physician members, across a wide-range of specialties. From federal legislative and regulatory issues, to state and local ordinances, to payor relations and public health concerns, external forces are continuously impacting your practice and your patients. We recognize there is strength in numbers and we provide a unified voice for physicians.

There are three easy ways to renew:

1. Online at www.msms.org/renew

2. Call your MSMS Account Specialist, Christina Spitzley, at 517-336-5762

3. Print the invoice from your account record and fax it to 517-336-5716

CONGRESS ALLOWS MEDICARE CUTS FOR PHYSICIANS STARTING JAN. 1

On Dec. 20, President Biden signed a stopgap continuing resolution, the American Relief Act (HR 10545), a year-end legislative package designed to keep the government funded until March 14, 2025.

This legislation included extensions for various expiring health care programs until either mid- or late March, such as pandemic-era telehealth waivers, the National Health Service Corps, the Teaching Health Center Graduate Medical Education Program, community health centers, the special diabetes program, the geographic practice cost index (GPCI) work adjustment, and the hospital-at-home initiative.

However, the legislation did not include relief from Medicare physician payment cuts. An earlier draft of the year-end package had proposed mitigating 2.5% of the planned cuts to Medicare physician payments in 2025. Despite initial bipartisan support, this proposal was ultimately dropped due to political pressure and broader concerns about government spending. As a result, the scaled-down spending package passed without addressing these payment reductions.

As of Jan. 1, 2025, physicians are facing a 2.83% reduction in payments under the 2025 Medicare Physician Payment Final Rule. This cut marks the fifth consecutive year that physicians have endured reductions in Medicare payments, exacerbating long-standing financial pressures on medical practices.

2024 AMA OVERDOSE REPORT HIGHLIGHTS NATIONAL ACTIONS AND STATE-BY-STATE DATA

The AMA recently released its 2024 Overdose Epidemic Report, showing progress in harm reduction services and policy promoting evidence-based care, but underscoring ongoing challenges as the nation’s drug overdose epidemic continues at near-historic levels. The AMA welcomes recent data showing decreases in drug-related mortality, but as the 2024 report shows, there are many actions that still need to be taken to save lives and improve outcomes for individuals with a substance use disorder or pain.

In addition to the national data cited in the report, the AMA created detailed state-by-state charts to enable medical societies to highlight specific, state-level trends to policymakers and public health officials. These trends emphasize—once again— that to reduce mortality and improve outcomes, policies must remove barriers to evidence-based care rather than focus only on restrictions and mandates. The national data show:

• Opioid prescriptions have decreased by 51.7% since 2012. State-level decreases from 2012-2023 ranged between 36 to 68%. [See chart for state-by-state level data]

• State prescription drug monitoring programs were used more than 1.4 billion times in 2023, a staggering increase since 2014 when they were used only 61 million times.

[See chart for state-by-state level data]

• Buprenorphine dispensed from retail pharmacies appears to have plateaued, likely due to a variety of factors including longer prescriptions, pharmacy reluctance to stock the medication, and confusion/fear over DEA suspicious order requirements. [See chart for state-bystate level data]

Compounding this issue, the Centers for Medicare & Medicaid Services (CMS) projects that the Medicare Economic Index (MEI), which measures the cost of delivering care, will increase by 3.5% in 2025. Given this growing disparity between Medicare payment rates and the rising costs of providing care, the AMA has renewed the urgent call for Congress to reverse the new cuts as soon as possible and implement a payment update that reflects inflationary pressures.

With the gap between reimbursement rates and the cost of care continuing to widen, the AMA and other physician advocacy groups argue that these annual payment reductions jeopardize access to quality care for Medicare beneficiaries and threaten the financial stability of medical practices across the nation. For more information and resources to take action, visit the AMA’s Fix Medicare Now website.

• Naloxone dispensed from retail pharmacies continues to grow. From 2018 to 2023, naloxone prescriptions increased from about 555,000 to nearly 2.2 million prescriptions. [See chart for state-by-state level data]

“Half-measures and outdated policies are costing lives, and we urge policymakers to act,” said Bobby Mukkamala, MD, AMA president-elect and chair of the AMA Substance Use and Pain Care Task Force. “With thousands of families and communities devastated by overdose deaths, the time for incremental change has passed. We need unwavering commitment to expand access to lifesaving medications, enforce parity laws, and address the glaring gaps in harm reduction. We cannot stand by as outdated policies and insurance barriers prevent patients from accessing evidence-based care.”

The report presents a national view of the epidemic, highlights multiple best practices, and provides detailed explanations and specific policy recommendations for state and federal policymakers, including:

• Meaningful enforcement of state and federal mental health and substance use disorder parity laws

continued on page 23

• Increased access to medications for opioid use disorder (MOUD) through efforts such as removing outdated prior authorization dosage requirements for buprenorphine, authorizing methadone to be prescribed outside of Opioid Treatment Program settings, and having the DEA remove buprenorphine from its suspicious order reporting requirements until further notice

• Eliminating punitive policies against pregnant and parenting individuals who rely on MOUD

• Removing harmful, one-size-fits-all restrictions on opioid therapy that contradict policies by the U.S. Centers for Disease Control and Prevention and the Federation of State Medical Boards

• Requiring payers to increase access to non-opioid, multi-modal pain care options

• Increasing access to naloxone in pharmacies, schools, universities and public settings

• Supporting efforts to fund and make other evidencebased harm reduction initiatives more widely available, including syringe services programs and overdose prevention centers

“The AMA, our Substance Use and Pain Care Task Force, and the nation's physicians continue to urge policymakers, health insurance companies and other payers to once and for all remove barriers to evidence-based treatment for substance use disorders, pain care and harm reduction initiatives,” said Dr. Mukkamala. “Delays or denials of this care only results in increased suffering and death. Ending the epidemic is possible, but much more work must be done.”

OCR ISSUES NEW PROPOSED REGULATION WITH UPDATES TO THE HIPAA SECURITY RULE

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published a new proposed regulation that modifies the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule.

OCR is endeavoring to further strengthen cybersecurity protections for electronic protected health information (ePHI) by covered entities (most health care providers, health plans, and health care clearinghouses), and their business associates. The HIPAA Security Rule was initially published in 2003 and most recently revised in 2013.

In light of the ever-increasing cybersecurity threats facing the health care sector, OCR is proposing several updates to the Security Rule’s standards. OCR proposes that Covered Entities and Business Associates provide greater specificity when conducting their security risk analysis, including a written assessment that contains identification of all reasonably anticipated threats to the confidentiality, integrity, and availability of ePHI. The proposal also includes new requirements for planning for contingencies and responding to security

incidents, including establishing written procedures to restore the loss of certain relevant electronic information systems and data within 72 hours. In addition, the regulation requires encryption of ePHI, the use of multi-factor authentication, and vulnerability scanning at least every six months and penetration testing at least once every 12 months.

The AMA is reviewing this proposed regulation. Many of the changes proposed by OCR would be extremely challenging for many physician practices to adopt. Public comments are due by March 7, 2025.

OFFICE OF CIVIL RIGHTS RELEASES GUIDANCE ON USE OF AI-ENABLED LANGUAGE ASSISTANCE SERVICES

HHS’ Office of Civil Rights (OCR) recently released new guidance for physicians and other health care professionals regarding the use of language assistance services for patients with limited English proficiency (LEP). Included in the “Dear Colleague” letter is guidance to health care professionals regarding the use of AI-enabled language assistance services. The guidance follows the finalization of the Section 1557 Non-Discrimination Rule, which implements, among other policies, a new prohibition on discrimination by clinical algorithms (including those utilizing augmented intelligence (AI)) and creates new burdens on health care professionals to make reasonable efforts to ensure clinical algorithms they may use do not result in discriminatory harms. The rule also creates new requirements to ensure meaningful access to care for patients whose primary language for communication is not English and who have a limited ability to read, write, speak or understand English.

The new guidance requires entities that use “machine translation” for critical documents to ensure that those documents are reviewed by a qualified human reviewer. Documents that will require this human review include documents where “accuracy is essential,” “when the source documents or materials contain complex, nonliteral or technical language,” or “when the underlying text is critical to the rights, benefits, or meaningful access” of individuals with LEP.

The guidance also notes some exceptions. Situations where a patient must receive urgent or emergent care will not require review by a qualified human reviewer. Human review will also not be required where the risk of translation errors to the patient is low, although in these cases, the guidance notes the patient should be warned that the translation in question may contain errors.

The OCR guidance is one of the first guidance documents to require the human review of AI-enabled outputs in a health care setting. The AMA is closely monitoring the implementation of new regulations impacting the use of AI in clinical practice. The AMA strongly supports prohibitions on discrimination by AI but is working to ensure physician liability for AI output errors is limited. F

MACOMB FOOD PROGRAM

Provides immediate relief to those in need of food through a network of more than 70 pantry sites, hunger relief organizations, and the Fresh To You Mobile Pantry. The program supplies food at no cost to income eligible seniors and families with children throughout Macomb County. For more information visit the Macomb Food Program website or call (586) 469-6004.

RENT AND MORTGAGE ASSISTANCE

Income-eligible Macomb County residents facing eviction, foreclosure, or homelessness may be assisted in resolving their emergency. Eligibility and guidelines will vary based on available programs. For more information contact your local Community Action Center at (586) 469-6964. For residents of Warren, Roseville, Eastpointe or Centerline call (586) 759-9150.

UTILITY ASSISTANCE - ELECTRICITY, GAS

Income eligible Macomb County residents facing utility shut off may be assisted in resolving their emergency. Utility assistance may be available for electric service, natural gas service, and deliverable fuels used to heat the home. Eligibility and guidelines will vary based on available programs. For more information contact your local Community Action Center at (586) 469-6964. For residents of Warren, Roseville, Eastpointe or Centerline call (586) 759-9150.

WATER RESIDENTIAL ASSISTANCE PROGRAM (WRAP)

Eligible households are offered credits on their water and sewer bills so that they pay no more than 3% of their household's annual income for up to two years. Eligible seniors and permanently disabled persons can obtain bill credit assistance without an expiration date.

To qualify for WRAP, households must be in a community in the service area, have a combined income at or below 200% of the federal poverty level, be primarily responsible for the water or sewer bill and have to reside in the home they rent or own. For more information and to apply visit the Macomb Community Action’s website or call (586) 469-6464.

TRANSPORTATION ASSISTANCE

This department provides transportation to essential medical appointments and other specific locations for eligible Macomb County residents. For more information visit Macomb Community Action’s website or call (586) 469-5225.

MYRIDE2 - CONNECTING SENIORS & ADULTS WITH

DISABILITIES TO RIDES

AgeWays (formerly Area Agency on Aging) MyRide2 service can help find transportation options for seniors and adults with disabilities – helping them get to the store, to doctor’s appointments, or out to visit friends and family. Myride2 is a transportation concierge service that arranges transportation from start to finish. There is no charge for arranging transportation through myride2, but there may be a cost for any transportation services they use. Payments are made directly to transportation providers. For more information visit MyRide2 website or call (855) 679-4332.

Macomb County Assistance Programs for Your Patients

In this tough economy many of your patients may be struggling to meet their basic needs as well as those of their families.

There are programs available to help. Below are some resources you can direct your patients to for assistance.

HOME INJURY PREVENTION

The Home Injury Prevention Program installs devices to ensure safety and prevent falls in the homes of eligible Macomb County seniors. A home assessment determines which safety devices will be installed. Services are free but contributions are appreciated. For more information visit Macomb Community Action’s website or call (586) 469-6329.

HOUSING REHABILITATION

The Housing Rehabilitation Program provides assistance to eligible homeowners to repair their homes to achieve decent, safe and sanitary housing. Assistance is provided in the form of a no-interest loan. For more information visit Macomb Community Action’s website or call (586) 466-6256.

WEATHERIZATION ASSISTANCE

The Weatherization Assistance Program performs the installation of energy efficient items to conserve energy in Macomb County homes. These improvements reduce energy use and can save an average of 30% on heat and utility bills. A home energy audit determines which items will be installed. Services are free for income-eligible residents. For more information visit Macomb Community Action’s website or call (586) 469-6329.

WARMING & COOLING CENTERS

There are places across Macomb County where individuals can find respite from the extreme heat and cold. For a full list visit Macomb Community Action’s website.

DIRECT CARE PROGRAMS – TO HELP SENIORS

STAY LIVING AT HOME

Home care services help seniors and people with disabilities continue to live safely in a home setting. These services provide assistance with daily activities a senior might have trouble doing for themselves – things like bathing, dressing, meal preparation or housekeeping. AgeWays (formerly the Area Agency on Aging) has several programs that offer direct care for Southeast Michigan families. For more information visit the AgeWays website or call (800) 852-7795.

PROGRAMS OFFERED SPECIFICALLY FOR SENIOR THROUGH MACOMB COUNTY SENIOR SERVICES

The following programs are offered to Macomb County residents age 60 or older. For more information on any of these services visit the Macomb County Senior Services website or call (586) 469-5228

ADULT DAY CENTER

Provides daytime assistance for aging adults in need of structured activities, exercise, and supervision. The credentialed center can provide caregivers with a needed break while giving older adults a chance to socialize with their peers and remedy the isolation and loneliness many experience. For more information call (586) 469-5580.

FRIENDLY CALLER

Program volunteers reach out over the phone to connect with seniors interested in a friendly social conversation. It’s an informal social call that can last anywhere from 10 minutes to 30 minutes depending on interest and natural flow of conversation.

HANDY HELPERS

Provides assistance with household maintenance tasks such as replacing light bulbs or faucets, washing windows and walls, repairing furniture, pest control, yard clean up, leaf raking, weatherizing, and more.

RESOURCE ADVOCACY

Provides consultation for seniors to assess needs, recommend services and assist with tax credits, Medicare Part D enrollment, Medicaid application process, community resources, and more.

NUTRITION ASSISTANCE

DINING SENIOR STYLE

A daily lunch program for seniors at 24 locations throughout Macomb County. Seniors are provided a well-balanced meal while also socializing with their peers.

MEALS ON WHEELS

Delivers a ready to eat meal to homebound residents no longer able to leave their homes on a regular basis without assistance or able to prepare meals.

ENSURE PLUS PROGRAM

Meals on Wheels offers cans of Ensure Plus as a supplement for Macomb County’s most vulnerable homebound seniors with a prescription from their physician for Ensure Plus.

HOLIDAY MEALS ON WHEELS

Holiday meals are available for seniors who would be otherwise home alone on the holiday. A special hot lunch is freshly prepared that day, including many traditional favorites. Meal delivery is available for Easter, Thanksgiving, and Christmas.

SENIOR PROJECT FRESH COUPONS

Offers income-eligible seniors the chance to purchase fresh produce such as carrots, tomatoes, melon, and even honey. Seniors who participate will receive a $20 coupon book to use at local farmers' markets and stands.

Macomb County Health Department Reportable Diseases Summary

Diseases Reported in Macomb County Residents*

Cumulative total for previous years, year-to-date total for December 2024 b

*Includes both Probable and Confirmed case reports. ZIKA

**Shiga-toxin producing Escherichia coli per MDHHS; combo of E. coli & Shiga Toxin 1 or 2.

^ Previously reported as "AIDS"

b 2024 total is tentative at this time.

2024 Michigan Legislative Wrap-Up

The 2023-2024 legislative session came to an end not with sweeping labor or environmental reform but with infighting and finger-pointing and virtually no major policy items advanced. House Republicans staged a walkout midway through the lame duck session and didn’t return until sine die, the procedural end to the term. House Democrats were not able to agree to a cohesive agenda resulting in the inability to garner 56 votes on all but the most benign bills. Ultimately, the House “threw in the towel” on December 19. The Senate remained in Session for a marathon 29 hours starting December 19 and finally adjourning for the year December 20, advancing as many Democratic priorities as they could.

Bills that ultimately did not make it to the Governor’s desk include: changes to medical liability laws, nurse staffing ratios, protections for the 340B drug pricing program, tobacco licensure laws, expanding scope of practice for nurse practitioners, requiring the use of the Electronic Death Registry System for death certificates, changes to direct access for physical therapy services, and the repeal of the sunset for the Interstate Medical Licensure Compact.

For a list of healthcare-related bills that were signed into law during the 102nd Legislature (2023-2024), click here

The MCMS would like to thank all of the physicians who contacted their legislators in opposition of the medical liability reform laws (HBs 6085-6086 & SBs 1158-1159) and participated in our emergency tri-county virtual meeting with legislators on December 9. Our efforts helped prevent an estimated 37% increase in liability insurance premiums that would have had disastrous consequences for healthcare in Michigan. When we work together we can accomplish great things!

Tri-County Legislative Committee

Lawmakers want and need to hear from professionals in the field of medicine!

The Tri-County Legislative Committee meets quarterly with legislators. These meetings provide an open forum for physicians to engage directly with legislators who are often seeking physician input and education on healthcare related legislation. Anyone interested in joining the Committee please contact Heidi Leach at HLeach@macombcms.org.

MICHIGAN SENATE

Sen. Stephanie Chang (D)

Senate District 3

SenSChang@senate.michigan.gov (517) 373-7346

Sen. Kevin Hertel (D)

Senate District 12

SenKHertel@senate.michigan.gov (517) 373-7315

Sen. Ruth Johnson (R) Senate District 24

SenRJohnson@senate.michigan.gov (517) 373-1636

Sen. Veronica Klinefelt (D) Senate District 11

SenVKlinefelt@senate.michigan.gov (517) 373-7670

Sen. Daniel Lauwers (R) Senate District 25

SenDLauwers@senate.michigan.gov (517) 373-7708

Sen. Michael Webber (R) Senate District 9

SenMWebber@senate.michigan.gov (517) 373-0994

Sen. Paul Wojno (D) Senate District 10 SenPWojno@senate.michigan.gov (517) 373-8360

COMMITTEES

Senate – Appropriations

Kevin Hertel (D), District 12

Veronica Klinefelt (D), District 11

2025 Macomb County Legislator Contact Guide

MICHIGAN HOUSE

Rep. Joseph Aragona (R) House District 60

JosephAragona@house.mi.gov (517) 373-1785

Rep. Jay DeBoyer (R) House District 63 JayDeBoyer@house.mi.gov (517) 373-1787

Rep. Kimberly Edwards (D) House District 12 KimberlyEdwards@house.mi.gov (517) 373-0852

Senate – Health Policy

Kevin Hertel (D), District 12

Veronica Klinefelt (D), District 11

Michael Webber (R), District 9

Paul Wojno (D), District 10

Rep. Jaime Greene (R) House District 65 JaimeGreene@house.mi.gov (517) 373-1775

Rep. Thomas Kuhn (R) House District 57 TomKuhn@house.mi.gov (517) 373-1706

Rep. Mike McFall (D) House District 14 MikeMcFall@house.mi.gov (517) 373-0140

Senate – Regulatory Affairs

Kevin Hertel (D), District 12

Dan Lauwers (R), District 25

Michael Webber (R), District 9

Paul Wojno (D), District 10

Rep. Donavan McKinney (D)

House District 11

DonavanMcKinney@house.mi.gov (517) 373-0849

Rep. Denise Mentzer (D) House District 61

DeniseMentzer@house.mi.gov (517) 373-1774

Rep. Ron Robinson (R) House District 58

RonRobinson@house.mi.gov (517) 373-1794

Rep. Josh Schriver (R) House District 66

JoshSchriver@house.mi.gov (517) 373-0839

Rep. Alicia St. Germaine (R) House District 62

AliciaStGermaine@house.mi.gov (517) 373-0555

Rep. Douglas Wozniak (R) House District 59

DouglasWozniak@house.mi.gov (517) 373-0832

Rep. Mai Xiong (D) House District 13

MaiXiong@house.mi.gov (517) 373-0845

HOUSE

COMMITTEES TO BE ANNOUNCED

Macomb Medicus Journal of the Macomb County Medical Society

The Macomb Medicus is the official quarterly journal of the Macomb County Medical Society. It is a full-color glossy magazine published both electronically and in hard copy format. It is a valued news source for our 600 plus physician members of all specialties and their staff throughout Macomb County. In addition to members the Macomb Medicus is sent to hospital executives, Michigan State Medical Society staff, other county medical society staff, and healthcare related businesses/organizations in Macomb County. The Macomb Medicus is read by an impressive cross section of the healthcare community and is electronically available on our website at www.macombcms.org. FREE Hotlink to Your Website & Free Advertising Design! For advertising rates and information, please contact: Heidi Leach, Executive Director & Managing Editor Macomb County Medical Society, PO Box 551, 810-712-2546 HLeach@macombcms.org | www.macombcms.org

County Medical Society

Macomb

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