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Volume 23, Number 4
Imaging clinic expands into a new space and with new patient-centered technologies Henry Dalsania, M.D.
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Internal Mediciine and Multispecialty Clinic • Cardiology • Endocrinology • Infectious Disease
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Editorial Thomas C. Gettelfinger, M.D. Managing Editor Allison Cook 2019 Board of Directors President Jimmie Mancell, M.D.
Inside This Issue Volume 23, Number 4
President-Elect Danielle Hinton Hassel, M.D. Vice President Justin Monroe, M.D. Secretary Christopher M. Pokabla, M.D. Treasurer David L. Cannon, M.D. Immediate Past President Autry J. Parker, M.D. Board Members W. Clay Jackson, M.D., DipTh Walter Rayford, PhD, M.D., MBA Paul Tackett, M.D. Lisa S. Usdan, M.D. Lindi Vanderwalde, M.D. Raymond R. Walker, M.D. Andrew Watson, M.D. Catherine Womack, M.D. JoAnn Phillips Wood, M.D. Ex-Officio Board Members LaTonya Washington, M.D., President of Bluff City Medical Society Karen Adams, President of MidSouth MGMA
3 5 8 9 10 14 16 18 21 22 25 26 27 28
Editorial Presidentâ€™s Letter Membership News Your Benefits Hospital Updates Spotlight: John L. Jefferies, M.D., MPH Feature Legislation Financial Q&A Community Work Research Practice In Training Bulletin
Cover: Henry Dalsania, M.D.
The Memphis Medical Society Quarterly
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Living To Be 100...And Happy Would you really want to? Then what’s your strategy? Aleksandar Jankov, oncologist with Baptist Medical Group brought the issue to The Memphis Journal Review Club at a recent meeting: How To Live To Be 100. The thesis: people are happier as they get older, so why not hang on as long as you can, enjoy the ride. He began with graphs, age versus happiness, mostly from the Brookings Institute, showing a U shape curve, trough at age 42, the low point of happiness, increasing thereafter, better and better with age. It’s not the young who are happiest, despite how we venerate youth in our society, in our advertising, in our memory. By this count, we’re happiest in old age. This of course is predicated on maintaining good health and, no surprise, good finances. Yes money is a strong correlate with health and longevity, not necessarily extreme wealth, but enough to meet basic needs. That presumes you don’t compare yourself to hedge fund managers, real estate magnates, tech company billionaires, colleagues in those high income specialties, a sure road to making yourself miserable. What interested me most was what came next: the importance of fasting in keeping good health, something new to me. So to help control weight, avoid diabetes and hypertenson…fast. However you do it, periodic fasting, fasting 12-14 hours every day (for example, skip breakfast, heresy in itself), fast enough to keep glycogen stores low, keeping blood sugar under control, avoiding hyperglycemia. It’s more complicated than that, but you may get the gist of the argument, sugar loads are the culprit. Well, you might suspect that not everyone agrees. Cardiologist Frank McGrew sticks to known facts, the party line: exercise to improve vascular tone, diet, avoid red meat, egg yolks, refined sugar, take statins to lower cholesterol level, themselves a revolution in reducing myocardial infarction, add newly approved viscera to lower triglycerides. He finds no support in the cardiovascular literature for a fasting strategy. Winter 2019-2020
And the venerable Ann Landers surveyed her readers years ago, and found people happiest in middle age, children gone, settled life style, not old age as Brookings says. So sure, exercise, like Mike Dragutsky in his home gym, luxurious, only surpassed in size by his wine cellar (red wine and health, that’s another story), or like Oakley Jordan, out to the gym by 6:30 in the morning, or Bob Skinner, counting steps on his watch, walking the downtown parks on weekends. Live to 100? From what I’ve seen in nursing homes, that may not be for me. But watch your diet. Exercise. And for my money…fast. I’ve done it anyway, a lifelong habit of no breakfast. And one more note. This thread all started at a Journal Review Club meeting. I noticed that the members, all doctors, when confronted with the choice of fish or red meat…70% went with the meat. What’s your opinion? Diet? Exercise? Genetics? Fast? Let us know: firstname.lastname@example.org, email@example.com.
Thomas C. Gettelfinger, M.D. 3
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Dear colleagues, This holiday season reminded me of gratitude. I want to take this moment and thank each and every one of you for your support of the Memphis Medical Society. Without it, we simply could not continue our mission. Furthermore, I am grateful for the care you provide in our communities each and every day. Curing some, healing others but always CARING. Caring and kindness are attributes of our profession we must never sacrifice. I am confident all of you could recite Hippocrates’ most famous oath- primum non nocere. There is another which I’ve held with a deep sense to our profession and have impressed upon our residents and medical students- “some patients though conscious their condition is perilous, recover their health simply through the contentment with the goodness of the physician.” In our current climate of societal and political “illness”, I pray we see more of our professional attributes leading to some much needed healing. May your new year be joyous with friends and family. With warmest regards, I remain,
Jimmie Mancell, M.D. Chief of Medicine and Assoc. Dean for Clinical Affairs President, UT Methodist Physicians Assoc. Professor, Dept. of Medicine, UTHSC Team Physician, Memphis Grizzlies
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Membership News Methodist Le Bonheur Healthcare Purchases Saint Francis Hospitals and Practices Methodist Le Bonheur Healthcare announced today that it has entered into a definitive agreement with Tenet Healthcare to purchase Saint Francis Hospital – Bartlett and Saint Francis Hospital – Memphis. The purchase includes the physician practices associated with both hospitals and six MedPost urgent care centers. This will give Methodist the ability to serve more members of the community. “Consistent with our mission, the addition of Saint Francis hospitals will increase access to high quality healthcare, expand services and enhance the delivery of care to improve the overall health of the communities we serve,” said Michael Ugwueke, President & CEO of Methodist Le Bonheur Healthcare. This transaction will deliver tremendous benefits to patients and the communities served by Saint Francis and Methodist Le Bonheur, including: Expanded clinical expertise across our system of primary, acute, and specialty care, and increased focus on high quality, efficient care for patients with chronic and complex conditions;
“We look forward to creating a more dynamic team of physicians, nurses and staff dedicated to delivering compassionate high-quality care to anyone who walks through our doors, regardless of their ability to pay,” said Ugwueke. “We have the highest respect for Methodist Le Bonheur, and we are pleased that our facilities will become part of this regional system,” said Sally Deitch, CEO of Saint Francis Healthcare. “Like Saint Francis and Tenet, Methodist Le Bonheur promotes a culture of compassion backed by strong core values and a clear commitment to patient-centered care. We believe this combination will provide the communities we serve with an even greater impact on care delivered.” The transaction is expected to be completed in 2020, subject to regulatory approvals and customary closing conditions. J.P. Morgan served as financial advisor to Methodist Le Bonheur Healthcare in connection with the transaction.
Acceleration of plans to establish the Methodist Cancer Institute to provide comprehensive care and treatment of cancer; Increased investment in medical technologies and innovative approaches to healthcare; Developing for policies that improve health outcomes for members of our communities; Enhanced ability to provide additional charity care, philanthropic support and healthcare educational programs designed to address the specific needs of the communities we serve.
The Memphis Medical Society Quarterly
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Our Top Ten Highlights of 2019 From Your President 2019 has been another year of growth for Memphis Medical Society and its associated entities. Please read on for a recap of those moments and what’s to come in 2020, most notably our President’s Gala on Saturday, January 25th, 6:00 p.m., at Shelby Farms Park. Thank you to all our members, staff, friends, and partners that made this year a rousing success.
We received transformational leadership from our medical student chapter leaders this year. The charge was led from Memphis by UTHSC students to increase Graduate Medical Education funding. What’s next? The Society is researching solutions to soften the student loan debt of our members, no matter their career stage.
Our 2019 re-imagined President’s Gala ended a fantastic presidency for Dr. Autry Parker, allowing me to take the reins of our 142-year old organization. Thank you again, Dr. Parker, for your continued service. What’s next? I hand over the reins to our new President, Dr. Danielle Hassel at President’s Gala 2020. All members need to attend so that we can showcase all the Society’s accomplishments. More than 50 physicians and friends attended, our annual Day on the Hill along with hundreds of other physicians from across the state. Join us on March 25, 2020.
We continued our partnership with Tennessee Medical Association and closed one of our most successful legislative sessions ever, combating issues like scope of practice, opioids and balance billing.
We continued to improve our online presence at mdmemphis.org, which includes a searchable member directory, blog, appointment bookings with select members, and a complete events calendar. What’s next? We will be able to provide data and guidance to our members regarding online presences and a business guide for physicians. We continued social events for our members to create collegiality and combat burnout, highlighted by our Gala, first-ever Resident Welcome and M1 Student Reception. More eventss to come ! We began the process to update the Society’s strategic plan. Our board meetings, member surveys and meetings with physician groups have informed our actions. We have received great feedback thus far and have already taken steps to modernize our organization. What’s next? Publication of the plan and a more modern Memphis Medical Society. Winter 2019-2020
We piloted and ultimately launched our Money and Medicine initiative, intended to support physician financial education throughout all career stages. What’s next? We are creating a page at mdmemphis.org dedicated to resources for our members on all things personal and practice finance. MEMPAC, our local political action committee, was re-energized and issued support to several candidates. We still need donations and are always looking for MEMPAC/Legislative Committee members. MedTemps, our in-house medical staffing and recruiting service, enjoyed one of its most successful years to date. Call the office and speak with Cailyn to get the support your practice needs. What’s next? A new software vendor, a growing staff and even more placements for our members. If you made it this far in the email, thank you for your commitment to our organization. I know I speak for the staff and Board of Directors when I say we are committed to making our members’ lives better at home and in the practice. Our doors are always open if you have suggestions for helping us do that. Stay engaged on social media and mdmemphis.org. Here’s to making 2020 our best year yet. Sincerely, Jimmie Mancell, M.D. 9
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Methodist North Hospital becomes First Adult Hospital in West Tennessee to Receive Prestigious Magnet® Designation Less than ten percent of hospitals nationally receive highest recognition Methodist North Hospital has received Magnet designation by the American Nurses Credentialing Center (ANCC), making it the first Adult Magnet Hospital in West Tennessee and the ninth Magnetdesignated hospital in the State. Less than ten percent of hospitals in the country hold the Magnet designation. “The Magnet designation is the
Baptist Memorial Hospital-North Mississippi recently won Baptist Memorial Health Care’s President’s Quality Award for its sepsis quality initiative. The award is the health care system’s top quality award and is given out annually to the hospital that develops an initiative that transforms and influences quality of care across the entire health care system. “It was my honor to award Baptist North Mississippi the 2019 President’s Quality Award,” said Dr. Henry Sullivant, vice president/chief medical officer for Baptist Memorial.
highest and most prestigious recognition a healthcare organization can receive for nursing excellence and highquality patient care,” said Michael Ugwueke, CEO of Methodist Le Bonheur Healthcare. “We are so proud of our North family for reaching this momentous achievement. Magnet reinforces and validates our commitment to providing a higher standard of care for all people in the communities we serve.” Directed by the ANCC, Magnet recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice.
“This initiative has elevated the quality of care at the hospital and saved many patients’ lives. I believe it will have a substantial impact on the quality of care within the Baptist system, and I look forward to seeing other Baptist Memorial hospitals implement this initiative and achieve great outcomes.” Sepsis is the body’s extreme response to an infection and can happen when an infection you already have — in your skin, lungs, urinary tract or somewhere else — triggers a chain reaction throughout your body. According to the CDC, nearly 270,000 Americans die as a result of sepsis each year.
Consumers rely on the designation as the ultimate credential for high quality patient care. “It’s because of true teamwork and dedication from our leaders and associates that we are able to make our Magnet dream a reality,” said Florence Jones, president of Methodist North Hospital. “Achieving Magnet designation tells our community that we are committed to providing everyone with exceptional care. It also reflects our commitment to providing our nursing team with continuing educational and developmental opportunities so they can always be at their best.”
Baptist North Mississippi’s Sepsis Champions quality team developed a protocol, or process, to ensure the consistent and early identification of sepsis followed by immediate and effective treatment. It included ensuring patients’ antibiotic therapy was appropriate and necessary. The initiative has saved 118 lives since being implemented in 2015. “We are very proud of this team of experts who are improving the outcomes of our patients who are fighting sepsis,” said Bill Henning, CEO and administrator of Baptist North Mississippi. “The team’s hard work is saving lives and will advance patient care.” The Memphis Medical Society Quarterly
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Q US News and World Report recognizes Regional One Health Subacute Unit For the second year in a row, Regional One Health’s Skilled Nursing and Subacute Care facility has been recognized by US News and World Report as one of the nation’s Best Nursing Homes. Regional One Health Subacute Care is among only 19 percent of facilities in the United States earning this honor. The ratings are based on U.S. News’s in-depth analysis of publicly available data, including information that is not factored into CMS’s star ratings.
Saint Francis Hospital-Memphis Receives Advanced Thrombectomy-Capable Stroke Center Certification from the Joint Commission Saint Francis Healthcare recently earned the Advanced Thrombectomy-Capable Stroke Center certification from The Joint Commission, in collaboration with the American Heart Association/American Stroke Association (AHA/ASA). This certification signifies the hospital meets rigorous standards for performing mechanical endovascular thrombectomy.
Unlike the star ratings, the U.S. News ratings recognize that patients undergoing relatively short-term rehabilitation have very different needs from those who require longer-term care. Regional One Health’s Subacute Unit provides the necessary postacute care for patients to help them realize their maximum potential. Due to the integration in the health system, the Subacute Unit is able to work closely with physician partners to coordinate patient appointments on the unit, removing the need for patents to be taken offsite unnecessarily.
To be eligible for the certification, the hospital was required to meet strict guidelines that include performing endovascular thrombectomy on a minimum of 15 patients in the past year, or 30 patients in the past two years, and the capability to perform endovascular thrombectomy around the clock, seven days a week. The hospital’s primary neurointerventionists also must meet the highest standards of subspecialty training. “Saint Francis Hospital-Memphis has thoroughly demonstrated a high level of care for patients experiencing a potentially lifealtering stroke,” said Dr. Audrey Gregory, market chief executive officer, Saint Francis Healthcare.
They are also able to accept patients with a higher acuity than would typically be seen in a skilled nursing unit because of their affiliation with the trauma center. Regional One Health Subacute Unit offers skilled nursing care; occupational, physical and speech therapy; social work; group and individualized activities; medical services; and special consultants available to meet other clinical needs. For more information about Regional One Health’s Skilled Nursing/Subacute Care services, please call 901-515-4300.
“We are excited to receive this recognition honoring our team for the work they do to serve the healthcare needs of the Mid-South community.” “With the recent advances in endovascular therapies for acute ischemic stroke, it’s important to recognize hospitals which can perform this critical intervention safely and effectively and we commend Saint Francis HospitalMemphis on this designation,” said Edward C. Jauch, MD, chair of the American Heart Association/American Stroke Association’s Hospital Accreditation Stroke Subcommittee.
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Member Spotlight John L. Jefferies, M.D., M.P.H., to govern TNACC John L. Jefferies, MD, MPH, is the new governor-elect of the Tennessee Chapter of the American College of Cardiology (TNACC) and will become governor of the organization in 2021. He believes these new positions will allow him to help Memphis and the University of Tennessee Health Science Center play leading roles in improving cardiac care across the state. Dr. Jefferies is the Jay M. Sullivan Endowed Chair in Cardiovascular Medicine and chief of Cardiology in the College of Medicine at the University of Tennessee Health Science Center. He is also the director of the UTHSC-Methodist Institute for Cardiovascular Science. “It is a huge honor and a privilege to be able to represent cardiovascular medicine for the state of Tennessee,” Dr. Jefferies said.“It gives us numerous opportunities to increase awareness of cardiovascular disease across the state. It also gives us a platform to discuss with decision makers, including payors and government, about things that could be optimized in our health system and where we should be investing our efforts. We want to be able to work with our partners throughout Tennessee to help to create a statewide effort toward 14
improving cardiac care.” Dr. Jefferies said he intends to focus on education and prevention of cardiovascular disease. “We spend a very large amount of money on cardiovascular care and a lot of that care is toward patients who are very much down the path, their disease has progressed and gotten quite severe, necessitating expensive therapies that may have limited benefit. A more impactful approach for patients and a cost-effective strategy would be to identify them before they develop disease, or at least intervene before they develop significant disease,” he said. “The way to do that is through education, through outreach, and through access to appropriate services and providers.” Dr. Jefferies oversees the clinical, research, and educational components of the of the UTHSCMethodist Institute for
Cardiovascular Science. He said the institute has expanded its educational offerings, including an advanced fellowship in electrophysiology. “I think the volume and quality of the applicants we have has increased. That is an important indicator that the word is out that we are doing something important here,” he said. Dr. Jefferies also said the UTHSCMethodist Institute for Cardiovascular Science has added more than 15 clinical trials since he joined the university in the summer
The Memphis Medical Society Quarterly
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of 2018. “We get patients from a large radius to participate in these 4th ANNU UAL studies. These trials offer people access to technology and innovation that otherwise they might not receive,” he said. “This is a way people can be involved in esentte ed by Methodis st cutting-edge investigation in a way prre that’s more economically feasible for them.”
Multii-Specia alty Confference for th fo he Prima ary Care Physicia an University Hospital
A two-time alumnus of the University of Tennessee System, Dr. Jefferies specializes in advanced heart failure, heritable cardiovascular disease, and cardiooncology. He graduated from UT Knoxville in 1992 and received his medical degree from UTHSC in 1996. He completed an internship and residency in internal medicine and pediatrics at the University of Kentucky. He also completed fellowships in adult and pediatric cardiology at Baylor College of Medicine in Houston. He came to UTHSC from the University of Cincinnati College of Medicine and Cincinnati Children’s, where he served as a professor of adult cardiovascular disease and pediatric cardiology, and a professor of human genetics.
Sa urday Sat day y, Fe Febru uary 29, 2020 2 Univers niv sity of Mem Me em mphis • Fe FedEx Institute of Te Tech hnology 365 36 65 In nnovatio on Drive • Memphis, TN N 38152 Regis Registe i te err online at www w..methodis stmd.orrg g
To register, pleasee visit www.methodistm md.org/cme.
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Imaging The Future With new location, Vascular Interventional Physicians Expands Services, Patient Comforts With its recent relocation to a full floor in an East Memphis office building, Vascular Interventional Physicians (VIP) offers patients a more comfortable clinic setting. “We wanted more space for procedures, and we also wanted to provide our patients a more personalized care experience, as opposed to a busy hospital setting,” says Henry J. Dalsania, M.D. VIP is the only clinic of its kind in the area, and one of only a few clinics regionally to perform certain highly specialized procedures. All VIP physicians are boardcertified in their areas of specialty. VIP patients have easy access to advanced technological procedures performed by highly trained interventional radiologists, including Radiofrequency Ablation Therapy to treat varicose veins without painful ‘vein stripping,’ Uterine Fibroid Embolization to control symptoms as a viable alternative to hysterectomy, and Peripheral Vascular Disease Screening to assess circulation in arms and legs to assist with limb preservation and would care. “Our patient population varies widely in their conditions and needs,” says Dr. Dalsania. “We care for diabetic patients, those on dialysis, as well as those suffering from peripheral vascular disease, varicose veins and venous insufficiency. We can even perform biopsies and tumor ablation, in the hospital setting. The clinic boasts half a dozen patient recovery rooms, each within steps of the large nurses’ station. “Each patient has a private room where all the prep work is done, and they return to the same room after the procedure. It creates a nice and more relaxing space for the patient and families,” he says. With an eye on the future, there are additional rooms 16
in the clinic that can be repurposed as additional patient rooms and even an additional procedure room. “We have been steadily growing, adding patients and staff, and we wanted a well-planned clinic that could grow with us for years to come,” Dr. Dalsania says. Having diagnostic technology onsite allows patients to usually leave with an answer to their health concern. “We wanted to be a one-stop-shop for our patients. We didn’t want to send them offsite for imaging or treatment only to have them return to our office for follow-up care,” Dr. Dalsania says. “We intentionally designed this clinic so that patients are cared for from beginning to end of their procedure with us.” There are several healthcare practices in the same building, and this allows for a natural overlap of patients. “If there are patients in other clinics in the building who need our services, it’s very easy on them to simply come upstairs to be seen here,” Dr. Dalsania says. “It has naturally expanded our reach in the community, and we are able to help more patients.” The scope of diseases and conditions that these physicians can diagnosis and treat is ever-expanding. The Memphis Medical Society Quarterly
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“With technology in imaging getting better and the quality finer, we expect our scope of treatments to increase in the coming years,” he says. “One reason I enjoy this field of medicine is the variety of cases we treat.” Most recently, the VIP team has begun treating uterine fibroids without surgery. “Uterine fibroid embolization is a newer treatment in our field, and it saves the patient from invasive surgery,” Dr. Dalsania says. “We are also seeing a promising new treatment for migraine sufferers. It’s exciting to be on the cutting edge of so many new treatment options for patient.” VIP also has a location in Southaven, Mississippi, and in Jonesboro, Arkansas. Vascular Interventional Physicians is a subsidiary of Mid-South Imaging & Therapeutics, a private, physician group of 41 radiologists in eight radiology subspecialty areas treating patients in hospitals, physician practices, and free-standing imaging center settings. The group has provided radiology professional services for more than five decades, and accepts all major insurance carriers as well as Medicare and Medicaid patients.. For a full list of procedures and treatments, visit their web site, www.vipphysiciansmemphis.com
The team at VIP includes physicians, physician assistants, nurse practitioners and administrative staff. This team-based approach provides the best care for patients and their families.
(Left) Musculoskeletal imaging uses state-of-the-art technology like radiology, CT, ultrasonography and MRI to diagnose and assess bones, joints and associated soft tissues. (Below) Recent advances in neuroradiological diagnosis, for example, CT, angiography and MRI, have been primarily due to progress in computer technology and this assists in the diagnosis of central nervous system disorders.
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Legislative Update Opposition to Proposal Addressing Surprise Medical Billing Tennessee Medical Association (TMA), Memphis Medical Society and other physician advocacy groups oppose a “compromise” that Congress announced this week on a bipartisan proposal to “address the issue of surprise medical billing.” TMA said in a recent media release that if the law is signed, it will be disastrous for physicians and patients alike.
practice of medicine, prohibiting balance billing or obstructing physicians’ right to be fairly compensated for the services they provide. The compromise keeps patients out of the middle but in no way offers fair compensation for physicians who provide out-ofnetwork services or a level playing field to negotiate reimbursement.
“The late addition of an independent review process, consistently espoused by TMA and organized medicine, is marred by other factors such as a $750 threshold, a 90-day ban on arbitration with the same health insurance plan, and insufficient benchmarks consideration for the arbitrator. If the compromise bill passes, health insurance companies will only be required to initially reimburse out-of-network physicians the market-based median in-network negotiated rate.
Hold health plans accountable to patients with reasonable network adequacy standards. The compromise fails. There are no measures to hold plans responsible to minimum standards for having enough providers in network to afford patients choice. Do not allow insurance companies to set their own reimbursement rates without negotiating with physicians and other healthcare providers. If plans can drive rates lower, soon all providers will be out of network.
The biggest sticking point for physicians throughout the negotiations is that Congress could allow insurance companies to effectively set the payment rates for out-of-network services. TMA has worked with the American Medical Association, Physicians Advocacy Institute and national specialty societies to explain to lawmakers how such a measure would incentive health insurance companies to cut their own costs (i.e. increase their own profits) by eliminating providers with highest rates and drive down the median, or average, to as close to zero as possible.”
Create a fair arbitration process to resolve payment disputes between providers and payers, and keep the patient out of it. The compromise includes such a measure but neuters it with insurance-friendly provisions.” To protect patients and physicians, TMA, AMA and many other organized medicine groups support “The Protecting People from Surprise Medical Bills Act,” sponsored by Reps. Raul Ruiz (D-Calif.) and Phil Roe, (R-Tenn.).
TMA and special interest groups have advocated to address the issue of surprise medical bills for the past few years. Engaging Tennessee’s congressional delegation, TMA has tried to ensure that federal legislation contains the core principles listed below, which the most recent bill touted by Congressional leaders does not adequately address.
“TMA urges members to contact their elected officials in the Senate and House of Representatives immediately, and let them know the so-called compromise does not go far enough to protect patients and physicians. Ask them to reject the compromise and instead support H.R. 3502.”
“Hold patients harmless for out-of-network charges without removing Tennessee’s ban on the corporate 18
The Memphis Medical Society Quarterly
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give e back
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Whe Whether th you volunte l teer once a week k or once a year, your time and tale ent matter. We need n primary and d specialty medical providerrs like you to care for th hose most in-need. V Vo oluntteer either Concourse in our Crosstown C Co ontact Courtney Munson M to lea arn about opporttunities for al providers and practices. individua 901-70 01-2338 or mu unsonc@churchh health.org.
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Protecting your investment portfolio
Q. I am a financial procrastinator and it seems I am always stressed trying to get my act together for tax season. I want to avoid the end of the year stress by working on my tax planning all year long. What tax planning strategies do you recommend? A. Organizing your tax records and paperwork is a to offset and or reduce gains from the winners. strategy that often gets overlooked or ignored. If you need help in this area, I suggest you start by getting a • Pay attention to mutual fund dividend distribution copy of last year’s tax return. You will need to review dates in taxable accounts. A fund dividend paid after a it and create a checklist of all pertinent facts. Common purchase is taxable to you in the current year. items include the following: personal information, income and investment records, self-employment and • Take required minimum distributions (RMDs) by the business documents, medical expense and charitable current year deadline (December 31st). donation summaries, and homeownership statements. Collect all the current information you have and start • Consider a Qualified Charitable Deduction for a acquiring missing data when possible. Try to avoid scheduled RMD. exhaustive searches for lost items. Replacement statements are usually easily accessible on the web. • Consider a Health Savings Account (HSA) if you Implementing an organized filing system is always a participate in a high deductible health insurance plan. good idea, but don’t make this a stressful chore. It is Allows pre-tax savings to pay for qualified medical more important to keep your process simple, safe, and expenses. easy to access. Your diligence will pay off when it comes time to prepare a return. • Review all beneficiary designations and update if needed. In addition, consider the list below for applicable tax planning strategies. A review of your W-4 is also a good practice to make • Take advantage of the 2020 annual gift tax exclusion sure you are withholding enough tax from your pay. of $15,000 per person. The IRS offers a withholding estimator on their • Contribute the maximum amount to your retirement website that can potentially help you avoid a surprise plans. Employee contributions to 401(k) plans and tax bill. defined contribution plans have a December 31st deadline. IRA contributions for the previous tax year Tax planning can be a challenging and stressful can be made up to the April 15 tax filing deadline. exercise, so consult a tax advisor for specific questions and recommendations based on your individual • Contribute to a 529 Plan or Education Savings situation. Account. Plans offer tax-deferred growth and tax-free withdrawals of qualified education expenses. William B. Howard, Jr., ChFC, CFP • Defer or accelerate income and expenses. • Gift appreciated property but sell property for a loss. • Maximize the itemized deduction benefit through additional charitable gifts. • Tax loss harvesting - sell investments with a loss Winter 2019-2020
International Place II 6410 Poplar Ave., Suite 330 Memphis, TN 38119 Telephone: (901) 761-5068 Facsimile: (901) 761-2217 E-mail:firstname.lastname@example.org 21
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Community Work Campbell Clinic Provides Free Foot Care at Annual Soles4souls Event
More than 200 members of the Memphis community received free foot and nail care from Campbell Clinic physicians and Campbell Foundation volunteers as part of the orthopaedic clinic's annual Soles4Souls event, held at the Memphis Union Mission's Opportunity Center. Soles4Souls is an annual event providing foot care, shoes and socks to the community's homeless population. The event is part of the Our Hearts to Your Soles program, a nonprofit with the mission of providing those less fortunate with shoes and free foot examinations. This program was founded in 2004 by then high school student, Matthew Conti, with the help of his father Dr. Stephen Conti, an orthopaedic surgeon at Allegheny General Hospital near Pittsburgh. Supporters of the program believe that proper foot health is an essential part of everyday life that should be available to all, as it is important to an overall health maintenance program.
Established in 1946, The Campbell Foundation is affiliated with Campbell Clinic Orthopaedics in Memphis, Tennessee. A scientific and charitable trust, The Campbell Foundation was founded by Dr. Willis C. Campbell’s partners to continue his commitment to the advancement of orthopaedic medicine. The Campbell Foundation receives support from grateful patients, physicians, resident and fellow alumni, staff, trustees, corporations, and friends in the community. For more information, visit www.campbellfoundation.org/.
At this year’s event, foot and ankle physicians from Campbell Clinic provided on-site foot care while shoes were generously provided by Red Wing Shoes. Additional support was provided by The Campbell Foundation and its Clinical Fellows, Orthopaedic Residents, Research Nurses and employees; Campbell Clinic Physician Assistants and the Campbell Clinic Cast Room Supervisor; and local medical students. Employees from Campbell Clinic and The Campbell Foundation donated nearly 400 pairs of socks for this year’s effort. Campbell Clinic has been participating in this effort for twelve years, holding the event each November during the week of Thanksgiving. For more information about the Soles4Souls program, visit http://soles4souls.org/.
The Memphis Medical Society Quarterly
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LEAVE YOUR LEGACY. PRESERVE THE LEVITT SHELL FOR FUTURE GENERATIONS.
Become a Preservation Circle Member today. From our dance ﬂoor bricks to Legacy Giving, your generosity and vision will sustain the Levitt Shell for generations of music lovers. A ﬁnancial commitment to the performing arts at the Levitt Shell will help preserve one of the few bandshells left in the United States. This gift supports a vibrant mission that brings thousands of Memphians together every year.
Building community through free music and education, ﬁnding common ground for a diverse audience.
LevittShell.org/PreservationCircle LauraBeth@LevittShell.org | 901-272-2722
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Celebrating our historyy & our future UARY 25 Y, JANU AY T SATURD FedEx Event Center, Shelbby Farms Park va 38018 C 415 Great View Drive East, Cordo
6:00 p.m. Cocktail attire
RSVP by scanning this code with a smar t phone’s camera: OK24/2020-presidents-gala Or, visit https://form.jotform.com/ACOO
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UTHSC-Led Study Confirms Heart Implant Device Prevents Stroke in Patients with Irregular Heartbeak A new study by researchers at the University of Tennessee Health Science Center and the University of Iowa provides good news for patients with atrial fibrillation (AFib), or irregular heartbeat, who are at greater risk for stroke but cannot tolerate long-term anticoagulation therapy, the first-line treatment to prevent stroke. The study determined that an implanted device, known as a left atrial appendage closure (LAAC) device, decreases risk of stroke for those with AFib, compared to the risk associated when anticoagulation therapy is not used. MMS member, Rajesh Kabra, M.D., FHRS, associate professor of Medicine, Cardiac Electrophysiology, is the lead author of the population-based cohort study of approximately 30,000 Medicare patients who received the device. The study was published in JAMA Network Open. The results found that the Watchman device, the first FDA-approved and most-commonly used LAAC device, provides a satisfactory option for patients unable to take blood thinners. The umbrella-shaped LAAC device is implanted into the heart to plug the left atrial appendage so that it cannot release clots into the heart. After the implant, patients spend about 45 days on blood thinners and eventually take only aspirin for increased stroke prevention. “I think it’s very reassuring to those who cannot take long-term blood thinners,” Dr. Kabra said. “Despite these being older patients with a lot of other comorbidities, the device was effective in preventing stroke in that population.” Atrial fibrillation is the most-common heart rhythm problem in the United States, Dr. Kabra said. It is associated with a five-times higher risk of stroke, especially in patients who are in their 80s. AFib accounts for one-fourth to one-fifth of all strokes.
He said blood thinners remain the first-line treatment for AFib. However, these devices are indicated in patients who cannot take blood thinners because they have bleeding issues, or are at risk for fall, or have other conditions. “Our study basically reaffirms that in the real world (as opposed to in a clinical trial), these devices do prevent stroke,” Dr. Kabra said. “Even though the patients were older and were sicker than in the clinical trials, the effectiveness in stroke prevention remained. So, we can be more confident in recommending these devices to our AFib patients who cannot take longterm blood thinners.”
“AFib currently affects approximately six million Americans,” Dr. Kabra said. “Over the next 10 to 15 years, that number is going to double, because it is seen more in the elderly population.” Winter 2019-2020
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Staffing Agency Awarded Gold Seal MedTemps Awarded Health Care Staffing Services Certification MedTemps awarded Health Care Staffing Services Certification from The Joint Commission MedTemps has earned The Joint Commission’s Gold Seal of Approval® for Health Care Staffing Services Certification by demonstrating continuous compliance with its performance standards. The Gold Seal is a symbol of quality that reflects a health care organization’s commitment to providing safe and quality patient care. Health care staffing firms place temporary staff in organizations that direct or provide patient care. Health Care Staffing Services Certification demonstrates MedTemps efforts to address how qualifications and competencies of staff are determined, placement of staff and how their performance is monitored. MedTemps underwent a rigorous, unannounced onsite review on October 18, 2019. During the visit, a team of Joint Commission reviewers evaluated compliance with related certification standards including (insert most relevant standards areas – examples include: program management, supporting selfmanagement, and delivering and facilitating clinical care). Joint Commission standards are developed in consultation with health care experts and providers, measurement experts and patients. The reviewers also conducted onsite observations and interviews. “Health Care Staffing Services Certification recognizes health care staffing firms committed to fostering continuous quality improvement in patient safety and quality of care,” says Mark Pelletier, RN, MS, chief operating officer, Accreditation and Certification Operations, and chief nursing executive, The Joint Commission. “We commend MedTemps for using certification to strengthen its program structure and management framework, as well as to enhance its staff recruitment and development processes.” “At MedTemps we want to be the solution to your clinic’s staffing issues,” says MedTemps Director, Healthcare Staffing, Cailyn Lillard.”We staff permanent, temporary and temp-to-perm positions, and we are thriledl that our work is again recognized by The Join Commission.” Call 901-761-0200 to discover how MedTemps can relieve the headache of staffing your practice.
The Memphis Medical Society Quarterly
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In Training MMS completes first year of financial courses for medical students The Memphis Medical Society expands their new financial education programing, Money & Medicine, to include seminars for physicians in all stages of career. Over the summer, MMS completed its Money & Medicine series in which more than 20 medical students took part in courses covering the basics of financial education, combined with customized information for physicians. The final course featured a panel of physicians and industry experts moderated by Society CEO Clint Cummins. Thank you to Dr. Neal Beckford, Dr. Catherine Womack, Dr. Wiley Robinson, DeSoto Floors CEO Chris Churchill and Jeff McIlvain from First Tennessee Bank for serving on our panel. Throughout the course, there were many excellent presentations and real-world stories from physicians and industry experts such as Dr. Lee Berkenstock, Dr. Jerome Thompson and Holly Bronson from Triumph Bank.. The course curriculum combined content produced by Ramsey Group, White Coat Investor and Daniel Burke with Burke Financial Group in Nashville. “After our initial six-week medical student education course, we received feedback that our members were craving even more levels of financial insight,” says MMS CEO Clint Cummins. “Personal, as well as business finances are a huge part of practicing medicine no matter what career stage the person is in, and our organization is pleased to be able to provide support for our members in this manner.” The next Money & Medicine program featured Daniel Burke, a CERTIFIED FINANCIAL PLANNER™ professional and the President of Burke Financial Group, LLC, a Nashville, Tennessee, company dealing with personal, business, and estate planning.Burke presented on financial wellness: investments and retirements. Future classes and seminars will be posted on MMS’s website: www.mdmemphis.org. Topics will include medical coding, contracting and more!
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Q The mission of the Memphis Medical Society is to unite the physicians of Memphis and Shelby County into an organization to promote the highest quality of medical practice and the health of our citizens.
The Memphis Medical Society 1067 Cresthaven Road Memphis, TN 38119 901-761-0200 Fax: 901-374-9574 CEO/Executive Vice President Clint Cummins
Society updates and events Upcoming Events January 25
President’s Gala, Shelby Farms Event Center
Day on the Hill
Physician Happy Hour, Railgarten
WE WANT TO HEAR FROM YOU! If you have ideas or suggestions for The Quarterly, please email email@example.com. We are always looking for updates, achievements and stories of our members. Volume 22, Number 3
Volume 21, Number 2
IN SERVICE TO OTHERS
Executive Assistant Janice Cooper
Members Serving Our Country Through Medicine
Marion Boyd Gillespie, M.D., MSc, FACS
State Air Surgeon, Cassandra Howard, M.D.
Feature: A House of Doctors
Director, Communications & Marketing Allison Cook Marketing and Membership Coordinator Cara Azhar
In Memoriam 2019
Director, Healthcare Staffing Cailyn Bautista Lillard Finance Director Leah Lumm MedTemps Administrative Coordinator Katie Yaun
Arnold M. Drake, M.D. — February 4, 1937- September 5 Robert P. Kline, M.D. —April 18, 1933-December 12 Helio Lemmi, M.D.— June 2, 1929-December 15 Robert Lytle Terhune, M.D. —October 1, 1940-December 7
The Memphis Medical Society Quarterly
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GIVE YOUR FINANCES THE SAME CARE AS YOU DO YOUR PATIENTS.
In today’s uncertain markets, having a bank that tends to your financial health is vital. First Tennessee Medical Private Banking can help with today’s needs and tomorrow’s goals. Our Relationship Managers offer guidance and solutions tailored to medical professionals. So you can focus on your priority: your patients. To make an appointment with a Relationship Manager, please contact: Margaret Yancey Senior Vice President Medical Private Banking ph: 901-681-2526 email: firstname.lastname@example.org
Jeff McIlvain Vice President Medical Private Banking ph: 901-681-2555 email: email@example.com
©2019 First Tennessee Bank National Association operating as First Tennessee Bank and Capital Bank. Member FDIC.
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1067 Cresthaven Road Memphis, TN 38119
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