MMS Quarterly Fall 2022

John Schorge, MD, joins UTHSC as the chair of obstetrics and gynecology.

Managing Editor

Allison Cook

2022 Board of Directors

President

Christopher Pokabla, M.D. Immediate Past President Andrew Watson, M.D. President-Elect

Lisa Usdan, M.D. Vice President

Dale Criner, M.D. Secretary

Catherine Womack, M.D. Treasurer

David L. Cannon, M.D.

Members-at-Large

James Beaty, M.D. Christopher Jackson, M.D. Desiree Burroughs-Ray, M.D. Walter Rayford, M.D. Kyle Smith, M.D. James Wang, M.D. Paul Tackett, M.D. Perisco Wofford, M.D. Melanie Woodall, M.D. Ex-Officio Board Members

LaTonya Washington, M.D., President, Bluff City Medical Society Andreana Smith, President, Mid-South MGMA

1067 Cresthaven Road Memphis, TN 38119 901-761-0200 mdmemphis.org

From Our President

The Case for Charity Care

Memphis has significant challenges in delivering healthcare. Our medical community is often times under-staffed and under-resourced. To make things worse, our patient population has a high percentage of uninsured people. Care is often fractured and there are difficulties in coordination. Another significant challenge is the magnitude of the problem.

Here are some representative statistics: 112,000 people in Shelby County are uninsured. 17% of working-age adults are uninsured.

Many patients are on waiting lists up to 10 months for critical specialty care.

Fortunately, we have great community resources including Christ Community Health Services, Church Health, Cherokee Health, and other safety net clinics. We also now have Project Access West Tennessee, an organization which seeks to increase access to specialty care for the uninsured population. Each of these institutions work independently, sometimes collectively, and with a host of other agencies to impact access to healthcare.

Let’s discuss potential solutions and ways we can contribute to provide the needed care for our uninsured patients in the Memphis community. These problems present an opportunity to us as physicians to give back to some that may need it the most.

Pokabla, M.D. President, Memphis Medical Society 2022

Christopher

Project Access West Tennessee

Welcome to charity care that benefits patients and physicians. We are expanding healthcare to uninsured, low-income people throughout western Tennessee. Join us in providing speciality care to those in need.

Flexible Commitments

Customize your level of commitment and choose from teleheath, phone consults or in-office visits.

Simple Billing

Our team collects all billing and reimbursement paperwork, and volunteers can receive CME for participating.

Liability Coverage

The Volunteer Health Services Act protects physicians providing charity care.

Easy Referrals

Our team coordinates referrals and guides the patient through each appointment.

Q Hospitals

The Area’s First GammaTile® Procedure Completed at St. Francis

Recently, Dr. Matthew Ballo, radiation oncologist and Medical Director of Radiation Oncology at West Cancer Center and Research Institute and Drs. Andy Boucher and Madison Michael from Semmes-Murphey completed the area’s first GammaTile® procedure at Saint Francis-Memphis. Saint Francis is one of a handful of hospitals in the state of Tennessee boasting the GammaTile® Technology. Designed to help prevent the reoccurrence of brain tumors, GammaTile® is a collagen tile implant that delivers radiation to the area where the patient’s brain tumor was removed—with the goal of leaving healthy tissue unaffected. It is a one-time treatment intended to eliminate the need for ongoing radiation treatments.

The GammaTile(s) are placed precisely where and when treatment will help the most— at the tumor site immediately after tumor removal. Like other radiation therapies, GammaTile® therapy works by disrupting the tumor cell replication process. Radiation damages the tumor cell DNA, so the cell is unable to replicate and eventually dies. The collagen tile keeps the radiation sources in place while the radiation is being released. Over time, the body naturally absorbs the collagen tile.

In a clinical trial, those who received the tile had twice as many tumor-free months compared to their last tumor resection surgery. The GammaTile® received approval from the U.S. Food and Drug Administration in 2018.

Florence Jones, President of Methodist North Hospital, awarded 2022 THA Senior Executive of Distinction

Tennessee Hospital Association awarded Florence Jones the 2022 Senior Executive Distinction award. Jones has been committed to the community and has been very hands on during the whole COVID-19 pandemic. She has contributed to the community in many ways, such as providing care packets to people as well as providing them with resources and education about the pandemic and how to deal with it. She also provided the community with information regarding agency partnerships. “What you focus on and what you are intentional about, is what’s going to grow and get better,” says Jones. She then goes on to explain how she’s passionate about improving the world we live in by making an impact and giving back to the community. Florence Jones has been working in healthcare for over 40 years, with at least 25 of those years being in an administrator or leadership role. She was named President of Methodist North Hospital in 2017 plans to continue to serve her community to the best of her ability.

Baptist Health Science University has earned candidacy status for proposed college

Commission on Osteopathic College Accreditation (COCA) has approved Baptist Health Science University’s proposed College of Osteopathic Medicine for candidacy status. COCA is recognized by the United States Department of Education as accreditor of colleges of Osteopathic Medicine. “We are excited to complete this first phase of the application process for the Baptist Health Sciences University College of Osteopathic Medicine,” said Betty Sue McGarvey, president, Baptist Health Sciences University. “This is a significant milestone for our program, and a great opportunity to advance health care quality and access in the Mid-South.” The next step in the process is getting a pre-accreditation status. After that, the college can start recruiting students for the fall 2024 semester. “We look forward to continuing the accreditation process for our proposed College of Osteopathic Medicine,” said Bell. “Earning candidacy status is a testament to the hard work and dedication of our implementation team.” Baptist has already hired many Doctors of Osteopathic Medicine for the proposed college as well as medical doctors and Ph.D.’s. “This school will help fill an important need for the Mid-South because like many areas of the country we are facing a shortage of health care professionals, particularly primary care and family medicine doctors,” said McGarvey. “This need, which was clearly highlighted during the COVID-19 pandemic, has only become more critical since the pandemic started.”

Regional One Health’s East Campus has opened a new oncology clinic

Surgical oncology consultations and same-day procedures for breast cancer, skin cancer, and melanoma patients is offered in the new oncology clinic. Dr. Martin Fleming and Dr. Ashely Hendry opened this clinic with intentions to improve access to advanced care. Patients can be seen at the East Campus location on Quince Road as well as the downtown campus location as well. “We’re excited to build the Regional One Health breast cancer program in both locations and to make it easier for surgical oncology patients to get the treatment they need,” Dr. Fleming said. Dr. Hendrix added, “Access to care is crucial, and breaking down barriers related to location is important to increasing access.” The visits will typically start with physical exams, getting a complete description of symptoms and family history and discussing patients unique risk factors. “We have navigators who help patients every step along the way,” Dr. Fleming said. “We take care of the whole patient and every aspect of their journey throughout their cancer treatment.” It’s important for the patients to understand their treatment plans, which is a huge goal for this new clinic. “We believe in shared decision making,” Dr. Hendrix said. “We provide information and explain the science behind our recommendation, then create a plan that melds the science to the patient’s desires.”

From Our CEO

Conflict may be as old as the first species. I imagine those first two life forces on our planet had some sort of conflict. It’s inevitable in our world: we will all have some sort of conflict throughout our life and careers.

One current, never-ending conflict we can agree on is with the insurance industry. Contracts are being cancelled at worst, and unfairly, renegotiated at best.

Think about all of the boxing underdogs who went in with a puncher’s chance. In those situations, almost everything had to go perfectly. Or, in some cases, one thing had to go exceptionally well. The puncher has to punch the entire bout, the defense has to take stand after stand, or the offense has to take extra risks that it would only take when facing a Goliath of an opponent.

So, in that “perfect” scenario, physicians build workflows, design processes, and create workarounds in EMRs. We optimize our patient scheduling and clinic time…only to stay on the phone with insurance companies all day, waiting for the approval, denial, or the next announcement of a reimbursement cut.

As Voltaire reminds us, “perfect is the enemy of good.” So, I propose, let’s change our focus from being perfect for an insurance industry, to being “good” for each other. Let’s find innovative ways to work together, even when some of us are in direct competition. There are plenty of lives to cover in our community. We can work together and deliver high-quality, low-cost healthcare that patients need.

I welcome your thoughts at ccummins@mdmemphis.org

Clint Cummins, MHA CEO, Memphis Medical Society

Do we have a Puncher’s Chance?

Together, we go further.

The practice of medicine is full of unforseen challenges, and an experienced, proactive partner will help navigate them. As a premier provider of medical malpractice insurance, our in-house attorneys and unique array of tailored services are always at the ready to help you be prepared for what lies ahead.

Q

MMS Welcomes Residents

Guests networked with new collegues and practicing physicians

MMS hosted resident members as well as practicing physician members at Wiseacre Brewing Co. The event was an ideal opportunity for physicians in training to catch up with their peers, sharing stories and suggestions from their assignments so far. Residents also enjoyed networking with practicing physicians to learn more about different practice environments and current issues facing active physicians. It was a fun and informative evening for everyone, and we are already looking forward to our next event.

Schorge Joins UTHSC

John Schorge, MD, joins the College of Medicine at the University of Tennessee Health Science Center as the chair of obstetrics and gynecology (OB/GYN).

Coming from Tufts Medical Center in Boston, he brings nearly three decades of experience. As OB/GYN chair and as a gynecologic oncologist, Dr. Schorge will be working with Regional One Health (ROH) to help with the development of its cancer program.

“We are incredibly excited to welcome Dr. Schorge – an international leader in OB/GYN – to the UTHSC College of Medicine and to Regional One Health. He literally wrote one of the premier textbooks on gynecology, is an editor of the premier journal in OB/GYN, and will bring much-needed expertise. In addition to his outstanding clinical acumen, he is a proven leader and a wonderful collaborator, who will grow our program while building bridges with our community,” said Scott Strome, MD, Robert Kaplan Executive Dean of the UTHSC College of Medicine and vice chancellor for Health Affairs.

“Part of my mission and interest in coming is helping build out a program for women with cancer in the Mid-South who don’t currently have access to gynecologic oncology services at Regional One Health. The people I met with during my recruitment have a real passion for turning that around, for providing comprehensive care for our patients right here, instead of sending them elsewhere,” said Dr. Schorge.

Dr. Schorge will also oversee the obstetrics side of the department, a unit caring for some of the most-complex pregnancy cases in the region.

Womens health stands at the forefront of his mission

“We serve as a center for excellence for these high-risk patients, and with the skill level of our maternal fetal medicine doctors, faculty, residents, and fellows, it’s absolutely one of the most accomplished units in the country,” he said. Dr. Schorge’s arrival at UTHSC will add expertise to the existing faculty, ensuring there is a top-notch team to care for pregnant patients with exceptionally challenging medical conditions.

Dr. Schorge received his Bachelor of Science degree from the University of Michigan in 1989 and his MD from Vanderbilt University School of Medicine in 1993. He completed his internship, residency, and fellowship at Brigham and Women’s Hospital/Harvard Medical School in Boston. He served as assistant professor at UT Southwestern Medical School in Dallas, associate professor at Massachusetts General Hospital/Harvard Medical School, and professor at Tufts University School of Medicine.

His most recent leadership positions include division chief of Gynecologic Oncology in the Department of Obstetrics and Gynecology at Tufts Medical Center and associate director for Cancer Operations at Tufts Cancer Center.

Dr. Schorge is the recipient of many awards and honors, including Best Doctors in Dallas, D Magazine (2006-2008); Top Doctors, Boston Magazine (2010-2021); and Top Doctors, U.S. News and World Report (2011-2019). Having received more than $1.7 million in research funding, he has published nearly 130 peer-reviewed papers, 30 book chapters, numerous editorials, case reports, abstracts, and authored/edited nine books.

Q

Survey on Practice Environment Challenges

The Physicians Foundation publishes results of physician survey of sustainable practice environments

The Physicians Foundation released part three of its 2022 Survey of America’s Physicians, which assessed the state of the physician practice and strategies to improve it. “Before the pandemic and now, regulations and compliance have changed the landscape of physician practice— resulting in an environment that has negatively impacted physicians’ ability to deliver patient care and their overarching outlook on the profession,” said Gary Price, M.D., president of The Physicians Foundation.

Capacity Issues Impact Physicians’

Ability to Deliver Patient Care.

Approximately one in three physicians has experienced a reduction in staff over the past year with the most shortages reported for registered nurses (90%), nursing assistants (86%), social workers (85%), physicians (84%) and licensed practice nurses (83%).

Among those who reported staff shortages, physicians stated that the most impactful contributing factors were:

· 85% reported administrative burdens

· 79% reported increased working hours without compensation

· 71% reported reduced salaries/benefits Furthermore, almost one-quarter of physicians stated violence in the workplace as a contributing factor to staff shortages.

Mounting Challenges Are Affecting

Primary Care

. Primary care plays one of the most important roles in shifting our health care system to one that prevents disease rather than treats disease. Unfortunately, physicians are facing mounting challenges in primary care, most notably:

· 85% report administrative burdens, such as EHRs and prior approval

· 70% report lack of insurance for patients

· 64% report not prioritizing mental health integration

· 63% report pay-for-performance measurement

Without action to address how we staff our care centers and how we deliver primary care, shortages will grow, and the resulting health of the country will worsen. The path towards this action is clear—physicians have identified the most important strategies to address staff shortages were:

· Removing low-value work

· Eliminating insurance approvals

· Customized retention strategies

· Addressing burnout

“There is extensive action needed on the systemic, structural, organizational and policy level to improve the state of physician practice in 2023 and beyond,” said Seligson. “As much as we are at a worrisome inflection point, we now know where we stand and how we can spur action and drive change, so we can preserve our health for today and tomorrow.”

Who is your mentor?

It’s our turn to give back

“We’ve all had mentors,” says Catherine Womack, M.D., Associate Dean of Student Affairs and Admissions at UTHSC. “We saw in them methods and ideas that we wanted to emulate when we practiced. I remember my mentor to this day, whether he knew it at the time or not. He was so kind to his patients, and he treated them with so much respect. I knew that was what I wanted to do. I believe it is important for practicing physicians to continue this tradition and to give back to those in training. It is how we build a community of strong physicians.”

After hearing many similar stories, Memphis Medical Society now offers a mentor program. Community physicians are asked to accept one mentee for six months with a goal of at least three impactful meetings or experiences. These can range from grabbing coffee together or meeting over Zoom to clinical shadowing opportunities. “Our students have wonderful academic mentors. What they need is to see community physicians truly in practice,” says Womack. “We need to teach them how to be good doctors like us.”

The program’s time commitment is fluid. The interactions are key. “To me, being a mentor means helping someone find the perfect residency fit for them and offering experiences they would not otherwise have. This means something different for each student and physician. It could be as easy as answering a student’s questions about realworld experiences that they may not have anyone else to ask,” says Womack. “Through the school, we can provide all the match data needed for the students. We have plenty of resources to share with the students and mentors. The mentor is the connection to actively practicing medicine in a community.”

Memphis Medical Society is currently seeking mentors in every specialty. Becoming a mentor is as easy as filling out a form. MMS will then pair a mentor with a mentee. At this point, the relationship is in the hands of the physician and student; however, MMS can offer supportive materials, data and more.

Please consider becoming a mentor: https://hipaa.jotform.com/ACOOK24/mms-mentor

Scan me for more information.

Financial Q&A

Protecting your investment portfolio

Q. My investment and retirement portfolios are going down in value and my anxiety level is going up. Some of my colleagues are getting out of the stock market now before the market declines further, and other colleagues say to stay invested no matter the circumstances. I’m confused as to the best course of action. Please advise.

A. Before taking any action, you should examine your current goals and objectives. What goals are important to you? What are your savings goals? What is your time horizon? The objectives of your investment and retirement portfolios will help dictate the asset classes and security types needed to accomplish the goals of your plan.

So far, 2022 has been a difficult year for the financial markets. Losses have been significant and widespread, but a short-term portfolio decline should not be the reason to abandon your goals and objectives. Over time, history shows that stocks consistently provide higher returns than cash and bonds, and higher returns in stocks help accomplish investment goals faster. Unfortunately, positive stock market outcomes are not always the result, and long-term investors in stocks must accept the possibility of greater risk (market swings) for the possibility of greater returns as the market’s price of admission.

The downside of selling during market declines to protect against future losses means you probably won’t be able to take advantage of future gains. Gains after significant declines are unpredictable and often come in bursts. While the appeal of market timing is obvious (improving portfolio returns by avoiding periods of poor performance), timing the

market consistently is extremely difficult, and investors that wait for the right time to invest often find themselves missing out on the best performing days the market has to offer. A simple example of this can be found by looking at an investor that stayed fully invested in the S&P 500 stock index from the beginning of 1997 through June 2022. Over this period, the investor with an initial $1,000 investment would have been rewarded as the investment grew to $3,452. The investor who missed out on the best 40 performing days (during the same period) experienced a loss as their initial investment of $1,000 declined to $399.

My advice is to stay the course, but you must be aware of your investment timeline. Longer timelines dictate a greater ability to tolerate market swings of risker assets. Conversely, shorter timelines dictate the need for safety and protection of investment principal. Combining assets with less risk (cash and bonds) with riskier assets (stocks) helps to reduce overall portfolio volatility and establish the foundation of a diversified asset allocation strategy. I would also advise you to seek further guidance from a qualified financial professional to review your risk tolerance and portfolio composition for the appropriate allocation.

William B. Howard, Jr., ChFC, CFP International Place II 6410 Poplar Ave., Suite 330 Memphis, TN 38119 901-761-5068 Fax: 901-761-2217 whoward@whcfa.com

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When Bob Leopold required a bone marrow transplant to treat leukemia, he needed a specialized team with proven clinical quality and safety. He got that and so much more. Our dedicated oncology experts and surgeons pushed the boundaries of stem cell research and exceeded every single one of Bob’s expectations. In a letter, he writes, “My surgery was successful because of the commitment, skills and positive energy of my team. They were always willing to go the extra mile. I am so grateful for the care you gave me.” Hear

BOB LEOPOLD Thankful Bone Marrow Transplant Recipient

My health issues are a lot smaller and I’m a lot happier.