MMS Winter Quarterly 2021 by mdmemphis

Volume 24, Number 4

Winter 2020

Member Spotlight: Claudette Jones Shephard, M.D.

Volume 24, Number 4

Winter 2020

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.

Editorial Thomas C. Gettelfinger, M.D. Managing Editor Allison Cook 2020 Board of Directors President Danielle Hassel, M.D. President-Elect Andrew Watson, M.D. Vice President Christopher M. Pokabla, M.D. Secretary Lisa Usdan, M.D. Treasurer David L. Cannon, M.D. Immediate Past President Jimmie Mancell, M.D. Board Members W. Clay Jackson, M.D., DipTh Christopher Jackson, M.D. Walter Rayford, PhD, M.D., MBA Paul Tackett, M.D. Lindi Vanderwalde, M.D. Raymond R. Walker, M.D. Catherine Womack, M.D. Ex-Officio Board Members LaTonya Washington, M.D., President of Bluff City Medical Society Eric Gibson, President of MidSouth MGMA

In this issue Editorial

President’s Letter

Hospital Updates

New Members

Member Spotlight:

Feature: The Value of MMS

Research

Your Benefits: New physician liasion

Finance Q&A

Legislative Update

The Memphis Medical Society, 1067 Cresthaven Road Memphis, TN 38119 901-761-0200 CEO/Executive Vice President, Clint Cummins Director, Communications & Marketing, Allison Cook Finance Director, Leah Lumm Physician Liaison, Cara Azhar Director, Healthcare Staffing, Cailyn Bautista Lillard MedTemps Administrative Coordinator, Katie Yaun

Editorial

A Colleague Has Fallen There are lessons to be learned

Among many stories, on February 8, 2021, one story in particular set the medical community abuzz. That day our colleague Dr. John Barton Williams, 36-yearold Orthopedic surgeon, died of COVID-19. He has a brilliant resume, the first Covington High School graduate to attend Harvard College; a high honors graduate of the College of Medicine at the University of Tennessee Health Sciences Center; an Orthopedic residency at University of Utah; fellowship in Hand Surgery in Miami. His Great Grandfather, Bozo Williams, founded the famous BBQ restaurant Bozo’s in Mason, Tennessee. In 2017, he returned to Memphis to join his long term mentor Dr. Timothy Henry Krahn at OrthoSouth. There’s more than the usual sadness in his story. His career, after all that effort, study, training, was only beginning. He had just married, was married all of 45 days. His mentor, Dr. Tim Krahn died unexpectedly on Christmas Eve. And, he had just received his COVID-19 vaccination. Despite all that could be done, including ECMO, Extracorporeal Membrane Oxygenation, he didn’t make it. It’s not just the virus. It’s the inflammatory response, in his case MIS, Multi-system Inflammatory Syndrome, not the severe inflammatory response first affecting lungs and pulmonary system often seen early in COVID-19. Dr. Mike Threlkeld made the diagnosis. Another of our colleagues, cardiologist Nancy Chase, M.D., herself having very likely contracted COVID-19 twice, now recovered and vaccinated, is familiar with MIS. She sees two versions, in older children and adults, one, MIS-C, the other MIS-A, C for child, A for adult. There was early confusion with Kawasaki’s Disease, a small vessel disease described in 1967, seen in babies and toddlers, high fever, inflamed palms and feet, peeling skin, coronary artery disease. COVID-19 children with the inflammatory process MIS-C have myocarditis, clean coronary arteries, much like adults with MIS-A most of whom test negative at admission, but who have been found to have positive antibodies. It was a case in an 8-year-old with MIS-C, mistakenly

Editorial

taken for Kawasaki’s, a different disease, that may well have exposed Dr. Chase to COVID-19 for a second time. Dr. Stephen Threlkeld, head of Infectious Disease at Baptist, has become the frequent media spokesperson for COVID-19 issues. He explained that on October 9, the Morbidity and Mortality Report from the CDC, reported 27 cases of MIS-A in Covid patients. Unlike Dr. Williams, none had been vaccinated. He is the first such patient. The question is obvious. Was his fatal immune response caused by the vaccine or the natural virus? Dr. Williams had nucleocapsid antibodies, confirming his immune response was to the virus, not to the vaccine. Dr. Threlkeld reiterates there is no evidence that it was a result of the vaccination, though the CDC is carefully investigating the issue, communicating almost daily with Dr. Threlkeld. So COVID-19 continues to perplex. Dr. Williams’ family, his wife Peria, grief stricken, have pledged cooperation in any way to help in the investigation. Surely Dr. Williams would have concurred. Anything to help others so stricken.

Thomas C. Gettelfinger, M.D. 3

President’s Letter

2020 brought growth in many ways for Memphis Medical Society and its associated entities. We are most proud of the resilience our members displayed in caring for our community. In case you have not heard it enough--THANK YOU! It is difficult to talk about our “top” moments with COVID-19 having rattled us to our core. But realistically, COVID-19 is part of our story that we cannot erase. It’s part of YOUR story. We should record it and learn from it. It is a history lesson to be shared for generations. And when we’ve finally overcome the bad, we can celebrate the good. Already, one positive is that MMS leadership found ways to support our members better. You will see some hints in this of what’s to come and what we are working toward in 2021. So, here goes… 1. 2020 President’s Gala. The event ended a fantastic presidency for Dr. Jimmie Mancell, allowing me to take the reins of our 143-year old organization. Thank you again, Dr. Mancell, for your continued service. What’s next? I hand over the reins to our new President, Dr. Andrew Watson. 2. Thrive. Our physician well-being initiative was launched. The highlight is a free, confidential hotline that physicians can access anytime they feel the need to connect with a psychologist. What’s next? We’re exploring peer-led counseling with a particular focus on supporting physicians who experience trauma due to clinical error, loss of a patient or other dramatic episode. 3. PPE. Well, this came out of left field didn’t it? Who knew we would be left without the equipment most of us probably took for granted. MMS distributed hundreds of thousands of items to our members and supported the largest systems in our community. We made sure our independent physicians were able to access necessities at a moment’s notice. What’s next? We are researching the viability of a group purchasing organization to meet our members’ needs through and beyond the pandemic. 4. Diversity, Equity and Inclusion Committee. This inaugural committee was created in partnership with Bluff City Medical Society (BCMS). Much appreciation to BCMS president, Dr. LaTonya Washington, for her dedication and collaboration in this endeavor. What’s next? The group will continue to meet and develop goals for the health care community and public in 2021 and beyond. 5. Digital communication. Our growth is evidenced by the early-on creation of documents and scheduling of Zoom meetings for educating members about all things COVID-19. The focus continues to be condensing the flood of information you receive from local, state and national resources into quick and easy-to-read documents. What’s next? An audio version of communication aimed at getting you news, information and education in less than five minutes. Watch your email and search for Memphis Medcast in your favorite podcast platform to learn more. 4

6. Fresh perspectives. We welcomed new and diverse leaders to our Board of Directors. We conducted our first Phone-a-Thon during which board members and volunteers made 450+ calls to nonmember physicians and recruited them for membership. We gained over 30 new members to the Society in about an hour! What’s next? A customized communication strategy aimed at creating an inclusive and supportive medical community in Memphis. 7. Partnership. We continued our bond with the Tennessee Medical Association and closed one of our most successful legislative sessions ever---combating issues like scope of practice, telehealth, COVID-19 and balance billing. 8. Money and Medicine. We evolved this initiative established to support physician financial education throughout all career stages. What’s next? We will increase its presence for offering tailored education to support physicians. 9. MedTemps. This entity has become a pleasant benefit to many. It seems each month we receive a report that MedTemps is aiding our members at a record pace. MedTemps has gone from essentially an afterthought to a leading asset for our membership. The service is contributing to the healthcare economy by placing leaders at our clinics. They are doing this at a rate that hasn’t been seen in 10 years! 10. MMS staff. Last, but definitely not least, I must thank the MMS staff for their hard work and commitment to the organization. This has been their most challenging year in quite some time. Behind the scenes, they’ve been rising to the occasion. I’d like to recognize their names and a few of their unique contributions to our advancement this year. • Cara Azhar (the PPE Queen and our new Physician Liaison) • Allison Cook (all those condensed and timely communications) • Cailyn Lillard (leading all of the growth of MedTemps) • Leah Lumm (leading our PPP loan application and absorbing new responsibilities) • Katie Yaun (leading all the efficiency and modernization of MedTemps) • Clint Cummins (inserting MMS into leadership positions in the community, particularly to support members through COVID-19) I speak for both the staff and Board of Directors when I say we are committed to making our members’ lives better at home and in their practices. Our doors are always open, so please let us know if you have suggestions for helping us keep that commitment. Stay engaged on social media and mdmemphis.org. Here’s to making 2021 our most excellent year yet! “…but with God all things are possible.” (Matthew 19:26 King James Bible) Best to all,

Danielle Hassel, M.D. 2020 Memphis Medical Society President 5

Hospitals

Methodist Le Bonheur Healthcare launches COVID-19 educational program for Latino community in Shelby County In response to an increase of COVID-19 cases within the Latino community, Methodist Le Bonheur Healthcare launched an educational program to help slow the rise in positive cases. According to a recent demographic update by the Shelby County Health Department, 27% of the county’s positive cases come from the Latino community near Methodist North Hospital’s service area. Across the health system, cases from the Latino have risen from three percent to eight percent. “We knew that outreach needed to be conducted in the community, so we developed an outreach awareness plan,” said Dexter McKinney, Community Development Director at Methodist North. The outreach program began with the distribution of educational flyers to businesses, churches and nonprofit organizations within the community. The program also provided more than 400 COVID-19 care packages including masks, hand sanitizer and a bilingual flyer detailing methods for preventing the spread of the virus. “If you don’t have those resources, you really can’t prevent the spread,” McKinney said. There was a sense of urgency to put the educational program in place since minority communities tend to have higher rates of diabetes and hypertension – conditions that can increase the likelihood of complications caused by the virus. “So this outreach had to be targeted to address the issue to reduce harm,” McKinney said.

Baptist Offers Grief Counciling for Families Affected by COVID-19 The COVID-19 pandemic has hit the Mid-South especially hard. Coronavirus deaths are sudden, and families cannot be with the loved ones during their last moments because of restrictions designed to stop the spread of the virus. “To help people cope with grief during COVID-19, Baptist’s grief support groups can play a role in the healing process,” says Angela Hamblen Kelly, executive director of Baptist Centers for Good Grief. “A lot of our families are grieving multiple people who have died from COVID-19,” says Kelly. “The griever might have had COVID-19 or may currently have COVID-19. They may not get to attend a memorial service because it is postponed or because they themselves are sick.” To help people cope with grief, Baptist Centers for Good Grief designed a six-week virtual support group. “Many people feel like they can’t talk about their loved ones because the pandemic is so big--there are so many deaths,” Kelly says. “However, listening is the best thing we can do for a grieving person. Our support sessions will give people a chance to come together virtually.” A grief counselor will help to facilitate discussions each week, and all services are free of charge and funded through grants and donations to Baptist Memorial Health Care Foundation. “Now more than ever, we need to talk to each other about how we are doing,” Kelly says.

Hospitals

Regional One Health’s Skilled Nursing and Subacute Care Facility Honored by U.S. News and World Report For the third year in a row, Regional One Health’s Skilled Nursing and Subacute Care facility has been recognized as a Best Nursing Home for 2020-21 by U.S. News and World Report. Regional One Health Subacute Care is among only 21 percent of facilities in the United States earning this honor. Regional One Health Subacute Care earned Best Nursing Homes status by achieving a rating of “High Performing,” the highest possible rating, for short-term rehabilitation. U.S. News gives the designation of Best Nursing Home only to those facilities that satisfy U.S. News’s assessment of the appropriate use of key services and consistent performance in quality measures. “It is our goal to help our patients realize their maximum potential. This recognition is a testament to the tireless work of our team who is committed to providing the safe and quality care to our patients they deserve,” said Nicole Lowe, LBSW, LNHA, MBA, administrator of Regional One Health Subacute Care. Regional One Health Subacute Care is a skilled nursing unit providing post-acute care to patients. The team provides physical and emotional support to patients and families as they navigate next steps in their care plan. Care includes skilled nursing and medical services; occupational, physical and speech therapy; social work; group and individualized activities; and special services customized to meet the individual patient’s clinical needs.

Saint Francis Hospital-Barlett earns The Joint Commission’s Gold Seal of Approval® Saint Francis Hospital-Bartlett earned The Joint Commission’s Gold Seal of Approval® for Total Hip, Knee, and Spine Certification by demonstrating continuous compliance with The Joint Commission’s performance standards. The distinction marks Saint Francis-Bartlett as the area’s only hospital holding certifications in all three areas, and only one of two in the state. The Gold Seal is a symbol of quality that reflects a health care organization’s commitment to providing safe and quality patient care. The certification focuses on the whole spectrum of orthopedic care, from the pre-surgical orthopedic consultation to the surgery itself, rehabilitation and follow-up. Saint Francis-Bartlett underwent a rigorous, two-day onsite review. During the visit, a Joint Commission reviewer evaluated compliance with related certification standards. Joint Commission standards are developed in consultation with health care experts and providers, measurement experts and patients. The reviewers also conducted on-site observations and interviews to gain further insights. “The Joint Commission accreditation offers further proof of the robust and clinically strong orthopedic services we have to offer the community,” said Chris Locke, CEO of Saint Francis-Bartlett. Dr. Michael Hood, an orthopedic surgeon affiliated with Saint Francis-Bartlett, said “The accreditation demonstrates the dedication to high quality care the hospital provides to total joint patients. We have worked hard to provide safe and efficient care for the total joint patient that maximizes their recovery and minimizes down time.” 7

Member Updates

New members

Society expands with new members. Welcome! STUDENT MEMBERS

Elizabeth Jordan Austin Elizabeth Octavia Clayton Nicholaus A. Cummins Jasmine Nicole Jefferson Kathryn Elizabeth Jordan Gene Gerard Lamanilao Sidharth Satish Mahajan Cassandra Harris McCarley Jam Caldwell McRee Philip Wayne Morgan Ugo Raven Okechuku Wachuku Michelle Rai Santoso Vidushi Sinha Mariaelena D. Uceda

PHYSICIAN MEMBERS

Winfred Abrams, M.D.—OrthoSouth Benjamin Andrews, M.D.—Christ Community Health Service Kristen Bettin, M.D.—UT Le Bonheur Pediatric Specialists Lee Walker Beville, lll, M.D.—West Cancer Clinic Ben Bowman, M.D.—Sound Physicians Melissa Breitling, M.D.—American Family Care Scott Burge, M.D.—MidSouth Ear Nose and Throat PC Alexandra Chantara, M.D.—Memphis Dermatology Kalyan Dadireddy, M.D.—University Clinical Health Thomas B. Hamilton, M.D.—Pediatric Anesthesiologists Omar Hamze, M.D.—Kidney Care Consultants William A. Hter, M.D.—OrthoSouth Aleksandar Jankov, M.D.—Baptist Cancer Center Aaron Kuperman, M.D.—TeamHealth Jim Lewis, M.D.—VA UTHSC William May, M.D.—Emergency Medicine Jonathan McCullers, M.D.—UTHSC Lora Jannette McGill, M.D.—CNS Healthcare Van Montgomery, M.D.—Memphis Radiological, P.C. Dwight M. Moore, M.D.—ObGyn Centers of Memphis , PLLC Mark Abi Nader, M.D.—Kidney Care Consultants Purvisha Patel, M.D.—Advanced Dermatology and Skin Cancer Associates Crystal Pourciau, M.D.—LeBonheur Children’s Hospital/UTHSC 8

Member Updates

Gina Raymond, M.D.—Memphis VAMC Sandra Reed, M.D.—Midsouth Anthia Stephanie Storgion, M.D.—UTHSC Gottumukkala Suneela, M.D.—FMP Bartlett Heather Swanson, M.D.—CareMore Health Lucas Trautman, M.D.—Lucas A Trautman, MD, MPH, PLLC Sailendra (Sal) Vasireddy, M.D.—Baptist Cancer Center Cyrilyn Walters, M.D.—University of Tennsee Health Science Center Nicholas Watson, M.D.—ApolloMD Joseph Weinstein, M.D.—Heart Center USA Matthew Wynne, M.D.—ApolloMD

RESIDENT MEMBERS

Arshad Iftekhar Husain, M.D.—University of Tennessee Internal Medicine Program Asif Jamal, M.D.—UT Department of Radiology Sarah Katherine Shore , M.D.—University of Tennsee Health Science Center MedTemps 2018 ad_Layout 1 5/16/2018 12:23 PM Page 1

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Member Spotlight

Claudette Jones Shephard, M.D. Claudette Jones Shephard, M.D., has been named the founding associate dean of Diversity and Inclusion for the University of Tennessee Health Science Center’s College of Medicine. She currently serves as an associate professor and interim chair of the Department of Obstetrics and Gynecology in the College of Medicine. “Last year was a very interesting year, not just with COVID-19 and the pandemic, but all the social issues,” Dr. Shephard said. “For me this role means that the college has come to realize that it’s time to have a specific role focused on diversity and inclusion. So I applaud it, I’m excited for this role.” Dr. Shephard has championed diversity and inclusion within the college for years. For 10 years, she has served as the college’s representative for the Association of American Medical Colleges’ Diversity and Inclusion Committee. As associate dean of Diversity and Inclusion, Dr. Shephard will be charged with assembling a team of leaders to develop a strategic plan with the goal to increase diversity and inclusion in the college for the next three years. This includes students, residents, fellows, and faculty within the college. She will also advise the Office of Student Affairs and Admissions and the Office of Medical Education on increasing recruitment of diverse students and faculty, and assist with the development of an inclusive curriculum for its students and faculty. Dr. Shephard will also advise the Office of Graduate Medical Education on ongoing efforts in diversity and inclusion and work with the Office of Research to address diversity and inclusion efforts in its strategic plan. Beyond measurable metrics, she plans to address inclusion issues and more. “Some people have different ideas of what diversity is, they think in terms of underrepresented minorities,” she said. “It goes beyond just the underrepresented, the inclusion piece helps you feel like you belong. You can invite me to the party, but if you don’t sit next to me, or let me play the games, then I don’t know that I want to be there.” In addition, Dr. Shephard will chair the College of Medicine’s Diversity and Inclusion Think Tank Committee. As associate dean she will meet quarterly with students, residents, and fellows to discuss ongoing efforts and their concerns, as well as collaborate with campus experts to establish a College of Medicine Diversity and Inclusion website which will feature resources and training. “Probably in no other profession is it as important to understand the needs of our clients, as a physician in this case, our clients are our patients,” Dr. Shephard said. “I want students to learn about the LGBTQIA+ population, 11

Member Spotlight

to learn about the African American and Latinx community, so that when they see patients, they can understand them and patients know that they are listening.” She will work not only with the Memphis campus, but the College of Medicine campuses across the state in Chattanooga and Knoxville to build diversity and inclusion numbers that are more representative of those communities. “Diversity enhances whatever product we have,” Dr. Shephard said. “We see the need and importance of different talents and perspectives when corporations are coming together. It’s the same thing when building a curriculum because we need to learn from the experience of everybody. I want everyone to feel excited about diversity and inclusion. For people not to feel like they are being forced to change because that’s not going to do it. People have to want to change because they realize it’s the right thing to do. And everybody wins.” Dr. Shephard has been with UTHSC for more than 30 years. She first joined the college as an instructor in the Department of Obstetrics and Gynecology. Over the years she has held the titles of assistant professor, program director, associate professor, and interim department chair for the UTHSC College of Medicine Department of Obstetrics and Gynecology. Dr. Shephard is the only fellowship-trained pediatric/adolescent gynecologist in the region. She serves as chief of Pediatric and Adolescent Gynecology. In addition, Dr. Shephard serves as a member of the Regional One Health Board. She is a graduate of Loma Linda University where she earned both her bachelor and medical degrees. Dr. Shephard completed her residency in Obstetrics and Gynecology at the SUNY-Health Science Center and her fellowship in Pediatric and Adolescent Gynecology at UTHSC. “We are delighted that Dr. Claudette Shephard will assume the role of inaugural associate dean for Diversity and Inclusion,” said Scott Strome, M.D., executive dean of the UTHSC College of Medicine. “Dr. Shephard has made a lasting impact in her roles as residency program director and interim chair of Obstetrics and Gynecology. Her exceptional insight, engagement, and ability to tackle complex problems will champion our efforts towards increasing diversity and inclusion, ensuring that the College of Medicine is accessible, welcoming, and kind.”

We Want to Hear From You! Let us know your thoughts on the magazine. Quarterly is a membership advantage, and we want it to be something you enjoy and can share with pride. We want to know if you read, if you enjoy it, what changes you’d like to see, and we are always looking for story ideas. We look forward to hearing from you! Use your smart phone’s camera to scan this code and answer a very short survey about our magazine. 12

Society Feature

Feature

After a difficult year in healthcare, our members highlight MMS’s everincreasing value “I appreciate the advocacy provided by Memphis Medical Society. The focus on high quality medicine, practice support, and community involvement are just a few of the qualities that MMS espouse, which garner pride from being a member. I have professionally grown as a direct result of MMS involvement. I would strongly encourage all Shelby County physicians to join The Memphis Medical Society! Make your voices count!” Dale Criner, M.D., MBA, FAAFP Chairman, Dept. of Emergency Medicine Emergency Department Medical Director St. Francis Hospital-Bartlett Affiliate Asst. Prof. of Medicine, UTHSC, Dept. Of Medicine

“My involvement in organized medicine particularly the Memphis Medical Society is very selfish. Particularly, as more physicians become employed, and legislative mandates and pressures become increasingly stronger, the Memphis Medical Society is the only place that truly nurtures the physician patient relationship. As legislative mandates and continued adherence to hospital metrics on performance intrude on our ability as physicians to care for patients, it is extraordinarily helpful to have a broad section of the Memphis medical community from which to draw to keep these intrusions at arm’s length. Coupled with the ability to have access to community decision makers to shape and drive pertinent health care policy provides a value year after year. Like insurance, I do not like the premium; however, I love the security of coverage during uncertainty.” O. Lee Berkenstock, M.D., FAAFP OLBHealthcare, PLLC 13

Reseach

“Memphis Medical Society (MMS) is a place where we all come together to work for our community. Whether we are working to help our patients, our medical students, our resident physicians or other Memphis practicing physicians take the best care of our Memphis community. We work to help our legislators understand the challenges that our patients face. We help the legislators understand that taking care of patients is a team sport and when we all don’t have our “A” game, we all lose. MMS works to assure we all have access to PPE and access to vaccines. MMS also works to assure that if needed, our members have counselors available to prevent burnout. I am proud to be a member and serve in whatever way that I can.” Catherine Womack, M.D. Associate Dean of Student Affairs and Admissions for the College of Medicine, UTHSC “I joined the Memphis Medical Society the year I started practice on the advice of several experienced physicians. They all felt that membership provided legitimacy to a physician’s practice. I attended a few meetings and met numerous physicians from various specialties in a setting outside of the office and hospital. They demonstrated to me what professional collegiality was, regardless of specialty or hospital affiliation. Through the years, the Memphis Medical Society has helped me with contacts, consults, financial and legal advice. The Society has also provided platforms for professional growth and for improving the care of my patients. It has given me the opportunity to serve my colleagues in the medical profession. I strongly encourage any physician who practices locally to join the Memphis Medical Society. Your membership will help you, your patients and your fellow physicians. Wiley Robinson, M.D., FHM 14

Research

UTHSC Researches COVID-19 Vaccines UTHSC Researchers Play Role in Supporting Development of COVID-19 Vaccines

To examine the efficacy of the Pfizer-BioNTech vaccine during development, the company needed a way to test the inhibitory effects of the antibodies generated after vaccination on virus infection. However, to work with SARS-CoV-2 requires a Biosafety Level-3 laboratory, which most companies do not have. To reduce the risk to workers testing the vaccine, Pfizer-BioNTech and other companies developing vaccines against COVID-19 have utilized a surrogate system, one of which was developed in the laboratory of Michael Whitt, PhD, associate dean of the Office of Medical Education in the UTHSC College of Medicine, chair of the Department of Medical Education, and a professor and former chair of the Department of Microbiology, Immunology, and Biochemistry at the University of Tennessee Health Science Center. The surrogate system developed by Dr. Whitt and his research group utilizes a virus that primarily infects horses, cows, and pigs, and does not cause serious disease in humans. As a result, it can be studied using lessstringent Biosafety Level-2 containment practices available in many laboratories. An additional property of this virus is that it readily assembles the surface proteins of other viruses, such as the S-protein of SARS-CoV-2. As a result, the surrogate virus binds and enters cells like SARS-CoV-2, but once inside, it does not release more infectious virus, and instead produces a reporter protein that can be easily assayed or analyzed. If antibodies from a vaccinated individual are mixed with this surrogate virus containing the SARS-CoV-2 S-protein and there is a reduction in the amount of reporter protein produced, that indicates the individual has generated antibodies that can inhibit SARS-CoV-2 infection. In collaboration with Kerafast, a company that markets the surrogate virus system developed by the Whitt Lab, more than 300 companies and individual research labs all over the world have obtained this surrogate system, specifically to study SARS-CoV-2 infection and to screen for both small-molecule inhibitors of virus infection and the production of protective antibodies from vaccines. “We were contacted very early during the start of the pandemic by several different companies looking for a way to quickly assay whether their vaccines were going to be efficacious against this novel pathogen, when it became clear that COVID-19 was going to impact a huge proportion of the population,” Dr. Whitt said. “They apparently were aware of the system we had developed and recognized that it could be used to speed the development of a vaccine. As a result, we had contracts from several companies to produce these surrogate viruses. Now that vaccines are becoming available, I’m proud to think that we had one small part in the testing of several different vaccine candidates, some of which have now received emergency use authorization, which we hope will eventually help get the pandemic under control.” Currently, Dr. Whitt’s lab is generating more surrogate-reporter viruses containing the various S-protein mutants that have arisen in the United Kingdom, South Africa, and other countries, to test whether antibodies made by individuals who previously were infected, or individuals who have gotten vaccinated, have antibodies that can inhibit infection with these new variants. “The hope is that the current vaccines will provide protection against these variants, but at this time we just don’t know,” Dr. Whitt said. “However, we can rapidly screen these new variants using our system to see whether this is the case or not.” 15

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Financial Q&A

Protecting your investment portfolio Q: I am 60 years old and plan to switch to part-time status at my practice in the next year before I fully retire at age 65. My group retirement plan offers a Roth 401(k) and traditional 401(k) option that I have contributed to for many years. I plan to use my 401(k) assets to supplement living expenses at retirement, but after reading an article on Roth distribution and taxation rules, I am unsure if that is a wise choice. Is it better to use traditional 401(k) or Roth 401(k) assets to supplement expenses at retirement? A. The answer depends on your financial situation. Traditional 401(k) contributions are made with pre-tax dollars, so if you plan to start distributions from the traditional portion of your 401(k) at age 65, the withdrawals will be subject to ordinary income tax. Withdrawals from a Roth 401(k) enjoy a different tax treatment because of the after-tax contributions. Any amount you contribute to a Roth 401(k) is considered basis and is always withdrawn tax-free. Amounts above basis are termed earnings, and they are subject to tax (early penalty & ordinary income) if distributed before a certain period. While disability or death can be a qualifying event for tax-free status, two basic conditions are normally required to qualify your Roth earnings as tax-free for distribution purposes. First, a five-year holding period must be met for the Roth account. This starts with the first Roth contribution made. The second condition requires that any distribution of earnings must begin after the account holder reaches age 59.5. In many cases, qualifying for tax-free status is not a problem because like you, most people started contributing to their Roth accounts early on, and they will not use the funds until after the 59.5 age requirement. You should also be aware the Roth 401(k) portion of your retirement plan will require an annual minimum distribution or RMD starting at age 72. You can avoid the RMD for the Roth 401(k) portion by rolling that amount into an existing Roth IRA. This will allow you to defer distributions from the Roth IRA until you are ready. Once again, distributions will be subject to the five-year and 59.5 rule for tax-free status on earnings, but the start for the five-year clock now depends on the age of the Roth IRA account. If you are rolling assets into an existing Roth IRA that was previously funded, you assume the five-year holding period of that account. If you open a new Roth IRA for the Roth 401(k) rollover, the five-year period starts with the first contribution of that account. Years of contributions made to the Roth 401(k) in your retirement plan would not be counted toward this five-year Roth IRA requirement. Here is a simple way to remember the order in which Roth distributions must be made. • Contributions come out first: Always tax-free. • Converted amounts come out second: Subject to the five-year OR 59.5 age rule for tax-free status. • Earnings come out last: Subject to the five-year AND 59.5 age rule for tax-free status. Before you take any action, I suggest you seek the advice of a financial professional for additional distribution questions and timing decisions. William B. Howard, Jr., ChFC, CFP International Place II 6410 Poplar Ave., Suite 330 Memphis, TN 38119 Telephone: (901) 761-5068 Fax: (901) 761-2217 whoward@whcfa.com

Legislative

2021 LEGISLATIVE PRIORITIES

Tennessee’s 112th General Assembly convenes January 12, setting the stage for these important battles your TMA advocacy team has prioritized in 2021. SCOPE OF PRACTICE TMA is a leader in efforts to preserve Tennessee physicians’ ability to supervise patient care and oppose unsafe scope of practice expansion by midlevel healthcare providers. Because of our leadership, advance practice nurses and physician assistants have not succeeded in changing state laws to achieve independent practice in Tennessee, and TMA remains steadfast in advocating for policies that improve and strengthen interprofessional relationships, not weaken them. TMA joined a coalition of medical specialty societies and other healthcare organizations promoting physician-led, team-based healthcare delivery teams as the best model for patient safety and quality of care. Visit tnmed.org/scopeofpractice for more info.

BALANCE BILLING TMA leads a coalition of hospital-based physician specialty organizations in protecting patients from narrow networks created by health insurance companies. State-wide listening sessions are being hosted with SB 001/HB 002 sponsors, Sen. Bo Watson and Rep. Robin Smith, as they offer a physicianfriendly balance billing solution. Their bill would only require patients to pay according to their in-network responsibility if they receive a surprise medical bill and would allow out-of-network physicians to pursue fair payment from health insurance companies through an independent arbitration process if the initial payment was unsatisfactory. The bill is based on a successful model used in Georgia. It would incentivize health insurance companies to offer fair, in-network initial payments to out-of-network hospital-based physicians. Visit tnmed.org/balancebilling for more info.

GRADUATE MEDICAL EDUCATION FUNDING The Centers for Medicare and Medicaid Services (CMS) ruled last summer that Tennessee must scratch its longstanding formula to fund graduate medical education slots through TennCare. It places millions of dollars and all of Tennessee’s residency programs at risk. TMA’s priorities will be to obtain a seat at the table for further discussions on resident funding, preserve the additional slots gained in 2019, and advocate for a sensible funding mechanism for the preservation of the existing slots.

18 701 Bradford Ave | Nashville, TN 37204 | tnmed.org/legislative | @tnmed

Facts Over Fear QI

Legislative

Preparing for the COVID-19 Vaccines Across Tennessee

TMA invites you to our newest CME class covering the technology and science of the COVID-19 vaccines. This curriculum puts healthcare professionals in a confident position to administer and address the vaccines with patients. • Know the science behind the vaccines, including safety and risks • Learn best practices for dealing with those who are vaccine hesitant • Address misinformation, misconceptions and patient questions Featuring public health experts Dr. Buddy Creech and Dr. Michelle Fiscus. Free of charge thanks to an unrestricted educational grant from BlueCross BlueShield of Tennessee Foundation.

TNmed.org/vaccine

For over 100 years, Semmes Murphey Clinic has been a leader in neurological and spinal care. Our dedicated team of doctors provides cutting edge treatment options with compassionate, personal care.

SEMMES-MURPHEY.COM CALL (901) 522-7700

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 Horizon 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, please contact: Margaret Yancey Senior Vice President Medical Private Banking ph: 901-681-2526 myancey@firsthorizon.com Jeff McIlvain Vice President Medical Private Banking ph: 901-681-2555 jmcilvain@firsthorizon.com

Crises don’t last. Commitment does. It’s not about challenging times. It’s not about “new normals”. It’s about staying true to what matters most. At Methodist Le Bonheur Healthcare, your safety remains our top priority. And we’re more committed than ever to your health. We will continue to do all we can to support our community and improve every life we touch. We’re here for you. Every single day.

To learn more about our services, visit methodisthealth.org.

Whitney Slade, MD

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10/19/20 3:43 PM