Memphis Medical Society Quarterly Fall 2018

Volume 22, Number 3

Fall 2018

IN SERVICE TO OTHERS Members Serving Our Country Through Medicine

State Air Surgeon, Cassandra Howard, M.D.

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Editorial Thomas C. Gettelfinger, M.D. Managing Editor Allison Cook 2018 Board of Directors President Autry J. Parker, M.D.

contents Volume 22, Number 3

President-Elect Andrew Watson, M.D.

Features

Vice President Danielle Hinton Hassel, M.D.

12 14

Fall 2018

Member Spotlight In Service to Others

Secretary Justin Monroe, M.D. Treasure David L. Cannon, M.D. Immediate Past President Phillip R. Langsdon, M.D. Frederick A. Fielder, M.D. W. Clay Jackson, M.D., DipTh Jimmie Mancell, M.D. Christopher M. Pokabla, M.D. Walter Rayford, PhD, M.D., MBA Lisa S. Usdan, M.D. Lindi Vanderwalde, M.D. Raymond R. Walker, M.D. JoAnn Phillips Wood, M.D. Ex-Officio Board Members Perisco Wofford, M.D., President of Bluff City Medical Society Karen Adams, President of Mid-South MGMA 2

Every Issue 3 5 8 19 22 24 27 28

Editorial Your President’s Lettter Your Society At Work Your Legislative Update Your Community Current Research M1 Reception Your Bulletin

Cover: Cassandra Howard, M.D., photo courtesy ANG

The Memphis Medical Society Quarterly

your editor Thomas C. Gettelfinger, M.D.

So What Did You Do Today?

Patients have their stories. So do doctors.

I started with my Journal Club, the oldest in Memphis, having met monthly over a 1,000 times, most recently at the University Club.

Good food, collegial banter, different specialties, scholarly review of recent journals, no audiovisuals, question and answer period, then a summing up by an appointed critic.

For example, John Fowler, now a hospitalist, follows 25 or so inpatients. He had just finished a 7-day shift, 12 hours each, with more to come. It’s challenging, and his role as a hospitalist is better for him than his previous office-based internal medicine practice.

Frank McGrew, cardiologist, in the hospital at 8AM, following 25 or so in-patients, from congestive heart failure, to arrhythmia, then to the office at 11, morning and afternoon clinic. He then has charts to finish, often at night, a trick he learned from a mentor during fellowship training at Duke.

On another occasion, I talked with George Flinn, at his regular Tuesday night dinner with musician Jason Dee Williams, Jason’s wife, Jennife,r and their son Canyon.

George described his day, that morning in his Claybrook office, from 8 until 5, doing procedures, Fall 2018

Remember those publications, A Day In The Life Of America…or in the life of some media personality, going from limo to meeting to highpowered lunch to some of-the-moment club, air-kissing and networking?

So what’s in a doctor’s day?

If you google it, you get mostly bland pablum.

So I’ve asked a few colleagues. biopsies, thoracenteses, reading So what of my day as an films and ultrasounds. ophthalmologist?

Lunch was at Methodist There’s still great pleasure in a doctor’s dining room, a regular well done cataract surgery, a group of colleagues, conversation procedure that patients are almost often of medical issues. always grateful for. But most The evening, after dinner, he enjoyable are the patient’s stories. was headed to one of his radio This morning was a woman, stations to finish the long day. manicurist, with a recurrent Then there’s my friend James pterygium who had escaped from Patterson, Ob-Gyn. The day we Vietnam years ago. Her children talked had been a little unusual for have done well, one a high school him since there were no deliveries valedictorian, another at an Ivy but he saw 20 to 30 patients in the League college. clinic. In practice since 1986, his Or the elegant African American workload has gotten worse over the woman, retired teacher, now with years. He’s seen many younger an early cataract. She had joined colleagues quit practice, worn out the Great Migration from Arkansas by the hard working lifestyle. to Chicago in the 1950s. Finding James has recently expanded his the life there dangerous and practice to include MetTrimMD, a worrisome, she called her white weight loss group that he joined in doctor back home in small town an entrepreneurial segue. His true Arkansas. He sent her the money to passion is collecting. And he’s return home, insuring that she good at it, flying around the world could eventually embark on her to look at art. He recently donated rewarding career. No racism she an important work to Brooks said. His generosity had saved her Museum where he serves on the from a very different fate. board.

At one time he had sold a I know this is all too brief. painting to another collector, who And simple. resold it for 5 million dollars.

But I like our patient’s stories. And James had sold it for a pittance those of our colleagues. of that, but he was happy that the resale reinforced his good We should listen to both. taste and eye for eventual value.

C’est la vie…

3

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your president Autry J. Parker, M.D.

Is It Really That Bad?

I never thought I would ever hear myself saying to young physicians that “Back when I started practice we…(fill in the blank).” To me that was akin to my Father telling me he walked 10 miles to school in the snow (uphill both ways), or the older docs telling me that during their residencies they were on-call every night and had to sharpen their own needles, and by the way, they weren’t paid at all, or when they were paid it would be in live chickens.

However, I often find myself, like many of my contemporaries, lamenting the changes in medicine and wishing for the “good old days.” So, I ask the question, “Are times really that bad, or is this just natural evolution?” If everything else in our society has changed, why shouldn’t healthcare? As a society, we seem to no longer value “expert” opinion or even the infallibility of science. Web searches provide instant answers for every question with little attention paid to the sources of that information. People now develop strong opinions based on what “they say.” We now place our personal beliefs on equal footing as those of experts when we disagree. I don’t “believe” in vaccines or global warming, being prime examples. So no wonder we physicians are no longer held to the esteem in which we were in the past.

However, we remain the indispensable experts to manage the evermore complex healthcare landscape. No internet search, patient care navigator or other healthcare provider can substitute for a physician to understand and prioritize the vast amount of information available to make healthcare decisions. We alone have the intimate knowledge of the unique characteristics of each patient to make a diagnosis and to develop a treatment plan specifically to fit his or her individual needs.

I submit that physicians are on a normal evolutionary path. We simply must adapt our communications skills to incorporate the new languages of social media and re-establish our expert credentials where people now look for healthcare information. Because most healthcare decisions start with internet searches, we need search engine optimization strategy instead of yellow pages ads. Our web interfaces need to be more than directories of clinic operations. They need to be trusted sources of information that announce over and over to the world that we are the experts.

It’s not really that bad.

Fall 2018

5

YOUR

BENEFITS we have to get better

Historically, our staff members are not seen or heard from much in our beloved Quarterly, but I wanted to communicate with each of you since I have been in the CEO/Executive Vice President seat for two years now.

At home, I am blessed to have two young, energetic boys (turning 7 and 4 soon) and a beautiful wife. I have begun talking to my soon-to-be seven-year-old about “getting better.” It’s become a mantra between the two of us: be it with his homework, athletics, or tying his shoes.

As I thought more about it, it occurred to me that the “getting better” mantra is also fitting for the current era of Memphis Medical Society. Simply stated, we must “get better” at serving you, our members, and the healthcare community around us.

Healthcare is changing, causing the physician’s life at home and in the practice to change. Memphis is growing and changing as well. There is no way we can “get better” without changing and improving what we offer to members.

I hope you will see through this issue, in future issues, and online at mdmemphis.org, we are making strides to serve you better with tools, events, and resources that you can access at your convenience. Most importantly, our goal is for these initiatives to be relevant and worthy of the time you invest in them—whether it be a threeminute read of our e-news or one hour participating in our soon-to-be-launched physician wellness program.

We know that the spirit of serving is within each of you because the practice of medicine called you. So in that spirit, we also ask that you join us. We have a wealth of committees to join—the physician wellness program needs a steering committee, for starters—and you are always welcome at our board meetings, typically held on the first Tuesday of the month at our offices at 5:30 p.m. Give me a call at 901.761.0200, or send me a note at ccummins@mdmemphis.org, if you would like to serve fellow physicians alongside us.

One final note: With fall comes winter, and that’s not a bad thing for the Society. It means a totally reimagined Annual Meeting. Now, the President’s Gala, still held on Saturday, January 26th, this year at Shelby Farms.

More information to come! We also have our sights set on relaunching our Alliance program for physician spouses and families, administering a membership survey (do you want a podcast?) and providing more referrals, appointments and relevant news online at mdmemphis.org.

I look forward to continuing to serve you, while we all strive to “get better” every day.

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The Memphis Medical Society Quarterly

We were STEM before STEM was cool.

Science, technology, engineering, and math excellence is a tradition at Memphis University School – and so is teaching boys in grades 7-12 to think, to reason, to write, to create, and to serve.

No pre-packaged programs here.

Our expert instructors tailor courses to meet the needs of our boys and the demands of college curricula.

Check us out at musowls.org.

There are hunters.

There are gatherers.

There are those who are both.

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Fall 2018

We Understand the Lay of the Land

7

Cooper Celebrates 20 Years Serving the Society Mrs. Janice Cooper celebrated 20 years in service to The Memphis Medical Society.

working for you

Throughout her career, Janice has been the go-to person in the office on everything from her sweet tea recipe to the timing on mailing out board ballots.

“She’s the mom in our office,” says finance director Leah Lumm. “She takes care of everybody.”

“She knows where the bodies are buried.

That’s for sure,” says current Board President, Autry J. Parker, M.D. “She sure keeps me on track too!”

“Mrs. Cooper is a beautiful person that I am fortunate to know. Her demeanor is always positive and inviting. She is very dedicated to her work and her professionalism is incomparable. More than that, she is a friend. I salute you, Mrs. Janice Cooper,” says Perisco Wofford, M.D., President, Bluff City Medical Society.

your

SOCIETY

“Janice is always bubbly and happy to welcome you,” says Gary Kimzey, M.D., MMS Board Past President. “She thoughtfully asks about my family and makes any room seem happy.”

8

“It didn’t take me long to figure out that Janice Cooper is the backbone of our organization,” says ceo/executive vice president Clint Cummins. “She gracefully mixes her warm personality with a passion for her work, making her an invaluable member of The Memphis Medical Society family. One of my daily goals is to convince her to stay another 20 years.”

We hope you’ll join us in celebrating Janice Cooper’s 20 years with us by helping HER with a special project.

Some of you know that Janice and her husband, Deryk Sr., lost their son, Deryk, Jr., more than two years ago to Non-Hodgkins Large B Cell Lymphoma at too young an age, leaving behind his parents, wife, newborn daughter, and countless other family members.

Janice has been quiety working to endow a scholarship with UT College of Pharmacy, where Deryk Jr. was a graduate, in his honor. We ask that in honor of her 20 years of support to The Society, you donate to her scholarship.

You can donate online at uthscalumni.com/derykcooper The Memphis Medical Society Quarterly

MedTemps Welcomes Katie Yaun Katie is excited to continue working after five years as a stay-at-home Mom to her two kids, Drew and Allie.

Katie Yaun has joined MedTemps as the Operations Coordinator.

She previously worked for Accredo and United BioSource Corporation for more than nine years as a Training Specialist and Analyst.

Katie is a graduate of Union University in Jackson, Tennessee.

Welcom ming May Medical to o Saint F Francis Medical Partners.

No matter where you live, you’re close to quality health care e. In fact, whatever your health needs are, chancces are we can meet them. From m yearly exams to managing m chronic conditions, we’re w here to kee ep you healthy – and keep you from f all that extra traveling. traveling ghlin Dr. McLau

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Fall 2018

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your hospitals Methodist University Hospital Earns Two Awards from the American Heart Association Methodist University Hospital has received the American Heart Association/American Stroke Association’s Get With The Guidelines® Stroke Gold Plus Quality Achievement Award. This award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines. MUH has the only Comprehensive Stroke Center in the Mid-South.

MUH earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients.

Additionally, MUH received the American Heart Association’s Target: Stroke℠ Elite Honor Roll Quality Achievement Award. To qualify for this recognition, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA.

Baptist Shows FCC How Telemedicine Saves Lives On Thursday, July 12, Federal Communications Commission Commissioner Brendan Carr toured Baptist Memorial Health Care’s Patient Placement Center and TeleGuardian eICU to observe how Baptist is using telemedicine to enhance care and save patients’ lives, especially in rural areas. The day before the visit, the FCC had announced a $100 million “Connected Care Pilot Program,” which will support telehealth for lowincome Americans, particularly veterans and those living in rural areas.

Baptist Memorial hospitals in Mississippi, Tennessee and Arkansas offer eICU and telestroke services. These hospitals use telemedicine to enhance care and save patients’ lives. In fact, as a result of a virtual consult, Baptist physicians saved a 25-year-old patient’s life and limbs. The patient, who was experiencing unusual paralysis symptoms, was at Baptist Memorial Hospital-Union County in New Albany, Mississippi, and the expert physician was more than 75 miles away at Baptist Memorial Hospital-Memphis, in Memphis, Tennessee. But because of Baptist’s telemedicine program, physicians could consult on the patient’s condition, identify a problem, quickly intervene and fly the patient to the Baptist tertiary referral center in Memphis for lifesaving care and treatment.

For more information about Baptist or our telemedicine program, please visit baptistonline.org.

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The Memphis Medical Society Quarterly

your hospitals Regional One Health Names New Chief Medical Officer Martin Croce, MD, has been named senior vice president and chief medical officer of Regional One Health.

Dr. Croce transitioned to this administrative role after a lengthy and distinguished career in one of the busiest trauma centers in the United States - the Elvis Presley Trauma Center at Regional One Health. As chief medical officer, Dr. Croce oversees quality, medical research, medical staff services, regulatory readiness and infection prevention for the system.

“Dr. Croce has been a valuable asset to this health system and this community, providing exceptional trauma care to countless patients over the past 30 years,” said Reginald Coopwood, MD, president and CEO of Regional One Health. “I am confident that he will bring this same level of engagement to help us continue on our journey improving upon and growing Regional One Health.”

Dr. Croce earned his medical degree from the University of Tennessee Health Science Center (UTHSC). He completed a surgical critical care fellowship at the University of Miami, Jackson Memorial Hospital in Florida, and then returned to Memphis. He completed a residency and internship with UTHSC that started his career in the Trauma Center at Regional One Health, where he has served as medical director since 2000.

We’re more than doctors. We’re your medical partners.

Saint Francis Medical Partners makes it easy to find the right doctor for you and your family. Through a single source, you can access dozens of area’s most established and respected physician groups, with numerous practice specialties and convenient locations throughout the Mid-South.

But SFMP is more than just a group of physicians. We’re your medical partners for all phases of your life. So whether you are due for check-up or need the ongoing care of a specialist, you’ll know exactly where to turn.

Each physician in the SFMP network is affiliated with either Saint Francis Hospital – Memphis, yet most maintain hospital privileges in other networks as well.

Many SFMP physicians are in-network with over 80 insurance plans and offer walk-in and same-day appointments, making it even easier to see the right doctor when it matters most.

Take advantage of our physician locator on sfmp.com to find the doctor that’s right for you. You’ll be able to search by physician name, practice location, practice specialty or a combination of specialty and location. Once you find the right doctor, book your appointment online or call the office directly.

Fall 2018

11

Physician’s Fight Against Diabetes is Personal

MEMBER SPOTLIGHT

Kashif A. Latif, M.D. Kashif Latif, M.D., decided to study endocrinology when his son, Ahmed, was diagnosed with Type 1 diabetes at 11 months. Dr. Latif knew it was time to make a difference — not only for his son, but also for others.

After Dr. Latif graduated from Aga Khan University Medical College in Pakistan, he arrived in Memphis in 1992 and completed his internal medicine training at the University of Tennessee.

“I was practicing as an internist after I graduated and during my practice, my son developed Type 1 diabetes, so subsequently, I went back to train as an endocrinologist," Dr. Latif said.

Ever since, Latif, who is now based in Bartlett, has been committed to helping those with diabetes — both through his work and a variety of causes focused on finding a cure.

Latif and his wife noticed their son urinated a lot and was always thirsty and tired, so they decided to take him to the doctor. At the doctor's appointment, it was revealed Ahmed had juvenile diabetes.

Latif said his child's diagnosis was surreal and tough to accept at first, but he and his wife knew their son had valuable resources available to him and would be taken care of.

He and his wife also decided they would not let this disease determine their son's future.

He was not going to be defined by this disease," Latif said. "He was still going to be his own person and do whatever he wanted to do and become, and he would not be held back just because he had an illness."

While treating his son, Latif decided to open the AM Diabetes and Endocrinology Center in 2002, which is named after his son.

"We have a comprehensive program for diabetes educators, dietitians and pump trainers, so that we can comprehensively impart all of the practical knowledge that a patient has to have when they are dealing with it on a daily basis."

Latif's goal was to provide a place that meets all the needs of his patients. At the center, patients receive medication and prescriptions, in addition to information on topics such as possible complications and insulin storage and usage.

Darrell Greene, who has Type 1 diabetes, arrived in Memphis in 2010 and inquired about a good endocrinologist.

"Dr. Latif was the name I got over and over again," said Greene, an anchor at Fox13 Memphis.

"I got an appointment thinking I would feel him out. As soon as I heard his story of why he became an endocrinologist, I was sold."

Aside from his AM Center, Latif makes a difference in the lives of those with diabetes in a variety of ways.

"Our emphasis at the AM Center has been to provide education from the start," Latif said.

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The Memphis Medical Society Quarterly

Latif works as one of the directors of the 5K Sugar Run, which benefits the Juvenile Diabetes Research Foundation's search for a cure for Type 1 diabetes.

The race has occurred for the past 12 years, with donations increasing every year. Last year the race raised $23,000. It has raised $150,000 during the last 11 years.

West Tennessee's JDRF will host its annual Promise Ball on June 9, which also raises money for the foundation's research. The event will take place at 6 p.m. in the Hilton Hotel on Ridge Lake Boulevard.

Greene, an executive board member and governmental advocate for JDRF, said Latif's contributions show his dedication and support.

"He raises thousands of dollars every year for research funding through JDRF. That shows his commitment to helping people with Type 1 diabetes," Greene said.

"His latest push to build a registry of Type 1 diabetics in Shelby County, his annual Sugar Run, and his constant support for JDRF and all we do in West Tennessee all shows that he's all in and fighting for us."

Fall 2018

Latif also hosts a summer camp for children with diabetes, which was started 30 years ago by Ahmed's first endocrinologist. Latif became the director of the camp after the endocrinologist retired.

"The camp gives the kids a sense of normalcy, safety and friendship because they are surrounded by other kids with the same disease," Latif said. "It also educates the children about the disease and shows them that this disease shouldn't stop them from enjoying life."

Latif's son attended the camp until his high school graduation. Ahmed is now a senior at Georgetown, majoring in computer science.

Latif said it is essential for parents to engage in thorough treatment of their children with diabetes.

"Type 1 is a condition that requires regularly attended doctor's visits and constant monitoring of insulin," he said. "It's also important to let your child continue engaging in regular activities. Having a disease doesn't mean we should limit them from being their full potential."

Reprinted courtesy: Raven Copeland, USA TODAY NETWORK — Tennessee

13

In Service to Others

By nature, physicians are giving people. They have dedicated their lives to helping and healing others. Some physicians have taken the road of serving our country while also practicing medicine. Here we highlight a few of our members who have given of themselves locally and around the world.

Kevin Foley, M.D. served in the United States Army for 17 years. Raised as a self-proclaimed Army Brat, the military life was nothing new to him. He enlisted in July of 1975, joining the Health Professions Scholarship Program.

Dr. Foley’s career in the Army began as a reserve medical student until his graduation from UCLA School of Medicine in 1979. He then completed a year-long surgical internship at Letterman Army Medical Center, and completed his residency in Neurosurgery at UCLA. Dr. Foley then transferred to the Brooke Army Medical Center for three years before moving to the Tripler Army Medical Center.

Finally, at Walter Reed Army Medical Center, he served as Chief of the Department of Neurosurgery and chaired the Army’s only neurosurgery residency training program.

“I practiced neurosurgery with a group of young people working with limited resources in a converted barracks building (military housing), and I learned that it was possible to provide good, quality care despite limited resources, as long as you had a dedicated team,” he says. “That drastically impacted how I practice medicine to this day.”

Left: Dr. Foley’s promotion to Lieutenant Colonel; his father, MG Thomas Foley, and his wife, Lynn, pinning on his insignias.

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The Memphis Medical Society Quarterly

David L. Cannon, M.D. served in the U.S. Navy for 14 years, after enlisting in North Carolina in 1993. Dr. Cannon was completing his residency at Duke University, and he wanted to use his medical training in service to the troop.

Dr. Cannon focused on hand surgeon, orthopedic resident training, orthopedic physician assistant training, and he served as Assistant Director of Bone and Joint/Sports Medicine Institute for the inpatient and outpatient facilities at The Naval Medical Center Portsmouth, formerly Naval Hospital Portsmouth, and originally Norfolk Naval Hospital. It is the oldest continuously running hospital in the Navy medical system.

Deployed twice, Dr. Cannon’s most memorable deployment was when he was assigned to an amphibious vessel and had the adventures of traveling on CH-53 helicopter, a C-130, a C-17 plane and on a Landing Craft Air Cushion, which is a class of air-cushion vehicle used as landing craft by the United States Navy’s Assault Craft Units. “During that deployment, we had a week of rest and reception in Israel, which was a one-of-akind opportunity for me.”

Honor, courage, and commitment are the core values of the U.S. Navy, and Dr. Cannon found these to be excellent standards for patient care. “The intense focus on teamwork carried over nicely into my current practice setting,” he says. “And, educating and training my service team taught me how important it is to have a team that is all working at their highest level.

That’s the goal I have in practice as well.”

Dr. Cannon is a hand surgeon at The Campbell Clinic.

Top and middle: Dr. Cannon, in khaki to the right in both, getting an injured Marine from the ambulance to transport him back to the ship via helicopter in Kosovo. Left: On the flight deck with Mt Olympus in the background. Above: landing area for the helicopters that were used to support the Marines on the ground at the Macedonia Kosovo border.

Fall 2018

15

Colonel Cassandra Howard, M.D. currently serves as the Vice-President, Chief Medical Officer (VP/CMO) for Methodist LeBonheur Germantown Hospital. Prior to her June 2017 appointment as VP/CMO, she served as the Medical Director of the Emergency Department (ED) at the same facility, while also working as a Staff Physician in the ED. “I have been an ED provider since 2003,” she says.

She is also a member of the Tennessee Air National Guard, serving as the State Air Surgeon (Colonel, 0-6), assigned to Joint Forces Headquarters in Nashville, Tennessee. Her responsibilities in this role include advising on all issues pertinent the Air National Guard’s medical readiness and response operations within the state of Tennessee and also at the national level.

“I enlisted at the encouragement of my father, (now retired) who was an active KC-135, Air Refueling Pilot in the 128th Airlift Wing, WI ANG,” she says. “I joined the 128th Airlift Wing, Wisconsin Air National Guard (WI ANG) in 1987 while in high school, and I enlisted as an entry level (Airman Basic, E-1), Aerospace Medicine Technician (a Flight Medic).”

Above: Dr. Howard State Air Surgeon (Colonel, 0-6), assigned to Joint Forces Headquarters in Nashville, Tennessee, 2016.

Throughout her 31-year carrer, Dr. Howard has served in multiple ANG units, including the WI ANG (1987-1989), DC ANG (1989 1994), back to the WI ANG (1994-2000) and TN ANG (2000 to present). “My unit transfers were driven by education (undergraduate school in D.C. and medical school in Wyomming) and medical training needs (internship and residency in Tennessee) in other states,” she says.

Her service is varied, but it has been primarily within the ANG Medical Service. “I enlisted as an Aerospace Medicine Technician and Above: Dr. Howard, Courtesy ANG served for nearly 10 Above: Dr. Howard 2004 years in the enlisted corp, achieving the rank of Technical Sergeant (E-6). I later joined the Medical Corp upon becoming a Commissioned Officer (1996),” she says.

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The Memphis Medical Society Quarterly

“My responsibilities, as a physician, involved ensuring the continued medical readiness of our Airmen. I then completed training at the USAF School of Aerospace Medicine (2003), earning my “wings” as a rated Flight Surgeon. My responsibilities broadened to include maintaining the health and operational safety of those on flying duty, supervising Public Health, Bioenvironmental Engineering, and the Occupational Health functions.”

In 2007, she assumed the role of 164th Medical Group, Chief of Aerospace Medicine and was responsible for all medical functions related to aeromedical flying and operational duty. “164th Medical Group Commander was Above: February 2011 my next role (2007 -2016), in which I proudly served leading an awesome team of enlisted and officer medics.,” she says. “My next and current role is State Air Surgeon for Tennessee (SAS). As SAS, I advise The Assistant Adjutant General for Air on aeromedical matters to include the state’s medical readiness, safety, missions, and any additional duties as assigned. I direct and advise the Medical Group Commanders to ensure the health, safety, and medical readiness of the 3,200 Airmen assigned to the TN ANG.” “After 31 of years of uninterrupted service, I am still motivated to put on my uniform (whether flight suit, ABU - airman battle uniform, or dress blues) and report for duty. I enjoy the comradery and esprit de corps felt by serving our country. We have and continue to perform some exciting missions at home and abroad,” she says. “I have enjoyed traveling around the world, but especially the opportunities to provide healthcare to underserved communities. My first humanitarian service mission occurred when I was a very young airman. Our unit deployed to Honduras for field training. While in country, we also provided much needed medical and dental care to the local community. The Honduran people were very appreciative of our care, and I also flew with the crew over the mountains of Tegucigalpa to perform other tasks as well. This gratifying experience left me feeling honored to wear the uniform and serve in the Air Force.”

Whether flying a mission or mentoring a young airman through his or her career, her service continues to enjoy her.

“I could not have predicted how much I would enjoy serving in the ANG. Air National Guardsmen, also known as citizen soldiers, have a dual mission (State and Federal). I am honored to serve and humbled by the level of leadership afforded me. The opportunity to serve as the SAS directing the air medical operations of the state of TN was not a role I could have imagined as a young airman. I am fortunate to have an opportunity to learn more about ANG leadership and operations at the state and national level.”

Above: Dr. Howard Vice-President, Chief Medical Officer (VP/CMO) for Methodist LeBonheur Germantown Hospital Fall 2018

“Without a doubt, I am the successful leader I am today due to my military service and training. The Air Force core values (Integrity First, Service Before Self, and Excellence in All We Do) have guided my thoughts, behaviors, and actions as an airman and leader. The degree of personal and professional development afforded me through my ANG affiliation has been priceless. I have benefited from the exposure to a team of awesome mentoring physicians and other leaders as I have matured through the ANG.” 17

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Your 2018 Legislative Recap TMA had one of its most active and successful legislative sessions in recent history during the second session of the 110th General Assembly. Our lobbyists tracked 447 bills and amended, supported or defeated more than 50 pieces of legislation impacting Tennessee physicians and/or patients. Hot topic issues included opioids, maintenance of certification, episodes of care, midlevel scope of practice, indoor tanning prohibition for minors, balance billing and tort reform.

The state’s largest and most influential professional organization for doctors passed three priority bills and amended or defeated numerous proposals that would have harmed the practice of medicine or interfered with the sacred doctor-patient relationship.

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Dr. James C. Fleming

Dr. Hollis H. Halford

Congratulations!

Church Health congratulates our long-time friends and volunteers, Dr. Hollis H. Halford and Dr. James C. Fleming for being 2018 Methodist Le Bonheur Healthcare’s Living Awards honorees.

On behalf of the Church Health family, thank you both for what you do for this community.

ChurchHealth.org/volunteer Church Health • 1350 Concourse, Ave. Ste 142 • Memphis, TN 38104 • 901.272.7170

keeping yourself fiscally fit William B. Howard, Jr., ChFC, CFP After serving as a medical doctor in the military for 10 years, I transitioned to the civilian world and now have my own successful practice. Thankfully, I have been blessed with the resources to donate to organizations that specifically help veterans. Should I be concerned about the 2017 tax legislation affecting my charitable contributions to these organizations? If so, are there alternate strategies you recommend?

Your generous gifts to veteran’s organizations are impacted only by the amount of future tax deduction received on your federal tax return. The 2017 tax legislation increased the standard deduction to $12,000 for individuals, $18,000 for heads of households, and $24,000 for married couples filing jointly. Total qualified deductions (including charitable contributions) will now have to exceed the higher standard deduction levels to be eligible for itemized deduction status and a tax deduction benefit.

In 2018, the maximum tax deduction received from a charitable contribution of cash to a qualified charity is 60% of adjusted gross income (AGI). Assets including long-term appreciated stocks and property (held over one year) are generally deductible at fair market value up to 30% of AGI. As a bonus, gifting appreciated assets rather than cash to a qualified charity increases the tax benefit because the donor avoids recognition of capital gain tax on the appreciation.

Unfortunately, the value of time spent volunteering is not deductible, but transportation cost and out-ofpocket expenses incurred are generally deductible if the expense is directly related.

Use caution with donations of household items and vehicles. The IRS limits the amount you can deduct based on condition and value of the donated item.

If you are over 70.5 years old, a qualified charitable distribution (QCD) from a tax-deferred retirement account (traditional IRA) may be a good alternative gifting strategy. A QCD is a tax-free distribution made directly to a qualified charity that satisfies the current year required minimum distribution obligation up to a $100,000 maximum.

There is no tax deduction, and you do not include the distribution as taxable income. Additional alternative gifting strategies include: private foundations, donoradvised funds, charitable gift annuities, and split interest trusts.

You should maintain detailed records of all your charitable contributions. Bank statements, payroll deduction records, and receipts from qualified charities are excellent ways to document your donations for the IRS. Your records should include the following information: qualified charity names, donation dates, donation amounts, description of properties contributed, property appraisals (if necessary), and a record of goods or services exchanged for gifts.

Crafting a plan that fits your specific needs can be complex, so I suggest you seek the advice of an estate/tax planning specialist in your area.

William Howard & Co. Financial Advisors, Inc. Fee only Financial Planning and Investment Advisory Services

William B. Howard, Jr., ChFC, CFP International Place II 6410 Poplar Ave., Suite 330 Memphis, TN 38119 Telephone: (901) 761-5068 Facsimile: (901) 761-2217

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your community Church Health A story of service to the community—Physician volunteers needed The story of Dr. Scott Morris' move to Memphis in 1986 and eventual creation of Church Health is wellknown in medical and philanthropic circles in our community. He came here to establish a clinic that would rely on volunteers from the medical community to serve people who worked but had no access to heathcare.

Morris’s story inspires countless people across the Greater Memphis community as well as teams from communities across the country to start faith-based health clinics of their own. In addition, the stories of the thousands of lives that have been improved thanks to the care they receive at Church Health highlight the trust, compassion and dignity experienced by patients for more than thirtyone years.

A Story of Trust Retired educator Lindia became an established patient after visiting Church Health’s acute care clinic. She was experiencing debilitating pain when she walked and was in need of orthopedic surgery. Dr. Morris referred her to the same doctor who had performed his own hip replacement.

“I was stunned that this doctor who didn’t even know me would refer me to his doctor,” Lindia said. “He didn’t have to do that, but he did.”

Months later, Lindia started experiencing fatigue and chronic stomach pain. She scheduled her appointment at Church Health. As she waited to for the day the appointment to arrive, she felt worse, and her condition deteriorated. Her daughter insisted that she visit the ER. She agreed despite her concern that she could not afford the care. At the hospital, her doctor assured her that Church Health would take care of all her medical costs. He also told her that if she had waited one more day to come, she possibly would not have survived.

“Church Health saved my life,” Lindia insists. “God put this place in my path to humble me and show me how I have to take care of myself so I can be here for my family and everyone else I know. Every day that I live is a gift from God.” 22

A Story of Dignity Senior patients like Lindia are common at Church Health. Historically, the organization has provided clinical care to working uninsured patients. Several years ago, Church Health began accepting Medicare coverage from established patients who had aged into the system. In addition, Church Health’s Healthcare Advisory Team offers guidance on Medicare, TennCare, and ACA Marketplace enrollment.

Providing this continuity of care ensures that Church Health patients – patients who may have chronic health conditions that are better managed with the wholeperson approach to care – can continue to access the care they need.

The MEMPHIS Plan, its signature program for selfemployed patients and small businesses, has been an integral program at Church Health for more than 25 years. Through the MEMPHIS Plan, small business owners and self-employed individuals based in Shelby County can provide affordable healthcare to their employees. “I have employees who have been on the MEMPHIS Plan for more than nine years,” said Elma Smith, owner of Caring For You Staffing, which provides at-home support for elderly and disabled patients. “That’s an indication that they are satisfied with Caring For You and the care they receive through the MEMPHIS Plan.”

A Story of Patience Church Health’s comprehensive healthcare requires support personnel serving alongside providers in each clinic. These “Champions of Care” include health coaches, social workers, nutritionists, counselors, dentists and many others who provide specialized care and support to patients who need to reach their health goals.

Allison Jones, LMSW, serves as Social Work Supervisor and has been on staff at Church Health since 2010. “I am grateful to be in a position to offer practical guidance and emotional support to our patients to help them navigate the challenges that life can present.”

The Memphis Medical Society Quarterly

current research UTHSC and Memphis VA Medical Center Part of Landmark National Study Showing Link Between Blood Pressure and Risk of Mild Cognitive Impairment and Dementia

Researchers at the University of Tennessee Health Science Center and the Memphis Veterans Affairs (VA) Medical Center were part of the SPRINT MIND (Systolic Blood Pressure Intervention Trial Memory and Cognition IN Decreased Hypertension) multisite clinical trial, which today released data showing aggressively lowering blood pressure reduces the risk of mild cognitive impairment (MCI) and a combination of MCI and dementia.

In Memphis, UTHSC was a large SPRINT study site following 175 participants since the study launched. Karen C. Johnson, MD, MPH, College of Medicine Endowed Professor in Women’s Health and professor of Preventive Medicine at UTHSC, is the principal investigator for the UTHSC SPRINT study site. Dr. Johnson is also the national vice chair of the SPRINT Steering Committee.

The Memphis VA Medical Center, also a SPRINT study site, entered 1,660 participants at 25 VA medical centers within the SPRINT Veterans Affairs Clinical Center Network (CCN). William Cushman, MD, chief of Preventive Medicine at the Memphis VA and professor of Preventive Medicine, Medicine, and Physiology at UTHSC, serves as the principal investigator for the VA Network. Dr. Barry Wall, also from the Memphis VA, is the co-principal investigator for the SPRINT VA Clinical Center Network and principal investigator for the VA Memphis SPRINT clinical site that recruited 80 veterans for SPRINT. Linda Nichols PhD, professor, and Jennifer Martindale-Adams, EdD, associate professor in the Department of Preventive Medicine at UTHSC, are also VA CCN consultants for the SPRINT MIND study. “To date, the results of SPRINT MIND provide the strongest evidence that by aggressively treating high blood pressure, there is a reduced risk of developing MCI or dementia,” Dr. Johnson said.

In SPRINT MIND, the researchers found a 19 percent lower rate of new cases of MCI in the intensive blood pressure treatment group, where the systolic blood pressure goal was less than 120 mm Hg. The combined outcome of MCI plus probable all-cause dementia was also 15 percent lower in the intensive treatment group versus the standard blood pressure group. The new SPRINT MIND findings provide promise that individuals can take steps to lower their risk of mild cognitive impairment and dementia, and it could be as easy as lowering their systolic blood pressure levels.

“Getting busy clinicians to get to a lower blood pressure goal will require the patient and all the members of the health care team contributing,” said Catherine Womack, MD, a SPRINT co-investigator and interim chair of the Department of Preventive Medicine and co-chief of the Division of Internal Medicine in the College of Medicine at UTHSC. “We were able to get patients to goal in SPRINT because we focused on an algorithm that required adjustment of blood pressure medications, if the individual participant was not at goal. As a result, the physician and the hypertensive patient will need to work together with regular visits to meet the lower target.”

Previous data from SPRINT has already had a world-wide impact on how people define hypertension and how doctors treat hypertension, with new blood pressure guidelines published by the American College of Cardiology and the American Heart Association in 2017.

“These results are promising in that there is strong evidence that there are things you can do that lower cardiovascular disease risk that will also reduce your risk of MCI and dementia,” Dr. Cushman said.

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The Memphis Medical Society Quarterly

ftäx à{x Wtàx President’s

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A REIMAGINED ANNUAL MEETING sA AT TURDAY Y,, jANUAR RY Y 26, 2019 6 O’CLOCK

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FEDEX EVENT CENTER, sHELBY fARMS PA PARK

your practice Vanessa L. Smith, CMDS Vice President ADF Medical Practice Development

Amid today's constantly changing healthcare landscape, successful medical practitioners are both skilled clinicians and savvy entrepreneurs. They recognize that, more than ever, medicine is a profession, but healthcare is a business. One of the many definitions of marketing for a doctor's office is: the ongoing process of finding, attracting and retaining patients. That's simple, short . . . and more challenging than ever to achieve with success.

Patients are our business. Creating and maintaining a patient-centered practice is not a new concept. Over 90 years ago, the creed of Cleveland Clinic founder Dr. William Lower provided exceptional insight, recognizing that "a patient is the most important person in the institution," and they "are not dependent on us, we are dependent on them," and ultimately "it is our job to satisfy them."

Savvy practitioners understand that "patient centered" has contemporary marketing interpretations. Recognizing patients as informed consumers who actively participate in their health care shows understanding of how your practice is the best one to meet those needs. Understanding that a connected relationship is an integral part of patient experience and satisfaction is key. Additionally, having a deep understanding of the needs and wants of potential patients and providing timely appropriate answers to those needs results in a greater degree of success.

Some medical practices rush to advertise what they most want to "sell," and they do so without regard for patient needs and expectations.

No one goes shopping to buy "a surgery" or a medical treatment. People are looking for providers who best communicate a greater well being and solution to their individual medical issue.

Some physician offices mistakenly account for marketing as if it were an expense item. In fact, it is the primary new revenue fuel, and the dollars wisely spent can achieve phenomenal ROI - upwards of 300%. Few investment in a medical practice achieve greater revenue growth. The most successful practices have implemented strategic, revenue-generating marketing and referral development with great success. Those principles apply to both small and large practices.

For more information on how to market and develop your practice, visit: www.adfmedical.com.

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The Memphis Medical Society Quarterly

M1

Reception & Dinner

Incoming medical students were treated to a reception and dinner hosting by The Memphis Medical Society at Dixon Gallery & Gardens Medical students, Society members and guests dined on barbecue from Leonard’s, enjoyed Memphis Made Brewing beer and Mountain Valley Springs water.

UTHSC Chancellor, Steve J. Schwab, M.D., spoke to the class as did M2 student Jennings Dooley and Memphis Medical Society President, Autry J. Parker, M.D. Everyone wished the students well as they begin their medical journey in Memphis.

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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.

your quarterly bulletin UPCOMING EVENTS October 2—Memphis Medical Society board meeting October 17—TMA Insurance Workshop, University Memphis October 18—MGMA Luncheon, Racquet Club November 6—Memphis Medical Society board meeting November 6-7—TMA President, Matthew Mancini, M.D., Visits Memphis November 11—New Alliance Kick Off Party, 3pm November 12—Legislative Reception, Buckley’s Lunchbox December 4—Memphis Medical Society board meeting

The Memphis Medical Society 1067 Cresthaven Road Memphis, TN 38119 901-761-0200 Fax: 901-374-9574 CEO/Executive Vice President Clint Cummins Executive Assistant Janice Cooper Director, Communications & Marketing Allison Cook Business Development Cailyn Bautista Finance Director Leah Lumm MedTemps Director, Healthcare Staffing Freda Reed MedTemps Administrative Coordinator Katie Yaun

January 26—President’s Gala

Memoriam Jack R. Halford, M.D. F. Oliver Hardy, M.D. Thomas Walker Monaghan, M.D. E. William Rosenberg, M.D. Clark B. Smith

April 25, 1929—August 2, 2018 July 8, 1943—June 30, 2018 October 19, 1932—August 5, 2018 March 11, 1930—July 21, 2018 June 6, 1932—November 30, 2017

The Memphis Medical Society Political Action Committee, also known as MEMPAC, is reinventing itself in order to place physicians at the forefront of politics in Memphis.

We have historically hosted an annual reception each year for our elected officials, and now want to add more elements such as bi-partisan candidate contributions and further opportunities to meet with candidates and elected officials.

To that end, we need your help!

Help us influence our next election by making a contribution today.

Visit www.mdmemphis.org and make a contribution today!

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The Memphis Medical Society Quarterly

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: myancey@ftb.com

Thomas Carlisle Relationship Manager Medical Private Banking ph: 901-681-2522 email: tcarlisle@ftb.com

Jeff McIlvain Vice President Medical Private Banking ph: 901-681-2555 email: jmcilvain@ftb.com

Chris Webb Vice President Medical Private Banking ph: 901-681-2523 email: cawebb@ftb.com

1067 Cresthaven Road Memphis, TN 38119