Summer 2013 TRIAD: Volume 24, Number 3

TriAd SUMMER 2013 vOLUME 24 ISSUE 3

THE AwARD wINNINg JOURNAL OF THE MICHIgAN OSTEOPATHIC ASSOCIATION

MOA COMPONENT SOCiETiES iN THiS iSSUE: • MAkE A diFFErENCE WiTH A COrE GrANT • THE NONAdHErENT OrTHOPEdiC SUrGiCAL PATiENT • HEALTH CArE rEFOrM iN 2014

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TABLE OF CONTENTS

FEATURES 17

Make a Difference: Apply for a Core Grant

18

Component Societies: What Can They Do for You?

23

Meeting the Challenges of the Nonadherent Orthopedic Surgical Patient

24

Health Care Reform: How Will it Affect Your BCBSM 2014 Renewal Rates and Invoices

10

DEPARTMENTS

18

5

Editor’s Notebook

7

President’s Page

9

AMOA News

10

D.O. Spotlight

12

Student Spotlight

13

Intern-Resident Program

14

Legislative Update

16

Inside the AOA

27

Practice Managers Column

28

Dean’s Column

30

Advertiser Index

24

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E d i T Or’S N O T E B O O k

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by JOHN SEALEy, D.O.

s the largest osteopathic medical association in our nation, Michigan is looked upon as a model for other states. We are consistently looking at ways to engage our members as well as provide additional value for their membership. Members of the Michigan Osteopathic Association (MOA) are always affecting positive change for our profession.

Our colleagues in the Lakeshore Component Society hosted an event featuring John Crosby, J.D., executive director of the American Osteopathic Association, where he discussed new ways of increasing member activity within our medical associations.

Our colleagues from the Oakland County Osteopathic Medical Association and Southwest Michigan Osteopathic Association both implemented the first-ever MOA Mini-Medical School. This educational event went into two different elementary schools within their districts and taught the students about bones, nutrition, exercise and much more.

Our colleagues in the Northern Michigan Osteopathic Association hosted another superior educational event, 2013 Annual Summer Conference, on Mackinac Island offering up to 20 hours of AOA Category 1-A CME credits.

These are just a few examples of what Michigan osteopathic physicians are doing or have done.

In this edition of TRIAD, the editorial committee wanted to provide a summer tour of our state by way of our component societies. The goal is really to introduce you to your local component society, get you updated on what they’re doing and help you get involved at your local level.

The MOA extends to 18 local component societies who represent the specific interests of osteopathic physicians within their specific district. The component societies exist to provide an opportunity for osteopathic medical professionals to network, advocate for the physicians, support each other and develop future state and national osteopathic medical leadership.

The component society is a first step in getting active in your association and help affect positive change for our profession. To learn more, please visit www.mi-osteopathic.org/governance.

JOHN SEALEy, D.O. IS TRIAD CO-EDITOR-IN-CHIEF AND A MEMbER OF THE MOA bOARD OF TRUSTEES. HE CAN bE REACHED AT DRIvERJwS@AOL.COM.

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PrESidENT’S PAGE

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by MICHAEL D. wEISS, D.O.

s the 115th President of your Michigan Osteopathic Association, I want to, first and foremost, thank you for your membership to our nation’s largest state association devoted to osteopathic medicine. Secondly, I am honored to serve the MOA members as president.

Being an MOA president is a mark on the continuum of things you can do to advance the osteopathic profession. As your president, I am honored to give back to a group of people that have taught me how to, essentially, live my life. Medicine is a huge part of my life and I have so many incredible people that have taught me life lessons.

Joanne Grzeszak, D.O. was the reason I went to D.O. school. I was involved as a counselor at 4-H conventions where I met Dr. Grzeszak. She took me on a tour of Fee Hall through the Anatomy lab and around the campus of Michigan State University. I fell in love with the osteopathic approach to medicine instantly, applied and started medical school.

Craig Magnatta, D.O. took me into the operating room to watch my first surgery. It was there that I met my first osteopathic physician; the renowned William G. Anderson, I, D.O., FACOS and his skillful surgical hands. And that was the beginning of my career.

These physicians and many others have all been generous with their expertise. They taught me as a medical student and continued to teach me as a resident and beyond.

That’s the osteopathic profession. That’s who we are. That’s what we D.O. My involvement in our association led me to these mentors and teachers who have made me a better physician and leader. It’s because of the Michigan Osteopathic Association, our educational opportunities, committees, component societies and much more that foster this connectivity which provide professional development.

MOA PRESIDENT MICHAEL D. wEISS, D.O. IS IN PRIvATE PRACTICE IN ObSTETRICS AND gyNECOLOgy AND SERvES AS THE DIRECTOR OF THE wOMEN’S wELLNESS INSTITUTE IN ROCHESTER HILLS. HE MAy bE REACHED AT DOCTORSTORk@SbCgLObAL.NET.

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AMOA NEWS

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by DANA bORENITSCH

t has been an amazing year serving as your president for the first time! I’m truly amazed at the support and help I received from everyone on my board and sincerely thank each of you! I appreciate all your time, interest and suggestions at our record attendance board meetings this year. I have learned a lot while meeting many outstanding doctors and advocates throughout the year!

I enjoyed beginning the year attending the freshman medical school student meet-and-greet. A flash drive was presented to each student to be used throughout the year at the barbecue as a result of one of our fundraisers. I also attended several MOCF board meetings and the leadership meeting held in Midland this fall as the Advocate representative. Several of us went to our state Capitol with some of our osteopathic medical students giving flu shots to many of the public and government officials.

It was an exciting experience to be at the National Convention in San Diego! Many of the advocates participated in the student Scavenger hunt around the downtown area cheering on the groups as they arrived at various check points. We also helped at the check-in table at the House of Delegates, and helped with the decorating for Nancy Granowicz’s installation. We were very excited to have two entire tables of Michigan advocates supporting Nancy Granowicz as she was installed as our National President. We are so proud of you, Nancy!

In November we got together to decorate the tree of peace at our MOA headquarters. This is another fundraiser we do when many families buy and sponsor various types of bulbs for our beautiful tree.

Last February was my first time attending the MOCF ball. It was one of the most elegant events my husband and I have ever attended! It was an enchanted, luxurious evening and I truly appreciated going as a guest of the Advocates!

One of the most exciting things we accomplished this year was raising money and getting contributions for a Virtual Driving Simulator. This enables a driver to experience distracted and impaired driving scenarios until you crash! We are so excited and motivated to move forward with this outreach to the public. We want to prove to the public the osteopathic profession’s dedication. We not only care for the health of our patients, but we are also, genuinely, concerned about their entire family and their safety on the roadways in their communities. We also featured the driving simulator at our membership table at the MOA’s 114th Annual Spring Scientific Convention, which many of you tried.

We had our most successful fundraising year-to-date at our state convention in Novi this spring! We conducted a raffle and had four large prizes. One was a stained glass caduceus; a large cooler filled with various Michigan products which included six bottles of wine and wine glasses; an iPod, iPhone and iTunes certificate; and the registration fee for next year’s state seminar. We thank you for your participation!

I cannot stress enough to those of you who haven’t yet joined our outstanding group of advocates, to please do so. This year has been a fantastic experience! I treasure the memories and sincerely thank everyone who had supported and helped our group accomplish our goals this year! I will continue as your president for a second year and am looking forward to a productive year with new experiences, meeting new members, serving, supporting and promoting the osteopathic profession any way we can!

We have such an exceptional group of Advocates! We’d love for you to become an active part with us. We welcome you and would love to hear your very important suggestions and ideas. Remember, you are needed!

DANA bORENITSCH IS THE PRESIDENT OF ADvOCATES FOR THE MICHIgAN OSTEOPATHIC ASSOCIATION. SHE CAN bE REACHED AT DbORENITSCH@HOTMAIL.COM. TRIAD, SUMMER 2013

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d.O. S P O T L i G H T iNSPirATiON. MOTivATiON. PErSPirATiON.

ON gERMAINE R. FRITZ, D.O.

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The route to fully realizing one’s life’s work requires all three.

Maybe in differing amounts, depending on the person, her experiences, her goals. Where she’s going, where she’s coming from.

Early in her medical training, Germaine Fritz, D.O., zeroed in on a very specific part of the body that inspired her, for its grace, for its importance. Even now, she gets excited when talking about it.

“The anatomy of the hand is the most beautiful portion of the body,” says Fritz. “There’s nothing you do on a daily basis that you don’t do with your hands. Eating, activities of daily living, work, hobbies, and sporting activities—there’s almost nothing you do that doesn’t involve your hands. That’s tremendous to me.”

Today Fritz is an orthopedist, and it’s no surprise that hand surgery is her subspeciality.

“My father was a strong motivator,” Fritz says. “Education was important. And he taught us that you could do anything if you put your mind to it.”

An interest in human anatomy, science and math began to develop for Fritz, and would end up defining her undergraduate experience.

When she was a student at the University of Michigan , she ran out of money and had to leave school. Leaning on her father’s teaching—and not one to give up—she moved home to save money and started taking classes at Macomb Community College.

Because she was paying for school herself, she opted to get a degree in something that would enable her to get a job sooner.

An associate degree in respiratory therapy got her in the medical field quickly, earning money and experience, and maybe most importantly, put her side by side with professionals that would impact her future enormously.

“When I got a job, I met a lot of osteopathic physicians and they were great. I asked them to tell me about osteopathic medicine,” Fritz says. What she learned inspired her to take the osteopathic medicine route.

Motivated by their work, she applied to Michigan State University’s College of Osteopathic Medicine with the assistance of those same inspirational colleagues, who wrote her letters of reference.

Because of her work in the ICU as a respiratory therapist, she first planned to become an intensivist.

But all that changed on the very first day of her orthopedics rotation.

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“My husband said, much later, that he knew that this is what I would end up doing by how I talked about it,” Fritz says.

“I love the procedures, office visits, simple surgeries, complex surgeries. I love the anatomy. There were a lot of things I was interested in in medicine. But I didn’t love the job. And I really like working with people. This fits all the criteria.”

Just as it takes these things to achieve something you enjoy doing to make a living, it also could be said that how well you embody them—by inspiring, motivating and encouraging others to work hard—creates a life.

Fritz is an avid foodie, kayaker, gardener and artist, creating for herself a well-rounded life in which there’s joy at work and at home—and setting an example of a successful life balance for those around her.

For the past ten years, she’s also selflessly given her time to

Orthopedics Overseas, using her skills and expertise to help medically underserved people in Peru, Costa Rica, Honduras, Nicaragua, St. Lucia, and Ethiopia. For two weeks every year when traveling with the organization, she makes a difference in the lives of many by teaching, performing surgeries and seeing patients.

“This is a very important part of me. It’s a wonderful thing to do,” Fritz said. “I’ve gotten so much out of it personally and professionally.” gERMAINE R. FRITZ, D.O., SPECIALIZES IN gENERAL ORTHOPEDICS, wITH A SUbSPECIALITy IN HAND AND MICROvASCULAR SURgERy. SHE IS A FREqUENT ACADEMIC LECTURER AND HAS PUbLISHED SEvERAL JOURNAL ARTICLES. SHE IS AFFILIATED wITH bOTSFORD HOSPITAL AND PRACTICES IN FARMINgTON HILLS, MICH.

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STUdENT SPOTLiGHT

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ON CHAUN M. gANDOLFO

s Student Doctor Trustee with the Michigan Osteopathic Association (MOA), Chaun Gandolfo shows great optimism and spirit in advocating for the osteopathic profession. Entering his second year at Michigan State University College of Osteopathic Medicine (MSUCOM), Gandolfo has already embraced the D.O. philosophy, despite the relatively short time he’s been active in the community.

“Osteopathic medicine attracts a different kind of person,” he says. “This community is caring, hardworking, intelligent, and friendly. I’m already forming long-lasting relationships both with my classmates and physicians. It’s such a close-knit family, and being a part of that is really great. Everyone is out there to help you and shares your goal of bringing osteopathic medicine to the world.”

It’s these aspects of the community that Gandolfo says not only started a love affair with osteopathy, but makes him confident in his choice of path in becoming a good physician.

Gandolfo earned his Bachelor of Science from Michigan State University in 2012, majoring in physiology and human biology and maintained a 4.0 GPA throughout his undergraduate studies. He serves as treasurer to the MSUCOM Class of 2016 executive board and as vice president of the Peer Mentor Organization. He is also a member of the Student Osteopathic Medical Association and Sigma Sigma Phi. Chaun enjoys working as a Blue Coat in an anatomy lab and volunteering at Ele’s Place.

He’s not quite decided on a specialty as of yet, but looks forward to getting more clinical experience in both a rural and urban setting under his belt to help make that determination. He does know that he’d like to stay in Michigan and deepening his relationship with the MOA family will remain a priority.

“I’d really like to be a dad and a husband some day - it’s my most important goal in life,” he says.

Making time for his family has always taken precedence; he cites making meals together with his Italian family as a great stress reliever.

“My best idea of fun is when my family is all together.” He also enjoys watching hockey and soccer.

Of his future in serving the MOA, Chaun says, “It’s been an incredible experience learning the intricacies of how the politics of medicine work. I look forward to becoming a stronger advocate, to bringing the concerns of my fellow students to the MOA, and helping to ensure the future of osteopathic medicine is represented well and integrated in moving the profession forward.”

CHAUN gANDOLFO IS A SECOND-yEAR MEDICAL STUDENT AT MSUCOM, STUDENT DOCTOR TRUSTEE, AND DEPARTMENT OF PUbLIC AFFAIRS CO-CHAIR. HE CAN bE REACHED AT gANDOLF4@MSU.EDU.

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iNTErN-rESidENT PrOGrAM

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by JASPER yUNg, D.O.

e truly stand at the crossroads of our generation. For the traditions of our past to become integrated in the future of our profession, we must define ourselves in the face of the new challenges that stand forth in the unification of the two major medical societies. There is a common respect that exists between the two, as we both bring forth the service of preserving and improving the profession of the healing arts. Our histories are entwined in the foundation of natural law and the human condition.

As Dr. Andrew Taylor Stills put forth that understanding the form of a structure, is to find function in its connection with everything it embraces. We must understand that our place in the dynamic changes of today will help bear meaning in our place in history. We must look beyond the scope of each day and find vision in the longevity of our profession. The world is watching as the two major societies learn to work in harmony towards the fabrication of a stronger medical society. Along this path towards a greater identity, we must also continue the process of fostering compassion and caring to our cause.

There is a constant concern over the shortage of post-graduate education programs available to our medical students prior to their matriculation. As our graduates take their first steps into applying their accumulated medical knowledge, they must be given the chance to enhance their acumen with residencies and fellowships available across the nation. This lack of continuing medical education threatens the livelihood of our future physicians and the legacy that they will leave behind. The shortage of postdoctoral education programs requires a collective effort in the establishing of new opportunities and improving upon the current training programs available.

As technology advances, we must evolve in our perspectives and utilization of these instruments for enhancing the public awareness of osteopathic medicine. The social network is now a constant wireless stream of communications that harbor the new possibilities of telemedicine and connective consciousness. These enhancements will further expand the reach of osteopathic medicine and its applications. This digital interactivity has provided an unlimited resource for educational enhancements and a continuous conduit for character development.

It is important that as we grow, we do not forget the past and the principles in which we have been founded upon as osteopathic physicians. It is this identity of understanding and intimate connections that brings us towards a greater presence within the medical community. The world is changing and as we approach our patients holistically, so too must we synergize the two medical societies.

Understandably the path is difficult and the call for action remains perpetual, it is imperative for us to remain vigilant in the preservation our professional identity. We must raise awareness, stay connected, and remain active in our community and in our cause to protect our professional legacy. We carry the torch to light the generations to follow. “United we stand, Divided we fall� (Aesop, 620-560 BC).

JASPER yUNg, D.O. IS THE EM/IM CHIEF RESIDENT AT ST. JOHN MACOMb-OAkLAND HOSPITAL AND A MEMbER OF THE MOA bOARD OF TRUSTEES. HE CAN bE REACHED AT JASPER.yUNg@STJOHN.ORg.

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LEGiSLATivE UPdATE

M by kEvIN MCkINNEy

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ichigan’s 2014 Fiscal Year budget was finalized on Tuesday, June 4 with the Senate approving the Omnibus Executive Budget bill on a nearly party-line vote of 24-14. The Education Omnibus budget had been approved by the Legislature during the final week of May with the House also giving approval to the omnibus Executive Budget bill during that time—allowing the Lower Chamber to claim it had met the self-imposed June 1 target date for having a completed budget. The final spending plan authorizes the total expenditure of $49.5 billion from all revenue sources.

While the budget process is now essentially complete, pending any gubernatorial vetoes, the actual heavy lifting took place during the final two weeks of May. The mid-May Revenue Estimating Conference generated new income numbers for the state giving lawmakers an additional $700 million to allocate if they wished. The money was quickly distributed during the Legislature’s target setting meetings with the Snyder Administration, with the bulk of the added money going to boost transportation ($350 million) and K-12 ($140 million) funding along with adding $75 million to the Budget Stabilization Fund. But, the target setting meetings also resulted in the decision not to delay the budget process in an attempt to address the two major political issues of the day—road funding and the expansion of the Medicaid program. Finding a legislative agreement to raise $1.2 billion annually for road and transit improvements has been pushed off until the fall, at the earliest. Despite the herculean push by the Governor and many business and health care provider organizations for passage of the Medicaid Expansion bill, the Senate did not take a vote on the bill during the last day of session prior to adjourning. Even though there appeared to be sufficient support in the Senate to adopt the measure, the Senate Republican Majority would not allow the issue to even come up for a vote on the Senate floor due to its own caucus rules in which a simple majority within the caucus (13 out of 26 members) must support an issue prior to allowing a vote on the floor. Bound by this caucus procedure, the Senate leadership was unable to convince its members otherwise and the bill will likely be sent to a committee for further review later this summer or early fall. The Michigan Osteopathic Association (MOA), along with most health care groups providing strong advocacy and lobbying efforts to expand the Medicaid program to provide health care for more than 450,000 uninsured working adults in Michigan will continue its efforts in hopes that the Senate will be able to return to session prior to the traditional return after Labor Day and pass the measure.

Due to the Governor’s priorities to adopt the state budget by June 1, resolve the road funding issue and adopt the Medicaid expansion program before summer break, many of the smaller but certainly no less contentious policy issues were pushed off or delayed until this fall when session resumes after the Labor Day holiday. I fully expect the legislature will take up scope of practice issues upon its return from summer break. Senate Bill 2 which is the APRN scope of practice bill remains on the Senate calendar, awaiting another concerted push by its sponsor and supporters. In response to SB 2, the Senate Health Policy Committee Chairman Jim Marleau will be introducing a health care work force bill that will provide a regulatory framework for primary care providers. While MOA has had initial discussions with Senator Marleau and his staff on the proposal, drafting of the bill will continue over the summer with an early fall introduction target date. The legislation will be an alternative approach to SB 2, but still one that seeks change and reflecting the level of education and training of APRNs. Given that the bill drafting continues on this measure, MOA has yet to take a formal position on Senator Marleau’s proposal.

I expect there will be a significant push for legislation to provide direct access to physical therapists

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(PTs). Physical therapists have long sought out direct access without a physician’s prescription and have made some headway in the legislature with a bill expected to be introduced this fall in the Senate.

I also anticipate a renewed effort in seeking additional changes and funding for the current loan forgiveness program for physicians. While MOA has been a strong supporter of previous and current legislative attempts to create a scholarship grant/student loan forgiveness program for primary care providers (expanded beyond primary care physicians) practicing in designated underserved areas, it appears that there is stronger interest to modify the current program rather than create a new program.

There will be a number of policy issues that MOA has on its 2013 legislative priority agenda that might get some attention this fall, including bills that would limit retro-active medical audits (HBs 4191 and 4192), a bill to limit the level of co-pay an insurer might require for a certain covered benefit or procedure (HB 4875), protection for patients with regard to co-insurance on specialty tier drugs (introduction this fall), requiring schools to have training and have non-patient specific auto-injectable epinephrine devices at school buildings to address anaphylaxis (HBs 4352 and 4353). MOA is also working with other key stakeholders including the Michigan Department of Community Health to continue to achieve/maintain high child immunization levels and to examine the recent spike of personal exemption waivers in the state.

Another attempt will be made by the auto insurance companies to place limits on personal injury protection benefits (PIP) which provide medical and rehabilitation coverage for auto-related injuries and place significant cost containment measures (fee schedules) on providers in Michigan’s auto nofault system. MOA will continue to work with the Coalition Protecting Auto No-Fault (CPAN) to oppose these proposals and work toward making necessary modifications to our system and address affordability of insurance, accountability for providers, insurers and patient, and address fraud in a fair and balanced manner.

Finally, during summer recess when legislators are home in their districts, I strongly encourage you make an effort to reach out and meet with them. You can do this through a scheduled appointment or stop in on one of their many coffee hours or open office hours they hold for constituents. Most often, when

there is not a burning issue or legislative crisis to be resolved, you will have the most impact in engaging your legislator and educating them on your particular issue of concern or interest.

If you do not already have a relationship with your legislator, please visit www.mi-osteopathic.org/MyElectedOfficials and find out who represents you in both the House and Senate.

Or, you may always call my office, 517-487-2811, if you have a particular question on a legislative or political issue prior to contacting and meeting with your own legislator. Your personal involvement in the legislative process and the political arena by generously supporting MOPAC will continue to foster a winning environment for both patients and physicians. kEvIN MCkINNEy HANDLES THE MOA’S gOvERNMENTAL AFFAIRS AND MAy bE REACHED AT kEvIN@MCkINNEyANDASSOCIATES.NET

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iNSidE THE AOA

YOUr AOA: NOT JUST ABOUT WHAT WE CAN dO FOr YOU, BUT WHAT WE CAN dO TOGETHEr

by JEAN O’bRIEN

Who do you call when you’re facing an audit, experiencing difficulties securing practice rights in another country, or struggling to pick up the pieces of your practice after a natural disaster? For several of our members, the AOA has been their first point of contact. When Hurricane Sandy hit the East Coast, the AOA’s Osteopathic Family Relief Fund responded with $94,000 in grants to DOs and osteopathic medical students whose homes or practices sustained damage. The AOA staff has been on the other side of the phone line as stressed members told stories of denied claims and expensive penalties. They listened, investigated, and wrote letters on their behalf so they could receive full compensation for their services.

And it’s not only the insurance companies the AOA speaks to on your behalf. The AOA is the only national physician organization that advocates solely on behalf of all osteopathic physicians. Outside of our borders, the AOA has worked tirelessly to make sure that the DO degree is recognized universally by establishing full practice rights for DOs in over 60 countries and counting. As the unifying voice of osteopathic medicine, we work to protect and promote the rights of all osteopathic physicians. Our Washington office is dedicated to preserving the cornerstones of osteopathic medicine, representing the profession at the White House, the Department of Health and Human Services and the Centers for Medicare and Medicaid Services. To keep you informed of these efforts, the AOA has hosted 25 town hall meetings over the past several years and broadcasted them on the Web. The AOA staff has moved the needle on policies that matter the most to our members, but they did not do it by themselves. Change would not have occurred without the participation of members who sign petitions, serve on our governing bodies, and attend legislative events in their state capitals or on Capitol Hill during DO Day when more than 1,000 DOs and osteopathic medical students come face-to-face with members of Congress. To continue our advocacy efforts, we will need the collective support of all our members.

The profession also manifests a strong presence on state legislation. State and national collaboration has been instrumental in securing and protecting seats on medical licensing boards and in addressing core issues with local legislatures, ensuring DOs needs are heard loud and clear. We have lobbied with and joined numerous affiliated organizations in sending joint letters to state officials on issues like scope of practice and professional liability insurance reform.

The AOA’s mission is to be the professional home for all osteopathic physicians. So, visit Osteopathic.org, give us a call, email us, and join your colleagues at OMED, our annual meeting coming up Sept. 30-Oct.4 in Las Vegas.

We’ve been here for our members for more than 100 years and we’ll be here for you too.

JEAN O’bRIEN IS CURRENTLy THE AMERICAN OSTEOPATHIC ASSOCIATION’S MARkETINg COMMUNICATIONS MANAgER. SHE CAN bE REACHED AT JObRIEN@OSTEOPATHIC.ORg.

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FEATUrE

MAkE A diFFErENCE APPLY FOr A COrE GrANT APPLICATIONS DUE by SEPTEMbER 30, 2013 Do you have a program or initiative in the works that needs funding? Michigan Osteopathic Association is committed to supporting our members’ projects through our annual Core Grants program, which was established in 2007 by the MOA Michigan Council of Osteopathic Physicians (MCOP).

Each year, MOA awards three Core Grants of $1,000 each to initiatives that illustrate a commitment to primary care and prevention, one of the basic tenets of osteopathic medicine and the “core” of good health.

Types of eligible projects include, but are not limited to: • Educational event series • Research projects • Patient-centric campaigns • Health clinics • Community education programs • Health fairs • Other projects that represent the osteopathic values of preventive health and wellness Some projects that have been funded in the past include: • Marketing and educational materials for a free skin cancer screening program • Student travel expenses for a medical missions • Materials and tools needed to provide free eye exams and eyeglasses • Bone marrow drives • Concussion education for athletes, coaches and parents

• Project goals including purpose, audience, methods and objectives • An explanation of why funding assistance from MOA is needed, how it would help in the implementation of the program and how funds will be used Three award winners will be chosen by a panel comprised of members of the MOA MCOP Committee and notifi ed in September 2013. Recipients of MOA Core Grants will be chosen based on three key criteria: need, project feasibility and how well the project embodies the osteopathic values of preventive health care.

Award winners and their programs will be highlighted in TRIAD and on the MOA website in order to share the details with other MOA members for possible replication in their own communities. Therefore, winners are requested to update the MOA MCOP Committee with project outcomes.

We look forward to receiving your submissions. Best of luck!

InTeresTed In ApplyIng for A core grAnT? here’s hoW: Please apply by September 30, 2013. Grant requests must include: • A project abstract (100 words or less) • A detailed project description (approximately 1,000 words) including: • How the project embodies the osteopathic values of preventive health care

Thursday, Feb

ruary 14, 201

4:00 p.m. – 7:0 Wharton Cen

419-787-1394 Derick Asah, u.edu asahderi@ms

3

0 p.m.

ter

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COMPONENT SOCiETiES

WHAT CAN THEY dO FOr YOU? by vERONICA gRACIA-wINg ThInk globAl. AcT locAl. We’ve heard the phrase time and again. For the Michigan Osteopathic Association, this philosophy is applied to our 18 local component societies throughout the state. The component societies represent the specific interests of osteopathic physicians within their specific district or county.

Component societies exist to provide an opportunity for osteopathic medical professionals to network, advocate, support each other and legislative issues and develop future state and national osteopathic medical leadership.

Additionally, each component society is entitled to identify a number of delegates based on the MOA bylaws. Those delegates serve in the MOA House of Delegates, the voting body of the MOA, which then acts on resolutions and matters of policy.

“Component societies are the eyes and ears for the profession,” says Lawrence Abramson, D.O., MHA. “They provide the necessary input for establishing programs and services for MOA members as well as developing advocacy positions for physicians and the patients they serve.”

Component societies are sources for developing the leaders for the state and national organizations by providing local opportunities to obtain the necessary experience for assuming leadership roles to interested physicians. Societies also provide a conduit for informing and educating physicians on clinical as well as health policy issues to enhance clinical practice and personal effectiveness.

“These opportunities support a sense of physician community,” notes Abramson.

Beyond their mandated responsibilities defined by their 18

TRIAD, SUMMER 2013

charters, component societies provide a place for social networking for physicians. In some areas where there are osteopathic medical students, interns or residents, it provides a place for social interaction between these individuals and physicians practicing in their communities. This provides a venue beyond the typical structural confines of a designated hospital or health system further enhancing a sense of an osteopathic community.

Component societies can provide education based on needs assessment within the local area, addressing health issues of greater importance to a designated area, engaging in community health programs to enhance the well-being of individuals living in their communities and assisting in communications from local health authorities to practitioners in the community.

“The healthcare environment change rate continues to accelerate and the pressures of maintaining a practice continue to increase with it; the burnout rate in recent surveys suggests that support systems need to be in place to address some of those issues,” says Abramson. “Learning is no longer limited to just clinical areas – learning how to effectively address the challenges of practice requirements, staying current clinically, and establishing life balance is critical for a healthy physician population.”

The shared experiences available through participation in component society activities serve as an aid to physicians in this struggle. Influencing health policy is just one aspect. Understanding how to effectively influence elected officials can go a long way to reducing some of the regulatory stresses in practice. The local component is a way to organize that activity.

Being involved has had an immense impact on Dr. Abramson,

FEATUrE

who currently serves as MOA Trustee and Department of Insurance Co-Chair.

“In the beginning I was much like most members – I just showed up. As I came to understand the role and potential role that the component society could and should pursue, it became evident to me that I needed to be more involved.

Over time this lead to assuming leadership positions within the component and eventually to leadership positions in other organizations both within and external to health care. I learned the roles of governance, management and education, and with that the associated tools and techniques to be effective in those realms; I learned about policy and politics – aspects that are generally unfamiliar to physicians. Being involved has added multiple dimensions to my professional and personal life. And, along the way, I have made numerous friendships that I would have otherwise missed.”

Donna Moyer, D.O, who served as MOA President in 20092010, shares similar feelings.

“I served as president of my component society for quite a long time,” Moyer says.

“The society, for me, was about being able to stay focused with my colleagues and address the issues physicians face, acting as a cohesive group. Maintaining camaraderie is incredibly valuable at many levels.”

To get a taste for the local component societies’ activities, we spoke to several around the state.

Read on to find out what they’ve been up to:

oAklAnd counTy osTeopAThIc MedIcAl AssocIATIon neWs froM presIdenT MAryJo Voelpel, d.o.

“The Oakland Count Osteopathic Medical Association has been busy working on a manual for board members. One of our goals this year is to develop a better understanding of what we need to be doing as a component society to maximize our impact for members. The board manual is just one way we think we can improve our level of commitment. We strive to incorporate education for students and physicians and social elements inclusive of members’ partners into our each of our meetings or activities. Commitment to community and area partnerships is also very important at OCOMA. On June 29, we celebrated our 2nd Annual Summer Blast, enjoying a pig roast, youth band, guests from the Michigan legislature and Dr. William Strampel. We presented a $500 donation to the Advocates for the Michigan Osteopathic Association following

5

norThern MIchIgAn osTeopAThIc AssocIATIon neWs froM presIdenT keITh WrIghT, d.o.

“The northern component society is pretty peaceful right now. We recently started a $30,000 endowment fund for the Michigan State University College of Osteopathic Medicine students, which will be managed at MSU’s discretion. Additionally, we just returned from the 2013 Annual Summer Conference, a tradition we’ve kept for 20 years. Over 130 providers joined us on Mackinac Island for community building and continuing medical education.

We’ve met our objectives for the year and were very pleased over the turnout at the annual meeting.”

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The Michigan Osteopathic Association (MOA) extends to 18 local component societies to represent the specific interests of osteopathic physicians within their specific district or county.

Component societies exist to provide an opportunity for osteopathic medical professionals to network, advocate for the physicians, support each other and legislative issues and develop future state and national osteopathic medical leadership.

Additionally, each component society is entitled to identify a number of delegates based on the MOA bylaws, to serve to the MOA House of delegates, the voting body of the MOA which acts on resolutions and matters of policy.

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Bay Association of Osteopathic Physicians and Surgeons, Inc. Region 2 President: William Morrone, D.O. (989) 583-6800 william.morrone@sbcglobal.net

Macomb County Osteopathic Medical Association Region 1 President: MaryJo Voelpel, D.O. (734) 692-5004 cearles@mi-osteopathic.org

Central Michigan Association of Osteopathic Physicians and Surgeons, Inc. Region 4 President: Monica Steury, D.O. (989) 291-5077 mokilee@hughes.net

Northern Michigan Osteopathic Association Region 5 President: Keith Wright, D.O. (989) 734-2171 wrightke@speednetllc.com

Eastern Michigan Osteopathic Association Region 2 President: Olan Dombroske, D.O. (810) 346-2757 Genesee County Osteopathic Society Region 2 President: Bonita Wang, D.O. (810) 732-1900 bwinmich@yahoo.com Ingham Osteopathic Association Region 3 President: Francis Komara, D.O. (517) 347-1555 moa@mi-osteopathic.org Kent County Osteopathic Association Region 4 President: Adam Wolfe, D.O. (616) 252-5201 adam.wolfe@me.com www.kcoa.us Lakeshore Osteopathic Association Region 3 President: Robert Piasecki, D.O. (269) 982-5864 lungs@qtm.net Lapeer County Osteopathic Association Region 2 President: Mark Braniecki, D.O. (810) 245-5562 mark.braniecki@genesyspho.com Livingston County Osteopathic Association Region 3 President: William Bush, D.O. (517) 548-1246 wbush2@earthlink.net

Oakland County Osteopathic Medical Association Region 1 President: Patrick McClellan, D.O. (734) 692-5004 cearles@mi-osteopathic.org www.ocoma.net Saginaw County Osteopathic Society Region 2 President: Edwin George Galsterer, D.O. (989) 753-7739 drgalsterer@chartermi.net South Central Osteopathic Association Region 3 President: Ralph Otten, D.O. (517) 353-3211 otten@msu.edu Southeastern Michigan Association of Osteopathic Physicians and Surgeons Region 3 President: Keith Barbour, D.O. (734) 241-0560 info@mindbodyandmotion.com Southwest Michigan Osteopathic Association Region 3 President: Kevin Beyer, D.O. (269) 385-9900 kevinbeyer@sbcglobal.net Wayne County Osteopathic Medical Association Region 1 President: Stephen Bell, D.O. (734) 692-5004 cearles@mi-osteopathic.org Western Michigan Osteopathic Association Region 4 President: Gary Doublestein, D.O. (231) 740-3363 gary.doublestein@hotmail.com

Component Societies

FEATUrE

Component societies are sources for developing the leaders for the state and national organizations by providing local opportunities to obtain the necessary experience for assuming leadership roles to interested physicians. their presentation on a new driver instructor tool used to teach people about the impacts of texting while driving. We’re challenging fellow component societies to donate to the effort in the hopes of having this valuable tool reach more people. Currently, we have about 800 members and would love to see both new and more involved faces alike.”

1,000 people attend the event and we’re proud of the value it provides to Saginaw County residents. We’d love to hear from anyone interested in joining an active component society!”

souTheAsTern MIchIgAn AssocIATIon of osTeopAThIc physIcIAns And surgeons

souThWesT MIchIgAn osTeopAThIc AssocIATIon

neWs froM presIdenT keITh bArbour, d.o.

“The southeastern component society is busy getting up to neWs froM presIdenT keVIn beyer, d.o. date and ‘legal.’ We will then be holding regular meetings to “The SWMOA held its biannual meeting in April in down- educate our members in the easy application of Osteopathic town Kalamazoo. Patrick Conley was a guest speaker, pro- Manipulative Treatment in any situation for the improvement viding an interesting and informative presentation on The of outcomes, bottom lines and public image and awareness of Affordable Care Act. Dr. Myral Robbins, a distinguished the osteopathic difference.” member of SWMOA, was voted to be President-Elect of MOA at the annual convention in May. SWMOA continues to strive MAcoMb counTy osTeopAThIc MedIcAl to provide its members with up-to-date legislative news as AssocIATIon well as pertinent health care related news. All local D.O.s are neWs froM presIdenT pATrIck McclellAn, d.o. encouraged to become involved in this association in order to “Macomb started off the year with the induction of board support the osteopathic profession and enjoy social interac- and officers with a dinner meeting at Sajos’ Restaurant. I, Pattion with colleagues. The next meeting of SWMOA will be in rick McClellan, D.O., was installed as MCOMA president. Just September.” a week later, we held a membership meeting that centered on the discussions between AOA and ACGME relating to educasAgInAW counTy osTeopAThIc socIeTy tion and training of our physicians. It was a panel discussion neWs froM presIdenT edWIn george comprised of Boyd R. Buser, D.O., Kari Hortos, D.O., Kirsten gAlsTerer, d.o.

Waarala, D.O., Michael Opipari, D.O., Jonathan Rohrer, Dmin, “We welcomed many new members this year, and couldn’t PhD. The group provided the facts that were available at the be more excited to offer this value to more physicians. We’re time and then opinions on where it was going along with a finding we’re diversifying our traditionally family practice ori- question and answer period. We hoped this would dispel some ented membership base to also now include more and more of the rumors circulating on the topic. Our goal this year is to specialists. We’re looking forward to a joint meeting with the educate our members on the topics that are affecting their pracSaginaw Allopathic Society in September. In November, we’ll tice of medicine and to provide insight to our student populahost a meeting at the Saginaw Country Club that will cover the tion on what to expect once they enter practice. important topic of ICD-10 for physicians. And in December, As MCOMA president, I would like to extend a heartfelt we’ll hold our annual holiday dinner and social. Most of our invitation to all physicians and their spouses to become a part meetings have a continuing medical education component, but of our osteopathic community in Macomb, either through the we also strive to ensure we’re inclusive of our members’ families medical association or with the Macomb Advocates group.” in our events as well. Every year we participate in the Saginaw County Free Health Fair, providing free health screenings. Over TRIAD, SUMMER 2013

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FEATUrE

WAyne counTy osTeopAThIc MedIcAl AssocIATIon neWs froM presIdenT sTephen bell, d.o.

“This has been a big year for Wayne County Osteopathic Medical Association, our longtime executive director, William Anderson, D.O. stepped down and I, Stephen Bell, D.O., was selected as his replacement. Our first big meeting of the year was our Legislative Forum held at Andiamo’s in Dearborn. We had nearly 100 of our members attend the event. WCOMA hosted the panel of legislators addressing the concerns of member physicians in Wayne County. Included on the panel were Senate Majority Leader, Randy Richardville (17th State District), State Representative Dale Zorn (56th House District), State Representative Bill LaVoy (17th House District), Thomas Stallworth (7th House District) and State Representative David Knezek (11th House District). During the panel discussion the topics included the expansion of Medicaid, Access to Primary Care, Scope of Practice issues, Auto No-Fault, strengthening funding for Mental Health Services and Chronic Disease, specifically Obesity and Type 2 Diabetes. Following the panel discussion, moderated by MOA legislative liaison, Kevin McKinney, some

of the legislators remained to speak one-on-one to our physicians. Our next meeting will be held in early September and is expected to provide one hour of 1-A CME credit with the topic being patient safety, we hope you can join us.”

In addition to the northern Michigan, Oakland County, southwest Michigan and southeastern Michigan societies, other societies around the state are the Bay Association of Osteopathic Physicians and Surgeons, Inc., Central Michigan Association of Osteopathic Physicians and Surgeons, Inc., Eastern Michigan Osteopathic Association, Genesee County Osteopathic Society, Ingham Osteopathic Association, Kent County Osteopathic Association, Lakeshore Osteopathic Association, Lapeer County Osteopathic Association, Livingston County Osteopathic Association, Macomb County Osteopathic Medical Association, South Central Osteopathic Association, Wayne County Osteopathic Medical Association and Western Michigan Osteopathic Association.

FOR MORE INFORMATION ON HOw TO CONTACT OR JOIN yOUR LOCAL COMPONENT SOCIETy, vISIT THE AbOUT/gOvERNANCE TAb AT www.MI-OSTEOPATHIC.ORg.

Component Societies To_learn_how_you_can_make_a_difference_in_osteopathic_medicine,_ please_contact_your_component_society_president_or_the_ Michigan_Osteopathic_Association_at_moa@mi-osteopathic.org_or_800-657-1556.

Name___________________________________________________AOA#_________________ Address______________________________________________________________________ Phone_____________________________E-mail______________________________________ Please_contact_me,_I_am_interested_in_learning_more_about:_ m_Becoming_a_member_m_Upcoming_meetings_m_How_to_become_a_Delegate_for_the_MOA m_Other________________________________________________ My_osteopathic_component_society_is: m_Bay m_Central_Michigan m_Eastern_Michigan m_Genesee_County m_Ingham m_Kent_County 22

m_Lakeshore m_Lapeer_County m_Livingston_County m_Macomb_County m_Northern_Michigan m_Oakland_County

m_Saginaw_County m_South_Central m_Southeastern_Michigan m_Southwest_Michigan m_Wayne_County m_Western_Michigan

You d.O. Make a difference

TRIAD, SUMMER 2013

s

e

MEETiNG THE CHALLENGES OF THE NONAdHErENT OrTHOPEdiC SUrGiCAL PATiENT

by CyNTHIA MORRISON, RN, CPHRM Orthopedic surgery as a specialty often requires timesensitive treatment options. Patient compliance with the plan of care is essential. The Doctors Company’s orthopedic closed claims study supports that factors such as nonadherent behaviors affect patient care outcomes. These behaviors include, but are not limited to, failing to comply with the recommended treatment plan (such as wound and cast care), missing or canceling follow-up appointments, and not following the prescribed medication/activity regimen. Consider the following tips for managing nonadherent behavior.

oVercoMe bArrIers To coMMunIcATIon. Effective communication provides the link to patient satisfaction—which leads to adherence and, ultimately, to a more favorable outcome. Failure to comprehend and adhere to the planned treatment process may be related to the patient’s health literacy or competency level, cultural barriers, or fi nancial restraints.

Determine the extent of the patient’s comprehension. Ask the patient or interpreter to repeat back what was said during the informed consent process, the treatment plan discussion, or any educational session with you or your staff.

Use language services for your limited English profi ciency (LEP) patients. Educational tools, such as the Ask Me 3 approach, are also helpful. Ask Me 3 identifi es three simple questions that all physicians should be ready to answer. More information about the Ask Me 3 communication tool may be obtained at www.thedoctors.com/askme3.

Establish written fi nancial policies and procedures and consider using payment plans to assist patients in meeting their fi nancial responsibilities.

MeeT The pATIenT’s eXpecTATIons.

Provide the patient with the information he or she needs to make an informed decision. A patient who is comfortable

and agrees to a recommended plan is more likely to comply. List the patient’s responsibilities as part of the written instruction plan, and provide a copy to the patient.

docuMenT The pATIenT’s behAVIor. Document the nonadhering behavior, such as canceled or no-show appointments, not taking medications, and failure to follow instructions. A well-documented record that refl ects the patient’s responses demonstrates the provider’s attempts to develop a plan of care. If, at some point, the physician-patient relationship is discontinued, documentation supports the physician’s efforts.

InVolVe The pATIenT. Emphasize patient involvement by using information tools, such as Web site links, bulletin boards, educational materials, written instructions, and reminder calls and notifi cations.

MAnAge conTInued nonAdherenT behAVIor. Continued nonadherent behavior impedes the ability to establish a therapeutic physician-patient relationship and may require dismissing the patient from your practice.

There are steps to be followed when dismissing a patient under your care. A patient safety representative can assist you with this process.

CyNTHIA MORRISON, RN, CPHRM IS A PATIENT SAFETy/RISk MANAgEMENT ACCOUNT EXECUTIvE wITH THE DOCTORS COMPANy.

THE gUIDELINES SUggESTED HERE ARE NOT RULES, DO NOT CONSTITUTE LEgAL ADvICE, AND DO NOT ENSURE A SUCCESSFUL OUTCOME. THE ULTIMATE DECISION REgARDINg THE APPROPRIATENESS OF ANy TREATMENT MUST bE MADE by EACH HEALTHCARE PROvIDER IN LIgHT OF ALL CIRCUMSTANCES PREvAILINg IN THE INDIvIDUAL SITUATION AND IN ACCORDANCE wITH THE LAwS OF THE JURISDICTION IN wHICH THE CARE IS RENDERED. REPRINTED wITH PERMISSION. ©2013 THE DOCTORS COMPANy (www.

THEDOCTORS.COM).

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TRIAD, SUMMER 2013

PrACTiCE MANAGErS COLUMN

by MIMI OwEN

r

unning an effective practice is not easy. With all the changes in our industry and the amount of incentive programs, it’s difficult to identify the options that work for you and your practice. Below I’ve identified some tips on a few programs that may be worth researching:

• Electronic Medical Records (EMR) – If you’ve implemented an electronic medical record system, or are still searching for one, remember to mention to your vendor that it’s not just the Meaningful Use incentive you are interested in. Many systems offer features like disease registry, test tracking and patient reporting at an affordable price that can help fulfill the requirements for incentive payment with just the click of a button. With the right choice, the cost of your EMR may be offset by the incentive dollars instead of claims dollars.

• Meaningful Use – When choosing the right program(s), take the time to weigh out the pros and cons. Ask yourself not just how much money will this bring in but also how much money it will cost to achieve the requested goal(s) that you’ve set. Will the incentive payment truly help revenue or will it be a wash? Do you have the man power to accomplish the tasks that are set forth? Can you afford to take a cut if you do not follow the governments requirements of going electronic? How will it affect the future of your practice if you don’t choose to participate?

Understand the use of the menu and core objectives and prepare your staff early for the changes that lie ahead.

• Patient Centered Medical Home (PCMH) – With the constant increase in work flow we sometimes think “How can we manage it all and still run an effective practice where quality patient care is the primary goal?” Taking on too many incentive programs at one time can be tempting but the disruption in work flow may cause a greater risk for patients and the dissatisfaction of feeling overworked for employees. Increasing revenue is optimal, however, when your medical assistant is dedicating more time to completing health assessment forms and registry information than to patient care, you may have to stop and look at the bigger picture.

• Physician Quality Reporting System (PQRS) – Once you have initiated some of the bigger program requirements, you will easily meet the criteria for CMS’ satisfactory reporting. You would not receive additional payment but it will keep your physicians from facing a penalty for non-participation but PQRS participation could help boost incentives in additional programs.

• ICD-10 – Deadlines are set and with every day that passes, we work harder to keep things in compliance. Dealing with rising operating costs and managing finances while trying to avoid Medicare cuts and insurance reimbursement delays doesn’t help make those goals any easier.

Make sure that your billing staff is certified and qualified while preparing for the October 1, 2014 deadline.

As always, your MOA practice manager committee is always available for questions. Please let us know how we can help you.

MIMI OwEN IS THE PRACTICE MANAgER FOR MAPLE CARDIOLOgy AND INTERNAL MEDICINE IN wEST bLOOMFIELD. SHE CAN bE REACHED AT MAPLECARDIOLOgy@yAHOO.COM.

TRIAD, SUMMER 2013

27

dEAN’S COLUMN

SEEdiNG THE FUTUrE

by wILLIAM STRAMPEL, D.O.

For all the expenses of running a top-notch college of osteopathic medicine, working to provide scholarships for our nearly 1,300 students is one of the highest priorities for our fund-raising. This isn’t simple philanthropy. It’s an important issue that impacts our recruitment, student success, and nothing less than choices that will signifi cantly impact the health care systems of our state and nation.

Hyperbole? Consider this, please.

Our tuition and fees, set by the MSU Board of Trustees, are among the highest of medical schools in the nation. In 2012-13, Michigan residents paid $38,634 and nonresidents paid $80,526 for each three-semester year, not counting living expenses, equipment, travel and more Among our 2012 graduates with educational debt, the average indebtedness was nearly $196,000.

With those data you can see the impact. Prospective students may have excellent qualifi cations otherwise but can’t see past that fi nancial black hole and choose other careers or other colleges. Enrolled students, working from dawn to dusk to keep abreast of their studies, cannot earn money for themselves or their families, and must deal with an additional signifi cant stress in medical school. And in a nation that has far too few primary care practitioners in the face of looming demand, student debt at graduation makes higher-paying specialties that much more attractive.

In addition, MSUCOM has since its inception valued the provision of health care to our most vulnerable populations. We know that recruiting osteopathic students from areas of need maximizes the chance that they will return as physicians to serve these areas of need. Our commitment means that even more scholarship funds will be requir ed for these students.

The Northern Michigan Osteopathic Association, an MOA component society, is the latest of our donors to create endowed scholarships for our students. Using some of the revenue from their annual convention, they’ve established a fund that will allow ongoing scholarships to help students from their area to attend MSUCOM. It’s a great example, and one that will reap benefi t for the northern Lower Peninsula and the Upper Peninsula as these students return to practice in the area, ensuring a vibrant D.O. presence.

If you or your organization is interested in establishing endowments for scholarships, please contact Chris Surian, director of development; christopher.surian@hc.msu.edu; 517-355-8355.

Thank you! wILLIAM STRAMPEL, D.O., IS DEAN OF THE MICHIgAN STATE UNIvERSITy COLLEgE OF OSTEOPATHIC MEDICINE. HE CAN bE REACHED AT PAT.gRAUER@HC.MSU.EDU.

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AdvErTiSEr iNdEX Association Benefi ts Company ...............................................4 TrIAd sTAff John W. Sealey, D.O. & Craig Glines, D.O., Editors-in-Chief

Botsford Hospital .................................................................25

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Brodsky Investment Company .............................................15

William Strampel, D.O., Contributing Editors Kris T. Nicholoff, Executive Director Lisa M. Neufer, Director of Administration

CT Lilly .................................................................................8 David Leszkowitz, D.O. .......................................................29

Kevin M. McFatridge, Manager of Communications Cyndi Earles, Director, MOA Service Corporation Shelly M. Madden, Manager of Membership Marc A. Staley, Manager of Finance Wendy Batchelor, Manager of Physician Advocacy

Health Law Partners PC .......................................................31 Kerr Russell & Weber PLC ..................................................29 Lean Fox Solutions ................................................................8

Carl Mischka, Advertising Representative Keystone Millbrook, Layout and Cover Design

MSU College of Osteopathic Medicine .................................29

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Michael D. Weiss, D.O., President Myral R. Robbins, D.O., President-Elect Robert G.G. Piccinini, D.O., dFACN, Secretary/Treasurer Edward J. Canfi eld, D.O., Immediate Past President

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Kurt C. Anderson, D.O., Past President

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Lawrence J. Abramson, D.O., MPH, & Bruce A. Wolf, D.O., Department of Insurance

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Lawrence L. Prokop, D.O. & Chaun Gandolfo, Department of Public Affairs John W. Sealey, D.O. & Craig Glines., D.O., MSBA, FACOOG, Department of Education Jeffrey Postlewaite, D.O. & Jasper Yung, D.O., Department of Membership The osteopathic profession in Michigan is made up of osteopathic physicians, osteopathic hospitals and an osteopathic medical school. This TRIAD stands together to serve our patients and one another. TRIAD, the offi cial journal of the Michigan Osteopathic Association, serves Michigan’s osteopathic community, including its osteopathic physicians, hospitals, medical school and patients.

The Michigan Osteopathic Association will not accept responsibility for statements made or opinions expressed by any contributor or any article or feature published in TRIAD. The views expressed are those of the writer, and not necessarily offi cial positions of MOA. TRIAD reserves the right to accept or reject advertising. The acceptance of an advertisement from another health institution or practitioner does not indicate an endorsement by MOA. TRIAD (ISSN 1046-4948; USPS 301-150) is published quarterly by the Michigan Osteopathic Association, 2445 Woodlake Circle, Okemos, MI 48864. Periodical postage paid at Okemos, MI 48864 and other post offi ces. Subscription rate: $50 per year for non-members. All correspondence should be addressed to: Communications Department, Michigan Osteopathic Association, 2445 Woodlake Circle, Okemos, MI 48864. Phone: 517.347.1555. Fax: 517.347.1566. Website: www.mi-osteopathic.org. Email: moa@mi-osteopathic.org. posTMAsTer: send Address chAnges To TrIAd, 2445 WoodlAke cIrcle, okeMos, MI 48864.

30 TRIAD, OSTEOPATHiC SUMMER 2013 ©2013 MiCHiGAN ASSOCiATiON

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