V1n1

Vol

1

•

No

1

winter2005

NCAFP 2005 Legislative Issues Dr. Edward L. Boyette 2004 Family Physician o f t h e Ye a r

The Alternative Minimum Tax Yo u m a y n o t b e g e t t i n g t h e returns you think you are

/&8 3&$0/%*5*0/&% 6-53"406/% 4:45&.4

$6450.&3 '0$64&% 4&37*$&

&95&/4*7& 1"354 130#&4 */7&/503:

"$640/ "5(&/&3"&-&$53*$ )1 "(*-&/5 .&%*40/ 1)*-*14 4*&.&/4 40/04*5& 504)*#"

(-0#".&%*$"*."(*/( TQFDJBMJ[FT JO TFMMJOH BOE TFSWJDJOH VMUSBTPVOE TZTUFNT GPS $BSEJPMPHZ 7BTDVMBS 0# (:/ 3BEJPMPHZ *OUFSOBM .FEJDJOF % % BOE (FOFSBM *NBHJOH OFFET

0VS NJTTJPO JT UP QSPWJEF ZPV XJUI UIF CFTU VMUSBTPVOE TZTUFN GPS ZPVS OFFET BOE CVEHFU "MM PG PVS VMUSBTPVOE TZTUFNT QFSGPSN VQ UP 0&. TQFDJmDBUJPOT BOE BSF FJUIFS OFX EFNP PS UPUBMMZ SFDPOEJUJPOFE UP MPPL BOE QFSGPSN MJLF CSBOE OFX 8F BMTP PõFS B POF ZFBS XBSSBOUZ GBTU EFMJWFSZ UPQ OPUDI DVTUPNFS TFSWJDF UFDIOJDBM TVQQPSU BQQMJDBUJPOT USBJOJOH BOE TFSWJDF DPOUSBDUT GPS FWFSZ QJFDF PG FRVJQNFOU UIBU XF TFMM

(SJöUI 3PBE 4VJUF $IBSMPUUF /$ 64"

XXX HMPCBMNFEJNBHF DPN

NCFP

Ta b l e o f C o n t e n t s

Vol 1 • No 1 winter 2005 PUBLISHED BY THE NORTH CAROLINA ACADEMY OF FAMILY PHYSICIANS The North Carolina Family Physician is published quarterly by the NORTH CAROLINA ACADEMY OF FAMILY PHYSICIANS P.O. Box 10278 Raleigh, NC 27605 919.833.2110 • fax 919.833.1801 www.ncafp.com 2005 NCAFP Board of Directors NCAFP Executive Officers President Karen L. Smith, MD President-Elect J. Carson Rounds, MD Vice President Michelle F. Jones, MD Secretary/Treasurer Christopher S. Snyder, III, MD Board Chair Conrad L. Flick, MD Executive Vice President Sue L. Makey, CAE Past President (w/voting privileges) Mott P. Blair, IV, MD The District Directors District 1 Donald Keith Clarke, MD District 2 Robert Lee Rich, Jr., MD District 3 Kevin B. Yow, MD District 4 William A. Dennis, MD District 5 Thomas H. Woollen, Jr., MD District 6 Thomas J. Zuber, MD District 7 R.W. Watkins, MD, MPH At Large Elizabeth B. Gibbons, MD At Large Richard Lord, MD IMG Physicians Constituency Ofelia N. Melley, MD Minority Physicians Constituency Claudia E. Gonzalez, MD New Physicians Constituency Jessica J. Burkett, MD Resident Director David C. Luoma, MD Resident Director-Elect Jennifer L. Mullendore, MD Student Director Kimberly W. Bennett Student Director-Elect Aye Otubu AAFP Delegates and Alternates AAFP Delegate L. Allen Dobson, MD AAFP Delegate Conrad L. Flick, MD AAFP Alternate George H. Moore, Jr., MD AAFP Alternate Mott P. Blair, IV, MD FP Department Chairs and Alternates Chair (UNC) Warren P. Newton, MD Alternate (Duke) J. Lloyd Michener, MD Alternate (ECU) (Interim) Mark Darrow, MD Alternate (WFU) Michael L. Coates, MD NCAFP Council Chairs Child & Maternal Health Shannon B. Dowler, MD Governmental Affairs Advisory J. Carson Rounds, MD Health Promotion & Disease Prev.

Mott P. Blair, IV, MD Mental Health Robert E. Gwyther, MD Professional Services Karen L. Smith, MD NCAFP Editorial Committee William A. Dennis, MD Chair Shannon B. Dowler, MD Elizabeth B. Gibbons, MD Richard Lord, MD David C. Luoma, MD

CREATED BY: Virginia Robertson, President vrobertson@pcipublishing.com Publishing Concepts, Inc. 14109 Taylor Loop Road Little Rock, AR 72223 FOR ADVERTISING INFORMATION: Jerri McCrary jmccrary@pcipublishing.com 501.221.9986 • 800.561.4686 edition

1

4 5 5 6

The 2004 Inaugural Address CME Calendar SAMS Study Hall NCAFP 2005 Legislative Issues 8 Edward L. Boyette: 2004 Family Physician of the Year 8 2005 Spring Family Physician’s Weekend 9 Winter Meeting Draws Over 400 10 Adolescent Obesity and Inactivity Joint Training

11 11 12 13 14 15 15

Session Welcome to New Academy Members NCAFP Foundation News Student News NCAFP/AAFP Quicktakes The Alternative Minimum Tax Now is the Time for Dental Varnish Patients May Inquire About Obesity & Activity Assessment Results

NCAFP Strategic Plan – October 2004 Vision Statement The vision of the North Carolina Academy of Family Physicians is to be the leader in transforming healthcare in NC to achieve optimal health for all people of NC. Mission Statement The mission of the North Carolina Academy of Family Physicians is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity.

Strategic Objectives 1. Health Promotion & Disease Prevention (Health of the Public): Assume a leadership role in improving the health of North Carolina’s citizens by becoming proactive in health promotion, disease prevention, chronic disease management and collaborating in other public health strategies.

2.Advocacy: Shape healthcare policy through interactions with government, the public, business, and the healthcare industry.

3. Workforce: Ensure a workforce of Family Physicians which is sufficient to meet the needs of patients and communities in NC. 4. Education: Assure high-quality, innovative education for family physicians, residents, and medical students that embodies the art, science, and socioeconomics of family medicine.

5. Technology & Practice Enhancement: Strengthen members’ abilities to manage their practices, maintain satisfying careers, and balance personal and professional responsibilities.

6. Research: Develop and promote new medical knowledge and innovative practice strategies through information technology, primary care research and assessment of the practice environment.

7. Communications: Promote the unique role and value of family medicine, family physicians and the NCAFP to the public, business, government, the healthcare industry and NCAFP members.

P. O . B o x 10 278 • R a l e i g h , N o r t h C a r o l i n a 276 0 5 – 919 . 8 33 . 2110

3

The

2004 Inaugural Address Delivered by Dr. Karen L. Smith, 2004-05 NCAFP President

I come to the North Carolina Academy of Family Physicians in the leadership role as president in an effort to carry out the strategic plan as created by the membership and implemented by the NCAFP Board of Directors. As a family physician in Raeford, NC, I have come to understand the special needs of not only the citizens of our state, but the physicians who desire to provide high quality healthcare. The state of Maryland is my native home, but North Carolina is where my husband Michael and our four children—Marcus, Marquise, Michaela, and Mikara—have come to cherish as our home since 1992. Our family has prospered as we live the vision of great leaders well known to our country.

The foresight of John F. Kennedy is acknowledged in his Presidential activities of 1962. He recognized the need to initiate a transition permitting all citizens of the United States to have opportunity that would allow the country as a whole to prosper. Dr. Martin Luther King, Jr. expressed the need to create a foundation which provides all citizens of our nation with equal access in a democratic society. These visionaries spoke their words to millions in the same time frame I was born—in 1962. The personal impact of their ideas became my reality after completing my undergraduate studies at Duke, my medical education at Hahnemann University School of Medicine, and then upon completion of the Family Medicine Residency Training at the Duke FAHEC Residency Program. With sheer determination, the babies born during the groovy sixties now have the responsibility to carry out the foundation firmly established by these brilliant leaders.

Through persistence, patience, and prayer I am able to come forth to serve as your president in 2005. I prepared for an endeavor of this nature upon arrival to North Carolina sev-

4

eral years ago. In my zealous travels throughout the state, the opportunity to visit the coast, mountains, and Piedmont, provided insight to the diverse population we care for. I learned many lessons, one of which I desire to share with you today.

While traveling up around Ahoskie I noted to my husband who’s from South Carolina that North Carolina had the tallest kale I had ever seen. He turned to me with a puzzled look on his face and stated, in a low tone of embarrassment, “that’s not kale, that’s tobacco.” Needless to say, I do not cook the collards for the holiday family meals. This was the signal to learn more about the state, especially if I was to be an effective physician practicing in a rural county. As a member of the Academy, the ideas of many family physicians are heard in order that the NCAFP can continue to remain a unified voice representing over 2600 physicians who share the common goal of caring for people. The state of North Carolina is not isolated from the obstacles noted in our current healthcare delivery system.

The NCAFP and the American Academy of Family Physicians share the mission to ensure that every person has a medical home.

Physicians are preparing to take on this challenge of change in healthcare delivery. It is through initiatives such as the American Academy of Family Physicians Future of Family Medicine Project that allows us to enhance our specialty for the inevitable transition in American medicine. Patients have stated for many years that they desire to have a doctor who is accessible, a doctor who listens, a doctor who can offer advice for their unique problem, a doctor who is cognizant of errors and attempts to prevent them, and a doctor they can relate to. In addition, Americans like technology and desire state-of-the-art for just about everything consumed; healthcare is no exception. However, our recent US Presidential debates highlighted the fact that the percentage of healthcare costs in the gross national product must be reduced without affecting overall quality.

I must refer back to another one of my road adventures to add perspective to this point. Two weeks ago, I traveled to the DMA in Raleigh.

We all know the NC Seafood Restaurant is next door, so I stopped in to carry dinner back to Raeford. Of course I decided to get a large cup of sweetened lemonade. Needless to say, just as I passed the Dunn exit on I95, there was a des-

perate need for a restroom.

Unfortunately, I did not see an inviting exit ramp (the kind with McDonald’s, Burger King, etc., on the sign). After exiting, I hit a dirt road and came upon Smith’s Auto Repair. Since this is something I could relate to, I decided not to turn around but to park the truck. The barred window storefront was decorated with advertisements from three cigarette makers and, of course, chewing tobacco. Due to the extreme urgency of the situation, I proceeded only to find both doors covered with a human size advertisement for Coca Cola. I entered to find mega-size bags of feed for every animal imaginable. After locating the restrooms, the business at-hand was taken care of. I thanked the store clerk and exited through the Coca Cola doors. Only this time I was met by two pit bulls whose owner held firmly onto a can of malt liquor at 3:00 pm in the afternoon.

There is no need to say that I may have read the front of the doors, but I surely did not see the other side as I moved for my truck.

This adventure outlined major areas of preventable healthcare expenditures, as well as the AAFP Americans in Motion Campaign. The work of previous NCAFP presidential projects is well exemplified by this story. The Tar Wars Campaign, the Adolescent Obesity Project, the Risky Drinkers substance abuse and prevention initiative, as well numerous others. This is the story of the NCAFP—working to identify the needs of not only our patients, but also the family physicians caring for them.

As your president, I am charged by the NCAFP board to further pursue the ideas outlined during the 2004 Board Retreat in Greensboro this past summer. The NCAFP revised the Mission Statement and Strategic Plan for the organization. I opted to pursue Electronic Health Records as a mechanism of introducing cost-effective technology into the office of every family physician who desires to advance in the practice of medicine. This year, the Academy’s Annual Meeting was the second in a series of Road Shows to be presented to physicians across the state during the year 2005.

The attendees are most impressed by other physician panelists who share their experience with the use of Electronic Health Records (EHR). It is our intention to continue this for-

North Carolina Academy of Family Physcians

NCAFP 2005 CME Calendar mat of education. Physicians teaching physicians is not only realistic, but quite effective.

We definitely cannot minimize the role medical students and residents play as we pursue these technology options.

Family physicians in North Carolina will be among the first in the state to move into a new era of medicine. The Academy recognizes the possible benefits of collaboration with other organizations, such as the NC Pediatric Society, the NC Medical Society, and the NC Cooperative Extension Office. The NCAFP is not the newest physician organization in the state, but we will certainly be known as the group of doctors who listened to their patients and constituents; and did something about the concerns voiced.

I must echo the words of one of our AAFP Directors noted in her campaign speech. She asked the rhetorical question, ‘Why me Lord?’ as she outlined the many sacrifices taken during the professional and personal life of a family physician. We all can speak those same words but can we all say “Thank You Lord” at the end of a busy day?

It is our intention to provide the same type of advice that each of us provides to our patients with each encounter. To provide the resources and options to make your profes-

sional life just a little bit easier.

The NCAFP is challenged to remain active in providing you with legislative alerts which impact the daily operations, to remain at the table for discussions centering around tort reform, to listen and participate in changes affecting managed care and reimbursement, to monitor and voice concerns regarding services provided to our patients via government or private carriers, and to maintain the integrity of our role as the physician caring for the individual patient.

The family physician is not only a doctor to several hundreds of people, but is also a spouse, a mother or father, a community leader, a church member, and perhaps a close friend. A family physician is a human being who delivers care with compassion. It is this doctor we desire to preserve in our new era of medicine.

The NCAFP is challenged to provide you with the tools so that you can say ‘Thank You Lord’ at the end of your busy day in the office.

As your new president, it is my intention to take the NCAFP Board of Directors’ lead and carry out our mission with the optimism noted in the visionaries who lived and died in the same decade of my birth.

Thank you.

Mark your calendar for NCAFP’s 2005 CME Meetings • 2005 Spring Family Physicians Weekend Ofelia Melley, MD CME Program Chair 20+ Credits CME April 7 - 10, 2005 Holiday Inn SunSpree Resort Wrightsville Beach, NC • 2005 Mid-Summer Family Physicians Weekend Christopher “Reb” Synder, MD CME Program Chair 30 + Credits CME July 3 - 7, 2005 Kingston Plantation Myrtle Beach, NC • 2005 Winter Family Physicians Weekend Robert Gwyther, MD CME Program Chair 19+ Credits CME Dec 1 - Dec 4, 2005 The Grove Park Inn Ashville, NC

SAMS (Self-Assessment Modules) Study Hall As part of the NCAFP’s plan to assist members with completing the ABFP Maintenance of Certification program for family physicians, a 4-hour MC-FP Diabetes SAMs Study Hall is being held on April 7 from 2:00 – 6:00 pm. This study hall is a stand-alone workshop and precedes the Spring Family Physicians Weekend in Wrightsville Beach, NC, April 7-10, 2005. The study hall fee is $45.00. Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending. The objectives of the Study Hall are: • Review the 60 questions of the Diabetes SAM as a group, led by a facilitator.

• After the review, participants enrolled in the MC-FP should be able to complete the module online with minimal time and trouble.

Six of these self-assessment modules, or SAMS, must be completed during the 7-year MC-FP cycle and the requirements have been designed to encourage physicians to complete one SAM per year, rather than doing several near the end of the MC-FP cycle. The SAMs which the ABFP has developed in 2004 are hypertension and diabetes mellitus. If you need additional information on the ABFP MOC requirements go to www.ABFP.org.

Contact Marietta Ellis or Christy Ayscue to obtain more information on how to register for the SAM Studyhall on Diabetes at (919) 833-2110 or via email at meetings@ncafp.com.

P. O . B o x 10 278 • R a l e i g h , N o r t h C a r o l i n a 276 0 5 – 919 . 8 33 . 2110

5

NCAFP 2005 Legislative Issues

by Carson Rounds, MD, Chair

budget bill. The Academy will support such a provision.

M e d i c a i d a n d C o m m u n i t y C a r e —The

he North Carolina Academy of Family Physicians anticipates facing numerous issues of importance to family physicians during the 2005 session of the North Carolina General Assembly. The Academy has had a long tradition of being on the forefront of legislative and administrative policy and continues to be regarded as a positive force by allied organizations and policy makers. The Academy is known for its informed, reasoned positions and common sense approach.

Year-round, the Academy identifies and remains in touch with a wide range of issues. The Governmental Affairs Advisory Council works monthly to identify and understand issues that may be problematic. Family physician leaders identify solutions and strategies for addressing the problems and the meetings provide a forum for vigorous discussion and debate. These discussions are a valuable tool for vetting ideas and examining the many facets of complex problems.

The following is a summary of several of the key issues that are likely to be addressed during the next session that begins in late January.

T

Fa m i l y M e d i c i n e C e n t e r a t E a s t C a r o l i n a U n i v e r s i t y —The flagship family medicine program in the state is in need of new facilities. Plans for a new Family Medicine Center were delayed last year as a result of changing university priorities. Bond money was secured to build a cardiovascular center. The Academy objected and as a political compromise, the ECU leadership promised to focus all energies on the construction of the Family Medicine Center as the next priority project after the cardiovascular center was underway.

The university needs special permission from the legislature to use Medicare funds earned by the medical school—previously earmarked as general revenue—as a portion of the funds necessary to construct the new Family Medicine Center. This type of permission is usually granted through special provision in the

6

Academy has supported the development of the Community Care Program and has been involved in this program since its inception.

The Community Care Program has become a national model for delivering quality care management and its success is attributable to the involvement of family physicians at the community level.

The Academy has helped maintain Medicaid reimbursement at levels which are near market rates and has helped discourage the implementation of any form of arbitrary and unnecessary managedcare type utilization restrictions or prior authorization requirements for any aspect of the practice of medicine. We will continue to support the Community Care Program and will oppose any efforts to reduce Medicaid fees or add arbitrary utilization restrictions.

The Academy also participated in a professional public opinion poll, the results of which were presented to legislators last year. The information provided by the poll played a major role in the defense of the Medicaid program during the 2004 session. The Academy and the Hospital Association will conduct an update to the poll early in 2005. The results of the new poll will be distributed to the members of the Legislature and be made available to Academy members.

N a t u r o p a t h i c M e d i c i n e —Naturopathic ‘physicians’ have been seeking licensure for a number of years. The legislation has never gained momentum during past sessions. The trade association for naturopaths has hired an attorney and former Senator to lobby the bill during the 2005 session. It is expected that a study commission authorized by the Studies Bill in 2004 will recommend new legislation. The Academy will review the finished legislative proposal, but it is likely that the Academy will oppose the legislation.

A d v a n c e d P r a c t i c e N u r s e s —The stated goal of advanced practice nursing organizations at the national and state levels is to increase the autonomy and independent practice of nurses. In North Carolina, the issue hinges on key phrases in the General Statutes that require all advanced practice nurses be ‘supervised’ by physicians. Legally, all activities performed by advanced practice nurses are performed contingent on the supervision of the physician. Without supervision the activities are not permissible.

Advanced practice nurses play a valuable role in the delivery of health care. This is particularly true in rural areas of the state.

Family physicians have very important working relationships with advanced practice nurses and the Academy will oppose any effort to remove the oversight and supervision of physicians in regard to their activities.

North Carolina Academy of Family Physcians

Pa t h o l o g i s t s a n d L a b Fe e s —There is a national effort by pathologists to restrict the ability of other physicians to charge for or mark-up charges for lab fees. This is an effort to restrict price competition. There are many family physicians who have their own labs within their practice or who have arrangements with private labs and subsequently add internal charges for administration and handling. The Academy will oppose any legislation that restricts or limits the ability of family physicians to either operate internal labs or add charges for the costs they incur for processing lab specimens.

C e r t i f i c a t e o f N e e d ( CO N ) —The Academy generally supports the CON process. However, there are areas where the process can be adjusted to create greater equity for physicians.

An administrative committee within the Department of Health and Human Services will be examining issues related to the licensing of endoscopic procedures. There are other issues that have surfaced recently regarding the licensure of facilities that will be difficult to

resolve. With these issues, it is always possible that any of these administrative issues which cannot be resolved administratively, will spill over into the Legislature.

The Academy will carefully monitor these issues and will contribute as necessary.

State Employees Health Plan—The Academy was successful in a past session in enacting legislation that required the SEHP to adopt a fee schedule that was fair, transparent, and easily understood by all physicians. The SEHP has protected the primary care specialties and has not reduced their reimbursement. However, we still do not have a transparent fee schedule. The Academy will continue to press the SEHP to adopt a fee schedule that is transparent and places a high value on primary care specialties.

Other issues are likely to arise during the session that will require a response from the Academy. When this occurs, the GACC will make a recommendation to the NCAFP Executive Committee and the Eexecutive Committee will determine the position of the Academy.

Potatoes aren’t very smart.

They don’t know:

Don’t work with a potato. Call us.

P. O . B o x 10 278 • R a l e i g h , N o r t h C a r o l i n a 276 0 5 – 919 . 8 33 . 2110

7

E d w a r d

L .

B o y e t t e

2004 FAMILY PHYSICIAN OF THE YEAR Many in Duplin County have marveled at the dedication, passion and energy that Dr. Edward L. Boyette of Chinquapin brought to work nearly every day in his nearly 50 years of practicing medicine. Boyette seemed perpetually on the go—constantly either treating a steady stream of patients at his office, doing rounds at the Duplin hospital, making house calls, or lending a helping hand at any number of community organizations.

On December 3rd, Boyette’s family physician colleagues awarded him the 2004 Family Physician of the Year Award. The annual award recognizes family physicians who demonstrate a high level of patient compassion as a physician and continually provide comprehensive family medicine in their communities. The award caps an extraordinary career for an individual affectionately known as the ‘good doctor’.

Boyette was born in Magnolia, NC in 1920 and attended Richlands High School, graduating almost three years earlier than expected. After a career in the US Navy where he served in the Medical Corps, Boyette enrolled in Wake Forest College and graduated in 1951.

He subsequently attained his medical degree from Bowman Gray School of Medicine and completed his residency training at Riverside Hospital in Newport News, VA. He would go on to establish his practice in Chinquapin in 1957.

Boyette was recognized for his high level of compassion in patient care, as well as his spirit, skill, and dedication to his community. In addition to his two generations of rural health service, Boyette was long active in his community and within a number of positions in organized medicine. His work with the North Carolina Medical Society was crucial in establishing the American

Board of Family Medicine in the late 1960s and his contributions at the local level were instrumental in the expansion of Duplin County’s hospital and the services it provides. As a strong believer in education, Boyette also served on the Duplin County School Board for fifteen years in a time that saw four new schools built and many improvements.

All this from a country doctor with a busy community practice.

Many patient letters described Boyette as a physician that went the extra mile, and that maintained a special releationship with everyone. He was known for his boundless energy and strong clinical skillls, and also as someone who could be counted on for encouraging words of wisdom.

Boyette is father to two adult daughters—Brenda Kates and Alisa Ortman— and has four grandchildren. He and his wife Helen reside in Chinquapin.

2005 Spring Family Physicians New Format & Activities

April 7 - 10th, 2005 at the Holiday Inn SunSpree Resort, Wrightsville Beach, NC

8

This year’s Spring Meeting promises registrants the flexibility of fun, sun and education. CME Program Chair, Ofelia Melley, MD will present over 20 accredited hours of pertinent topics for family physicians.

The weekend will begin with optional workshops from 4:30 pm to 9:30 pm on Thursday, April 7. General session lectures will start on Friday morning and end on Sunday in the early afternoon. Topics include nutrition, obesity, exercise induced asthma, diagnosing back pain, adult ADHD, and PMS. The first NCAFP Fun Run/Walk

will take place on Saturday morning April 9th at 6:30 am. You won’t want to miss it — so register now.

Remember $25 of your $30 registration fee goes to a worthy cause.

Run with your buddies or walk with a friend. Challenge yourself just to get up early and have a good time — this is what it’s all about — having fun and doing something good for the Academy’s Foundation Student Activity Endowment Fund!

Hotel accommodations are always top-notch at the Holiday Inn SunSpree Resort, located on Atlantic’s Ocean’s beautiful oceanfront. This beautiful resort offers an

North Carolina Academy of Family Physcians

2004 Winter Meeting Draws Over 400 The NCAFP’s Annual Winter Family Physicians Weekend in Asheville attracted over four hundred physicians, including honorary guest AAFP Board Member Dr. Rick Kellerman. Program Chair Dr. J. Carson Rounds presented over twenty hours of topics that included presentations on minority health, bipolar disorder, depression and Restless Legs Syndrome. As always, the Grove Park Inn provided for a magnificent and relaxing backdrop for the weekend’s activities.

HONORS AND AWARDS The NCAFP presented its 2004 Family Physician of the Year Award to Dr. Edward L. Boyette of Chinquapin, NC. The award caps a long and remarkable career for Boyette who has devoted more than fifty years to serving his patients and community in rural Duplin County. (See related story.)

In other honors, Dr. L. Allen Dobson, Jr. of Concord, NC was awarded the 2004 NCAFP Lifetime Achievement Award. Long active in

Weekend abundance of activities, along with breathtaking views of the Atlantic ocean. The SunSpree offers an arcade, two swimming pools and rooms with microwave and refrigerators. The cut-off date for reserving rooms at the group rate of $134 oceanview or $149 oceanfront plus tax per night is March 7, 2005.

Reserve your rooms now, they will fill up quickly!

Register early to receive the early bird registration rate before March 5, 2005. Please check our website, at www.ncafp.com for updated meeting information and to submit your online registration.

organized medicine and Academy affairs, Dr. Dobson was recognized for his unwavering commitment and passion for the specialty, as well as his tireless work with the NC Medicaid program. Dobson was named North Carolina’s Family Physician of the Year in 1992 and recognized for Distinguished Service to the specialty in 2002 and 2003. He currently serves the association at the national level as a delegate to the AAFP Congress.

The Academy also recognized Dr. Mott P. Blair, IV of Wallace with the NCAFP Distinguished Service Award.

The award recognizes individuals demonstrating exemplary service to the family medicine specialty and commitment to improving the health of North Carolinians. Blair was cited for his development of the Adolescent Obesity and Inactivity Project aimed at improving the state’s adolescent health and lifestyles. The project has received grant funding from the Health and Wellness Trust Fund Commission of

North Carolina and is currently being piloted in 13 counties across the state.

BUSINESS MEETINGS The Academy Board of Directors met on Thursday and Sunday morning.

The Sunday meeting reviewed recommendations and action items generated from the NCAFP Councils, which met previously during the weekend. Notable items included the merger of the Family & Community Health Council with the Health Promotion and Disease Prevention Council. Also approved was a measure by the Governmental Affairs Advisory Council to begin dialog with organizations interested in mental health reform.

In other actions, the Board also approved the development of the NCAFP Editorial Board and a new name for the Academy’s official publication—the North Carolina Family Physician. The Editorial Board is charged with review and oversight of the publication and consists of Drs. Dennis (Chair), Dowler, Lord, Luoma, and Gibbons.

The Future of Electronic Health Records is Now! Two excellent a solo family physician shows still available from Raeford, NC, who in 2005! Sponsored has been recognized

by North Carolina nationally for her use Academy of Family of EHR in clinical Physicians, Inc. and North Carolina practice. Registration is still available Pediatric Society. Platinum Sponsor: for the two dates in 2005: Saturday, Misys Healthcare Systems March 12 in Greensboro and Saturday, The EHR Roadshow for Practicing September 17 in Wilmington.

Physicians has been designed to eduAll practicing physicians and praccate physicians and participants on tice managers are encouraged to join issues related to the adoption and utius for one or both of these exciting lization of electronic health records events. Register today on-line by technology(EHR). The printing out a pdf Roadshows are being brochure or call the chaired by Karen L. Academy's office, 919Smith, MD, NCAFP's 833-2110 or NC 1-800Platinum Sponsor President. Dr. Smith is 872-9482.

P. O . B o x 10 278 • R a l e i g h , N o r t h C a r o l i n a 276 0 5 – 919 . 8 33 . 2110

9

Adolescent Obesity and Inactivity Joint Training Session

Members of the North Carolina Academy of Family Physicians (NCAFP) and agents with the North Carolina Cooperative Extension Service (NCCES) have teamed together to address the rising rates of childhood obesity and inactivity in communities throughout the state. The program, the Adolescent Obesity and Inactivity Project (AOI) – Reaching Families through Family Physicians is one of 19 other Fit Together Initiatives – a three-year public-private partnership between the NC Health and Wellness Trust Fund and Blue Cross Blue Shield of North Carolina.

The session, led by Dr. Mott Blair, IV and Carolyn Dunn, PhD, took place on Saturday, December 4 during the Winter Family Physicians Weekend in Asheville. Thirty-one individuals representing Buncombe, Cabarrus, Dare, Duplin, Hoke, Granville, Guilford, Mitchell, Sampson, Surry and Yancey counties attended. Participants developed action plans for their working relationship within each county. The ideas generated will be used as models of participation as other counties are recruited for the project. Other counties involved in the pilot are Franklin and Hertford.

Teens ages 12-18, as well as their families, will be recruited as participants. Physicians and agents using tools and local resources will work to help families eat smart, move more and live healthier lives. By year three, more than 60 counties will be working with the program.

For more information on how you and your practice can participate, please contact the Adolescent Obesity and Inactivity (AOI) Project Coordinator at 919-833-2110 or tsingletary@ncafp.com.

In practice, in life.

MAG Mutual is here to help.

Physician-owned and physician-led, MAG Mutual understands the issues that may interfere with your primary focus— providing quality patient care. With our insurance, financial services and business solutions, we can help.

In your practice:

In your life:

• Medical professional liability insurance

• Homeowners, auto and personal umbrella liability insurance

• Various medical office and employee insurance programs

• Home mortgages

• Pension plans, employee benefits, health insurance

• Personal retirement and estate planning with discounted legal services

• Medical transcription, billing and consulting services

• Long-term care and disability insurance

There’s more to the story. For more information, call MAG Mutual’s George Russell at 800-586-6890 or visit us at www.magmutual.com today.

Insurance coverages provided by MAG Mutual Insurance Company or available through MAG Mutual Insurance Agency, LLC and/or MAG Mutual Financial Services, Inc.

INSURANCE • FINANCIAL SERVICES OFFICE SOLUTIONS • PRACTICE MANAGEMENT

10

North Carolina Academy of Family Physcians

We l c o m e To N e w A c a d e m y M e m b e r s The Academy wishes to extend a warm welcome to all new members. If you have any questions regarding membership, please contact Tish Singletary at (919) 833-2110 or via email at tsingletary@ncafp.com Active Members John F. Barr, MD (Cleveland) Paul V. Bondy, MD (Nashville) Douglas A. Brown, MD (Morganton) Thomas B. Cannon, MD (Winston-Salem) Tracy L. Colchamiro, MD (Wake Forest) Norman L. Carlos, MD (Maitland, FL) David A. Cosenza, MD (Chocowinty) Brian D. Devine, MD (Charlotte) Stacey E. Devine, MD (Charlotte) Dane R. Floberg, MD (Charlotte) Lisa H. Free, MD (Cherokee) Jennifer M. Hart, MD (Rocky Mount) John J. Hart, MD (Rocky Mount) Jeffery Heck, MD (Asheville) Natalie C. La Mond, DO (Hendersonville) Wendy A. Mason, MD (High Point) Benjamin T. Ott, MD (Salibury) Subbarao V. Pemmaraju, MD (Fayetteville) Susan R. Pitman, MD (Locust) Deepa K. Reddy, MD (Chapel Hill)

Michael W. Semelka, DO (Fayetteville) David M. B. Smith, MD (Franklin) Vesna Tomavich, MD (Denver) Anthony J. Viera, MD (Chapel Hill) Charles S. Watras, MD (Marble) Catherine S. Young, DO (Raleigh) Inactive Members Madhavi V. Cherukuri (New Rochelle, NY) Angela Y. McLeod, DO (Greenville) Michael M. McLeod, Jr., MD (Greenville) Resident Members Joy A. Baldwin, MD (Charlotte) Lisa A. Cutchen, MD (Asheville) Susan D. Ehrsam, MD (Asheville) Robert M. Geist, MD (Asheville) Linda Kornfeld, MD (Asheville) Paul A. Midkiff, MD (Asheville) Balichand Permashwar, MD (Greenville) Wendis A. Santana, DO (Wilmington) Ryan M. Truxillo, MD (Asheville) Carlos S. Villar-Gosalvez, MD (Asehville)

James D. Worriax, MD (Wilmington) Student Members Mr. Joel F. Bradley, lll (Winston-Salem) Ms. Kathryn A. Chwastiak (Chapel Hill) Ms. Meghan B. Gannon (Winston-Salem) Mr. Graham S. Duncan (Chapel Hill) Ms. Jennifer Hobbs (Carrboro) Mr. Ryan C. Johnson (Winston-Salem) Ms. Kristin M. Karnap (Winston-Salem) Ms. Natalie D. Muth (Chapel Hill) Ms. Oritsetsemaye G. Otubu (Durham) Mr. Caleb E. Pineo (Chapel Hill) Ms. Megan Shaw (Winston-Salem) Mr. Stephen B. Thompson (Chapel Hill) Mr. Luke Yuan-Je Wang (Durham) Ms. Dana R. Wood (Winston-Salem) Ms. Ayaba G. Worjoloh (Durham)

N C A F P Fo u n d a t i o n N e w s 2004 SILENT AUCTION A RESOUNDING SUCCESS!!

The NCAFP Foundation’s 2004 Silent Auction was a resounding success!! We’re pleased to report that this year’s Silent Auction was one of the best and most successful in years. With the help and support of both Academy and Foundation Board members, as well as the Academy membership, we had over 200 items on display in the Exhibit Hall during the Winter Family Physicians Weekend at The Grove Park Inn. We even had to bring in more tables to display the 40+ items that members brought with them!

The auction was held over a 2-day period, and members, guests, and exhibitors had a great time bidding on artwork, jewelry, weekend getaways, sports tickets and memorabilia, handcrafted items, toys, and Christmas items. This year’s Silent Auction brought the Foundation a grand total of $13,340! We’d like to extend a special “thank you” to our Silent Auction Sponsors – University Health Systems of Eastern Carolina (Platinum Sponsor) and Iredell Memorial Hospital, Lenoir Memorial Hospital, Inc., Spruce Pine Community Hospital, and Union Regional Medical Center (Silver Sponsors). We’d also like to extend a heartfelt “thank you” to Martini Print Media, Inc., who donated their services to produce the Silent Auction booklets. Marlene Rosol, Development Coordinator, did a superb job of organizing the auction, and we’d like to thank Silent Auction Co-Chairs Dr. James G. Jones and Rudy Snow for their leadership. We also want to thank the NCAFP Academy staff, all our volunteers, and Sandy Panther of the AAFP Foundation for their invaluable assistance! The Silent

Auction continues to hold a special place for the NCAFP Foundation, and we greatly appreciate our members’ support and involvement!

MEMBER SUPPORT IS CRUCIAL TO WHAT WE DO… The NCAFP Foundation extends a special “thank you” to all our members who made individual contributions in 2004! Your support is crucial to what we do! We are steadfast in our mission of providing quality healthcare to the people of North Carolina, and we couldn’t do it without your support. With programs such as Tar Wars, Into the Mouths of Babes, and the Adolescent Obesity and Inactivity Project we show the citizens of North Carolina that we care about the quality of their health. With the Student Scholarship Program, Student Activities Endowment Fund, and Family Medicine Interest Groups we show our students and residents that the specialty of family medicine is a worthwhile choice. We hope you will continue your support of our programs and projects in 2005. For more information on any of the Foundation’s projects, please contact Marlene Rosol, Development Coordinator, at (919) 833-2110, (800) 872-9482 [NC only], or mrosol@ncafp.com. Thank you – your support is crucial to what we do!!

FOUNDATION SCHOLARSHIP PROGRAM North Carolina medical students are eligible to apply for one of four scholarships in 2005. Applications are available through the four FMIG programs or you can download them on the NCAFP website (www.ncafp.com). For more information on student scholarships, or how you can make a donation to the Scholarship continued on Page 13

P. O . B o x 10 278 • R a l e i g h , N o r t h C a r o l i n a 276 0 5 – 919 . 8 33 . 2110

11

student news

2004 Outstanding Residents

Student Buddy

The following third-year residents were recognized at the 2004 Winter Family Physicians Weekend as the Outstanding Resident at their residency program. All Outstanding Residents were honored for ‘demonstrating compassionate patient care and maturity in interpersonal relationships in the specialty of family medicine’. The winners were as follows: Joseph A. Cefalu, MD – Duke University Merlene V. Christopher, MD – Camp Lejeune Dominique C. Davenport, DO – WOMACK Aaron G. Ellison, MD – Carolinas Medical Center at Eastland Stephanie B. Elkins, MD – Cabarrus Julia F. Johnson, MD – Mountain AHEC Asheville E. Kelly Levi, MD – Carolinas Medical Center Union Cristy P. Page, MD – University of North Carolina Chapel Hill Noelle C. Robertson, MD – Moses Cone Susan A. Schmidt, MD – Brody School of Medicine at East Carolina University Matthew L. Silvis, MD – Wake Forest University Nadine B. Skinner, MD – New Hanover Maria Joanna S. Villena, MD – Southern Regional AHEC

The following attendees at the 2004 Winter Family Physicians Weekend signed up to be a Student Buddy. The Student Buddy program allows student members to receive their registration fee back during the Student Section Meeting. The Academy would like to thank our Student Buddies for their kindness!

Community Teaching Award Each medical school’s Family Medicine Interest Group recognizes a family physician for their dedication to teaching medical students.

The award recipients for 2004 were presented with a plaque at the State-of-the Academy Address and Award Luncheon in recognition of ‘dedicated service to medical student education by advancing the principles and ideals of family medicine.’ The following received awards: Aimee Lischke, MD – Wake Forest University Brandon M. Peters, MD – Duke University Rae Lynn Yates, MD – Brody School of Medicine at East Carolina University Ronald E. Hughes, MD – University of North Carolina at Chapel Hill

Practice Management Conference The NCAFP will hold the annual Practice Management Conference and Opportunities Fair for second-year family medicine residents on Friday, March 18th, 2005. This one-day event is designed to introduce practice management skills to residents and to expose them to various employment opportunities.

If you or your practice are interested in exhibiting at the fair, please contact Christy Ayscue at 800-872-9482 or cayscue@ncafp.com.

New Student/Resident Leaders Elected The following members were elected by their peers at the Winter Family Physicians Weekend to represent the students and residents on the board: NCAFP Academy Board of Directors Student Director – Kimberly W. Bennett (UNC) Student Director-Elect – Oritstetsemaye G. “Aye” Otubu (UNC) Resident Director – David C. Luoma, MD (Cabarrus) Resident Director-Elect – Jennifer L. Mullendore, MD (Moses Cone) NCAFP Foundation Board of Trustees Student Ad-Hocs – Natalie D. Muth (UNC) Marty Welch (ECU) Resident Ad-Hocs – Parker S. McConville, MD (Duke) Dimitrios P. “Takie” Hondros, MD (CMC Union)

12

Sara Jessica Edward T. Bentley Mark Shannon Andrew Suzanne Lauren Melissa Eva Ruth Robert Douglas Terry Champ Michelle Catherine Thomas Eugene David J. Paul A. Thomas Susan Maureen John Robert D. Dean Kathleen Brookellen Mark Rudy Christopher Catherine James Patricia Gustav

O. J. S. D. B. E. B. W. E. I. M. F. M. F. C. E. E. T. W. M. D. L. R. S. C.

Beyer Burkett Campbell Crabtree Jr. Darrow Dowler Dyksterhouse Eaton Jones Franklin Franklin Guyer Gwyther MD, Hammer Hess Jones Jr. Jones Kelly Koinis Link Luoma Martin May III Murphey Murphy Newton Patterson Patton Rice Rider Robinson Snow Snyder Sotir Thompson White Wilde

MD MD MD MD MD MD MD MD MD MD MD MBA MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD

Attention Second-Year Residents Practice Management Conference The NCAFP will hold its annual Practice Management Conference and Opportunities Fair for second-year family medicine residents on Friday, March 18th at the Radisson Governorís Inn in Research Triangle Park, NC. This one-day event is designed to introduce practice management skills to residents and to expose them to various employment opportunities. If you or your practice are interested in exhibiting at the fair, please contact North Carolina Academy of Family Physcians

NCAFP/AAFP Quicktakes NCAFP Members Receive Fellowship Designation Nine NCAFP family physicians have achieved the Degree of Fellow of the AAFP. The degree was conferred in a convocation ceremony in October in conjunction with the AAFP’s 2004 Annual Scientific Assembly. The following physicians were conferred: Dr. Tamara Cheatham Babb, Dr. Timothy P. Daaleman, Dr. Mary Nolan Hall, Dr. David H. Hall, Dr. Carolyn McCormick, Dr. Shamil J. Morayati, Dr. John P. Sherrod, Dr. Albert A. Verrilli, and Dr. Thomas M. Whyte. The Academy would like to congratulate each of these physicians for this honor.

Mott Blair Appointed to UNC-TV Advisory Board NCAFP Past President Dr. Mott P. Blair, IV, of Wallace has been appointed to the Advisory Board of UNC-TV. The Board is currently working to develop a series of short media advisories focused on addressing the issues of obesity and the importance of nutrition and physical fitness. Thirty segments will be produced over a 3-year period.

News Media Coverage of Family Medicine/Family Physicians The NCAFP Child & Maternal Health Council and Academy Board of Directors needs members help in tracking news items covering patient care. Members who see or hear media coverage that omits family physicians or family medicine professionals are being asked to alert Academy offices so this can be addressed. Please direct responses to Peter Graber, Director of Communications at (919) 833-2110 or via email at pgraber@ncafp.com.

Christy Ayscue by phone at 800-872-9482 or via email at cayscue@ncafp.com.

March 18th, 2004 at the Radisson Governor’s Inn Research Triangle Park Practice management is an issue that affects all physicians, especially residents, as they enter the first years of practice. Attend this seminar to learn more about the issues facing physicians.

Registration is only $50 for members. Brochures will be available through your residency program and the NCAFP. For more information, contact Christy Ayscue, Programs Coordinator at 800872-9482 or via email at cayscue@ncafp.com

Virtual Family Medicine Interest Group In case you haven’t visited the AAFP website lately, family physician preceptors have an updated tool that can be used in encouraging students to consider family medicine. The Virtual FMIG (http://fmignet.aafp.org) has been revised and updated and features expanded content, new tools and describes what it means to be a family physician. Log on today!

Center for Health Information Technology Launches Site The AAFP’s Center for Health Information Technology (CHIT) recently launched its own website, available at www.centerforhit.org. The site provides AAFP member physicians with valuable information on technology issues, with an emphasis on electronic health records systems. NCAFP’s Dr. David Kibbe is Chair of the Center.

NCAFP Foundation News continued from Page 11

Program, please contact Christy Ayscue, Programs Coordinator, at (800) 872-9482 [NC only], (919) 833-2110, or cayscue@ncafp.com.

GIVING TO THE FOUNDATION IS JUST A “CLICK” AWAY! With just a “click” you can make a donation to the Foundation. And it’s safe and secure! The NCAFP Foundation’s on-line donation page is up and running on our website. Access the NCAFP web site at www.ncafp.com and click on “Foundation” and then “Contributions.” Your donation will be automatically transmitted to the Foundation and processed immediately. Contact Marlene Rosol, Development Coordinator, at (800) 872-9482 [NC only], (919) 833-2110, or mrosol@ncafp.com if you have any questions or concerns.

THE FOUNDATION VALUES ITS CORPORATE MEMBERS! We are so appreciative of our 2004 Foundation Corporate Members! Their participation and support are a big part of what we do, and we’re proud to include them as part of our Foundation family. We look forward to their partnership again in 2005. Thank you!!

Thank you to our 2004 Corporate Members!

We couldn’t do it without you!

Grand Patrons: First Citizens Bank, Raleigh, NC* NC Academy of Family Physicians, Raleigh, NC* Patrons: Novant Health, Winston-Salem, NC** UNC Hospitals, Chapel Hill, NC** Supporters: ECR Pharmaceuticals, Richmond, VA** MedCost, LLC, Winston-Salem, NC* Misys Healthcare Systems, Raleigh, NC* Moses Cone Health System, Greensboro, NC* Triangle Securities, Raleigh, NC* *Corporate Members – Unrestricted **Corporate Members – Restricted

P. O . B o x 10 278 • R a l e i g h , N o r t h C a r o l i n a 276 0 5 – 919 . 8 33 . 2110

13

The Alternative Minimum Tax You may not be getting the returns you think you are People love free stuff. Things that are taxfree are good too. That’s why tax-free municipal bonds are very possibly the favorite investment vehicle among Physicians. But things may not be what they seem. In fact, for the first time, you may find yourself having to pay income tax on those beloved taxfree municipal bonds (a.k.a. munis). This is because the Alternative Minimum Tax (AMT) is creeping into our lives and in some cases makes tax-free municipal bonds taxable. The AMT is becoming quite a pest.

Imagine how surprised IRS Commissioner Mark Everson was when he stated in 2004 he had to pay AMT tax for the first time. If it hasn’t impacted you already, it is going to real soon. This article will teach you to avoid AMT tax on your tax-free municipal bonds.

Problem Many Physicians are in the 33% federal income tax bracket (earn $174,700—$311,950 if Married Filing Jointly). Because of this, they search for investments that are tax efficient (pay little or no income tax). The preferred vehicle for tax-free returns is the taxfree municipal bond. Unfortunately, the AMT has quietly evolved into a hidden tax that will impact some of your tax-free muni bonds.

First, let’s illustrate why municipal bonds are so desirable. In order to do so, we will need to level the playing field between taxable & non-taxable investments. To accomplish this, we use the Tax Equivalent Yield (TEY). This concept expresses what a taxfree return would have to generate if your current federal & state income taxes were applied to it. For example purposes, let’s say you earn $175,000, are in the 33% Federal income tax bracket, and have state income tax of 7%. This would mean a municipal bond paying 5% tax –free would yield the same after tax return as an 8.02% taxable bond. (no, the formula is not 5% / (33% +7%). It’s a little more complicated, but beyond the scope of this article).

So you are happy to be receiving 5% tax free. The problem is, the AMT will be applied to your municipal bond if it is a Private Activity bond. Let’s understand this a little more. There are two general classifications of municipal bonds. The first type is secured by the ability of the municipality to repay the loan via taxation – called a general obligation bond. The second type is a revenue bond. Private activity bonds are a revenue 14

bond, so they are not secured by the ability to repay the loan from taxes. This explains why they usually pay a slightly higher interest rate than general obligation bonds—they have higher repayment risk. These bonds are used to fund projects like the building of sports stadiums. The loans are repaid from operating revenues from the business using the stadium. Because these bonds don’t have the same “common good” as a water treatment plant, school, or bridge, their interest is deemed taxable under AMT rules (called an AMT tax preference item).

If the muni bond is a private activity bond, and we apply the same tax constraints as above, your 5% bond is really only going to yield 3.6% after tax (the AMT tax rate will be applied at 28%). This is almost certainly not what you were planning on.

Background When Towns, Cities, and States raise funds for development projects, they frequently issue municipal bonds. These bonds are tax-free from a Federal income tax perspective. If the bond is issued in your home state, you will not pay state income taxes on the bond interest either.

Let’s learn a little more about the AMT. AMT is a parallel method for determining federal income tax—for individuals as well as businesses. After performing the income tax calculation using regular tax rules, you must recalculate federal tax payable using AMT rules. The higher amount is what you will owe. AMT is calculated in a similar manner to regular tax rules but does not have provisions for many of the current regular tax deductions: • state & local income tax • real estate property tax • itemized deductions & standard deduction • accelerated depreciation • personal and dependency exemptions • student loan interest • mortgage interest on 2nd home • tax exemption private activity Muni Bonds The AMT was brought into being in 1970 when Congress noticed there were individuals earning a great deal of income, but because of clever use of deductions, were not paying any federal income tax. Thus they developed a parallel federal income tax set of rules to ensure a minimum amount is paid by everyone. We are witnessing a growing number of taxpayers hit by the AMT. This is

because the guidelines for determining AMT have not kept pace with inflation, resulting in many more individuals hit with AMT tax.

When the AMT was brought into being, the AMT rate was 10% and the maximum regular income tax rate was 70%. It thus did not impact many people (original intent). Now, most Physicians are in the 33% (Married Filing Jointly) federal bracket. The AMT tax rate is 26% on AMT income up to $174,700, and 28% on AMT income over this amount.

Thus, we see the spread has dramatically been reduced 60% (70 -10) to 5% (33 – 28).

This means, the AMT tax is impacting many more people than initially intended.

Solution Whenever you buy a Municipal bond, make sure you understand whether it is a private activity bond or not. Your financial planner or broker should know. The bond inventory they review will have a field indicating whether AMT applies.

Also, keep in mind that if you are AMT eligible (most people reading this article are), it no longer makes sense to pull deductions into the current year to lower regular tax payable because chances are, your deductions won’t apply to AMT. Please make sure you check with your Financial Planner and/or Tax Accountant on the use of deductions.

Summary Recent tax cuts are very popular, but they may not be helping you because the AMT is unaffected by the tax cuts. Thus, the tax cuts are something of a red herring. Most people reading this article are affected (or will be very shortly) by AMT and thus don’t benefit from tax reductions for regular tax rules.

Because 2004 was an election year, to make sure we don’t get impacted too badly in 2005, Congress signed an AMT relief extension.

Keep in mind that Federal Government budget deficits are huge. Funds need to come from somewhere to reduce the deficit (never mind the debt). There is no election in 2006 nor 2007, so there’s a very strong chance we won’t see another extension of AMT relief.

You should be planning your muni bond purchases with this information in mind.

Jeff Seymour is Managing Director of Triangle Wealth Management LLC (www.triwealth.net). His practice works solely with Physicians and Dentists in personal financial planning, wealth management, asset protection, and procurement consulting.

North Carolina Academy of Family Physcians

Patients May Inquire About Obesity & Activity Assessment Results NCAFP responsible for development of new tool at www.fittogethernc.org Family physicians should be on the lookout for patients holding reports detailing their health risks related to obesity and inactivity.

The reports are generated by a new web-based health risk assessment tool that the NCAFP developed for http://www.fittogethernc.org, a website launched in late November promoting healthier weight and lifestyles to North Carolinians. The site is sponsored by the NC Health and Wellness Trust Fund Commission (HWTFC) and Blue Cross/Blue Shield of North Carolina and is located at http://www.fittogethernc.org.

As part of HWTFC’s statewide obesity prevention initiative, the web site features extensive information and tools for helping individuals make positive changes in their communities and their personal lives relevant to their exercise and lifestyle habits. The site presents localized information on fitness programs, exercise facilities and counseling services. Visitors are even encouraged to utilize the health risk assessment tool developed by the NCAFP to gauge their obesity and lifestyle risk factors. The tool generates a report users can print out on their printer.

Earlier this year, NCAFP Board Chair Dr. Mott Blair of Wallace led a committee of NCAFP and NC Pediatric Society volunteers in

creating the assessment tool. Users answer a series of questions regarding their activity and lifestyles and a report is generated based on their input. Patients may be bringing these reports to physician offices and inquiring about the results.

The Academy would like to recognize the following family physicians for their time and involvement in developing the assessment tool. Dr. Mott P. Blair, Chair, Dr. Don Bradley, Dr. Lloyd Michener, Dr. Carson Rounds, Dr. Conrad Flick, Dr. Christopher Synder, and Dr. Michael Coates.

Over the next several months, the HWTF Commission and BCBSNC will be conducting a media campaign featuring TV, print, radio and internet advertising highlighting how select North Carolinian counties are working to improve their community’s health. These best-practice examples will attempt to offer lessons and ideas that other communities can draw upon. The campaign will also raise overall awareness of the site and the tools and information it offers.

Now Is the Time for Dental Varnish!

by Kelly Haupt, IMB Project Coordinator

Into the Mouths of Babes, NC Oral Screening and Fluoride Varnish Project, is into its fifth and final year as a demonstration project. You will be proud to know that our project has become a national model – representatives from approximately 35 states have contacted IMB program staff requesting information and assistance in establishing their own programs. Congratulations to you, family physicians, for your important role in the success of IMB! Your support and participation is one reason that the training as well as Medicaid and Health Choice reimbursement will continue after this fifth year.

If you are not participating in this exciting endeavor, now is the time to get on board. There are 340 private practicing physician offices, health departments, rural health centers, and residency programs already offering this important service to their youngest patients at risk for dental caries. Even with over 160,000 procedures performed during the past five years, only 40% of eligible Medicaid and Health Choice-covered children have received the service.

There are many more at-risk children that could benefit from this oral preventive procedure and early detection of caries.

Did you know that fluoride varnish is not only beneficial as a caries preventive, but also when applied to early carious lesions?

Research has shown that regular varnish application can slow the progression of caries. This could be especially important for children where treatment may be delayed due to difficulties accessing dental care.

Why not go ahead and provide this oral preventive service? Training and materials are free of charge during the demonstration project and will be brought to your office at your convenience. Contact Kelly Haupt, Project Coordinator at 919.833.2466 or khaupt@ncafp.com for more information or to schedule a session.

P. O . B o x 10 278 • R a l e i g h , N o r t h C a r o l i n a 276 0 5 – 919 . 8 33 . 2110

15

The North Carolina Academy of Family Physicians, Inc. P.O. Box 10278 Raleigh, NC 27605

Presorted Standard U.S. Postage PA I D Little Rock, AR Permit No.2437

Milk, Cheese, and Yogurt May Help Your Patients Lose More Weight Dairy foods, including milk, cheese, and yogurt, do more than build strong bones. Research shows 3 daily servings of dairy foods may actually improve your patients’ weight- and fat-loss results when part of a reduced-calorie diet.1,2 The mix of essential nutrients found in dairy foods, including calcium and protein, appears to improve the body’s ability to mobilize and burn fat.3 A recent study published in Obesity Research showed that people on a reduced-calorie diet who consumed 3 servings of milk, cheese, or yogurt each day lost significantly more weight and more body fat than those who consumed calcium supplements or just cut calories while consuming little or no dairy.1 Recommend that your patients include 3 servings of dairy foods a day in their weight-loss plans and advocate a healthy lifestyle that includes ample physical activity. The dairy case has a wide variety of reduced-fat, lowfat, and fat-free products to choose from to fit your patients’ reduced-calorie eating plans.

For more information about the important role dairy foods play in weight loss, visit www.3aday.org.

To download a FREE Healthy Weight Education Kit, including materials appropriate for distribution to patients, visit www.nationaldairycouncil.org.

© 2004 National Dairy Council 1 2 3

Zemel MB, et al. Dietary calcium and dairy products accelerate weight and fat loss during energy restriction in obese adults. Obesity Research. 2004; 12(4): 582-590.

In the study, dairy products that counted as a dairy serving were excellent sources of calcium and good sources of protein.

Zemel MB, et al. Dairy (yogurt) augments fat loss and reduces central adiposity during energy restriction in obese subjects. The FASEB Journal 2003; 17, 5: A1088.

Melanson, EL, et al. Relation between calcium intake and fat oxidation in adult humans. International Journal of Obesity. 2003;27: 196-203.