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Campus Eye Group Vision for Life The Only Destination Patients Need to Have for Complete and Continuous Ophthalmic Care Also in this Issue • Proposed Legislation Requiring Surgical Practices to be Licensed Passes House and Senate But Not Signed by Governor Christie • CMS Releases 2012 Medicare Physician Fee Schedule • From a Patient’s Point of View-What Doesn’t Kill You Makes You Stronger


Princeton Insurance knows New Jersey, with the longest continuous market presence of any company offering medical professional liability coverage in the state. Leadership: Over 16,000 New Jersey policyholders Longevity: Serving New Jersey continuously since 1976 Expertise: More than 55,000 New Jersey medical malpractice claims handled Strength: Over $1 billion in assets and $353 million in surplus as of December 31, 2010 Service: Calls handled personally, specialized legal representation, knowledgeable independent agents, in-office visits by our skilled risk consultants Knowledge: New Jersey-specific knowledge and decades of experience Innovation: Three corporate options, specialty reports, practitioner profiles, office practice toolkits, optional data privacy coverage


Publisher’s Letter Dear Readers, Welcome to the January issue of New Jersey Physician. Changes are coming soon. We are hard at work setting up our new website which will have our current issue featured each month along with an archive of past issues. Additionally there will be a section for late breaking news, so plan on visiting us often. We will also give readers the option of receiving our publication either by regular mail in hard copy, viewing online, or by email. We will soon allow you to communicate with us regarding how to best provide you with the state’s only voice for physicians. I have known Tom Touzel for many years. He has shared with me the battle he waged against his own cancer and the amazing results that have been achieved. Tom is a very determined person who gives every effort in life his full attention. I thought this story about him, originally published in a Canadian newspaper, might prove to be valuable to our physician readers to see serious illness from the other side. I hope you find it inspiring. Bollinger Insurance has taken a strong stand in the professional liability community, recently acquiring Argent Professional Agency as well as The Woodland Group, Allied Insurance Services Agency, and The Szerlip Agency. These acquisitions will make Bollinger one of the nation’s leading insurance agencies. They have formed

Published by Montdor Medical Media, LLC Co-Publisher and Managing Editors Iris and Michael Goldberg Contributing Writers Iris Goldberg Leon Smith, MD Leslie Thomas, CPA Anthony M. Rainone, Esq. Joseph Conn Keith Roberts, Esq. Debra C. Lienhardt, Esq. John Fanburg, Esq. Mark Manigan, Esq. Joseph Gorrell, Esq. New Jersey Physician is published monthly by Montdor Medical Media, LLC., PO Box 257 Livingston NJ 07039 Tel: 973.994.0068 Fax: 973.994.2063 For Information on Advertising in New Jersey Physician, please contact Iris Goldberg at 973.994.0068 or at igoldberg@NJPhysician.org

a new professional liability agency within the company which will be headed by Henry Kane and Brian Kern of Argent. Recently, legislation was passed by both the state house and senate requiring

Send Press Releases and all other information related to this publication to igoldberg@NJPhysician.org

surgical practices to be licensed. The matter is not law yet as Governor Christie has

Although every precaution is taken to ensure

not signed the ruling, thereby “pocket vetoing” the legislation.

accuracy of published materials, New Jersey

CMS has published the 2012 medicare physician fee schedule, which you will find inside. Unless there is further action, the new schedule calls for a 27.4% reduction in reimbursements on March 1. If the past is any indication of the future I wouldn’t count on these reductions taking place.

Physician cannot be held responsible for opinions expressed or facts supplied by its authors. All rights reserved, Reproduction in whole or in part without written permission is prohibited. No part of this publication may be reproduced or transmitted in any form or by any means without the written permission from Montdor Medical

We had the pleasure of meeting one of the most comprehensive opthalmic

Media. Copyright 2010.

practices in the state, Campus Eye Group. The vision of Dr. E. Bruce DiDonato, CEG is a full service vision center, offering the services of many sub-specialists within opthalmics who practices in one location. State-of-the-art technology includes the

Subscription rates: $48.00 per year

Izon® High Resolution Lenses which are customized to correcting tiny microscopic

$6.95 per issue

irregularities or aberrations.

Advertising rates on request

With warm regards,

New Jersey Physician magazine is an independent publication for the medical community of our state and is not a publication

Michael Goldberg Co-Publisher New Jersey Physician Magazine

of NJ Physicians Association


4

Contents

Campus Eye Group Vision for Life

The Only Desitination Patients Need to Have for Complete and Continuous Ophthalmic Care CONTENTS

9

Health Law Update

10

Hospital Rounds

12

Statehouse

13

Vendor News

14

Patient Point of View

New Jersey cancer docs form network

Argent Professional Insurance Agency, LLC announces its acquisition by Bollinger, Inc.

What doesn’t kill you makes you stronger.

COVER STORY 2

New Jersey Physician

Cover Photo: E. Bruce DiDonato, Founder and President of Campus Eye Group


Surgery Center Liability Specialists 30 Technology Drive, Warren, NJ 07059

•

(877)769 -1999

Argent Professional is New Jersey’s leading medical professional liability insurance agency, specializing in Ambulatory Surgery Centers, and other healthcare facilities. Our knowledge, expertise and access to all of the major NJ markets helps to ensure our clients find the best possible coverage at the lowest available rates.

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To obtain an indication, please complete and fax to (908)769-7477 Facility Name:

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City:

State:

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Procedure type: Effective Date: Coverage Type: Insurance Company:

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(If Claims Made: Retro Date:

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September 2011

3


Cover Story

Campus Eye Group Vision for Life

The Only Desitination Patients Need to Have for Complete and Continuous Ophthalmic Care By Iris Goldberg

In today’s healthcare arena, patients have

Over time, technology was put into place in

and so we did, with the development of our

the opportunity to receive treatment from

order to provide state-of-the-art treatment for

retina center in 1989,” he reports. “And for more

an ever-growing number of physicians who

nearly every condition affecting the eye.

than 20 years now, we have been providing

have been highly trained in sub-specialized

everything right here,” Dr. DiDonato adds,

areas within a particular branch of medicine.

“During the 1980s, if you needed anything other

referring to the addition of virtually all specialty

While the benefits of this in terms of the

than glasses, contacts or perhaps a cataract

medical and surgical treatment for the eye as

level of care patients receive is obvious, the

operation or other small procedure, you had

well as the most innovative optical services

logistics for managing all of the trips to the

to go to a major university medical center,”

available.

various locations that are often required can

Dr. DiDonato, relates. He shares that often

be challenging. Comprehensive vision care in

the patient would have an evaluation on the

Today, Campus Eye Group has evolved into a

particular, especially as patients grow older,

first visit and then be required to travel back,

multi-specialty, interdisciplinary eye care prac-

usually involves treatment from more than one

sometimes a considerable distance, days or

tice, including its own impressive Medicare-cer-

specialized practitioner.

even weeks later for the appropriate treatment.

tified, AAAHC-accredited ambulatory surgery

This was prominently in the mind of E. Bruce

Dr. DiDonato remembers that he and others

specialized ophthalmic surgeons perform ev-

DiDonato, O.D., back in 1981, when he founded

in the field at the time were frustrated by the

ery conceivable surgical procedure for the eye.

Campus Eye Group. Dr. DiDonato invited

inefficiency of this system and the tremendous

skilled eye care providers from numerous sub-

inconvenience for patients. “I wondered why

Campus Eye Group’s ASC was actually

specialties to practice with him in one location.

no one had brought sub-specialty care here

developed in 1985 when Dr. DiDonato realized

center (ASC), where fellowship-trained sub-

the importance of providing the safest and most technologically advanced environment for his patients who were having cataract surgery. “I wanted to have more control over the outcomes,” he relates, citing concerns about possible complications. Since then, the ASC has been continuously updated with the most sophisticated laser and computerized equipment in the region, enabling the surgeons at Campus Eye Group to perform many advanced eye surgeries as well. Some of these include corneal transplants, treatment of diabetic retinopathy, macular degeneration and glaucoma. Additionally, eye muscle and eyelid plastic procedures are performed by Campus Eye Group’s skilled subp During LASIK vision correction, the surgeon creates a precise thin hinged corneal flap that is pulled back to expose the underlying corneal tissue.

4

New Jersey Physician

specialists.


A great many of the patients who are treated at Campus Eye Group come for vision correction. In fact, there have been patients who have traveled from all over the United States and even some who have flown in from other countries to undergo LASIK laser vision correction surgery with the renowned experts at the Campus Eye Group. Their vast experience coupled with the latest LASIK technology has helped countless patients achieve 20/20 vision or better throughout the years.

Overview of Services Provided by Campus Eye Group • V  ision Correction Cataract Surgery with Premium IOL Implants Lasik Laser Vision Correction PRK Laser Vision Correction Phakic Intraocular Lens (IOL) Surgery • C  ornea Services Corneal Transplants DSEK Pterygia removal with amniotic tissue graft • R  etina Services Laser treatments, Medical Care and anti-oxidant therapy to slow or reverse progression of Macular Degeneration Use of innovative medications and up-to-the-minute laser technology to treat Diabetic Retinopathy Latest techniques for treatment of Retinal Detachment

For patients in and around Mercer, Middlesex and numerous other

• G  laucoma Treatments Advanced technology for early detection Minimally invasive laser therapy Surgical procedures to reduce intraocular pressure and prevent vision loss Shunt Implantation

counties in New Jersey and in fact, many who come from locations

• Neuro-Ophthamology

throughout the tri-state area, Campus Eye Group has served as an all-

• O  culoplastic Surgery Blepharoplasty (surgery to correct Ptosis or drooping eye) Surgical correction of Entropian and Ectropian (folding inward or sagging outward of lower eyelid) Eyelid reconstruction

p A specialized laser is used to reshape the cornea and the flap is then repositioned onto the underlying cornea without sutures.

inclusive hub, providing routine, medical, optical and surgical eye care, eliminating the need to travel to numerous ophthalmic facilities in order to address all of their eye care needs. “We do everything here that is done in tertiary and university care centers with the exception of oncology,” Dr. DiDonato emphatically states. He also points out the tremendous savings that are realized when insurance companies make payments to ASCs as compared to those made to hospitals as another significant advantage that Campus Eye Group offers. Brian M. Cohen, O.D. is Director of Clinical Services at Campus Eye Group. Dr Cohen discusses the comprehensive scope of the practice. “We have more than 30 doctors on staff here,” he remarks. “In fact, we’re one of the largest practices in the country,” Dr. Cohen states. In terms of the services offered, Dr. Cohen emphasizes that from routine eye care to the most advanced surgeries and treatments and everything that falls between, Campus Eye Group’s team of experts, equipped with the most innovative technology, provides it all. “We really are a one-stop location for complete eye care,” he says. (See Fig. 1)

• O  cular Aesthetics Botox Injectable fillers for wrinkle removal • O  ptical Services Hundreds of fashion and designer frames Advanced extra thin and light lenses Newest progressive bifocals IZON® lenses for high definition Safety and sports glasses Lens treatments including: UV protection, photochromic, polaroid, scratch resistance, anti-glare and fashion tints Prescription and non-prescription sunglasses • H  earing Services Hearing evaluations with leading-edge diagnostic equipment Dual sensory evaluations Sophisticated hearing aids Licensed audiologist on staff

Fig. 1

January 2012

5


may not be good candidates for laser vision correction surgery, the physicians at Campus Eye Group can perform surgery to implant phakic IOLs for vision correction. These innovative devices, which are similar to contact lenses, are placed within the eye as an additional lens. Following this procedure, which takes less than 30 minutes, most patients experience improved vision immediately. In addition to the abundant volume of patients who are treated at the Campus Eye Group each year for cataract surgery and vision correction, many

p The lens with the cataract is removed

undergo

advanced

procedures

performed on site by the specialty-trained LASIK eye surgery is appropriate for the

implants (IOLs) to replace the lens that has

ophthalmic surgeons on staff. Dr. Cohen shares,

majority of patients who suffer from poor vision

become clouded, including ReStor, Technis

“What sets us apart from some other practices

due to myopia (nearsightedness), hperopia

Multifocal, Toric and Crystalens.

is the specialty care we offer. Many conditions

(farsightedness) and/or astigmatism. During

that a general ophthalmologist might refer out,

the brief outpatient procedure the surgeon

AcrySof ReStor and Technis are multifocal

first creates a precise thin-hinged corneal flap.

IOLs, which restore vision at all distances. The

Next, the flap is pulled back to expose the

Toric IOL corrects pre-existing astigmatism and

For example, corneal tissue can be affected by

underlying corneal tissue. A highly specialized

improves distance vision. The Crystalens is an

a number of serious eye conditions, such as

excimer laser then gently ablates (reshapes)

accommodating lens implant engineered to

keratitis, which is inflammation of the cornea

the cornea. The flap is then repositioned onto

correct presbyopia as well as nearsightedness

and keratoconus, in which the eye’s surface

the underlying cornea without sutures.

and farsightedness.

weakens causing the cornea to curve outward.

At Campus Eye Group custom LASIK is

Before the availability of these premium IOLs

corneal disease where the endothelium

achieved through wavefront technology that

many patients who underwent cataract surgery

becomes less able to control the cornea’s fluid

uses light projected on the back of the retina

still needed to wear eyeglasses at times,

content. Damage to the corneal tissue can lead

to create measurements of each patient’s

especially for reading. Today, the significantly

to impaired vision that often cannot be treated

individual

resulting

growing number of cataract patients who opt

with laser vision correction.

waveprint is as unique as a fingerprint and

for these upgraded IOLs return for follow-up

enables the surgeon to customize the LASIK

visits delighted to report that they no longer

At Campus Eye Group, a fellowship-trained

procedure for each patient based on the

wear glasses at all.

cornea specialist who has performed thousands

we treat right here.”

Fuch’s Dystrophy is a progressive, inherited

visual

system.

The

information it provides.

of corneal procedures will do a comprehensive For some patients without cataracts who

Thousands of patients undergo cataract surgery at Campus Eye Group’s ambulatory surgery center each year. Leaving the facility with vision that has been restored or perhaps is better than it ever was is the outcome for a great number of patients. “Cataract surgery today has become a refractive procedure,” Dr. Cohen explains. “Patients’ expectations today are much higher than they were even five years ago,” he adds. In order to provide the best and most customized result for each individual patient, the surgeons at Campus Eye Group offer the latest and most sophisticated premium intraocular lens

6

New Jersey Physician

p The new lens is being placed into the eye

evaluation to determine the best treatment


may be asymptomatic initially, eventually the swelling of the retina interferes with vision. Left untreated, diabetic retinopathy can lead to blindness. The priority at Campus Eye Group’s retina center is to closely monitor diabetic patients with advanced testing in order to detect and treat this devastating condition as early as possible. With revolutionary medications and the most current laser technology, patients who are treated at Campus Eye Group for diabetic retinopathy are spared further progression of disease and can p A multifocal intraocular lens replaces the lens that was clouded.

also have a reversal of its severity.

remedy for each individual patient. If surgery is

aggressive wet AMD, caused by the abnormal

In some patients conditions affecting the retina

indicated, it is performed on site in the state-of-

formation of new blood cells, early detection

can cause the retina to separate or detach from

the-art ambulatory surgery center.

and treatment is crucial.

the underlying tissue. Retinal detachment

Progression of cornea disease may eventually

At Campus Eye Group an individualized

loss if not treated immediately. Dr. DiDonato is

require

can lead to sudden and permanent vision corneal

treatment plan is developed for each patient

pleased to inform that Campus Eye Group has

transplant surgery, during which a cornea

a

patient

to

undergo

that may include a combination of laser

procured the technology to begin performing

obtained from a donor eye bank is expertly

treatments, Avastin or other drug injections,

retina reattachment on site. This service will

transplanted to the affected eye. A newer

and/or vitamin supplements to slow down or

be available imminently and will certainly be

partial transplant procedure, DSEK, which

in some cases, even reverse the progression of

a significant benefit for any patient or referring

stands for Descemet’s Stripping Endothelial

macular degeneration. “We are in our fourth

physician who suspects a retinal detachment.

Keratoplasty is now being performed at

generation of medications that are injected,

Campus Eye Group as well. During DSEK, using

which arrest the disease and in 15 percent of

Glaucoma, which affects the optic nerve, is

microsurgical techniques, the thin corneal

cases, vision actually improves,” Dr. DiDonato

another serious eye condition that requires

inner layer called Descemet’s membrane is the

is pleased to report.

immediate treatment to avoid permanent vision

only layer transplanted, along with endothelial

loss. However, glaucoma is a slowly progressing

cells, rather than the full corneal thickness as

Patients with diabetes are at great risk for

disease that can be managed quite effectively if

is done in the traditional transplant procedure.

developing diabetic retinopathy, a condition

caught early on and provides another example

The remainder of the patient’s healthy cornea

in which the blood vessels in the retina become

of the exemplary specialty care available at

is left in tact. DSEK is less invasive than the

damaged and leak blood. Although patients

Campus Eye Group.

standard corneal transplant and requires less recovery time. Many patients seen at Campus Eye Group come to be treated by its team of retina specialists. When retinal tissue is damaged by injury or disease, the ability of the retina to transmit light may be compromised, leading to vision loss or even blindness. For individuals who are over the age of 65, macular degeneration (AMD), which is a partial deterioration of the part of the retina known as the macula, is the leading cause of blindness. Whether suffering from dry AMD which is caused by a gradual breakdown of cells in the macula or the rarer and more

p Besides his role as President of the practice, Dr DiDonato makes time to treat patients January 2012

7


These aberrations have a significant impact

New Jersey and beyond has been the mission

on the quality of vision affecting things like

at Campus Eye Group since it was founded

depth perception, crispness, contrast, color

three decades ago. Dr. DiDonato and the other

perception and night vision. From this data a

expertly trained specialists who have joined

unique “eyeprint” is derived. Like fingerprints,

him throughout the years have continuously

no two individuals have the same one. In fact,

provided

each eye has its own unique print. Campus Eye

technologically advanced eye care available

Group patients who are found to be appropriate

today. As Campus Eye Group begins another

candidates for the Izon® technology receive

decade, the vision of a future with endless

eyeglasses that provide vision correction

possibilities for its patients is crystal clear.

the

most

comprehensive

and

created solely for them that is far superior to what they were able to have with standard

Campus Eye Group is located at 1700

lenses.

Whitehorse-Hamilton Square Road, Hamilton, NJ 08690. For more information or to make

Preserving as well as enhancing the gift of

an appointment call (609) 587-2020 or visit

sight for hundreds of thousands of patients in

www.campuseyegroup.com

p Dr Cohen administers the IZON® exam

The skilled surgeons offer advanced testing and effective treatment options to arrest glaucoma before significant damage can occur. Depending upon the type and severity of glaucoma in each individual case, eye drops, minimally invasive laser therapy and/or surgery to reduce intraocular pressure are used. In addition to the comprehensive spectrum of routine and specialty eye care, patients who visit Campus Eye Group have access to an impressive array of optical services. Besides hundreds of the latest fashion and designer eyeglass frames, Campus Eye Group offers the latest technology in lenses and lens treatments. A revolutionary development in eyewear vision correction has recently allowed the skilled opticians at Campus Eye Group to customize each individual prescription to match every patient’s unique optical requirements. Izon® High-Resolution Lenses are produced using information from measurements obtained in the traditional way and also a revolutionary computerized capability to measure tiny microscopic irregularities or aberrations that oftentimes distort light as it passes through the cornea and lens and onto the retina.

8

New Jersey Physician

p Izon technology produces unique “eye prints” (top) for each patient, which are used to create customized lenses for vision without aberrations.


Health Law

Health Law Update

Update

Provided by Brach Eichler LLC, Counselors at Law

Medicinal Marijuana Program Rules Take Effect; BME Clarifies Position on Prescribing Marijuana On December 19, 2011, the rules governing New

vised from the BME’s originally proposed rules.

untoward side effects, physical problems or

Jersey’s Compassionate Use Medical Marijuana

The revisions came in response to controversy

psychological problems. Notwithstanding this

Act went into effect. The adopted rules – origi-

surrounding the Legislature’s interpretation of

clarification, if such problems do arise, then the

nally proposed by New Jersey’s Department of

the BME’s rule as requiring physicians to pe-

prescribing physician is required to either (1)

Health and Senior Services (DHSS) – are iden-

riodically attempt to wean patients off of their

modify the dose of marijuana, (2) undertake a

tical to those proposed by DHSS in February

medicinal marijuana. The revised rules retain

trial of other drugs or treatment modalities or

of 2011.

a provision requiring physician reassessment

(3) discontinue the use of marijuana. Addition-

of the patient’s medicinal marijuana use every

ally, a physician who is required to take action

In addition to DHSS’s rules, the New Jersey

three months. However, the new rule makes

must also consider referring the patient for in-

State Board of Medical Examiners (BME) ad-

clear that physicians can continue to prescribe

dependent evaluation or treatment in order to

opted its own rules concerning the prescrip-

medicinal marijuana if it is helping the patient

achieve the patient’s objectives.

tion of medicinal marijuana, which were re-

reach his or her treatment objectives with no

CMS Releases 2012 Medicare Physician Fee Schedule CMS published the Medicare Physician Fee

ated with the second and any subsequent

Records incentive program have been up-

Schedule (MPFS) for calendar year 2012 late

advanced diagnostic imaging tests per-

dated and modified to allow for increased

last year. Payments under the MPFS are based

formed on the same patient on the same

upon the Sustainable Growth Rate formula im-

day. For 2012, this policy is expanded to

•T  he quality and cost measures that will

posed under the Balanced Budget Act of 1997.

apply to the professional component as

be used in establishing a new value-based

Based on that formula, the 2012 MPFS provides

well, with payment being reduced by 25%

modifier have been finalized, which will

that Medicare’s payments to physicians will be

for the professional component associ-

ultimately be used to reward physicians

reduced across the board by 27.4%. However,

ated with the second and any subsequent

for providing higher quality and more effi-

on December 31, 2011, President Barack Obama

advanced diagnostic imaging tests, includ-

cient care, commencing with specific phy-

signed legislation which delays the implemen-

ing MRI, CT and ultrasound.

sicians and physician groups in 2015 and

participation.

tation of the reduction until February 29, 2012.

• The Geographic Practice Cost Indices will

Unless there is further action, Medicare pay-

incorporate different data sources to deter-

•P  roviders are required to conduct a health

ments will be reduced as of March 1, 2012.

mine the various cost differences among

risk assessment as part of the Medicare

localities in connection with the physician

patient’s annual wellness visit, and Medi-

Some of the other key provisions of the MPFS

work RVU, the practice expense RVU and

care will increase payment for the HCPCS

include:

the malpractice RVU.

codes associated with the health risk as-

• The Multiple Procedure Payment Reduc-

•C  ertain aspects of the Physician Quality

tion policy currently reduces payment by

Reporting System, the e-Prescribing incen-

50% for the technical component associ-

tive program, and the Electronic Health

expanding to all physicians by 2017.

sessment to take into account the additional time and paperwork involved.

January 2012

9


Health Law Update

Proposed Legislation Requiring Surgical Practices to be Licensed Passes House & Senate But Not Signed by Governor Christie On January 9, 2012, legislation that would have

quired to register with DHSS and obtain either

enactment. The bill provided, however, that

required surgical practices to be licensed by

certification by CMS as an ambulatory surgery

surgical practices in operation prior to the date

DHSS as ambulatory care facilities was passed

provider or ambulatory care accreditation from

of enactment would not have been subject to

by both the New Jersey Senate and Assem-

an accrediting body recognized by CMS.

the ambulatory care facility assessment or to

bly.

However, Governor Chris Christie did

DHSS regulations pertaining to physical plant

not sign the bill into law by January 17, 2012,

This bill would have repealed the registra-

and functional requirements for ambulatory

thereby “pocket-vetoing” the legislation.

care facilities.

Un-

tion requirement and instead mandated that

der the “Codey Law,” surgical practices are not

all surgical practices be licensed by DHSS as

required to be licensed. Instead, they are re-

ambulatory care facilities within one year of its

New Jersey Bill Would Require Certain Advertising Disclosures A bill originally introduced last June in the

The bill requires that:

•C  ertain health care professionals who pro-

New Jersey Legislature, which requires certain

•A  person licensed to practice medicine or

vide information regarding health care ser-

health care professionals, working in an of-

surgery by the State Board of Medical Ex-

vices on an internet website that is directly

fice, to disclose to patients their name, type of

aminers, who is also certified in a medical

controlled or administered by that profes-

license and highest level of academic degree

specialty, must disclose, while working in

sional or that professional’s office person-

(A4185), was recently reported out of the As-

an office, the name of the certifying board

nel, must prominently display on that in-

or association

ternet website their name, type of license

sembly Regulated Professions Committee. The bill requires that information must either be

• Advertisements by a health care profes-

prominently displayed in the office of such a

sional for health care services must include

health care professional or in writing to a pa-

the professional’s name, type of license and

The bill was not addressed in the last day of the

tient on the patient’s first office visit.

highest level of academic degree

legislative session held on January 9, 2012.

and highest level of academic degree

Hospital Rounds

N.J. Cancer Docs Form Network By Jaimy Lee

A group of physician practices in New Jersey

Associates; Hematology Oncology Associates

compassionate care, cutting-edge therapies

has formed an oncology physician network

of North New Jersey; Hope Community Cancer

and clinical trials while reducing the cost of

that comprises more than 70 cancer-care

Center; Monmouth Middlesex Hematology

cancer care,” said Dr. Andrew Pecora, president

specialists and 500 employees at 20 care sites

Oncology; Northern New Jersey Cancer

of the network.

within the state.

Associates; Sparta Hematology Oncology; The

Regional Cancer Care Associates, based in

Center for Cancer; and the practices of Dr.

Pecora is the chief innovations officer and

Kenneth Nahum and Dr. Usha Niranjan.

vice president of cancer services at the John

Hackensack, N.J., expects to treat about 90,000 patients each year, according to a news release.

Theurer Cancer Center, which is part of the “Regional Cancer Care Associates physicians

Northern New Jersey Cancer Associates

and staff accept our responsibility to work

network, according to a spokesman for

The network is made up of 10 oncology

with insurance companies, our hospitals

Regional Cancer Care Associates.

physician

practices:

and referring physicians to provide patients

Oncology

Center;

10

the

Central

Hematology

New Jersey Physician

Jersey

Oncology

continued

access

to

the

highest-quality


Health Law Update

New Jersey Bill Phases Out Tax on Cosmetic Medical Procedures: Awaiting Governor Action A bill recently passed by the New Jersey legis-

as well as the administrative burden that the tax

lature would phase out New Jersey’s cosmetic

places on providers who are required to collect

medical procedure gross receipts tax. The tax,

the revenue.

initially passed in 2004, currently imposes a 6% gross receipts tax on the purchase of cos-

The bill (A-3646/S-1988) would begin reduc-

metic medical procedures, defined as those

ing the current 6% rate on such procedures

procedures performed in order to improve an

to 4% starting on the first day of the calendar

individual’s appearance where such proce-

quarter after the bill is passed. The rate would

dures do not significantly serve to prevent or

then drop to 2% on or after July 1, 2012. The

treat illness or disease. This includes cosmetic

tax would subsequently be eliminated for pro-

surgery, hair transplants, chemical peels and

cedures performed after July 1, 2013. During

cosmetic dentistry, as well as a host of other

the final voting day of this legislative session on

procedures. The tax is paid by the individual

January 9, 2012, both the general assembly and

receiving the cosmetic procedure and collect-

the senate voted to approve the bill, and it has

ed by those billing for the procedure. The bill

now been sent to Governor Christie for signa-

is meant to reduce the cost of such procedures

ture or veto.

Let Brach Eichler’s Health Law Practice Group Help You Chart a Strategic Course For Your Health Care Business Health care providers have long come to rely on the attorneys of Brach Eichler to navigate the regulatory environment at both the state and federal levels. Now that health care reform is being implemented, Brach Eichler is ready to help you make sense of the significant changes, the statutory framework and the ramifications for health care providers in New Jersey. Health Law Practice Group Todd C. Brower Lani M. Dornfeld

John D. Fanburg Joseph M. Gorrell

Richard B. Robins Jenny Carroll Chad D. Ehrenkranz

Carol Grelecki Debra C. Lienhardt Kevin M. Lastorino Mark Manigan

Lauren Fuhrman Eric W. Gross Rita M. Jennings

Leonard Lipsky Isai Senthil Edward J. Yun

101 Eisenhower Parkway • Roseland, New Jersey 07068 • t. 973.228.5700 • f. 973.228.7852 • www.bracheichler.com January 2012

11


Statehouse

New Jersey Statehouse NJ Bill Would Require Health Care Workers to Get Flu Shots By Susan K. Livio

Beginning in the fall, medical professionals

testifies to their decision not to get vaccinated,

oppose any vaccine mandate. “This opens

who come into contact with patients would

according to the bill.

the door for vaccine mandates for adults.

have to get a flu shot under a bill that won final legislative approval Monday evening.

Records will be maintained regarding who has All health care facilities would have to report its

received this vaccine and who has declined

annual compliance rate to the state Department

it,’’ according to an email sent Friday by the

Health care facilities would have to provide a

of Health and Senior Services, according to the

New Jersey Coalition for Vaccine Choice to its

vaccination program for its employees by the

bill, (A3920).

members.

would have to get the vaccine, show proof they

The bill passed, despite calls from anti-vaccine

The Senate passed the bill 36-3 just before 6

got it on their own, or sign a statement that

groups urging people to tell lawmakers to

p.m.; the Assembly passed the bill last month.

start of the next flu season in the fall. Employees

Singer Bill to Require Study of Looming Doctor Shortage in NJ Approved by Senate Health Committee Legislation sponsored by Senator Robert Singer

Singer’s legislation, S-173, was introduced in

discussing the redistribution or expansion

(R-30) which would require the Commissioner

response to a report issued by the Physician

of residency slots to address shortages in the

of Health and Senior Services to convene a

Workforce Policy Task Force in 2010 which

state and investigating ways to include more

planning summit to examine an expected

predicts a shortfall of nearly 3,000 doctors

community hospitals in resident rotations

shortage of physicians practicing in New Jersey

in the Garden State by 2020, including 1,000

in family medicine, internal medicine and

has been approved by the Senate Health,

primary care physicians and 1,800 specialists.

pediatric medicine.

The legislation seeks to address that shortage

“The summit proposed by this legislation

“A recently completed report predicts that

by requiring the Commissioner of Health and

would bring together experts from across

within the next decade, New Jersey will face a

Senior services to convene a strategic planning

the state to determine the most effective way

shortage of thousands of physicians practicing

summit comprised of relevant State agencies,

to prevent or minimize the looming doctor

in family care and important specialties,” said

boards and key stakeholders, including

shortage,” added Singer. “Once we have their

Singer. “Unless we get to work now to prevent

representatives

recommendations, we will be able create and

that shortage, many New Jerseyans may soon

teaching hospitals in the state.

Human Services & Senior Citizens Committee.

of

medical

schools

and

enact a plan to ensure that New Jersey trains

find themselves without doctors or unable to

and retains enough doctors to meet all of our

obtain appointments or treatments when they

The summit would be charged with analyzing

need them.”

the

12

New Jersey Physician

state’s

physician

workforce

supply,

residents’ needs.”


Vendor News

Argent Professional Insurance Agency, LLC Is Acquired by Bollinger Argent Professional Insurance Agency, LLC

prospect of creating one professional liability

professional liability insurance for physicians

announces its acquisition by one of the nation’s

division within Bollinger, and are honored to

and healthcare facilities, accountants and

leading insurance agencies, Bollinger, Inc.

be tasked to lead it,” commented Henry Kane,

attorneys.

“Bollinger is a leader in virtually every area of

ARM, President, Argent. Bollinger, Inc. is headquartered in Short

the insurance industry, and with the acquisition of Argent, we feel we have solidified our place

The acquisition also comes at a time when

Hills, NJ with branch offices in Greenwich CT,

on top of the professional liability market as

many professionals – particularly in healthcare

New York NY, Monticello NY, Philadelphia PA

well,” remarked Jack Windolf, CLU, CPCU,

– are experiencing widespread consolidation

and additional NJ locations in Moorestown,

Bollinger Chairman and CEO. This acquisition

and regionalization. “As the clients we serve

Sparta, Vineland and Wall. The firm has over

will make Bollinger one of the largest

throughout a number of professions continue

440 employees and is currently ranked as the

professional liability insurance agencies in the

to expand geographically, and diversify into

nation’s 17th largest insurance broker.† It is one

nation, combining Argent’s vast network and

new areas with new exposures, we are thrilled

of the 2009 Best Places to Work in Insurance.††

seasoned leadership, with Bollinger’s extensive

to be able to partner with Bollinger . Having

resources and national presence.

access to Bollinger’s

Bollinger has formed a new professional

resources helps ensure that our clients’ needs

wide range of customers, as well as specialty

liability division within its agency in recognition

will be met for many years into the future,”

insurance programs for golf and country clubs,

of its new role as a leader in the niche. In

noted Brian Kern, Esq., Co-Founder of Argent.

amateur sports, and schools and colleges.

also recently acquired other agencies with

Argent Professional Insurance Agency, LLC,

For more information on Bollinger, Inc.

professionalliability

including

was founded in 2009 by Henry Kane, ARM,

www.BollingerInsurance.com

The Woodland Group and Allied Insurance

and Brian Kern, Esq., and has grown rapidly to

Services Agency. “We are excited by the

become one of New Jersey’s leading writers of

Bollinger provides business and personal insurance and employee benefit programs to a

addition to acquiring Argent, Bollinger has expertise,

† As reported

January 2012

13


Patient Point-of-View

What Doesn’t Kill You, Makes You Stronger

By Justin Bromberg

bleeding started and I stopped taking Coumadin and it kept on bleeding,” he recalled. “Within a week, I was in the hospital.” His first surgery took place in Miami in April 2005, and Touzel recalls his doctor coming in post-operation and uttering a few simple sentences. “He said, ‘So Tom, can you hear me and understand me?’ I said, ‘Sure.’ He said, ‘Well, it’s not pretty. What you need to do is go home and get your s--t together.’ That’s literally what he said - and he walked out of the room.” Touzel decided right then and there that the diagnosis would not control his life. He began researching cancer care centres that deal with bladder cancer and decided on the M.D.

T

what you need to do,’ that’s when you lose.

Anderson Cancer Center in Houston, Texas.

after deciding several years ago that he would

“It’s important to get involved in your own

The surgeon he would see was Dr. Colin

not succumb to bladder cancer, chose to fight

care and be involved with doctors and nurses

Dinney, though the latter didn’t know it yet.

it, and won.

and technicians and so on, so that you

om Touzel learned one of life’s most important lessons, perhaps unintentionally,

Touzel, who lives in Vankleek Hill but travels

understand what’s going on and you can better

“I went into the clinic and they told me they

communicate to them what’s going on.”

weren’t taking any new patients,” said Touzel. “So I went back to admissions and said, ‘I know

abroad on a regular basis, said despite having to undergo regular checkups for his health, he

Touzel was first diagnosed with bladder cancer

there’s a great turnover in patients. I will sit here

lives a relatively fit and active lifestyle - and he

in the spring of 2005, when he visited his

and wait until Dr. Dinney comes to me.’

feels good.

primary physician in Fort Lauderdale, Florida. At the time, he was taking a blood thinner

“The next morning I went back there, and

His advice? Take your care into your own

(Coumadin) after suffering a stroke about a

around 11 o’clock, he came over and said, ‘Mr.

hands and be relentless.

decade earlier - and wrongly assumed the

Touzel, I understand you’re pretty persistent.’

blood in his urine was linked to the medication.

I said, ‘I am, because I want a winner. I don’t intend to lose this battle and I want you on my

“No matter what you’re dealing with, especially with cancer, the proactive are the survivors,”

“I never thought to discuss it with my doctor

he said. “When you sort of walk in and say, ‘Do

until one time, when I was in Korea and the

14

New Jersey Physician

team.’”


Touzel had with him his MRIs, scans and

and metastize and spread?” he noted.

reports, but nevertheless was scoped again at

“Whether you’re in Canada or the U.S. - both medical systems work - you still need to learn

M.D. Anderson. The clinic would not offer a

But what gives him such a positive outlook on

how to work the system,” he said. “You can’t

definite prognosis, only saying its team would

his condition, Touzel was asked.

just sit back and let the system work you. When

do the best it can do - along with robotic surgical procedures and drugs.

you have an issue that needs special attention, “There are some truths that are absolute,”

you need to demand special attention from

he stated. “The proactive are the survivors.

primary physicians - and you’re entitled to it.

“I just started with treatments there, including

The people that engage their own illness and

two surgeries, and was rendered clean and

treatment are the ones that come out on top.

“It’s the same thing down here [in the U.S.]

declared clean,” he said. “A couple of years

That’s all I know but I’m grateful that I’m happy

with Medicare and insurance; most companies

ago, I reached my five-year point of being clean

and healthy and have a great family and live a

have restrictions on the doctors themselves,

and [Dinney] said, ‘Okay, are you ready for a

great life.”

on who’s included in their plan, and you have

prognosis? If you keep doing exactly what we

to make demands. Speak up and say, ‘I am a

tell you to do, I can promise you will not die of

This week, Touzel also celebrates a noteworthy

human, I am covered by you and that is what I

bladder cancer.’”

milestone: once an alcoholic, he is now 38

want - and I want the best.’”

years clean in Alcoholics Anonymous. Asked One year into the treatment, Dr. Dinney asked

about what inspires him to be so forthcoming

Touzel refers to that approach as “speaking up

him to serve as a patient advocate for bladder

- and public - about his disease, he says being

and attacking the system, making it do what it’s

cancer. Touzel said he was initially concerned

involved in that group and abstaining from

supposed to do for you.”

it would be “like giving people ice and water,”

alcohol taught him an important lesson that he

but he quickly learned it meant being part of

readily referred to after his battle with cancer.

“I am not a religious guy, but I’m pretty spiritual,” he continued. “I’m not a Sephardic Jew or a

“a very complex group of people that acts as “I learned very early in AA that the key to

born-again Christian or a radical Buddhist, but

survival is sharing,” said Touzel. “Sharing, not

we have to somehow develop a sense of faith...

“It’s not about battles but translating what

being afraid to share you story and your fears

and that’s really where the freedom for all of us

they’re feeling and thinking, making sure their

and I’ve always done it. That’s sort of the way

comes, is engaging and embracing the faith -

questions are answered, their needs are met,

it is with cancer, too. The fact that I’m cancer

wherever we find it.

no bulls--t, up front and honest,” he said. “I’ve

free today is something that can give hope to

been doing that for five years now and I’ve

someone, someday, who is just embarking on

“We are powerless over all kinds of things in

become involved with other advocates and

this journey.

this world, and cancer is one of them, but we’re

referees between doctors and patients.”

not powerless in dealing with it. People need to

many other disease sites.”

search out the optimum in treatment and care

Take your care into your own hands and be relentless.

and go for it.” Those are the so-called words of wisdom from a man who, at an age where most people settle into retirement, now travels the world as a judge for dog shows. Touzel relocated to

Staying positive

“They say, ‘Look, an old fart with wrinkled hair

Vankleek Hill several years ago after operating

Bladder cancers is one of the cancers of which

has beat it’ and they have hope then. They also

a kennel in Pointe-Fortune for 20 years, noting

there is no cure, meaning it requires regular

see patients walking around with no colour in

“this area is really home.”

care and management. Touzel continues to be

their face and that’s frightening - so we need

examined every three months and will likely do

to keep the hope up for all these people.

He doesn’t spend much time in the gym, but

so for the rest of his life - as there’s always the

Everybody is entitled to hope and faith.”

calls himself “fairly fit and active” as well as grateful to live the lifestyle he does - and when

chance it’ll “pop up” again.

Words of advice

he’s tired of flying on airplanes, to be nestled

“We all have cancer cells floating around in our

Touzel’s advice, again, is to be proactive - and

comfortably in eastern Ontario.

systems and one of the great mysteries is: what

don’t assume you can just sit back and let the

triggers them to grow and become tumours

system take care of you.

“Be proactive - if not, you’re giving up.” January 2012

15


Food for Thought

Super Bowl Sunday Buffalo Wings Roseland, New Jersey By Iris Goldberg Michael and I have been attending Super Bowl par-

Fast forward to Super Bowl 2012. Giants vs. Patriots.

was surprised to see him walk into my hospital room.

ties since we moved to New Jersey. Back then, as

Even I am excited. Friends who live in Roseland have

It was only half-time. “Why are you here?” I asked. “I

many as ten couples, each with anywhere from one

taken on the annual event. There are five couples.

couldn’t enjoy it without you,” he answered with a

to three children in tow, gathered at one particular

Two are from the original group. We are now “ma-

straight face and the utmost sincerity.

home in Livingston every year. They had a big play-

ture” adults ranging in age from late 50s to early 60s.

room down in the basement where all the kids could

The moment we arrive, Michael heads straight for the

I am looking forward to attending many more Su-

go (be banished to is more accurate), leaving the

den where the other men are already settled. I take

per Bowl parties with Michael in the years to come.

adults upstairs to enjoy the game, each other and the

my spot at the kitchen table. Does this sound famil-

Wherever and with whomever we find ourselves seat-

food and drink. While this would seem to be a fine

iar? Wait, it gets better.

ed, Super Bowl Sunday has come to be about good

plan on paper, it actually played out like this:

people, good food and this year- a team that brought I sit next to a lovely woman who I like very much but

us all to our feet. Although I have to say, I kind of

It would take about five minutes until a fight broke

only see from time to time at various events – wed-

missed the kids.

out downstairs, requiring at least two moms to ref-

dings and funerals mostly. She has a full-time career

eree. The men were already congregated in the den

as do I. She immediately pulls out her cell phone to

in front of the television, never to be seen or heard

show me a picture of her granddaughter and I re-

from again until it was time to collect the kids and

spond by sharing every detail of my daughter’s preg-

go home. The women would sit around the kitchen

nancy. Next, a third woman reveals the plans for her

table, snacking and commiserating. Every so often,

son’s upcoming “destination” wedding.

one or two moms would run downstairs to negotiate a settlement. Also, a child or two would find his or

By this time the game has started and the men are

her way upstairs now and then to complain or to just

screaming every few minutes. We are watching on

get some TLC.

a smaller TV in the kitchen which has a time delay so we hear the mens’ shouts before we actually see

When the women did have a chance to talk, the topic

what has occurred. It doesn’t really matter because

was almost always something about their children.

we are only half-watching. While we are conversing

Toilet training, the “terrible twos,” sibling rivalry,

we are feasting on a variety of scrumptious delights.

Michael’s Super Bowl Sunday Buffalo Wings

Someone has made a multi-layered creation of gua-

Ingredients:

intellectual development (most of us were former

camole, bean dip, salsa, Monterey Jack, shredded let-

Chicken wings - separated into two main

teachers), pre-school programs, etc., were the most

tuce and other ingredients that I’m sure I am forget-

pieces, and toss out the tip

common subjects. In the days when the kids had not

ting. There was a lovely crudite with a tangy dressing

Salt, Pepper, Garlic Powder, Flour

yet started school, we were all stay-at-home moms

and a variety of chips, nuts, cheeses, etc. Our contri-

Oil for frying in a sauté pan

so this was truly our main focus. I must admit, there

bution was the wings.

were many years when I didn’t even know which teams were playing.

Michael had spent most of the afternoon preparing about 40 of these beauties. They were a hit! Just the

Now for the food! The fare was always the same. Our

right amount of heat and the meat was perfectly

hostess, Barbara found a way to make Super Bowl

seasoned and cooked. I was so proud of him that I

Sunday a charitable event. She purchased “sloppy

glanced toward the den hoping to catch his eye. No

Joes” and all of the sides from a deli that contributed

such luck. He was caught up in the excitement of the

part of their profit to a cancer-fighting organization.

game and the camaraderie of other men.

The only items that varied were the nibbles. Usually,

1 cup of Frank’s Original Flavor Hot Sauce (must be Frank’s, do not substitute) One stick of butter Celery Good blue cheese dressing such as Marie’s In a large bowl, place the chicken, generously add the salt, pepper and garlic powder, mix together. Put enough flour into bowl to lightly coat the wings by stirring. Heat the oil to about 375º and cook the wings to a golden

each couple contributed something. Whatever there

I suddenly remembered one Super Bowl Sunday

brown. Place them in a heat proof bowl, Mix

was – nachos, miniature franks in blankets, crudite –

many years before, when I did not join Michael and

the Frank’s Hot Sauce in a separate pan with

everything tasted delicious, especially when accom-

the kids at the usual party. I was in the hospital re-

the melted butter and stir until combined. Pour

panied by a bloody Mary or a glass of wine. I remem-

covering from surgery. I had encouraged him to go

the sauce over the cooked wings. Serve with

ber I particularly enjoyed the tangy buffalo wings that

without me, thinking it would be good for him to

the celery and blue cheese dressing on the side.

were a tradition on this special Sunday.

spend an enjoyable few hours away from the hospi-

Can be cooked ahead and warmed in the oven

tal, watching the game in the company of his pals. I

when ready to serve.

16

New Jersey Physician


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NJ Physician Magazine January 2012