ONONDAGA COUNTY MEDICAL SOCIETY
BULLETIN VOL. 83, NO. 2
IN THIS ISSUE:
• Meet New OCMS Executive Director Erika Barry • 2019 Legislative Forum • Upstate Medical Residents and Students Participate in MSSNY Poster Symposium • 2019 House of Delegates
Onondaga County Medical Society Endorsed
DISABILITY INCOME PROTECTION
The coverage that works for you, when you canâ€™t work For more information, contact:
Charles J. Sellers & Co., Inc. Endorsed Administrator
4300 Camp Road, Athol Springs, NY 14010 (P) 800-333-5440 (F) 800-462-1121 firstname.lastname@example.org www.sellersinsurance.com
Insurance Services Since 1920 Underwritten by: Life Insurance Company of Boston & New York: Athol Springs, NY. This policy provides Disability insurance only. It does not provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. The expected benefit ratio for this policy is 60%. This ratio is the portion of future premiums which the company expects to return as benefits when averaged over all people with this policy. See the Product Brochure and/or Policy Form DIC-N (0900) NY for details concerning policy benefits, limitations and exclusions. CJS552 4/19 Exp. 4/30/21
A community healthcare system built with exceptional people. A healthcare system without walls, Nascentia Health takes a holistic approach to patient care, addressing immediate needs, supporting positive long-term medical and lifestyle choices, and leveraging leading-edge in-home care approaches and technologies to promise more effective care. Specialties include: ○
In-Home Nursing & Medical Services
Home Health Aides & Elder Care
Complete Cross-Continuum Care Management
Community Health & Wellness Programs
Transportation, Equipment & Innovative Care Technology
Chronic Disease Management
Managed Long-Term Care (MLTC) Plan
Medicare Advantage Plan
1050 West Genesee Street, Syracuse, NY 13204 888.477.HOME
ONONDAGA COUNTY MEDICAL SOCIETY
BULLETIN VOL. 83 NO. 2
Published by Onondaga County Medical Society, Inc. Learbury Centre | 329 North Salina Street, Suite 303 | Syracuse, New York 13203 Telephone 315.424.8118 | Fax 315.424.0614 Cover photo: 2019 OCMS Legislative Forum
Onondaga County Medical Society Executive Council Officers
Table of Contents Coming Events
Meet New Onondaga County Medical Society Executive Director Erika Barry
MaryAnn Millar, M.D. President Justin Fedor, DO President-Elect Joseph Spinale, DO Vice President
2019 Legislative Forum
2019 House of Delegates
Upstate Medical Residents and Students Participate in MSSNY Poster Symposium
Improving Medical Outcomes for Refugees & Immigrants
The Legal Treatment
OCMS Ask the Carriers Conference
Welcome New Members
Health Care Providers Comment on Advising Prostate Cancer Patients and Survivors to be Physically Active
Delegates to MSSNY
Measles Fact Sheet
Richard Beers, M.D. LouAnn Giangreco, M.D. Ruth Hart, M.D. Brian Johnson, M.D. Digant Nanavati, M.D. David T. Page, M.D. Barry Rabin, M.D. Richard D. Semeran, M.D. Darvin Varon M.D.
Staff Erika Barry, Executive Director Debbie Colvin, Director of Finance Patty Corasaniti, Office Manager Sandy Emmi, Director of Publications The Bulletin is published quarterly March, June, September and December. The Editors endeavor to publish only that which is authentic but disclaim any responsibility for the statements of contributors. The BULLETIN will accept advertising which it considers ethical, but such acceptance does not imply endorsement. Please address all correspondence to The Bulletin, c/o Onondaga County Medical Society, Learbury Centre, 329 N. Salina St., Ste. 303, Syracuse, New York 13203.
Michael G. Sheehan, M.D. Treasurer Barry Rabin, M.D. Secretary Brian Johnson, M.D. Past President
Members-At-Large Ramsay Farah, M.D. Michael Fischi, M.D. LouAnn Giangreco, M.D. Barbara Krenzer, M.D. William D. Schreiber, M.D. Kevin Walsh, M.D.
Delegate from SUNY Upstate Medical University Sunny Aslam, M.D.
Resident Representative Vamsee Neerkonda, M.D.
Medical Student Representative Zachary Visco
Retired Physicians Lunch Monday, June 17 • 12 p.m. (Coffee/registration at 11:30) Holiday Inn, 441 Electronics Parkway, Liverpool The Onondaga County Medical Society invites all retired members to join us for the spring retired luncheon Monday, June 17th. 50-year citations will be awarded at this event. Dr. Robert Dracker, a past president of the Medical Society, would like to underwrite the cost of the luncheon for those physicians who are no longer working. For all others who attend, including spouses, the price is $27 each. For more information or to register for this event, please contact Patty Corasaniti at the Medical Society, (315) 424-8118, email@example.com.
New York State Fair August 21 - September 2 • NYS Fairgrounds The Onondaga County Medical Society will once again help staff the MSSNY booth at the NYS Fair this year. We will need physician volunteers to represent OCMS at the booth. Volunteer sessions normally run in 4- to 6-hour shifts. However, we will work around your schedule! To volunteer for the fair, or for more information, please contact Patty Corasaniti, (315) 424-8118, firstname.lastname@example.org.
Retired Physicians Lunch Monday, October 7 • 12 p.m. (Coffee/registration at 11:30) Holiday Inn, 441 Electronics Parkway, Liverpool The Onondaga County Medical Society invites all retired members to join us for the retired luncheon Monday, October 7. The cost for all who attend, including spouses, is $27 each. For more information or to register for this event, please contact Patty Corasaniti at the Medical Society, (315) 424-8118, email@example.com. JUNE 2019
OCMS Past President’s Dinner Wednesday, October 30 • 6 p.m. Arad Evans Inn, 7206 E Genesee St, Fayetteville This OCMS Past President’s event is a “dutch treat,” three-course menu at $55.00 per person. Selections are: beef, chicken, fish, vegetarian, and can be decided the night of. Dinner includes salad, entrée, and dessert. If you are a past president of the Medical Society and would like to attend, please email firstname.lastname@example.org or call the Medical Society office at (315) 424-8118.
OCMS Annual Dinner November 7 • Embassy Suites by Hilton Destiny USA Save the Date! The Onondaga County Medical Society Annual Dinner is set for Thursday, November 7, 6 p.m. at Embassy Suites Hilton Destiny USA. Justin Fedor, DO, will be installed as President of the Onondaga County Medical Society.
MARYANN MILLAR, M.D.
Dear Colleagues: I am pleased to have this opportunity to inform you of the Medical Society’s accomplishments during this past quarter. First and foremost, we have hired Ms. Erika Barry to be our new Executive Director. She has previously led nonprofit organizations and statewide initiatives. She is experienced in lobbying at the state and federal levels. Her education includes a BA, dual majors in Political Science and American Studies, from Vanderbilt University and a Master of Public Administration with a Concentration in Nonprofit Management and Social Policy from The George Washington University. She is highly qualified and quite enthusiastic to be our Executive Director. I could not be happier to welcome Erika to OCMS. Thank you to Dr. Brian Johnson MD, and the members of the Search Committee for your work and congratulations on your success. With the lease on our office’s North Salina Street location expiring on June 30, 2019, one of Erika’s first tasks will be to supervise the move to our new location on 6707 Brooklawn Parkway in Syracuse, off of Carrier Circle. The space is newly built out and includes a conference room where we can have all of our meetings. I want to thank Dr. Jeffrey Kahn MD, for all of his help in finding our new home. Once we are up and running we will have an open house to show it off. Hope to see you there! Our annual Legislative Forum took place on April 6, 2019. We had more physician and medical student participation than we have ever had in the past,
as well as outstanding attendance by our legislators. The considerable degree of access to our lawmakers that we had at the forum is truly rare, a reverse Lobby Day of sorts, and demonstrates the high level of respect they have for our physicians. Their willingness to participate in dialogue to serve their constituents, our patients, is admirable. We welcomed new legislators State Senator Rachel May, County Executive Ryan McMahon and a representative for State Senator Bob Antonacci. Our incumbents, Assembly representatives Will Barclay, Pam Hunter, Bill Mangnarelli and Al Stirpe as well as a representative for Senator Charles Schumer were “There is good news in attendance. Our Congressional regarding women’s Representative John Katko, while unable to be there, submitted a video health legislation. This specifically made for the forum and spoke about the bipartisan Resident past March, the New Physician Shortage Act that he recently introduced. If signed into law, this bill York State Assembly and would provide funding to increase the Senate unanimously number of residency positions eligible for graduate medical education under passed bills that would Medicare by 15,000 slots (3,000 per year for 5 years). Our medical student establish Maternal representative on the Executive Council, Zachery Visco, made a presentation Mortality Review in support of this bill as well. Other Boards and a Morbidity presentations included medical students Robertha Barnes, Elena Cappello, Advisory Council. ” Sydney Russell Leed and Yaa Takyiwaa on the importance of access to health care, Dr. Sarah Gregory MD, Ob-Gyn resident, in opposition to the C-Section Informed Consent Mandate bill, Dr. Robert Weisenthal MD, Chair of the OCMS Legislative Committee, on Electronic Health Records Interoperability, Dr. Brian Johnson MD, immediate Past President of OCMS, on the consequences of cannabis legalization. Dr. Indu Gupta MD, Onondaga County Commissioner of Health, reported on pertinent Public Health issues and I presented on the recently signed into law New York State Reproductive Health Act. Thereafter, time was allocated for individuals to either ask questions of our legislators or to advocate for a policy.
Thanks to all of you who were able to come to the forum. I hope even more will be able to attend next year. There is good news regarding womenâ€™s health legislation. This past March, the New York State Assembly and Senate unanimously passed bills that would establish Maternal Mortality Review Boards and a Morbidity Advisory Council. New York currently ranks a low 30th out of 50 states in its maternal death rate and compared to white women, black women are three times more likely to die during pregnancy and childbirth. Passage of this bill was critical in that creation of these review boards will help us better understand the causes of maternal deaths and to develop strategies for prevention. It is anticipated that Governor Cuomo will sign it into law. I wish everyone a peaceful and happy summer. Respectfully Submitted, Dr. MaryAnn E. Millar MD, FACOG President, Onondaga County Medical Society
Meet New Onondaga County Medical Society Executive Director
he Onondaga County Medical Society welcomes Erika Barry, who was recently hired as the Executive Director for the Society.
Erika Barry brings deep expertise in nonprofit management and catalytic systems change to Onondaga County Medical Society. She was most recently Director of Business Expansion with Hillside Family of Agencies, where she was responsible for government affairs, led strategic planning efforts, built new local and national partnerships across sectors, and cultivated nontraditional sources Erika Barry of funding in order to scale programs for OCMS Executive Director youth and families along the continuum of care. Prior to joining Hillside, she was Executive Director of the Syracuse Northeast Community Center. She also served as Executive Director at Thrive DC, serving men and women facing poverty and homelessness in the nationâ€™s capital. Ms. Barry has provided fundraising and board governance consulting to community-based nonprofits across the country, and she also brings direct experience in education and health and wellness programming. Ms. Barry graduated from Vanderbilt University summa cum laude and Phi Beta Kappa and was a Fleming Public Administration Fellow at The George Washington University in Washington, DC, where she earned a Masters in Public Administration and specialized in Social Policy and Nonprofit Management. To contact Ms. Barry, please email email@example.com.
It Costs No More To Hire The Top
ATTENTION TO DETAIL The grand foyer featuring elegant curved staircase opens to the well appointed interior. New $400,000 addition includes a magnificent appliance-rich kitchen with Woodmode cabinets. Newly added gathering room, gorgeous stone fireplace and spectacular ceiling. Columns, moldings, marble and hardwoods, French doors, Judges paneling & custom built-ins. A full bath and laundry center too. 4 bedrooms including a remodeled master en suite. Lower level with game room and full bath. Covered patio w/kitchen, bar, dining, sitting areas and in-ground pool! $729,900
FABULOUS ESTATE A circular drive leads to this fabulous Estate nestled on 17.28 rolling acres. The grand foyer and exquisite staircase welcome you to this distinctive home. 7482 sq. ft. of upscale living space at its best. Hardwoods, French doors, 4 fireplaces, custom built-ins, dentil moldings and an abundance of windows. Formal living and dining rooms, high-end kitchen, dramatic great room, study, first floor master suite w/bonus room, 4 bedrooms each w/private bath up. Lower finished walkout. In-ground pool, paved terrace & tennis court. 4 car garage. $1,495,000
WONDERFUL ONE LEVEL LIVING Nestled in most sought after Pointe East. The open floor plan offers a great room with gas fireplace overlooking the gorgeous golf course setting. Florida/sun room opens to a deck with electric awning. Eatin light and bright appliance-rich kitchen. Custom Hunter Douglas window treatments plus darken shades in bedrooms. Central vacuum system too. Two generous bedrooms and master with wonderful closets and gorgeous bath. Additional full bath and powder room. The yard has a sprinkler system and lighted landscaping. Two car attached garage. $429,000
DISTINCTIVE RANCH The grand foyer opens to the well appointed interior. French doors, crown moldings, judges paneling, cherry floors, quartz countertops, walls of windows w/transoms, custom cherry built-ins, surround sound, 3 heating zones, generator & more. Formal living & dining rooms, gourmet eat-in kitchen, Morning room. Family room w/ stone gas fireplace, stunning Florida room opens to composite deck, hot tub & gorgeous grounds. 4 bedrooms, 2-1/2 baths. Lower w/family room, media room, bedroom & bath. 2 car attached, 3 car detached with loft area. $659,900
INVITING CONTEMPORARY Home boasts magnificent views from almost every room. Gleaming hardwoods, light and bright living room, gracious dining room with large windows and French doors, gourmet eat-in kitchen that opens to an oversized deck that overlooks the backyard. Family room with wood accent wall and brick walled fireplace, skylights and slider to access deck. 4 generous bedrooms with California Closets and two full baths up. Master with walk-in closet and jacuzzi bath. Lower walkout with family room, study area and full bath. 3-1/2 car oversized garage. FM Schools! $324,000
BEYOND YOUR EXPECTATIONS French Country design and tranquil private setting can be found here.This home boasts stately windows many with transoms, vaulted ceilings, lovely floor coverings and attention to detail throughout. Formal living and dining rooms, study/office, magnificent kitchen, 5 generous bedrooms including first floor master suite, 4 full baths, 2 powder rooms, first floor laundry center and mud room. Three car attached garage, expansive multi-level deck, stunning in-ground pool and nestled on a 2.52 pristine acre setting. Fayetteville-Manlius schools. $699,900
SPRUCE RIDGE ABSOLUTELY GORGEOUS 1 acre privare setting in Spruce Ridge. Lovely entrance leads to the formal living room, French doors open to the dining room, light and bright eat-in kitchen and breakfast room with a wall of windows. The hearth warmed family room leads to the deck and treed yard. 4 generous bedrooms up including the master suite, and 2nd floor laundry center. The lower level with familyroom has an additional full bath. There is a three card attafched garage. Freshly painted in 2018.Fayetteville/ Manlius Schools. $449,900
DRAMATIC CONTEMPORARY On a 1+ acre setting boasting an inground pool, koi pond, private yard and tranquil seclusion. Two story foyer with wall of windows opens to the formal hearth warmed living room with sliders that lead to a covered deck. The dining room features a curved brick wall. The eat-in kitchen has an abundance of cupboards and breakfast nook. The main level with hardwoods, office, study and laundry center. There are 5 bedrooms and 4 full and 2 half baths. The lower walkout has a family room with fireplace and rec room. Jamesville-Dewitt Schools. $374,900
Diane M. Ragan, CRS
R. Matthew Ragan, J.D., LL.M
(315) 427-0528 (D)
(315) 399-7767 (D)
Licensed Associate R.E. Broker
Licensed R.E. Salesperson
6866 E. Genesee St. â€˘ Fayetteville, NY 13066
Over 23 million dollars in sales in 2018!
2019 Legislative Forum T
his year the Onondaga County Medical Society’s annual meeting with legislators and city officials followed a new public forum format, with brief presentations followed by a question and answer period.
Dr. Indu Gupta speaks about public health concerns in Onondaga County.
The forum was open to all physicians and medical students. Discussion topics were health-related, with much back and forth about cannabis legalization, its potential pitfalls and the financial and social costs. Both County Executive Ryan McMahon and Health Commissioner Dr. Indu Gupta voiced concerns about the ramifications of another intoxicating drug being freely available in Onondaga County. Other issues discussed were women’s health, access to care, the resident physician shortage, and EHR interoperability. 8
Assemblymember Al Stirpe accepts a “Best in Show” award from OCMS President Dr. MaryAnn Millar, for his campaign commercial.
It was well attended; the conversation thoughtful and productive. Special thanks to those legislators who attended, including State Senator Rachel May, Assemblymembers Will Barclay, Pam Hunter, Bill Magnarelli, and Al Stirpe, and County Executive Ryan McMahon. Thank you as well to those who sent representatives. OCMS President MaryAnn Millar, MD, was interviewed by WSYR News Channel 9 for the event. If youâ€™d like to see that video clip, click here.
County Executive Ryan McMahon and Assemblymember Al Stirpe
State Senator Rachel May
Assemblymembers Bill Magnarelli and Pam Hunter
Upstate Medical students talk equal access to health care
2019 House of Delegates
our OCMS delegates were hard at work at the Medical Society of the State of New York (MSSNY) House of Delgates (HOD) this year. Seven of our physician members: Drs. Rich Beers, Brian Johnson, MaryAnn Millar, Barry Rabin, Richard Semeran, Jef Sneider and Darvon Varon represented Onondaga County at the HOD, and each spent three days listening to and debating testimony about official positions of the organization and its policies. The HOD provides an opportunity for physicians to talk about challenges facing them every day, and determines the legislative outcomes for which MSSNY will lobby in the future. View 2019 HOD resolutions and actions here.
Dr. MaryAnn Millar, OCMS President, speaking on womenâ€™s health at the MSSNY HOD.
OCMS delegates (l to r) Drs. Rich Beers (center), Richard Semeran and Barry Rabin.
New MSSNY President Dr. Art Fougner. Click here for podcast in which Dr. Fougner discusses the legislative priorities for his presidency.
Upstate Medical Residents and Students Participate in
MSSNY Poster Symposium
ongratulations to the Upstate Medical University residents and medical students who were chosen to present their case studies for the research poster symposium at the MSSNY House of Delegates (HOD). Prashnath Ashok Kumar (PGY-1, Internal Medicine), Mary Pinkes (MS-3), and Pooja Poudel (PGY-2, Internal Medicine) did a great job representing Upstate Medical University and Onondaga County. This project involves a lot of workâ€”participants submit abstracts for which they are first authors of the research for consideration and scoring. Only the top 50 resident/fellow and top 20 medical student scores are invited to present. If you would like to read their abstracts, click here.
Dr. Prashnath Ashok Kumar (poster #53)
Medical Student Mary Pinkes (poster #15)
Dr. Pooja Poudel (poster #44) 12
Improving Medical Outcomes FOR REFUGEES & IMMIGRANTS
Building Trust MARY STRONACH, Interpreter Highland Communications
“Physicians are frequently frustrated by patients’ “non-compliance” with prescribed diet, exercise, and medication. To be sure, the causes of non-adherence are complex. But one important reason may be that the patient’s way of explaining his illness to himself is at odds with that of the physician. Research shows that a patient’s explanatory model is not simply going to disappear because the patient has had a clinical encounter. These ways of perceiving one’s life and health are deeply ingrained and meaningful. They reflect a person’s lived experiences, contexts, and identities.” -- Dr. Namratha Kandula, Assistant Professor Northwestern University’s Feinberg School of Medicine
onsider José, an 8-year-old son of a new immigrant from Mexico. He presents with intense headaches which have lasted for several days. After some tests, your initial diagnosis is that the headaches are probably stressrelated. You prescribe appropriate medication and ask the parent to return in a week if the headaches persist. Upon leaving the office, the mother appears dissatisfied and doesn’t go to the pharmacy to buy the medication. Instead, she goes to the local faith healer.
“I know it’s the ‘evil eye’ (el malojo),” she tells her husband. “The other day a lady in the grocery store was staring at José. I think she was jealous that her son wasn’t as handsome. The faith healer will take care of him. That doctor just doesn’t understand. I don’t trust him.” How could you gain the trust of this parent and begin a successful treatment regimen? In an article entitled, “Addressing barriers to cultural competence” in the Journal for Nurses in Staff Development, R. Taylor suggests that “cultural competence requires health care providers to make a shift from authority figure to learner in cross-cultural interactions.” When it comes to refugees and immigrants who speak little or no English, three components are necessary to building a trust relationship and improving outcomes: use a trained interpreter, take advantage of translated texts to explain the diagnosis and the treatment … and become a learner by using a strategy to better understand the situation from the patient’s point of view. It isn’t as difficult or as time-consuming as you may think. A few well-chosen questions could make the transition smooth and invaluable in ensuring increased compliance by your patient. Psychiatrist and anthropologist Arthur Kleinman’s theory of explanatory models (EMs) proposes that individuals from other cultures may have completely different notions of health and disease. Eliciting responses to the typical questions: “where does it hurt? When did it start?” “How bad is the pain?” etc. do not reveal the patient’s perspective of the illness and could result in non-compliance. He suggests that the medical provider take a few minutes to get the patient’s perspective of what is happening. It could reduce cultural barriers which sometimes hinder the proper implementation of the treatment plan. As in any other doctor visit, you elicit the typical information about symptoms, duration, etc. Further, you might follow the model below with our culturally diverse populations (some physicians suggest that such questions could actually be beneficial with all patients):
The 5-step LEARN Model by EA Berlin and WC Fowkes (Edited – M. Stronach)
1. Listen: Listen with empathy and understanding to your patient’s perception of the problem. Encourage your patient to discuss his/her understanding of the causes and effects of his illness and to describe the treatment and resources he/she feels will contribute to recovery. “What do you feel may be causing your problem? What do you feel might help or hinder your recovery?” are examples of questions that elicit patient feedback.
2. Explain Explain your patient’s illness, the recommended plan of care and subsequent management of self-care simply, so that the patient can understand. Take into account literacy level, cultural beliefs, and past experiences which may affect understanding and acceptance of any suggestions you give. If possible, link your explanation to something the patient already knows. (Rather than asking if he/she understands, ask the patient to repeat what you said. This confirms whether the patient truly understands.)
3. Acknowledge Acknowledge your patient’s feedback and understanding of his illness and plan of care. Areas you agree upon should be recognized and differences resolved. This will help promote patient involvement. Whenever possible, integrate your patient’s suggestions into any care approach. This will give him/her a sense of control and commitment. If his/her suggestions would have a negative effect, explain the consequences and try to make the appropriate plan of care more desirable.
4. Recommend Recommend a plan of care that fits within the patient’s parameters or willingness to comply. The more involved your patient is in the development of his plan of care, the more interested he/she will be in its outcome. It is important to listen to concerns your patient may have and agree on solutions that will enhance commitment.
5. Negotiate Negotiate agreement with your patient on a course of action. This requires a keen understanding of your patient’s perspective and the ability to integrate the information you learned. Successful completion of this final and key step can lead to a variety of patient-specific approaches that will increase the chance of a successful recovery and healthier life. JUNE 2019
I would add one final step: Take advantage of having the interpreter with you and ask the interpreter to write your instructions in the target language for the patient. Each patient is different. Cultural practices, religious limitations in diet and activity and their understanding of how their body works all differ from country to country, and even person to person. Unless you dialogue with the patient, you will not understand how these will impact your patient’s compliance to treatment regimens. Dr. Kandula’s experiences and those of other doctors confirm that such dialogue improves outcomes: “I find that eliciting a patient’s explanatory model is helpful with most patients and in common clinical situations, including sore throats, high blood pressure, high cholesterol, and back pain. Why? Because understanding a patient’s explanatory models gives me critical insight into what is most important to the patient, what the patient believes about health and illness, and what they think will help them get better. “I cannot effectively counsel a patient with high blood pressure to change her diet or take medication unless I understand her way of explaining her hypertension and how she thinks her blood pressure should be treated. Once I understand that, we can discuss her issues in a language that we both understand. If the goal is really to improve health care quality and outcomes, clinical care must be guided by a meeting of the doctor’s expertise and what matters most to the patient. And it works.” By Mary Stronach firstname.lastname@example.org 315-796-9284 Mary Stronach has been an interpreter and translator in Spanish and Italian and an interpreter trainer for many years. She has written numerous articles, addressing interpreting and translating issues and cultural competency. Through her company, Highlander Communications, she offers written translations in over 200 languages, provider trainings on how to get the best outcomes when working with refugees and immigrants who speak little or no English, and customized cultural competency trainings. If you have any questions, you may call or e-mail Mary.
The Legal Treatment DAVID ADELSON, ESQ. DAVID N. VOZZA, ESQ.
Preventing Insurance Audits Don’t be Accused of “CLONING” your Notes
T David Adelson, Esq.
ime and time again, medical practitioners are counseled that a successful defense to a billing and coding audit is always predicated on well-documented medical records. This rule applies to audits arising from any source, whether it be Medicare/Medicaid, a commercial insurance company or other investigative agency. The introduction of EHR (Electronic Health Records) unveiled many solutions to this problem, allowing practitioners more time to actually attend to the care and treatment of patients. However, we have seen that EHR also presents many new challenges to the practitioner related to their efforts to appease auditors.
EHR software programs vary widely and each present both unique and respective complications as well as problems common to all. The two most prevalent issues, discussed here, are the ability to customize the EHR in accordance with a particular medical specialty David Vozza, Esq. and the general concern known as “cloning”. Also discussed are general recommendations as to how best maximize an EHR program resulting in a more complete and individualized medical record.
The first recommendation is to make sure that your software contract provides for individualized tailoring of drop-down lists and descriptive fields for your specialty. Utilizing descriptions, procedure identifications and codes that are inappropriate to your specialty, will raise questions in many circumstances and particularly during an audit. After software demonstrations have been viewed and prior to any installation, the practitioner and biller should meet with the software representative to go over every possible portion of the EHR that the practice will be utilizing to ensure the final software version meets all relevant needs. The second and more significant issue is referred to as “cloning.” Cloning is generally defined as the intentional or inadvertent cutting and pasting of narrative descriptions into one’s EHR. Inadvertent cloning in isolated situations is not as damaging and usually results when the HER system automatically populates blank narrative fields with information from a prior patient record. If possible, it is best to turn off or remove that type of automatic documentation carry-over and to always make sure to double check the narrative fields prior to signing each record. The more problematic scenario occurs when practitioners see patients with many common repetitive problems and deem it more efficient to simply cut and paste the same or very similar progress notes into the narrative field or fields. The ramifications of this widespread practice when identified during an audit are irreparable and lead to many unfounded accusations of improper patient care and questioning of services rendered as compared to what has been billed. All insurers view cloning of notes as a red flag that may result in additional scrutiny of a practitioners’ records and billing practices. When documenting the narrative portions of a patient encounter, practitioners are encouraged to keep in mind that no two patient encounters (and the description thereof) should be identical. Even when the complaints or diagnoses are similar, there is always a portion of that encounter and note that is particular to a patient and should be recorded as such. As is often the case, technology can make professional lives easier and more complicated at the same time. Make sure you are properly utilizing your record keeping technology!
If you have any questions, we invite you to contact David N. Vozza at email@example.com or David L. Adelson at firstname.lastname@example.org. You can also contact Norris McLaughlin, P.A., by calling our Healthcare Hotline at (888) 861-1141 or visiting our website at www.norrismclaughlin.com.
This Health Care Law Article provides information about current legal developments of general interest in the area of health care. The information contained in this Alert should not be construed as legal advice, and readers should not act upon such without professional counsel. Copyright ÂŠ 2019 Norris McLaughlin & Marcus, P.A.
OCMS Ask the Carriers Conference
ur 2019 Ask the Carriers Conference was once again a great success! Special thanks to the all of the following exhibitors, speakers and sponsors who helped make this event possible:
AdvoWaste Medical Services, LLC
Alzheimer’s Association, Central New York Chapter
National Government Services/ NGS Medicare
Answer Syracuse BioServ, Inc./Shredsmart, Inc. Bryant & Stratton College Central New York Agency LLC
MLMIC Insurance Company
Nascentia Health Noble Health Services, Inc. Norris McLaughlin, P.A.
Charles J. Sellers & Co.
NYS Workers’ Compensation Board
Oviatt Hearing and Balance
Empower Federal Credit Union
Pep Talk Health
Excellus BlueCross BlueShield
Practice Recourses, LLC
Healthwear Rental, Inc.
Hospice of Central New York
The Wladis Co./One Digital
Jennie L. Brown, MD Jennie L. Brown, MD, is a board-certified Family Medicine physician with St. Josephâ€™s Physicians, located at 5100 W. Taft Rd., Suite 1D, in Liverpool. Dr. Brown received her medical degree from SUNY Health Science Center in Syracuse. She is currently accepting new patients, and can be reached at (315) 452-2121.
Stella Castro, MD Stella Castro, MD, is a board-certified physician specializing in Allergy and Immunology with Allergy and Asthma Associates. Dr. Castro received her medical degree from University of The Philippines College of Medicine, and completed an internship and residency at St. Barnabas Medical Center in Livingston, NJ. She did a fellowship in Allergy and Immunology at the University of Rochester, Strong Memorial Hospital in Rochester, NY. Dr. Castro can be reached at her office at 4402 Medical Center Drive, Ste. 402, in Fayetteville, (315) 663-0005.
Ankur Chawla, MD Ankur Chawla, MD, has joined University Surgical Associates, 750 E. Adams St., Ste. 8140 in Syracuse. Dr. Chawla is board-certified in general and vascular surgery. He received his medical degree from the University of Rochester. He can be reached at his office, (315) 464-6271.
Joseph Cincotta, MD Joseph Cincotta, MD, is board-certified in family medicine. He received his medical degree from SUNY Upstate University, and is part of the Upstate Family Medicine practice. Dr. Cincotta can be reached at his office located at the Upstate Madison Irving Clinic, 475 Irving Avenue, Ste. 200, in Syracuse, (315) 464-4686.
Joan Dolinak, MD Joan Dolinak, MD, is a board-certified surgeon with University Surgical Associates, 750 East Adams St. in Syracuse. Dr. Dolinak did her residency in general surgery at Akron General Medical Center, and a fellowship in Burn Surgery at Vanderbilt University. She completed an additional fellowship in Surgical Critical Care/Trauma at the University of Pittsburgh. Her specialty is Surgical Critical Care. Dr. Dolinak can be reached at (315) 464-1800.
Igor Kraev, MD Igor Kraev, MD is board-certified in family medicine. Dr. Kraev received his medical degree from SUNY Upstate University. Dr. Kraev can be reached at his office located at the Upstate Madison Irving Clinic, 475 Irving Avenue, Ste. 200, in Syracuse, (315) 464-4686.
Susan Levinsohn, MD Susan Levinsohn, MD, is board-certified in family medicine. Dr. Levinsohn did her residency at St. Josephâ€™s Hospital Health Center, and completed a fellowship in Integrative Medicine at the University of Michigan. She can be reached at the Upstate Madison Irving Clinic, 475 Irving Avenue, Ste. 200, in Syracuse, (315) 464-4686.
Amy Lucia, DO Amy Lucia, DO, is a board-certified surgeon with Upstate Surgical Associates. Her specialty is surgical critical care. Dr. Lucia received her medical degree from New York College of Osteopathic Medicine. Her office is located at 750 East Adams St., Ste. 8141, in Syracuse. She can be reached at (315) 464-1800.
Nevena Radonjic, MD/PhD Nevena Radonjic, MD/PhD, is a board-certified psychiatrist with Upstate Medical University. Dr. Radonjic completed her residency and fellowship at UConn Health Center in Farmington, CT. Dr. Radonjic is the author of many research articles, the most recent of which is “The need for depression screening in patients with adrenal incidentalomas and (possible) autonomous cortisol secretion - the role of integrated care.” She can be reached at thePsychiatry and Behavioral Sciences Building, 713 Harrison Street in Syracuse, (315) 464-7319.
Karna Sura, MD Karna Sura, MD, is a hematologist-oncologist at 1056 Upstate Cancer Center, 750 East Adams Street, Syracuse, NY 13210. Dr. Sura did his residency and internship in Radiation Oncology with William Beaumont Hospital in Royal Oak, MI. He can be reached at (315) 464-5276.
Thomas VanderMeer, MD Thomas VanderMeer, MD, is a board-certified surgeon with Upstate’s Department of Surgery. Dr. VanderMeer received his MD from Virginia Commonwealth Medical College of Virginia, and did a general surgery residency at University of Massachusetts Medical Center. He completed two fellowships, one in Hepatobiliary & Pancreatic Surgery with University of Toronto School of Medicine, the other in surgical research at Harvard Medical School. Dr. VanderMeer can be reached at his office at 750 East Adams Street, Ste. 8141, in Syracuse, (315) 464-6295. JUNE 2019
MEDICAL SERVICES, P.C. 4811 Buckley Road, Liverpool, NY 13088
Ph. (315) 457-3091 • Fax (315) 457-4305 Dr. Robert A. Dracker • Medical Director
OUTPATIENT INFUSION/NYS LICENSED TRANSFUSION CENTER
• Immunoglobulin Therapy, including IVIG, RhoGam, and HepBig • Monoclonal Therapy including Remicade, Entyvio, Orencia, Tysabri, Stelara, Inflectra, and Renflexis • Antibiotic Administration • High Dose Steroid Therapy
• Parenteral Hydration • Hyperemesis Therapy • Therapeutic Phlebotomy • Prolastin Therapy • Boniva, Reclast and Prolia Treatments
• Immune Suppressive Treatments • Nutritional, Fluid and Electrolyte Supplementation • Vascular Access Device Placement and Maintenance • Parenteral Iron Therapy
THE INFUSACARE DIFFERENCE
• Minimal referral requirements • Immediate patient scheduling • Physician on site at all times
• Continuous medical supervision by nursing staff • Follow-up treatment documentation • Comfortable, pleasant environment ensuring patient satisfaction
QUALITY CARE FOR PATIENTS OF ALL AGES
OCMS BULLETIN OCMS BULLETIN
Health Care Providers Comment on Advising Prostate Cancer Patients and Survivors to be Physically Active FRED WILSON, MS
tâ€™s well documented that health care providers have an enormous influence on whether patients with prostate cancer are physically active.
Patel and colleagues (2018)1 recently interviewed urologists, medical oncologists, radiation oncologists, general practitioners with training in complementary and alternative medicine, and specialty nurses. The goal was to uncover factors that influenced whether these providers did or did not advise their patients to be physically active.
Urologists One important factor was treatment-related side effects. For men undergoing androgen deprivation therapy (ADT), one urologist encouraged patients to perform weight-bearing activities in a gym. A urology nurse specialist suggested that patients focus on both resistance and aerobic exercise to maintain muscle mass. The nurse also provided a hormone care plan that included simple exercises. For patients undergoing ADT, urologists felt that physical activity helped to counteract treatment-related loss of bone mass and muscle mass and weight gain (mainly abdominal fat mass). They stressed how these changes can increase the risk that obesity, osteoporosis, type 2 diabetes, and metabolic syndrome would develop. Urologists advised patients to perform both resistance and aerobic activity, which is consistent with the literature for improving body composition of men on ADT. Another factor focused on locally advanced prostate cancer. One urologist stated that patients who had undergone an operation for locally confined
Online Personal Training Cancer Patients & Survivors Active Older Adults Fred Wilson, MS, Medical Technology Certified Cancer Exercise Specialist Prostate Cancer Survivor
Fred before prostate cancer (age 71)
Fred after prostate cancer (age 76)
• Lower cost than one-on-one training • Exercise video provided • Gym not required • Train in privacy of home • Train at your own pace • Train at your convenience • Workout schedules provided • Minimal equipment needed • Progress monitored • Trainer available by phone or email
email@example.com www.fitnessafter50.net 315-559-1662
disease would benefit the most from physical activity because they had a 10- to 15-year life expectancy. One urologist referred patients to a physiotherapist. “They are better trained in terms of giving them the right advice for the right exercises,” the urologist said.
Oncologists A third factor was time constraints. Since medical oncologists usually treat men with advanced prostate cancer and, in some instances, limited life expectancy, they have little time during a consultation (e.g., 30 minutes) to address physical activity for their patients. The oncologists suggested that physical activity could be addressed by other providers since no one else can give them (patients) the specific advice of a medical oncologist. “There are a lot of medical information aspects (e.g., bone health) to cover and that leaves very little time to address these other (exercise) issues,” one oncologist said. Another barrier is the oncologists’ perception of safety of physical activity in patients who have advanced prostate cancer with bone metastases and other comorbidities. Recent studies, however, suggest that regular physical activity that includes both resistance and aerobic exercise can be a safe and effective adjunct therapy even in advanced prostate cancer and bone metastases.2,3 Some oncologists do make time to at least comment on physical activity. A radiation oncologist “mentions exercise” to patients who have been treated radically and are highly motivated to do everything they can to remain cancer free. A medical oncologist, when asked by patients what they can do to help with their treatment, tells the patients that “across the board in cancer, there is increasing evidence that there’s improved outcomes if you remain physically active.”
Complementary and Alternative Medicine Providers Complementary and alternative medicine providers were included in the study because many cancer survivors perceive these treatment modalities to provide holistic treatment and improve their well-being. These practitioners based their advice on philosophical principles and suggested gentle activities to heal the body from within. For example, a general practitioner with acupuncture training applied the Chinese model, which states that prostate cancer is due to stagnation of qi (life energy), blood stasis, and accumulation of dampness. He recommends that patients walk and perform qigong breathing, tai chi, and exercises to open
the pelvis. Another similarly trained practitioner suggested specific stretches, motions, and breathing as well as yoga, tai chi, and Pilates.
Comment The report of Patel and colleagues (2018), like so many others, fails to address the most important factor for success when health care providers counsel patients about physical activity. That factor is the role that physical activity plays in the lifestyle of the provider. As a personal trainer and prostate cancer survivor, I must practice what I preach to clients with cancer. My goal is to inspire clients to empower themselves against their disease. I know from experience that regular exercise lowers the risk that my cancer will recur and I know that I’m doing everything I can keep my PSA at zero. I owe it to myself, my family, and my clients to be physically active myself. Clients sense the strength of my commitment and this helps them to get started and to maintain a healthy lifestyle. Online exercise programs for cancer patients (and their providers!) are locally available through me, a 77-year-old prostate cancer survivor and Cancer Exercise Specialist certified by the American College of Sports Medicine. I also hold an MS Degree in Medical Technology from Upstate Medical University. My clients include survivors of prostate cancer, breast cancer, colon cancer, and glioblastoma. Please contact me at firstname.lastname@example.org or 315-559-1662 for a free, no-obligation consultation. References 1. Patel A, Schofield G, Keogh J. Influences on health-care practitioners’ promotion of physical activity to their patients with prostate cancer: a qualitative study. J Prim Health Care. 2018;10:31-38. 2. Schmitz KH, Courneya KS, Matthews C, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42:1409-1426. 3. Cormie P, Galvão DA, Spry N, et al. Functional benefits are sustained after a program of supervised resistance exercise in cancer patients with bone metastases: longitudinal results of a pilot study. Support Care Cancer. 2014;22:1537-1548.
In Memoriam John E. Kelly, Jr., MD John Edward Kelly, Jr., MD, a life member of the Medical Society, passed away on March 15, 2019. He was 89. Dr. Kelly obtained his medical degree from the University of Maryland, did his initial internships and residency in Baltimore and subsequently received a commission as an officer in the Navy. He was promoted to Lt. Commander and completed his naval service in 1963. After completing his residencies he returned to Syracuse, where he established his practice in internal medicine and general surgery and practiced until his retirement. He was predeceased by his wife, Sheila, in 2015. He is survived by five children, Chris (Lynn), AJ (Cynthia), Jennifer, Maggie and Terry (Leigh); six grandchildren: Paige, Connor, Shannon, Jess, Sarah and John; and one greatgrandson, Wyatt. Dr. Kelly was a dedicated physician, who took the care of his patients with a passion many have never forgotten. He will be remembered for his work ethic, wonderful bedside manner, and his openness to see a patient in need at any time, regardless of circumstance. Memorials may be made to the favorite charitable organization of your choice. Sign the guestbook at https://robertdgrayfuneralhome.weebly.com/obituaries-guestbook/john-edward-kelly-jr-md#comments
Kendrick Sears, MD Kendrick A. “Rick” Sears died on March 13, 2019, following a brief illness. He was 86. Dr. Sears was a life member of the Medical Society, and in recent years served as coordinator and emcee for the retired physicians’ luncheon. He is survived by his wife of 62 years, Gracia Emeline, four sons, two daughters-in-
law and six grandchildren. Dr. Sears was an Orthopedic Surgeon and chaired the Board of the Office of Professional Medical Conduct for several years. Contributions in memory of Dr. Sears can be made to the Southern Legal Poverty Center, 400 Washington Ave., Montgomery, AL 36104. Sign the guestbook at https://obits.syracuse.com/obituaries/syracuse/obituary. aspx?n=kendrick-sears&pid=191891775.
Robert Lawrence Scheer, MD Robert “Bob” Scheer, MD, a life member of the Onondaga County Medical Society, passed away on March 15th, 2019, at his home in Tully, NY, surrounded by family and friends. He was 92. Dr. Scheer entered the U.S. Army in 1945 and served in Germany, France and North Africa as a medical technician. After his discharge, he married his wife Lynne and moved to Syracuse, where they raised four children. Dr. Scheer entered private medical practice in Syracuse, specializing in nephrology. He was instrumental in introducing kidney dialysis and transplantation in Central New York. His devotion to his work extended beyond long hours at the office and in the hospital. As a member of the Medical Committee for Human Rights, he travelled to Mississippi where he provided medical care for civil rights demonstrators. Evenings after work were often spent reading medical journals. He also served as the editor of the Onondaga County Medical Society Journal. As a clinical instructor at SUNY Upstate Medical Center (now SUNY Upstate Medical University), he helped train generations of medical students, many of whom are now doctors practicing in the Syracuse area. Dr. Scheer was the founder and Medical Director of the first dialysis unit in Central New York, located at St. Joseph’s Hospital. His practice grew to include several nephrologists and serve hundreds of patients yearly from around the region. After retiring from active practice he continued to serve as the administrator of the dialysis unit. Dr. Scheer is survived by his children, David (Brenda), Lisa (Hugh), Tony (Julie) and Bill (Brenda). Contributions can be made to the Nature Conservancy, 4245 Fairfax Drive, Suite 100, Arlington, VA 22203-1616, or the Musical Association of Central
New York, Inc. d/b/a Symphoria, PO Box 1161, Syracuse, NY 1320.1 Sign the guestbook at https://www.legacy.com/obituaries/name/robert-scheerobituary?pid=191885626.
Edwin H. Yarwood, MD Dr. Edwin H. Yarwood, 89, a life member of the Onondaga County Medical Society, passed away after a brief illness on May 3, 2019. With an office on the first floor of his Liverpool home, he was that original oldtime family doctor. He was able to get to work quickly wearing his signature suspenders and neck tie, and the phone was always answered by a person, endearing him to so many. Dr. Yarwood worked his way through high school, then college and medical school, working at Solvay Processing’s Lab & at Cross-Hines. He graduated from Syracuse University with a degree in chemistry, and received his medical degree from New York Medical College (Flower and Fifth Hospital in the Bronx). He is predeceased by his wife Joanne Zinsmeister –Yarwood. He is survived by his son Craig, daughter Marta Loomis, his first wife Sally Yarwood, daughterin-law Christine, 4 grandchildren - Alanson, Anna, Caila and Camryn, a sister, Joan Blacklock, 5 stepchildren and many nieces and nephews. Donations can be sent in memory of Dr. Ed Yarwood to the Lewy Body Dementia Association (lbda.org) or to the Edwin H. Yarwood M.D. Residents Scholarship Fund at St. Joseph’s Hospital (sjhsyr.org). Sign the guestbook at https://www.maurerfuneralhome.com/obituary/dr-edwin-yarwood
ONONDAGA COUNTY HEALTH DEPARTMENT FACT SHEET
ONONDAGA COUNTY HEALTH DEPARTMENT FACT SHEET ONONDAGA COUNTY HEALTH DEPARTMENT FACT SHEET
Measles Fact Sheet: ONONDAGA COUNTY HEALTH DEPARTMENT FACT SHEET Measles Fact Sheet:Provider Update Onondaga County Measles Fact Sheet: Onondaga County Provider Update Measles Fact Sheet: Onondaga County Provider Update What is Measles? Onondaga County Provider Update What is Measles?
Measles virus is highly contagious and causes fever and a rash. Anyone can become infected with measles, but the virus is more severe in infants, pregnant women, and people whose immune systems are weak. Measles virus What is Measles? spreads through the air when an infected person sneezes or coughs. The virus remains active and contagious in the Measles virus is highly contagious and causes fever and a rash. Anyone can become infected with measles, but the air and on surfaces for to two hours. Awomen, person will be four days beforeinfected the appears and for virus is more severe in up infants, pregnant and people whose immune systems arerash weak. Measles virus Measles virus is highly contagious and causes fever and acontagious rash. Anyone can become with measles, butfour the days rash appears. They are no longer contagious the fifth dayvirus after the rash starts. Early symptoms What isthe Measles? spreads through the when an infected person sneezes oron coughs. The remains active and contagious virus after is more severe inairinfants, pregnant women, and people whose immune systems are weak. Measles virus in the include: fever, cough, runny nose, and red, watery eyes. Three to five days after initial symptoms, a rash of red spots air and on surfaces to two A person will be acontagious four days before theactive rashwith appears and for four spreads through theforairup when an hours. infected person sneezes or coughs. The virus remains and measles, contagious the Measles virus is highly contagious and causes fever and rash. Anyone can become infected butin the appears onthe the faceappears. that then spreads over the entire body. Complications of measles include: diarrhea, ear days after rash are no contagious on the fifth day after the rash starts. Early symptoms air and on surfaces for toThey two hours. Alonger person will contagious four days before the rash appears and for four virus is more severe in up infants, pregnant women, and be people whose immune systems are weak. Measles virus infections, pneumonia, encephalitis, premature birth or Three low birth weight in pregnancy, and death. include: fever, cough, runny nose, and watery eyes. to days after initial symptoms, acontagious rash of red in spots days after the rash appears. They are nored, longer contagious thefive fifth day after the rash starts. Early symptoms spreads through the air when an infected person sneezes oron coughs. The virus remains active and the appears onsurfaces thecough, facefor that spreads the entire body. Complications of measles include: diarrhea, earred include: fever, runny and over red, watery eyes. Three to fivefour daysdays after initialthe symptoms, a rashand of spots air and on upthen to nose, two hours. A person will be contagious before rash appears for four infections, pneumonia, birth or lowon birth inof pregnancy, and death. appears onthe therash faceappears. thatencephalitis, then spreads over the entire body. Complications measles include: diarrhea, ear days after They are premature no longer contagious theweight fifth day after the rash starts. Early symptoms infections, pneumonia, encephalitis, premature birth or Three low birth weight pregnancy, and death.a rash of red spots include: fever, cough, runny nose, and red, watery eyes. to five daysinafter initial symptoms, Diagnosis and Treatment appears on the face that then spreads over the entire body. Complications of measles include: diarrhea, ear If you suspect measles, you should obtain: birth or low birth weight in pregnancy, and death. infections, pneumonia, encephalitis, premature Diagnosis and Treatment
1. A throat swab nasopharyngeal swab) and Diagnosis and(orTreatment If you suspect measles, you should obtain: 2. A urine sample from patients suspected If you suspect measles, you should obtain: to have 1. A throat at swab nasopharyngeal swab) and virus Diagnosis and Treatment measles first(or contact with them for measles 1. A throat swab (or nasopharyngeal swab) and 2. urine sample from patients suspected PCR and/or viral isolation. If you suspect measles, you should obtain: to have 2. Specific A urine sample frommay patients suspected to have measles at first IgM contact with them for measles virus 3. serum be useful. 1. A throat swab (or nasopharyngeal swab) and virus measles at first contact with them for measles PCR and/or viral isolation. There is no specific medicine to treat the measles 2. A urine sample from patients suspected to have and/or viralIgM isolation. 3. PCR Specific serum may be useful. virus. Most at of first the time, people with will get measles contact themmeasles for measles virus 3. Specific serum IgM maywith be useful. There no specific medicine to treat the measles better symptomatic treatment. PCRiswith and/or viral isolation. ThereMost is no of specific medicine treatmeasles the measles virus. the time, peopletowith will get 3. Specific serum IgM may be useful. virus. the time, people with measles will get betterMost with of symptomatic treatment. There iswith no specific medicine to treat the measles better symptomatic treatment. virus. Most of the time, people with measles will get Post-exposure Prophylaxis better with symptomatic treatment.
��in rash on a �a�ent�s ab�omen ���ays a�er the onset of a measles infec�on� Image courtesy of CDC Public Health Image Library ��in rash on a �a�ent�s ab�omen ���ays a�er the onset of aon measles infec�on� Image courtesy ��in rash a �a�ent�s ab�omen ���ays a�erofthe CDC Public Health Image Library onset of a measles infec�on� Image courtesy of CDC Public Health Image Library ��in rash on a �a�ent�s ab�omen ���ays a�er the onset of a measles infec�on� Image courtesy of CDC Public Health Image Library
People exposed to measles who cannot readily show that they have evidence of immunity against measles should Post-exposure Prophylaxis be offered post-exposure prophylaxis (PEP) or be excluded from the setting (school, hospital, childcare). To Post-exposure Prophylaxis potentially provide protection orcannot modifyreadily the clinical of disease among susceptible administer People exposed to measles who showcourse that they have evidence of immunitypersons, against either measles should MMR vaccine within 72 hours of initial measles exposure, immunoglobulin (IG) within sixagainst days ofmeasles exposure. Do be offered post-exposure prophylaxis (PEP) or be excluded from the setting (school, hospital, childcare). To should People exposed to measles who cannot readily show thator, they have evidence of immunity not administer MMRprotection vaccine and IG simultaneously, as this practice the vaccine. Post-exposure Prophylaxis potentially provide or modify theorclinical course of disease among susceptible persons, eitherTo administer be offered post-exposure prophylaxis (PEP) be excluded from theinvalidates setting (school, hospital, childcare). MMR vaccine within 72 hours of measles exposure, (IG) within six days ofeither exposure. Do potentially provide protection orinitial modify the clinical ofimmunoglobulin disease among susceptible persons, administer People exposed to measles who cannot readily showcourse thator, they have evidence of immunity against measles should not administer MMR 72 vaccine and IG simultaneously, as thisor,practice thewithin vaccine. MMR vaccine within hours ofDepartment: initial measles exposure, immunoglobulin (IG) six days of exposure. Report to Local Health be offered post-exposure prophylaxis (PEP) or be excluded from theinvalidates setting (school, hospital, childcare). To Do not administer MMRprotection vaccine IG simultaneously, as invalidates the vaccine. potentially or modify the clinical course of disease among susceptible persons, administer Measles is aprovide disease that mustand be reported promptly to this the practice local health department by phone (NYSeither Sanitary Code MMR vaccine within 72 hours of initial measles within six days of exposure. Do Report to10). Local Health 10NYCCR 2. If you suspect aDepartment: patient having exposure, symptomsor, ofimmunoglobulin measles, obtain a(IG) detail history including vaccination not administer MMR vaccine IG simultaneously, as practice invalidates the vaccine. Report Local Health Department: status and history. You and should isolatepromptly the patient, obtain infectious disease consultation readily Code Measles isto atravel disease that must be reported to this the localan health department by phone (NYSifSanitary available Emergency Department andhaving Inpatient settings), and immediately Onondaga County Health 10NYCCRis(in 2.a 10). If you suspect a patient symptoms measles, obtain acall detail history vaccination Measles disease that must be reported promptly to theof local health department by phoneincluding (NYS Sanitary Code Department atLocal 315.435.3236 further guidance. Report to status and2. travel You for should isolate thesymptoms patient, obtain an infectious if readily 10NYCCR 10). Ifhistory. youHealth suspect aDepartment: patient having of measles, obtain disease a detail consultation history including vaccination available Emergency and Inpatient settings), andan immediately call Onondaga HealthCode status and history. You should isolate the patient, obtain infectious disease consultation readily Measles is(in atravel disease that Department must be reported promptly to the local health department by phoneCounty (NYSifSanitary Department at 315.435.3236 for further available Emergency Department andguidance. Inpatient settings), immediately Onondaga County Health 10NYCCR(in 2. 10). If you suspect a patient having symptoms of and measles, obtain acall detail history including vaccination Department at 315.435.3236 further guidance. status and travel history. You for should isolate the patient, obtain an infectious disease consultation if readily available (in Emergency Department and Inpatient settings), and immediately call Onondaga County Health Department at 315.435.3236 for further guidance.
Prevention Vaccination is the best way to prevent measles. Anyone who has received two doses of a measles-containing vaccine is
Vaccination the best and way to prevent measles. Anyone who has received two doses of a measles-containing vaccine is consideredisimmune highly unlikely to get measles. considered immune and highly unlikely to get measles.
Onondaga County Prevention
So far, there have been no measles cases in Onondaga County with or without epidemiological linkage to Rockland
So far, there ishave no measles cases in Onondaga with or without epidemiological linkage to Rockland Vaccination the been best way to prevent measles. AnyoneCounty who has received two doses of a measles-containing vaccine is County or NYC.More More than 95%our of our school-age children have been fully immunized with Measles-Mumps-Rubella County or NYC. than 95% of school-age children have been fully immunized with Measles-Mumps-Rubella considered immune and highly unlikely to get measles. vaccines as reported by NYSDOH in the 2017-2018 school year. Therefore, measles, if introduced into ournot area, may not vaccines as reported by NYSDOH in the 2017-2018 school year. Therefore, measles, if introduced into our area, may poseaasignificant significant threat to our school-age children. However, due to unknown vaccination/immunity status of adults, pose threat to our school-age children. However, due to unknown vaccination/immunity status of adults, Onondaga County thosewho whodo donot not have immunity against measles be vulnerable to the infection. Wetoask youask to please those have immunity against measles will bewill vulnerable to the infection. We ask you please all your ask all your So far, there have been nostatus measles cases in Onondaga County with or without epidemiological linkage to Rockland patients their vaccination status against measles and offer vaccination. patients their vaccination against measles and offer vaccination. County or NYC. More than 95% of our school-age children have been fully immunized with Measles-Mumps-Rubella vaccines as reported by NYSDOH in the 2017-2018 school year. Therefore, measles, if introduced into our area, may not Special Concerns pose a significant threat to our school-age children. However, due to unknown vaccination/immunity status of adults, The regarding vaccination continues atochallenge is negatively impacting the health of those who do not have immunity against measles willtobebevulnerable to and the infection. ask you to please askthe allour your Themisinformation misinformation regarding vaccination continues be a challenge and is We negatively impacting health of our communities the United States including in NYS. We strongly encourage you to engage all your patients— patients their throughout vaccination status and offer vaccination. communities throughout theagainst Unitedmeasles States including in NYS. We strongly encourage you to engage all your patients— especially parents—in this conversation and provide all the resources regarding benefits of vaccinations. At the same especially parents—in this conversation and provide all the resources regarding benefits of vaccinations. At the same time, checkConcerns the immunization status of each of your patients every time they are seen in your office, and make sure Special time,they check thetoimmunization status of each of your patients every time they are seen in your office, and make sure that are up date. The thatmisinformation they are up toregarding date. vaccination continues to be a challenge and is negatively impacting the health of our communities throughout the United States including in NYS. We strongly encourage you to engage all your patients— Resources especially parents—in this conversation and provide all the resources regarding benefits of vaccinations. At the same Consider downloading a https://www.cdc.gov/ free immunization offered by the CDCtime for quick andseen convenient consultation of the time, check the immunization status of eachapp of your patients every they are in your office, and make sure recommended in your office. app offered by the CDC for quick and convenient consultation of the that they are upvaccine to date.schedules Consider downloading a free immunization
recommended vaccine schedules in your office.
Consider downloading a free immunization app offered by the CDC for quick and convenient consultation of the recommended vaccine schedules in your office.
Call Us Please call us at 315.435.3252 with any questions.
Call PleaseUs call us at 315.435.3252 with any questions. REFERENCES Please call us at 315.435.3252 with any questions.
nyc.gov/site/doh/health/health‐topics/measles.pageh�ps�//���1.nyc.gov/site/doh/health/health‐topics/measles.page health.data.ny.gov/�ealth/�chool‐�mm�ni�a�on‐���vey‐�ist�ict‐�evel‐Map‐2017/xq3k‐6pt2 REFERENCES
CATEGORY DEFINITIONS: Ambulatory Surgery Center of Distinction: This award honors an Ambulatory Surgery Center (ASC) where surgeries that do not require hospital admission are performed. ASCs may perform surgeries in several specialties or dedicate their services to one specialty, such as ophthalmology, cardiology, orthopedic, obstetrics/gynecology, or neurology to name a few. Healthcare Facility of Distinction: This award honors an inpatient or outpatient healthcare facility that serves patients for any number of ways. This could include a doctor’s office, medical specialty center, or hospital. Excellence in Dentistry: This award honors a dentist whose job performance is considered exemplary by patients and staff. Factors to be judged include evidence of positive outcomes, patient satisfaction and testimonials from peers and administrators. Excellence in Medicine: This award honors a physician whose job performance is considered exemplary by patients and staff. Factors to be judged include evidence of positive outcomes, patient satisfaction and testimonials from peers and administrators. Excellence in Surgery: This award honors a surgeon whose job performance is considered exemplary by patients and staff. Factors to be judged include evidence of positive outcomes, patient satisfaction and testimonials from peers and administrators. Excellence in Veterinary Medicine: This award honors a Veterinarian whose job performance is considered exemplary by family members and staff. Factors to be judged include evidence of positive outcomes, family satisfaction and testimonials from peers and administrators. Excellence in Nursing: This award honors a nurse who has performed in exemplary ways. Factors to be judged include satisfaction and evidence of performance effectiveness, testimonials from superiors, peers, and patients.
Outstanding Physical Therapist: This award honors a physical therapist whose job performance is considered exemplary by patients and staff. Factors to be judged include evidence of positive outcomes, patient satisfaction and testimonials of peers and administrators. Outstanding Hospital Executive: This award honors a hospital executive whose job performance is considered exemplary by patients and staff. This category is open but not limited to any executive in the C-suite, department heads, administrators. Factors to be judged include evidence of positive outcomes, patient satisfaction and testimonials from peers and administrators.. Heart of Healthcare: This award honors volunteers in the healthcare community by making an impact and affecting positive change for the people they have contact with on a regular basis.. Impact Players: This award honors individuals who serve our community by providing service in a clinical setting. The category is open but not limited to, licensed practical nurses, health care aides, emergency medical technician, physician assistants, senior care and mental health professionals. Outstanding Rising Star: This award honors an individual recognized by peers/colleagues/mentors as destined for greatness in their field. Their efforts have made a positive impact in the community. This category is open to anyone affiliated with healthcare. Healthcare Innovator: This award honors a company or individual primarily responsible for a medical discovery or for development of a new procedure, device or treatment that can save lives or improve life for many people.
MLMIC is now part of Berkshire Hathaway. For more than 40 years, MLMIC has been a leader in medical malpractice insurance. In fact, we’re the #1 medical liability insurer in New York State. Now, as part of the Berkshire Hathaway family, we’re securing the future for New York’s medical professionals. When it comes to medical malpractice insurance in New York, nothing compares to MLMIC.
Learn more at MLMIC.com or call (888) 996-1183.