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The Journal of the Oklahoma Osteopathic Association

OKLAHOMA D.O. July/August 2013 May/June 2013

Volume 78, No. 2

2013-2014 AOA President

Oklahoma D.O.

Norman E. Vinn, DO


Oklahoma D.O. | July/August 2013


Oklahoma D.O. PAGE 2


Oklahoma D.O. | July/August 2013

The Journal of the Oklahoma Osteopathic Association


May/June 2012 May/June 2013 July/August 2013


Volume 78, No. 2

January 2012

November 2012

July/August 2013 May/June 2013

OOA Officers: Bret S. Langerman, DO, President (South Central District) Michael K. Cooper, DO, FACOFP, President-Elect (Northeastern District) C. Michael Ogle, DO, Vice President (Northwest District) Layne E. Subera, DO, FACOFP, Past President (Tulsa District) OOA Trustees: Kenneth E. Calabrese, DO, FACOI (Tulsa District) Dale Derby, DO (Tulsa District) Melissa A. Gastorf, DO (Southeastern District) Timothy J. Moser, DO, FACOFP (South Central District) Gabriel M. Pitman, DO (South Central District) Christopher A. Shearer, DO, FACOI (Northwest District) Kayse M. Shrum, DO, FACOP (Tulsa District) Ronald S. Stevens, DO (Eastern District) OOA Central Office Staff: Lynette C. McLain, Executive Director Lany Milner, Director of Operations and Education Matt Harney, Advocacy and Legislative Director Marie Kadavy, Director of Communications and Membership Lydia Cheshewalla, Administrative Assistant

The Oklahoma D.O. is published monthly from the Oklahoma Osteopathic Association Central Office: 4848 N. Lincoln Blvd., Oklahoma City, OK 73105-3335. Lany Milner, Graphic Designer and Associate Editor

For more information: 405.528.4848 or 800.522.8379 Fax: 405.528.6102 E-mail:

Oklahoma D.O. | July/August 2013

“Time For A Change?” provided by Bret S. Langerman, DO, 2013-2014 President


OOA Post Trip Information


Inaugural Address by Norman E. Vinn, DO, AOA President


Meet the New AOA Executive Director


AOA House of Delegates Recap


“Embrace Change” provided by Jamie Calkins


“Come Join” provided by Vicki Stevens, 2013-2014 AOOA President


“2013 OSU-CHS Rural Health Option Graduates”

26 “Clin-IQ Project Clinical Question: In adults with chronic insomnia, is melatonin as effective as prescribed medications in promoting sleep, but with fewer side effects” 28

Legislative Recap




What DO’s Need To Know


“How to Beat Heat Rash” provided by the American Osteopathic Association


“Band-Aid-Just a Cover Up” provided by Angela Wall, PMP Educator


“OSU-CHS Student Update” provided by Trace Heavener, OMS-II


September Birthdays


OEFOM Memorials


Classifieds & Calendar of Events


The OOA Website is located at


Oklahoma D.O.

Copy deadline is the 10th of the month preceding publication. Advertising copy deadline is the 15th of the month preceding publication.

Lynette C. McLain, Editor Lany Milner, Associate Editor

BRET S. LANGERMAN, DO President 2013 – 2014 oklahoma osteopathic association Time For A Change?

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Summer is well upon us now and I hope this finds you and your family well. I recently returned from the annual American Osteopathic Association House of Delegates meetings where I was accompanied by 27 delegates and alternate delegates from Oklahoma as well as staff from the OOA central office. I would like to give my thanks to those that attended, as this was a busy four days packed with meetings and politicking. Several resolutions were debated and passed during the House. We saw the presidency of the AOA handed over from our own Ray E. Stowers, DO, FACOFP dist. to Norman E. Vinn, DO, FACOFP, who I feel will continue to serve us well on a national level. A great thanks to Dr. Stowers and his wife, Peggy, who have served us and this profession so well. We can certainly be proud of his accomplishments. Additionally and probably the biggest news to come out of the House was in regards to graduate medical training. Let me start with some history. In 2011 the ACGME (Accreditation Council for Graduate Medical Education) announced that they would restrict advanced training (essentially fellowship training) to all of those physicians (D.O.’s) who were not trained in ACGME residencies. This would cease the ability for D.O’s who had done their residencies within the Osteopathic Graduate Medical Education pathway to gain access to ACGME fellowships. They also reported that they would no longer give credit for osteopathic internships or the PGY1 year to count within the ACGME training programs. As you can imagine this became a priority for the AOA. Over the ensuing 18 months they worked closely with the ACGME to establish a unified graduate medical education training pathway. This in itself brought on a lot of controversy within the osteopathic world. Would this be an end to Osteopathic Graduate Medical Education? The AOA went into the negotiation process with some basic principles that were non negotiable. These principles would limit the ACGME to graduate medical education only. They would not be allowed to intervene in our schools, board certifications or licensure. The COMLEX would continue to be the tool used to evaluate our physicians for licensure. The D.O. sys-

tem of board certification would continue to remain intact and under the control of the AOA accrediting body. Our graduates would be on a level playing field with those of the allopathic colleges. And finally, the ACGME would leave intact and not harm our training programs already in place, particularly those that have been developed in the rural community settings. In June of this year, a Memorandum of Understanding was issued from the ACGME to the AOA that did not adhere to these basic core principles and the AOA was not given any negotiating power or a “seat at the table.” In response to this, negotiations have ceased and at this time there is no path for a unified graduate medical education system. The AOA has assured us that they will continue to pursue talks and lobby the ACGME on behalf of our osteopathic graduates. There are future meetings scheduled in that regard and we will keep you updated on this process. Although there is great concern about the ability of our profession to train our graduates, there is good news on the horizon. The AOA announced that over the last year, we have had an increase in available osteopathic residency slots of about 10%. They will continue to work diligently to increase that number and provide training for our graduates. In Oklahoma alone, we have added 80 new residency slots, of which 25 are new first year slots. These include slots within psychiatry, OB/GYN, pediatrics, internal medicine, family medicine and emergency medicine. Under the leadership of Kayse M. Shrum, DO and the team at OSU College of Osteopathic Medicine, I feel those numbers will continue to grow. Please have an enjoyable and safe summer with your family. I would also like to personally invite you and your family to the OOA post AOA convention trip from October 3-6, 2013. We are going to The Tanque Verde Ranch in Tucson, Arizona, which offers a variety of activities for the whole family. Information is available through the OOA office and travel is being arranged by Bentley Hedges Travel. OK

Oklahoma D.O. | July/August 2013


Oklahoma Osteopathic Association Post OMED Convention Trip


Tanque Verde Ranch October 3-6, 2013 Join Dr. Bret and DeLaine Langerman on a four-day post OMED convention getaway October 3-6, 2013, at Tucson, Arizona’s Tanque Verde Ranch. The ranch stables approximately 180 horses for walking trails rides, loping trail rides and a multitude of equestrian events. If you prefer, take in the scenery by foot or mountain bike. Enjoy hiking, fishing, basketball and tennis or simply relax poolside. Guests can schedule a soothing massage or body treatment at the on-site spa or find championship golf nearby for an additional fee. The resort offers indoor and outdoor pools, a children’s wading pool, indoor and outdoor whirlpools, and an exercise room. Wi-Fi is available in all guest rooms and throughout the resort.

On Saturday night, experience Tanque Verde Ranch’s highly popular outdoor Cowboy Cookout with live western entertainment while you dine. Sunday morning, hit the trail for an hour-long horseback ride in the mountains and partake in breakfast cooked over an open fire. The trip includes three nights of accommodations, three meals daily, including the Cowboy Cookout and Sunday breakfast trail ride, and a President’s Welcome Reception with hosted bar, as well as any and all regularly scheduled ranch activities. Three hours of CME credit will also be available.

Visit to learn more about the resort’s activities and accommodations.

Three night package: • $1,275 - per person, double occupancy • $1650 - single occupancy • $540 - per child (3 to 11 yrs) sharing with 2 adults

Four night package: • $1575 - per person, double occupancy • $710 - per child (3 to 11 yrs) sharing with 2 adults

Trip Price Includes: • Three nights accommodations at Tanque Verde Ranch, including hotel taxes and three meals daily, including the Cowboy Cookout and Sunday breakfast trail ride • President’s Welcome Reception with hosted bar • 3 hours of CME available • Access to any and all regularly scheduled ranch activities • Wi-Fi available in all guest rooms and through-out the resort • Coordination and personal assistance by Travel Leaders/ Bentley Hedges Travel – Steve & Angie Hendricks

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Not Included: Alcohol beverages / Individualized airfare to Las Vegas and return from Tucson or roundtrip to Tucson / Airfare from Las Vegas to Tucson – approximately $100 per person / Roundtrip transfers from Tucson airport to Resort - can be arranged / Harmony with Horses, Sunset Trail Rides (available upon request)

Oklahoma D.O.

Norman E. Vinn, DO, FACOFP American Osteopathic Association President 2013-2014

Inaugural Address by Norman E. Vinn, DO, July 20, 2013 Provided by the American Osteopathic Association

Thank you, Ed, for hosting today’s event. Thank you, House of Delegates, for the opportunity to serve our profession. Welcome colleagues, friends and family. We need to talk about some things that are important for our present circumstances and to our future…about putting the challenges of the present into context with our history…about recognizing how many of our challenges are actually opportunities to help shape our own future…and about the tools we will need to keep us on course as we continue on the journey of the osteopathic medical profession. As many of you know, I talk a lot about culture, and I’ve been thinking a lot about the importance of culture. As mentioned yesterday, Dr. Nichols often quotes Peter Drucker, “That culture eats strategy for lunch every day.” Now you’re probably wondering why I have this picture up on the screens.

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What is culture? It’s a shared set of interests, skills, values, goals or experiences. It’s a common heritage. It could be ethnic, military, professional, sports or business. It’s collegial. It’s passionate. And there’s a sense of commitment to those common interests. Now the reason I have this picture on here…the obvious answer is I’m a surfer. Now I will have to qualify that…thanks to the hospitality of many people and organizations that are represented in this room, I’ve been having so much good food and drink that now when I paddle out, I’m more worried about getting harpooned than catching a wave. But the less obvious answer is this picture represents a culture. This picture is the constant journey of the surfer. Surfers are in search of the perfect wave. In our surf culture, we also have our equipment, techniques, lingo: rad; awesome…you heard my friend, Pat, say awesome, which is common terminology; shaka; gnarly dude. We got a lot of that…cool. But we’re a family with a shared passion for common interests for the sport of surfing. Now our DO profession has a strong culture. Clearly, we have a passion for what we believe in. We find our own lingo and interests and skills, which you’re all dedicated to. You’ve reaffirmed those distinctive skills just in the last 24 hours, haven’t you? Oklahoma D.O. | July/August 2013

But I’ve been trying to find some commonality in these two disparate cultures. I was wondering how to share a cultural commitment to both passions, and that made me think of branding. Because with our surfboards, we say, I ride a Stewart. I ride a Rusty. I ride a Dewey Weber. But I’ve decided to create a new brand of surfboard. You see it on the screen…I’m getting ready to ride my new DO. Just to reinforce I brought it along today. You know in our lingo, we say a board really rides well. It shreds. This board manipulates. So what’s the point of all this—or, as Carl Pesta has said before, “Does this train of thought have a caboose?” Well, it’s about culture, and culture is important. It is the glue that holds us together. It’s the key to sustainability. It holds the surf family together, and it holds the DO family together. It has for 139 years. Let’s flash back to 139 years ago. Post-Civil War chaos in medical practice, a lot of conflicting theories…purging, bleeding, leeches. You heard Dr. Krpan describe in his A.T. Still Memorial Lecture this morning about how an MD—our founder, A.T. Still, MD, DO—evolved a vision of a new philosophy of health and disease, principles and techniques designed to supplement, not replace, other available treatment modalities. He combined this philosophy with an emphasis on a humanistic approach and on evaluating and treating the whole patient. Now that seems self-evident to us today, but his road wasn’t easy. Despite a loyal following of grateful patients, despite other practitioners who wanted to learn Dr. Still’s principles and share his vision, osteopathic medicine was rejected by the mainstream medical community. It was too different from current medical thinking. It was too disruptive. He and his fellow practitioners were branded as a cult. But we know that life is a marathon and not a sprint. Dr. Still never gave up. Despite many challenges and seemingly insurmountable obstacles, he remained deeply committed to his beliefs. He was stubborn. Eventually his school of medical practice became known as osteopathy, which we know as osteopathic medicine today. The early DOs were passionate about a common vision, values and skills. They had a lingo and, most importantly, a sense of unity. They stuck together. The DOs weren’t a cult. They were a culture. They endured, and our profession remains strong today. We have many bright spots. There’s more than 104,000 in our profession and about 83,000 are DOs, but here’s a fascinating fact. We did some research this year. Many of you may not know that since our inception only about 105,000 DOs have received the DO degree. Of those, 80% earned their degree in the last 40 years. That’s an interesting fact, isn’t it? Twenty percent of all medical students are enrolled in osteopathic medical schools. We’ve been listed as the fastest-growing health care profession in the United States. Our degree is recognized for full licensure in 66 countries. Our legacy is a sustainable profession. We’ve overcome many discrimination battles. We’ve endured incredible challenges. We’ve survived. We’ve prospered. And the challenges continue. One of the current challenges is graduate medical education, or GME. But that’s not a new issue. Arnold Melnick, DO, who published a whole series of essays that you may remember in The DO magazine, once wrote that, when he graduated from PCOM in 1945, only one in three graduates could get a GME slot—one in three.

The next day Dr. Sparks says, “Why don’t you just stick around a little while, get your thoughts together and plans made? Oklahoma D.O. | July/August 2013


It was like a culture shock. He was overwhelmed. First of all, country medicine was probably a little barbaric back then. He certainly didn’t feel he had the skills to be ready for that, so he left, practically broke. He went to Dallas, the nearest big city, because he heard there was a DO hospital there and a DO named Sam Sparks. He walked up to this complete stranger and said, “I don’t know what to do. I don’t have any training. I’m broke. I don’t know where to go. I’ve got to make a success of myself.” Dr. Sparks says, “Why don’t you put your stuff down in the basement? Relax, go into the dining room. Get a good meal. Get a good night’s sleep. We’ll talk in the morning.”

Oklahoma D.O.

And I’ll tell you a story about another PCOM graduate, who in 1940 graduated and could not get an internship or a residency. He knew he needed to make a living. He knew he didn’t have many opportunities, so he heard a story of a country doctor down in east Texas who was looking for an associate. He went down there; he gave up everything he knew and ended up in a small town in the middle of the night with only a lone cow mooing in the distance. And he went to work for this doctor.

But while you’re here, would you mind seeing a few patients? I can give you food, a place to sleep.” He started seeing patients. Weeks turned into months. Once in a while, Dr. Sparks would come in and say, “Here’s $5. You’re working awfully hard. Go out, have dinner and go to a movie.” Then after a year, Dr. Sparks came in one day with a piece of paper. He said, “Here’s your internship certificate. You’ve got your internship.” That person was my father. So what does Ed Vinn’s journey symbolize? Endurance…commitment…stubbornness. I’ve got to tell you, he was one stubborn guy. We take care of our family members and support them. It’s the kindness of strangers, another member of the DO family that pulled him out of a tough spot. It is our legacy and our destiny to continue the journey as a professional family and overcome the challenges that lay before us, and we will overcome those challenges. I’ve been on my own osteopathic journey for 40 years, from Texas to Philadelphia to Michigan to California and, ultimately, to the national role where I’m honored to serve you today. Now I keep referring to my roots back in Texas, but we have a saying, “I’m gonna dance with them what brung me.” I want to thank some people who helped me on this journey. First and foremost, my wife, Marsha. I met Marsha during my internship in Michigan. I took her home to Texas during the holidays. I wanted to introduce my parents to this beautiful girl. My mother was a die-hard Texan. She liked Marsha. She turned to me and said, “Norm, she’s pretty nice for a little Yankee girl.” Marsha, you’re the light of my life, thank you. My daughters: Vanessa, the other Dr. Vinn; Lily, who is a sophomore at Ole Miss with her Mississippi Mama and Papa, Cherri and Bill Mayo. We’re not sure what she’s majoring in; we think it may be sorority. And Danielle, the poet. And my other friends and family members. For those of you present, I’m so honored to have you here with me today. This is a great day to share with you. And to my parents…to Ed Vinn…he was a character, a great guy, and I miss him. And my mother…she was the politician in the family. My father never talked to anybody other than patients. He was very quiet, very shy and never held any leadership roles. He was just a good doctor. My mother was the politician, and that’s why she was up there as the president of the Texas Auxiliary. It was Rita Baker who actually found that picture so thank you, Rita, for recovering a little piece of history there. Osteopathic Physicians and Surgeons of California…my colleagues, friends, soul mates in many ways, surf buds like Greg Pecchia…Adam Crawford…Blake Wylie… My college, the American College of Osteopathic Family Physicians, they’ve been very supportive and just a great group of people. And my mentors, the AOA past presidents, who I didn’t even know the connections and how they would last. My mentors from Michigan were so great early on…so supportive, such great teachers and role models. But especially Don Krpan, DO, my lifetime, career-long mentor…Don, stand up and be acknowledged. You, the House of Delegates, thank you for your support.

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John Crosby, 16 years of service. We’ve been kidding with John that he’s been on the “Victory Tour” here for several months, and he deserves every bit of it for being such a great part of our lives. My fellow AOA trustees who’ve been so supportive and have been such great partners to work with as we struggle with really thorny issues. And the leaders and members of our bureaus, councils and committees, many of whom are in the audience today, who are so diligent in this volunteerism and labor of love. And most importantly Ray Stowers. You’ve inspired us to better ourselves, to improve the level of care provided to our patients and to “stay ahead of the curve.” Thank you, Ray. Stand up and be recognized. Now our journey is going to continue. On any journey there are going to be rocks in the road. When you’re surfing, there’s going to be some bumps in the reef. But are they challenges or are they opportunities? Thomas Edison once said, “Opportunities are often missed because they’re dressed in overalls and they look like work.” Dressed in overalls and look like work. Things don’t always go as planned. We get knocked off. In surfing, that’s what we call “going over the falls” or a wipeout. But we Oklahoma D.O. | July/August 2013

paddle back out, and we keep going. We don’t give up. There are uncertainties in our future, uncertainties about the Affordable Care Act, the sustainable growth rate, the growth paradox that Don pointed out so eloquently this morning. We’re growing, but in our studies, affinity to our profession has declined. Despite our growth, our market share is declining nationally and in many states. We measure that. We watch it very carefully. With 60% of our graduates going into ACGME training programs, Don pointed out that only about 10% of them stay in the AOA. That’s a fixable problem. That doesn’t have to be that way. Of course we have this pending mismatch of demand and capacity and the ACGME situation which, as John said, was our finest hour…an extraordinary show of unity. The single pathway issue remains. We’re well aware of that, but to the students, residents and others affected by these challenges, I need to reassure you personally that we will do everything in our power to preserve existing career opportunities and to create new ones. We’re with you. We’re there for you. This is wicked strategy either way. Despite these opportunities that look like work, our future remains bright. We hear from all sorts of sectors that we are the key to what’s missing in health care. We have a strong cultural foundation. We have endured for 139 years. We’re a family; that’s very important. And we are a well-organized minority. Margaret Mead once said, “A small, well-organized group can change the world. In fact, it’s the only thing that ever has.” That’s us…that’s us. We’re on this journey together, and we’re going to prevail. So what are our next steps? Steven Covey says, “First things first.” We are aggressively and effectively managing a very smooth transition for our executive director to our dynamic, new Executive Director Adrienne White-Faines, who you’re going to meet tomorrow. Ray Stowers and I have been planning this transition for a whole year. We started out talking about how to make a smooth continuum between what Ray was doing and what I was going to do. I’ve already started working on this with Bob Juhasz about being sure there’s a smooth integration between his priorities and the things I hope we’re going to achieve this year. But we also need to begin with the end in mind. Where do we want to be? We always talk about being great. We have our G.R.E.A.T. Family of pathways in our strategic plan: governance, research, education, advocacy, teamwork, family. We’re going to follow that plan. We need to harness and reinforce the strength of our culture to preserve our unity. We can have both culture and strategy for lunch. That’s our opportunity here. We need to establish some guiding principles. What do I mean by guiding principles? They’re like a litmus test. They’re like the signposts on our journey into the future that we use to read, “Are we on course? Are we drifting off course?” We can test things we’re thinking about doing. Are these things we ought to be doing? Should we be changing course a little bit? I have some that I’m going to talk with you about today. Innovation and evolution…they go hand-in-hand. Will Rogers said, “Even if you’re on the right track, if you’re not moving fast enough, the train is going to run you over.” This is not your father’s AOA. This is not my father’s AOA nor should it be. We have got to continually evolve—evolve our management processes, our governance processes. We need to be more nimble, more efficient in how we make use of our limited resources. We need new business models…non-dues revenues that will reduce dependence on our dues and the burden on you, our members. We need new alliances, internally and externally, to enhance our influence and our impact.

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Diffusion…the Board of Trustees receives voluminous reading materials from outside sources, journal articles, government studies. The Strategic Planning Committee receives a lot of those. They review that, they digest that. But there’s no franchise of this information. We’re developing what we call the LEADRs program: Leadership Education and Development Resources. The whole idea is to start diffusing all this information to a broader base in our profession so we can raise the bar of our knowledge, raise the bar of our thinking, raise the bar of our planning, and work toward the really important issues together.

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Winston Churchill once said, “The only thing worse than fighting with your allies is fighting without them.” We need to get past any disagreements. Sure, we’re going to have points of disagreements, but we need to look at the big picture…look beyond that. We need to look at our new educational models, like the Blue Ribbon Commission. Customer-centric is a broader definition. It’s not just the patient. It’s payors. It’s integrated delivery systems. It’s hospital systems. We need to be churning out physicians who are efficient and ready to work in that context.

Relevance…Charles Schwab said, “Ask the customers what they want.” Will Rogers stated it much more simply and said, “When you’re riding out in front of the herd, you better look back once in a while to make sure they’re still behind you.” Now we have all these targeted segments in our profession. It’s like a company that has different types of customers. You are the guardians of the profession here. You and I have all drank the Kool-Aid. We’re the loyal troops. But what about the millennials? The ACGME trainees? Our increasing cadre of specialists? We need to be sure we’re meeting their needs. We must maintain increased affinity to the AOA and to the profession. Part of the way you do that is through engagement. We had some speakers here over the years who talked about the importance of just being involved, not even in a big way but maybe in a small way. We’re all pretty engaged. That’s why we’re here. But we can do better at creating a better sense of engagement, particularly with our third- and fourth-year students. As Don said, “Where are they training? Who are their role models? What’s their connection?” And those in their GME years, whether it’s OGME or GME, we need to create a sense of to stay connected to the DO family. There’s a lot of mentorship going on out there in various sectors that is oriented toward great career-planning, great educational choices, but what about just teaching people how to stay connected and why you should stay connected? That’s something we can do. The Council of Interns and Residents started an extraordinary and visionary initiative to form an ambassadors program, and I believe they’ve got 58 ambassadors. They’re supposed to create a better connection to the residents. We’ve also re-engineered the President’s Advisory Council, and they’re going to be ambassadors…the whole cadre of them who are willing to serve. The goal is to try to touch those 1,000 residency programs out there and touch all those DOs…not only teach them about educational pathways but to teach them why they’re part of a family, why it’s good to be part of a family and how to stay connected with the family. We need to be inclusive. I bet everybody in this room knows DOs who in the ‘70s or the early ‘80s were good DOs, but they wanted to take MD training because it was close to them or the best possible training they could get. We all know somebody who was told, “If you go take that MD training, don’t bother coming back.” I call them the “lost generation.” We need to reach out to those people, even if they don’t come back, and let them know that they were not rebels…that they were pioneers. They were innovators. We need to constantly look at ways to lower the barriers to reengage with the profession, ease the restrictions for eligibility for program directors. Now I know that’s a thorny issue, but these are people who believe in the profession.

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We need to “pay it forward” through stewardship. We need to be role models, and we need to encourage other people in the profession to be role models, to lay down paving stones for the road to the future and help others have the opportunities that were created for us. We’re going to enhance the effectiveness and reach of our mentor program. We're going to be re-engineering it this year. But the first thing we said is, “Let’s do an inventory.” We gave out a STAR Award today to Ohio because of their efforts to do a state-level mentorship program. We have some specialty societies doing mentorship programs. We have an AOA mentorship program. That was an innovation and a recommendation of Darryl Beehler, DO, and it survives today. It was great, and it remains great. It can be even better. We want to eliminate the redundancy, the overlap, and we want to identify the best practices. We just need to know who’s mentoring who. That would probably be a good start, and we can do all that. Our final guiding principle is celebration. Celebration, if you read much about culture in history, is the cornerstone of a strong culture. We honor and celebrate our great heroes, our Great Pioneers. We did some honoring of some very special heroes today, but we need to honor and celebrate you, the Guardians of the Profession. You’ve served the profession in leadership roles—state, county, national—and you know other people, your predecessors and role models who served. You’re all Guardians of the Profession. Like the Marines, we need to celebrate the guys on the front lines. You all know people, living and deceased, like my father. They didn’t serve in any leadership roles, but they were great role models, and as we say in our pledge, they live every day as an example of what an osteopathic physician should be. Now the best thing, if you’re going to work on something like that, is to get started. We’re going to get started today since each one of you, I know, knows Guardians and you know Unsung Heroes. We’re going to do what salespeople call “induce an act of commitment.” I’m going to ask you to actively join me in paying homage to the Unsung Heroes and Guardians of the Profession. I’m going to ask that before you leave this ceremony, you complete recommendation forms, which the pages are going to pass out, and we have boxes out front. I’m going to ask every one of you to come up with an Unsung Hero, at least one, and you can come up with more, and a Guardian, and put them in that box out there. Our goal is to leave this House of Delegates Oklahoma D.O. | July/August 2013

with 400 Guardians and 400 Unsung Heroes, and we’re going to recognize and celebrate them at OMED in September. As we get the word out on this through social media and our website, we want to hit 1,000 of each by OMED…2,000 by the end of my term, and Bob, I’m setting a big goal for you…4,000 by the end of Dr. Juhasz’s term. We can do it, right, Bob? Now is this a reasonable request? Are you ready to do this? Another thing we’re going to do that you’ve already been seeing a little of, is called Osteopathic Media Moments, and what its acronym? OMM! This is people…this is DOs…this is family having fun as a family not practicing, not doing surgery, but having fun as a family. It’s a reminder that we celebrate together, and we’re going to encourage submissions: photos, videos, any type of media you’d like, profession-wide. They’ll be available on Facebook and YouTube. We’re going to have some awards and as my daughter would say, “shout-outs” or recognition for the best submissions. I’m going to leave you with one last touch point of culture: the hug. Did you ever notice how we’re always hugging each other? We were in a meeting with John Gimpel, DO, recently, who said, “I have an MD friend who says, ‘You guys are always hugging each other. It’s like you actually like each other.’ A hug is a symbol of our unique bond…a sense of family…our belief in the power of touch. Now many fraternal organizations have a secret handshake. We do not have one, but I propose that we officially designate the DO hug as the secret handshake of our profession. I’d like to close with a short video on this subject. I do think it qualifies as an Osteopathic Media Moment, but I’ll let you be the judge of that. We can turn challenges into opportunities. We have a history of doing this. When I was a kid, my father used to say, “You know DOs will go into the areas where no one else wants to go, and they’ll make successes of themselves.” That’s what we did in inner cities. That’s what we’ve done in rural health. And we’ll do it again, and we’re going to keep doing it. We’re going to follow our plan. It’s the road to the future. We’re going to use our guiding principles and signposts. We’re going to focus on the bright spots, and we’re going to celebrate and strengthen our culture. It’s the glue that holds us together. Let’s continue our journey together as we prepare for the future. We are the solution. I look forward to working with you over the next year and thank you for your support. And remember to fill out your forms before you leave! Thank you!

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Oklahoma D.O. | July/August 2013

Adrienne White-Faines, MPA executive director American Osteopathic Association


Adrienne White-Faines, MPA, is the new executive director of the American Osteopathic Association In July 2013, Adrienne White-Faines, MPA, became Executive Director of the American Osteopathic Association (AOA), which proudly represents its professional family of more than 104,000 osteopathic physicians (DOs) and osteopathic medical students.

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In this position, White-Faines is in charge of carrying out the AOA’s strategic agenda, supporting the organization’s physician and student members and its commitment to promoting public health, advancing scientific research; and serving as the accrediting agency for osteopathic medical schools, hospitals and health care facilities.

lion hospital redevelopment project. She also worked as a health strategist with the New York City Health and Hospitals Corporation and as a practice administrator for a large physician group practice in Whittier, Calif. White-Faines remains active with numerous Chicago and national nonprofit organizations, including the Erikson Institute, American Field Service-USA and as a fellow with Leadership Greater Chicago. She holds a master’s of public administration from the University of Southern California in Los Angeles and a bachelor’s of arts from Amherst (Mass.) College.

For 10 years prior to joining the AOA, White-Faines She resides in Chicago with her husband Larry served as vice president of health initiatives and advo- Faines, MD, and her children Mari and Kamau. cacy at the American Cancer Society (ACS), Illinois Division, where she was accountable for cancer research, education, advocacy, and patient service programs. Prior to employment at ACS, she served as chief operating officer at Chicago-based Renwal Emergency Medical Services, a health care management consulting firm for hospitals and physicians, and at Chicago’s Northwestern Memorial Hospital where she oversaw a $600 mil-

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Oklahoma D.O. | July/August 2013


The House of Delegates kicked off with committee meetings on Thursday, July 18 for the purposes of informational presentations, as well as to consider resolutions assigned to committee for the purpose of consideration before the entire House of Delegates. Committees include: Rules and Order of Business, Credentials, Constitution & Bylaws, Education, Professional Affairs, Public Affairs, Resolutions, House Budget Review, Ad Hoc, as well as several reference committees. Bureaus include: Bureau on State Affiliate Concerns, State Government Affairs, and Socioeconomic Affairs.

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Several of these committees and bureaus began meeting on Thursday afternoon. AOA President and Oklahoman Ray E. Stowers, DO, moderated and provided a briefing at the Town Hall on Thursday evening, sharing an overview of the upcoming resolutions to be presented to the House of Delegates. On Friday, July 19 the House of Delegates convened for a morning session in advance of an afternoon of reference committee meetings.

Also, AOA Trustee Boyd R. Buser, DO, updated the House of Delegates on the discussion of a unified accreditation system. For the past year and a half, the American Osteopathic Association (AOA) and the American Association of Colleges of Osteopathic Medicine (AACOM) have been exploring the possibility of a new unified graduate medical education (GME) accreditation system with the Accreditation Council for Graduate Medical Education (ACGME). The AOA and AACOM announced they have been unsuccessful in reaching an agreement with ACGME on a Memorandum of Understanding (MOU) for a unified graduate medical education accreditation system. However, the AOA and AACOM remain open to continued discussions with the ACGME. Both AACOM and the AOA strongly believe that the health of Americans will benefit from a uniform path of preparation for the next generation of physicians designed to evaluate the effectiveness of GME programs in producing competent physicians. The AOA also remains committed to protecting the distinctiveness and identity of the osteopathic medical profession, including the five core principles that were significant to developing a unified graduate medical education accreditation system: • The discussion is limited to GME and does not extend backward to undergraduate medical educa- tion or forward to licensing or certification. • The osteopathic medicine licensing examination (COMLEX-USA) remains in place and viable. • Osteopathic board certification remains in place and viable. • Osteopathic physicians must be given an equal opportunity to participate in all training programs under any unified accreditation system. • Any unified accreditation system must not adverse- ly affect primary care programs in community- based settings. The osteopathic medical profession will continue to grow OGME programs across the U.S. to ensure that all DO graduates have a place to train once they graduate. Just this past year, more than 1,100 new OGME positions were created within 75 new programs. This means that now there are more than 12,000 osteopathic graduate medical education positions available. The AOA and AACOM remain strong in protecting the identity and distinctiveness of the osteopathic Oklahoma D.O. | July/August 2013

medical profession while ensuring that our training programs are of top quality. Ultimately, while no agreement has been made, support continues for discussions on a unified accreditation system for GME. Answers to frequently asked questions regarding ACGME Unified Accreditation System can be found at On Friday, outgoing AOA Executive Director John Crosby gave a rousing speech entitled, “From Kirksville to Gettysburg: Rededicating the AOA to the People.” Mr. Crosby spoke of the need to preserve and protect the future of osteopathic graduate medical education. “OGME must not face the same fate as the soldiers who gave their lives at Gettysburg, noble though their sacrifices were. OGME must endure!” “As a member of the AOA Task Force that represented the AOA in our discussions these past 18 months, I—we—are fully aware that many feel their lives, their careers, and perhaps the future of the organization are at stake. Students and residents want the freedom to be trained in the residency of their choice. Faculty, program directors and DMEs want to teach and train with the knowledge that their DO degree and board certification will be accepted without discrimination. “Whether you are OGME trained, ACGME trained, or yet to be trained, whether you are a family physician or a surgeon, whether you are a member of the AOA or not—we are here for you.” “I call upon your loyalty based not on your self-preservation, but rather what we need to do to preserve the profession and its tenets…years from now.” “Dedicate yourselves here to the great task remaining here before you—that we take increased devotion to the tenets of osteopathic medicine. Resolve that our efforts to protect and preserve the distinctiveness of osteopathic medicine have not been in vain. That this association, under A.T. Still, shall have a new birth of relevance. And that this profession of DOs, by DOs, for DOs, shall not perish from the earth.”

Oklahoma D.O. | July/August 2013


At the Oklahoma delegation dinner on Friday evening at Fulton’s on the River, President Bret S. Langerman, DO, awarded AOA First Lady Peggy Stowers an official OOA citation for her support and service of outgoing AOA President Ray E. Stowers, DO.

Oklahoma D.O.

Mr. Crosby led the American Osteopathic Association into an era of tremendous growth. There are now more than twice as many osteopathic medical school graduates annually than when he took over the reigns of the AOA 16 years ago.

On Saturday, July 20, Donald J. Krpan, DO, gave the annual A.T. Still Memorial Lecture. Dr. Krpan mentioned the osteopathic profession is nearly 140 years old and throughout its history there have been critical issues which challenged its existence and its concepts. Dr. Krpan divided osteopathic history into three 40 to 50-year cycles. The first 40 years were all Dr. Still, who faced bias and prejudice against his concepts of a different and improved method of practice. He encountered difficulties in obtaining licensure and acceptance by the organized medicine of the time, but held a rigid belief in his concepts. Dr. Still was eventually able to become licensed in Missouri and developed a clinic, school, and a hospital. The next cycle featured difficulty for DOs in achieving licensure in many states. This period in American history features three major armed conflicts, including World War I, World War II, and the Korean War. In all three instances, DOs were denied military commission even as drugless practitioners. During World War II, DOs were exempted from the draft and were declared ineligible for voluntary service in the medical corps. At home, DOs continued to be denied privileges in allopathic hospitals despite taking care of the patients of many conscripted MDs. In spite of this, DOs built large practices, and by 1945, they had increased the number of osteopathic hospitals to 260. By the end of this second cycle (1962), DOs had achieved unlimited licensure in 38 states and were recognized as qualified to be commissioned as medical officers in the U.S. military.

This year, we graduated 4,900 osteopathic medical students from existing colleges with the capacity, within our profession, to train 2,900. We must ask ourselves, “are we honest with the students we recruit when we tell them we are going to train them to be a different kind of physician, knowing all the while, that 50% to 65% of them will need to take ACGME training in order to be licensed. What is different about them? Are they osteopathic?” Dr. Krpan went on to say the AOA is currently facing as great a challenge and risk as has ever been presented. The three

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Dr. Krpan entered Kansas City College as a first-year medical student in 1963—which is also the first year of the current era. Two terms that impact the major challenges of today

include “dependent minority” and “educational entrepreneurism.” Dependent minority refers to the notion that we are depending on another profession to train our graduates. Education entrepreneurism comes into play as colleges increase enrollment at twice the rate of available training slots. Dr. Krpan also shared some additional data: • When he graduated in 1967, there were five os- teopathic colleges graduating approximately 500 students per year. • There were more than 200 osteopathic hospitals with the required number of postdoctoral positions for all the graduates. • From 1967 until 2003, a 36-year span, the number of osteopathic schools increased by 14 to a total of 19 campuses, an increase of less than one college every two years. • From 2003 until this year, 2013, a span of 10 years, the number of campus sites has increased to 37. That is an increase of 18 campuses or 1.8 per year. • There are currently inquiries from an additional 11 sites.

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values of accreditation, licensure, and certification are all threatened and must be preserved. The crisis we face is of our own making. We have achieved parity which we have always reached for. Dr. Krpan closed by asking that we remove ourselves from the status of “dependent minority” and that we closely monitor the “educational entrepreneurism” that exists within our ranks by suggesting that the governing body of the AOA be more involved and “get to work.” Two of the three individuals who received the Presidential Citation were Oklahomans! Both David F. Hitzeman, DO, and Lynette C. McLain were recognized Friday, July 19, with this distinctive honor from outgoing AOA President Ray E. Stowers, DO. David F. Hitzeman, DO, was recognized for his expertise in delivery system design payment reform and his commitment to the next generation of physicians, as well as more than two decades of leadership in the Oklahoma Osteopathic Association. Lynette C. McLain, who has served as the Executive Director of the Oklahoma Osteopathic Association for more than 40 years, was honored for her leadership and commitment to the profession in Oklahoma and across the country. Gilbert E. D’Alonzo Jr., DO, was honored for his career-long commitment to advancing the osteopathic medical profession and its tenets, which includes 15 years as the editor-in-chief of the Journal of the American Osteopathic Association (JAOA).

Presidential Citation for Lynette C. McLain:

Whereas Lynette C. McLain has devoted 40 years to the osteopathic medical profession through her work with the OOA; and Whereas Mrs. McLain, who became Executive Director of the Oklahoma Osteopathic Association in 1999 has displayed vigorous commitment to protecting the practice rights of DOs in the state of Oklahoma; and Whereas Mrs. McLain was actively involved in the creation of the Oklahoma Osteopathic Education Center, which has served as the professional home of the OOA family since 1985; and Whereas in her position as Secretary-Treasurer of the Oklahoma Education Foundation for Osteopathic Medicine, Mrs. McLain has played a role in fulfilling the need for additional physicians in the state and ensuring better health care for all Oklahomans, by granting scholarships to outstanding osteopathic medical students each year; and Whereas Mrs. McLain, as past President of the Association of Osteopathic State Executive Directors, which is comprised of representatives from the AOA’s affiliated state osteopathic medical associations, aiming to strengthen these societies while also promoting coordination among them; and Whereas Mrs. McLain has received numerous awards and recognition for her leadership and service to the osteopathic medical profession including the: Ruth Evans Service Award in 2013 from the Advocates of the Oklahoma Osteopathic Association, the Bob E. Jones Award in 2007 from the AOA, and the Association Professional of the Year in 2000 from the Oklahoma Society of Association Executives; now therefore Be it Resolved, that the AOA Board of Trustees bestows this Presidential Citation on Lynette C. McLain for her leadership and commitment to the osteopathic family in the state of Oklahoma and across the country.

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Oklahoma D.O. | July/August 2013

At the Annual AOA Awards Luncheon on Saturday, Pam Smith of the American Osteopathic College of Radiology and the late James M. Yonts received the Bob E. Jones Award. Bob E. Jones was the longtime Executive Director of the Oklahoma Osteopathic Association. Also, President Stowers was one of four individuals recognized for his leadership as a Great Pioneer in Osteopathic Medicine at the Awards Luncheon. Saturday afternoon, official House of Delegates business continued with discussion and action on resolutions. Later, collections for the Osteopathic Family Relief Fund totaled more than $13,000. Oklahoma committed $1,000 to this fund. While contributions were being collected by “passing the boot,” four individuals were honored for their heroism during times of crises. Oklahoman Stephanie K. Barnhart, DO, was recognized for her quick thinking and decisive action immediately following the EF-5 tornado that hit Moore, OK, on May 20. George Smith, DO, was recognized for saving 100 nursing home residents in the aftermath of the fertilizer plant explosion in West, Texas. Danielle A. Deines, DO, a firstyear pediatrics resident, and AOA Immediate Past President Martin S. Levine, DO, were recognized for their impromptu, life-saving triage following the Boston bombing.

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The American Osteopathic Information Association-Osteopathic Political Action Committee, commonly known as OPAC, raised funds in advance of the 2014 elections. The Oklahoma delegation obtained 100% participation in OPAC, an impressive feat especially given the large size of our delegation. Our 27 delegates and alternate delegates contributed a total of $7,055 for OPAC out of a total of just over $122,000—more than 5% of all funds raised! OPAC works to elect and re-elect pro-physician candidates to Congress through direct contributions, voter education, and targeted political activism. Saturday’s official House of Delegates business concluded with the inauguration of Norman E. Vinn, DO. Dr. Vinn was sworn in as the AOA's 117th president. In his inaugural address, President Vinn emphasized the importance of culture holding the DO profession together. He reminded his colleagues about the discrimination DOs faced in the past and praised the endurance, commitment, stubbornness, and sense of family that enabled the profession to survive and prosper. President Vinn concluded his remarks by asking delegates to get started on the celebration principle by nominating DOs for recognition as "unsung heroes" or "guardians of the profession." And he expressed confidence about what lies ahead: "It is our legacy and our destiny as a profession to overcome the challenges that lie before us - and we will overcome them."

Oklahoma is again well represented on AOA Departments, Bureaus, Committees, and Councils. Several members of the Oklahoma family received appointments: Bureau of State Affiliate Concerns: Gabriel M. Pitman, DO (2016) Lynette C. McLain (2014)

Council on Building: Bret S. Langerman, DO (2014) Information Technical Advisory Bureau: Dennis J. Carter, DO (2014) Council on Continuing Medical Education: Layne E. Subera, DO (2015) LeRoy E. Young, DO (2015) Bureau of Conventions: Scott S. Cyrus, DO (2014) AMA RUC Committee: David F. Hitzeman, DO, Chair (2016) Joseph R. Schlecht, DO(2014) Joint Committee on Quality and Payment: Joseph R. Schlecht, DO, Chair (2014) David F. Hitzeman, DO (2014) Bureau on Osteopathic Specialty Societies: Scott S. Cyrus, DO (2014) Bureau on Membership: Scott S. Cyrus, DO (2014) Layne E. Subera, DO, Advisor (2014) Bureau on Membership- Ethics Subcommittee: Layne E. Subera, DO (2016) Scott S. Cyrus, DO (2017) Bureau of Socioeconomic Affairs: David F. Hitzeman, DO, Chair (2016) Joseph R. Schlecht, DO (2014) Bureau on State Government Affairs: Sherri L. Wise, Observer (2014) Council on Women’s and LGBTQ Health Issues: Sherri L. Wise, Observer (2014) Council on Research: Stanley E. Grogg, DO (2014)

Bureau of Osteopathic Specialists-Executive Committee: J. Michael Wieting, DO, Vice Chair ( 2015) Commission on Osteopathic College Accreditation: Ronnie B. Martin, DO (2014) Bureau on Federal Health Programs: Ronnie B. Martin, DO (2014) Council on Osteopathic Postdoctoral Training Institutions: Charles E. Henley, DO (2015) Oklahoma D.O. | July/August 2013

Delegates in their Own Words: What made you want to serve as a delegate? “I have wanted to serve as a delegate to the AOA HOD to represent the osteopathic physicians in the state of Oklahoma at the national level. It is vitally important that members of the delegation come together in Chicago in the shared interests of OOA members and work to achieve policy and promote leadership within the AOA that reflects the values and commitment of the osteopathic physicians in Oklahoma.” - Gabriel M. Pitman, DO

What made you want to serve as a delegate? “I wanted to serve as a delegate at the AOA meeting to learn more about the legislative process of the AOA. Prior to the House of Delegates meeting, I knew very little about how the AOA voted on health care policies and elected members to the AOA’s Board of Trustees. When I agreed to be a delegate I hoped that I would see the AOA building in Chicago. I was honored to get to tour the boardroom and see the helm of osteopathic governance. I also knew that as a delegate I would have the opportunity to meet other osteopathic students and physician leaders from around the country. Our future is very bright!” -Heather Hardebeck, OMS-II

What was your favorite part of the House of Delegates? “My favorite part of the HOD was getting to know members of other state delegations and enjoy the similarities that exist in all members of the osteopathic family. I also enjoyed Dr. Krpan’s AT Still Memorial Lecture. It reinvigorated both my pride in the history of osteopathic medicine and reminded me that we practice a unique art.” - Gabriel M. Pitman, DO


Oklahoma D.O. | July/August 2013

Oklahoma D.O.

What was your favorite part of the House of Delegates? “I most enjoyed seeing the concern physicians and residents had for current osteopathic medical students. Physicians were not hesitant to stand and voice their concern for legislation that affected students.” -Heather Hardebeck, OMS-II

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medical center

“we are embracing this welcomed change. The new rooms will enhance our patient care and medical education program and minimize family disruption by eliminating the need to transport women to different rooms following delivery.”

Oklahoma State University Medical Center is about to embrace change again with the much-needed renovations to the third floor, labor-delivery-postpartum rooms of the Department of Maternal Child Health (MCH). Changes recently began with the entire Department of MCH temporarily relocating its services to different floors to ensure the safety of the patients and to expedite the 14 to 18 month renovation project. The relocation of services during the interim will soon be forgotten when the multi-million dollar project is completed in the spring of 2014. The renovations that encompass 12,000 square feet include moving walls to enlarge patient rooms and bathrooms, updating the medical gas system and medical equipment, modernizing the interior to create energy cost savings and adding family-friendly furnishings to facilitate parent-infant bonding.

Oklahoma D.O. | July/August 2013

Thank you to our generous donors for their contributions to the Department of Maternal Child Health renovations. Morningcrest Healthcare Foundation George Kaiser Family Foundation Ruth Nelson Family Foundation Tulsa Community Foundation The Foundation for OSU Medical Center is not affiliated with or a branch okDO of Oklahoma State University or the OSU Foundation.


Tracey Kiesau, Manager of MCH, states “we are embracing this welcomed change. The new rooms will enhance our patient care and medical education program and minimize family disruption by eliminating the need to transport women to different rooms following delivery. The new interiors will include energy efficient lighting and easy-to-clean materials for the floors,

Diane Rafferty, Chief Executive Officer of Oklahoma State University Medical Center, also welcomes the changes to MCH and credits the generosity of donors with this soon-tobe transformation. “We truly appreciate our supporters; they saw our potential and invested in our growth. The renovations add to our exceptional patient care in MCH and strengthen our ongoing recruitment for the future residents and graduate students,” stated Ms. Rafferty. There are more opportunities to contribute to the MCH renovations and to be more involved with OSU Medical Center by contacting the Foundation for OSU Medical Center at 918.599.5934 or

Oklahoma D.O.

The renovations will create 13 multi-purpose obstetric/labor/ delivery/recovery/postpartum (LDRP) rooms from 19 outdated, cramped rooms that have not been upgraded in 20 years. Each room will be more spacious, versatile, and interchangeable than the prior configuration. One large, LDRP multipurpose room will accommodate a woman during her labor, delivery and postpartum, as well as her healthy newborn, family members, her medical team, and medical equipment. Two of the 13 rooms will meet the Americans with Disabilities Act statues for LDRP. The third floor of MCH will also house an examination room and two patient rooms bringing the total number of newly-renovated rooms to 16.

which will reduce upkeep and maintenance costs. Warm colors with wood finishes in patient rooms, at the nurse’s station and on the furniture will give the third floor a relaxing feel of home rather than that of a clinical setting. According to Mrs. Kiesau, “close attention to design details, such as hiding the medical gas system behind artwork, underscores our commitment to a pleasant environment while optimizing space and functionality.” Mrs. Kiesau went on to say “in a few short months, mothers, babies and family members will be able to bond in a beautiful, new environment; we expect the number of women giving birth at OSU Medical Center to grow considerably”.

Vicki L. Stevens President 2013 – 2014 Advocates For the oklahoma osteopathic association The Advocates for the Oklahoma Osteopathic Association (AOOA) encourage you to come join. The following is from our bylaws; ARTICLE II. OBJECT The object of this organization, The Advocates for the Oklahoma Osteopathic Association (AOOA), a 501 (c)3, non-profit organization, shall be to correlate the activities of the state and district advocate groups for the purpose of promoting and supporting the public health and educational activities of the osteopathic profession, and to render service to community health endeavors which are within the general objectives of the Advocates for the American Osteopathic Association (AAOA). Said in fewer words, to me this means: THE AOOA'S GOALS ARE TO SUPPORT YOUR IDEAS ABOUT PUBLIC HEALTH, AND EDUCATION ABOUT THE OSTEOPATHIC PROFESSION, DONE IN YOUR COMMUNITIES.

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YOU ARE NEEDED! We know that to continue to thrive, we must set our objectives so that we wisely invest our time, energy, and talents. Now more than ever we need to expand our connections and keep our family informed.

standing strong with our “Osteopathic Profession” foundation fundamentals. Our world has changed dramatically, and it continues to change daily, and to continue our organization as a constructive force in society we must save and apply the Osteopathic ideas and principles upon which we were formed: 1. This organization is a unit and contains minds, bodies and spirits. 2. The parts of this organization have relationships. 3. This organization has the ability to heal itself. 4. We benefit when we apply these tenets. To ignore our past is to lose our identity. We have a defined purpose of proven significance; we have a sound structure and a strong heritage. We have a small but dedicated membership. Please join and help make the AOOA stronger. Your ideas are wanted. BRING YOU, so we can be a greater positive influence for our spouses and their profession, and our medical families.

As the cycles of lives continue, we want to be mentors to those in the beginning of their medical family careers, and during the momentum years, we want to be a guiding light of support,

Oklahoma D.O. | July/August 2013

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Congratulations to the 2013 OSU-CHS Rural Health Option graduates who are excited about becoming physicians and serving rural Oklahomans. A special “thank you” to all those who provided support, encouragement, inspiration, and training to keep their dreams alive and produce, not only needed rural physicians, but rural community leaders as well. Thank you for your dedication to making a difference.





“Working with Jamie Gore, DO, helped me gain valuable knowledge of the challenges facing rural doctors.” Dr. Smith is a PMTC recipient and plans to return to western Oklahoma to practice close to her hometown of Elk City. In 20102011, she served as the StORM Secretary. Dr. Smith will complete her residency at the Texas A&M – Scott & White Internal Medicine Residency Program in Temple, Texas, before returning to western Oklahoma.

“I very much enjoyed the patient contact-it was much more personal than what we see in an urban clinic. Monty J. Grugan, DO’s clinic in Broken Bow was a very busy practice and the patient-base offered a great deal of variety.” Dr. Bullard is from Clayton, Oklahoma, and plans to practice in rural Oklahoma. She is currently in the Tahlequah City Hospital Internal Medicine Residency Program.

“I am committed to returning to rural Oklahoma.” Dr. Armstrong lives in Vian, Oklahoma, with her husband and their 3 children. Dr. Armstrong is a PMTC recipient and completed many of her rotations in the Tahlequah, Oklahoma, area. She is currently in the Tahlequah City Hospital Internal Medicine Residency Program.

Born and raised in Enid, Oklahoma, Dr. Gibson spent much of her 3rd and 4th year rotations in northwest Oklahoma. “One experience allowed me to work at a community clinic that provided free healthcare and free medications. I found it extremely rewarding to help out those who did not have insurance and did not have any access to health care.” Dr. Gibson is in the family medicine residency program at the INTEGRIS Bass Baptist Health Center in Enid.

Oklahoma D.O. | July/August 2013




“I am from a small town myself, so Prague was a place I knew that I would enjoy. Everyone was extremely welcoming, friendly, and helpful. The patients in rural Oklahoma are very appreciative of their doctors and nurses and value their opinions.” Dr. Alsup is from Cushing, Oklahoma, and served as the 2010-2011 StORM Treasurer. She completed her 3rd Core Rotation in Enid, Oklahoma. She is now at the OMECO Teaching Health Center Family Medicine Residency Program in Tulsa, Oklahoma.

“I once had a patient tell me ‘Don’t forget your roots.’ Well, I haven’t forgotten my roots and plan to give back to the community that raised me.” Dr. Pattison ‘s hometown is Holdenville, Oklahoma. “In the larger rotations, there are many students, residents, and fellows, making access to procedures very competitive. This is not the case in rural rotations. After, my core rotation in Durant [Oklahoma], I walked away feeling confident in several procedural skills, the management of critical patients in ICU, and the practice of evidence based medicine. I have discovered as a rural physician that you are not only a doctor; you are a leader in the community.” Dr. Pattison served as the 2010-2011 StORM President. She matched at the Texas A&M – Scott & White Internal Medicine Residency Program in Temple, Texas.

“In all of the clinics and hospitals that I’ve had the distinct pleasure of working in as a student, the patients have been kind, respectful, unassuming, and very thankful.” Dr. Roberts will be completing his emergency medicine residency at INTEGRIS Southwest Medical Center in Oklahoma City, Oklahoma and plans to return to rural Oklahoma to work at a critical access hospital. “The most welcoming, warm ,and sincere medical professionals I’ve ever known are living and working in rural Oklahoma.”

Dr. Jantzen is from Ada, Oklahoma and completed many of his rotations in southeast and northwest Oklahoma. “I enjoyed working with Jeffrey R. Jones, DO daily. He is a great advocate for osteopathic medicine using OMT on a large number of his patients.” Serving as the 2010-2011 StORM Vice President, Dr. Jantzen has been active in the National Rural Health Association attending national conferences, the NRHA Student Constituency Group, and serving on the NRHA Rural Health Policy Congress. In 2012, Dr. Jantzen received the prestigious NRHA/John Snow, Inc. Student Achievement Award for his service and dedication to rural health. Dr. Jantzen is also a great advocate for the Rural Health Option and the Osteopathic Rural Medical Track Programs at OSU CHS. He currently resides in Enid and is in the family medicine residency program at the INTEGRIS Bass Baptist Health Center in Enid.

Oklahoma D.O.



Oklahoma D.O. | July/August 2013

Jeffrey D. Hodgden, MD, Faculty Mentor Department of Family Medicine

Clin-IQ Project Clinical Question: In adults with chronic insomnia, is melatonin as effective as prescribed medications in promoting sleep, but with fewer side effects? Authors: Beth Hites, DO (PGY-2) Answer: Inconclusive for effectiveness; Yes, for fewer side effects Level of Evidence for the Answer: B Search Terms: melatonin, melatonin agonist, insomnia, chronic insomnia, comparison, sleep, benzodiazepine, benzodiazepine receptor agonist, and antidepressant

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Inclusion and Exclusion Criteria: Inclusion: Humans, English, Age 19+, Randomized Control Trials, Clinical Trials and Meta-analysis Exclusion: Case Studies Summary of Issues: The most common sleep disorder, insomnia, can have a major impact on an individual’s physical and psychological health, personal life, and career. It is defined as difficulty in initiating and/or maintaining sleep, or waking too early, and occurs despite adequate opportunity and circumstances for sleep.1 A study by Singareddy, et al., of 1,246 individuals followed for seven years, who did not report insomnia at baseline, found the overall incidence of chronic insomnia to be 9.3%, with a higher incidence among women than men. Factors found to increase the risk of chronic insomnia were younger age (20-35 years), non-white

ethnicity, and obesity. Predictors of chronic insomnia included: poor sleep, mental health – maladaptive personality traits, and excessive use of coffee at baseline. Surprisingly, short sleep duration and sleep apnea were not found to be predictors of chronic insomnia.2 The most common self-reported daytime complaints by those suffering from chronic insomnia include fatigue/malaise, poor concentration, social/vocational dysfunction, mood disturbances, daytime sleepiness, decreased energy, increased errors and/or accidents, headache, gastrointestinal disturbances, and worry/anxiety about sleep. An ambulatory assessment conducted by Varkevisser, et al., on chronic insomnia and daytime functioning found that, while subjective well-being was compromised in insomniacs vs. control participants, the objective performance level between the two groups was comparable. This study’s findings were comparable overall to multiple other studies, with only minor deviations in performance noted by a few (i.e., decreased balance, decreased performance in conditions lacking external stimuli, etc.).3 Summary of Evidence: A review of published data that directly compared both the efficacy in promoting sleep and/or patient reported side effects between melatonin and one or more prescribed medications for insomnia was conducted. Only one randomized controlled trial (RCT) was found that met the criteria for side effect comparison. There were no RCTs found that directly

St. Anthony Family Medicine Residency 1000 N. Lee Oklahoma City, OK 73101

compared the efficacy of melatonin to benzodiazepines,non-benzodiazepine agonists, melatonin agonists, or antidepressants in the treatment of chronic insomnia. There were several RCTs and meta-analysis that compared prescriptive medications for chronic insomnia with each other and/or cognitive behavioral therapy (CBT), or compared classes of prescribed medications to CBT. A 2003 study by Rogers, Kennaway, and Dawson looked at the neurobehavioral performance effects of daytime melatonin compared with temazepam administration. Sixteen healthy individuals with a mean age of 21.4 were given melatonin 5 mg, temazepam 10 mg, or placebo at 1200 (noon) in a randomized doubleblind crossover fashion. Neurobehavioral performance tasks (unpredictable tracking, spatial memory, vigilance, and logical reasoning) were completed and assessed hourly from 0800 – 1100, and every two hours from 1300 – 1700. Results showed more negative changes in performance with temazepam than with melatonin (p<0.05). Subjective sleepiness levels were greater with temazepam and melatonin than with placebo (p≤0.05), with temazepam’s greatest sleepiness level from 1300-1400, and melatonin’s greatest sleepiness level from 1300-1700. These results demonstrating fewer negative cognitive effects while patients are awake suggest that melatonin may be preferable to benzodiazepines in sleep disorder management.4 One review comparing melatonin and placebo suggests that melatonin is effec-

Oklahoma D.O. | July/August 2013

tive in decreasing sleep onset latency, advancing sleep onset/offset time, and increasing total sleep time in circadian rhythm sleep disorders such as those seen in jet lag or shift work.5 One RCT of 43 participants evaluated the effectiveness of a melatonin, magnesium, and zinc combination against placebo. This study showed significant subjective improvement in ease of getting to sleep (p<0.001), quality of sleep (p<0.001), hangover on awakening from sleep (p=0.005), alertness and behavioral integrity next morning (p=0.001), and total sleep time (p<0.001) for those taking the melatonin, magnesium and zinc combination.6 Conclusion: In adults, there are few, if any, trials directly comparing the effectiveness of melatonin to prescribed medications for the treatment of chronic insomnia. Given the prevalence of sleep disorders and the health care costs of treating chronic insomnia, this is an area that is in need of more research. In adults with chronic insomnia, it does appear that melatonin has fewer reported side effects than temazepam. Against placebo, melatonin appears to be safe and effective in decreasing sleep onset latency and increasing total sleep time, without significant adverse effects. References: 1. American Psychiatric Association. 307.42 Primary Insomnia. In: Diagnostic and Statistical Manual of Mental Dis orders, 4th Edition, Text Revision. Washington, DC: American Psychiatric Publishing, Inc., 2000. 2. Singareddy R, Vgontzas AN, Fernandez-Mendoza J, Liao D, Calhoun S, Shaffer ML, Bixler EO. Risk factors for incident chronic insomnia: a general population prospective study. Sleep Medicine 2012; 13(4):346-353. 3. Varkevisser M, Van Dongen HP, Van Amsterdam JG, Kerkhof GA. Chronic insomnia and daytime functioning: an ambulatory assessment. Behavioral Sleep Medicine 2007; 5(4):279-296. 4. Rogers NL, Kennaway DJ, Dawson D. Neurobehavioural performance effects of daytime melatonin and temazepam administration. Journal of Sleep Research 2003; 12(3):207-212. 5. Buscemi N, Vandermeer B, Pandya R, et al. Melatonin for Treatment of Sleep Disorders. Rockville (MD): Agency for Healthcare Research and Quality (US); 2004 Nov. (Evidence Reports/Technology Assessments, No. 108.) Available from: 6. Rondanelli M, Opizzi A, Monteferrario F, Antoniello N, Manni R, Klersy C. The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: a double-blind, placebo-controlled clinical trial. Journal of American Geriatric Society 2011; 59(1):82-90.

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2013 Legislative Recap

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Provided by Matt Harney, OOA Advocacy and Legislative Director

Oklahoma D.O. | July/August 2013

Top Stories The 2013 Oklahoma legislative session ended one week early and featured many bills affecting the health care profession. The big news from this session was the appropriation for our teaching hospital. The Oklahoma Osteopathic Association is encouraged by the $13.25 million appropriation to the OSU Medical Center, which will also receive no less than $5 million in federal matching funds. This is the largest appropriation in the history of our medical center and will be used to upgrade and modernize systems and equipment. While we are very pleased with this outcome, it will take a renewed effort from the entire osteopathic family to advocate for a recurring annual appropriation. The OOA will continue to fight for a much-needed recurring annual appropriation for the OSU Medical Center to ensure it will serve the public well into the future. With your continued commitment, we will work to make this a reality. The other big legislative victory was the defeat of the PT direct patient access bill. With the support of like-minded organizational partners, the OOA was also able to successfully defeat HB 1020, legislation that would have given physical therapists the right to practice without a prescription from a licensed physician. It is essential for the well-being of all Oklahomans that patients receive exams from licensed physicians, and we were able to guarantee this patient protection. Another important item to note revolves around the health care coverage needs of working class and low-income Oklahomans. These constituencies went largely ignored as Medicaid expansion was denied while no viable solution was passed to extend Insure Oklahoma. In February 2013, the Oklahoma Health Care Authority contracted with Leavitt Partners to evaluate its current Medicaid program and to make recommendations on how to maximize access and quality of health care in Oklahoma.

Oklahoma D.O. | July/August 2013

During her State of the State speech earlier this year, Fallin touted the Leavitt report as an element in her "Oklahoma Plan" alternative to the Affordable Care Act. Unfortunately, 40 months after the ACA was signed into law, details of Gov. Fallin’s “Oklahoma Plan” have yet to be disclosed. While no state plan is in place, starting October 1, 2013, individuals can go to the Health Insurance Marketplace to fill out an application and see your health plan choices. Application information includes: your family, your household size, and your income. Coverage starts as soon as January 1, 2014. Applications and additional information can be found at: Insure Oklahoma Facts • 29,986 individuals receive health insurance and 4,732 small businesses offer subsidized health plans through Insure Oklahoma.

• Of these individuals, 21,584 with household incomes above 100% of the federal poverty level will be eligible to purchase insurance in the federal health insurance exchange with premium tax credits effective Jan. 1, 2014.

• Those individuals with incomes below 100% of the federal poverty level (8,402) will lose coverage from Insure Oklahoma. For a household of four, 100% of the federal poverty level is $23,550 in annual income. Health Care Budget Highlights

The Oklahoma Health Care Authority received an additional $39.7 million for SoonerCare maintenance and annualization of the program. It shall provide funding for six months for 44,000 children and 17,000 adults who are eligible today but not enrolled in SoonerCare. The Department of Mental Health and Substances Services received an additional $17.4 million to support initiatives including suicide prevention, prescription drug abuse and treatment, and counseling for children with mental illness.


The Leavitt Partners determined that the proposal could provide health care coverage to 275,000 Oklahomans and while the direct cost to the state over 10 years would be about $850 million, it would actually result in state budget savings

Until that point, the plan recommends that the state encourage federal officials to extend funding for the Insure Oklahoma Program, which is due to end Dec. 31. The program uses federal Medicaid money, state tobacco tax revenue and other funds to underwrite private insurance costs of some 30,000 working poor Oklahomans. The Obama administration has canceled federal participation in the program after December 1, because of the current cap on participants in the program.

Oklahoma D.O.

The Leavitt Partners outlined the Oklahoma Plan, recommending principles from an existing effort known as Insure Oklahoma to help working, low-income Oklahomans get health insurance. The Oklahoma Plan calls for using "enhanced federal funding," including the Medicaid expansion funds, to help individuals purchase private insurance. The Medicaid funding would not be used to expand the number of people on Medicaid, but would underwrite the purchase of private insurance for poor Oklahomans. Such a move would require federal approval.

of $464 million after the economic impact is calculated. The earliest the plan could be in place is 2015.

Budget Concerns HB 2032, Shannon/Bingman, reduces the top individual income tax rate from 5.25% to 5.0% for tax year 2015, with further reduction in the top individual rate from 5% to 4.85% beginning Jan. 1, 2016, provided the Board of Equalization determines that the amount of General Revenue Fund growth exceeding the anticipated amount of collections to the fund would decline as a result of reducing the rate 0.15 percentage point. Further, the bill creates the Oklahoma State Capitol Building Repair and Restoration Fund and apportions $120 million-$60 million each in 2014 and 2015. On June 6, 2013, a legal challenge was filed in the Oklahoma Supreme Court against HB 2032 by Oklahoma City attorney Jerry Fent. Fent claims the legislation violates the “singlesubject” rule in the Oklahoma Constitution, failed to receive the three-fourths “super majority” vote required of revenue raising measures, and creates a special appropriation by diverting revenue that would otherwise go to the General Revenue Fund to the special fund set up to repair the Capitol. Oral arguments began July 9. According to the Oklahoma Policy Institute, the proposed tax cut eliminates $1,478,000 in revenues from 20112022. Conversely, the cost of expanding Medicaid for the same period would be $689,000.

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Lawmakers to return September 3rd for Special Session on Lawsuit Reform Lawmakers will return to the State Capitol on Sept. 3 after Gov. Mary Fallin issued an executive order directing the Legislature to convene a special session. The executive order recommends lawsuit reform as the subject of the special session, specifically the provisions of the Comprehensive Lawsuit Reform Act of 2009, which was ruled unconstitutional in June by the Oklahoma Supreme Court for violation of the single-subject rule. “Any legislation should be drafted in such a way to ensure that Article 5, Section 57 of the Oklahoma, or any other Constitutional provision, is not violated,” Fallin wrote in the executive order, referring to the single subject rule. Governor Fallin’s executive order did not include a call to address efforts to save Insure Oklahoma during special session. Insure Oklahoma provides health care for nearly 30,000 low-income, working Oklahomans. Bill filing procedures and deadlines likely will not be set until the special session convenes. Health Care Legislation that Passed: As previously noted, HB 2301, authored by Rep. Martin/ Sen. Jolley, appropriates $13.25 million to the OSU Medical Authority to support graduate medical education programs affiliated with the OSU Medical Center and the OSU Center

for Health Sciences. The funds will be appropriated once OSU Medical Authority has clear title to the assets, property and all necessary functional authorities of OSU Medical Center. OSU Medical Center officials asked for $18.25 million in state appropriations for the hospital this year, saying that without it a number of possible negative outcomes, including potentially closing the facility, would come into play. By leveraging a portion of that funding against available federal health funding, the facility will end up with the $18.25 million needed. HB 1235, Derby/Crain, (D.O. - Temporary Licenses), request from the Oklahoma Osteopathic Association to bring the D.O. licensure board in parity with Medical Licensure Board. It adds that upon application, the State Board of Osteopathic Examiners may also issue special licenses, including a Temporary License, a Resident Training License, a Telemedicine License or a Military Spouse License. HB 1031, Cox/David, (Supplemental Hospital Offset Payment Program-SHOPP), extends the sunset date from December 2014 to December 2017 and updates provisions to ensure payments to hospitals are made in a timely manner. • Enacted in 2011, SHOPP allows hospitals to provide additional money for the state to draw down federal matching funds to approximately the federal upper payment limit. Federal upper payment limit is equivalent to what Medicare would pay for the same patient service. Before SHOPP, Oklahoma hos- pitals were paid by Medicaid an average of 67% of Medicare rates for the same service to patients. • SHOPP assesses hospitals 2.5% of annual net patient revenue up to 4% to initially generate approximately $152 million annually for the state’s share to garner $269 million in federal funding for a total of $421 million. Of the $421 million, $338 million is paid to hospitals as supplemental payments for care provided to cover the unreimbursed cost of Medicaid (SoonerCare) patients and $83 million is used to maintain current SoonerCare payment rates for physicians and other providers to ensure access to care for Oklahoma patients. • 77 hospitals participate in the assessment, while 71 hospitals are excluded, including critical access hospitals, 14 long-term care hospitals, 14 specialty hospitals, OU Medical Center, one Medicare certified children’s hospital, and a hospital which provides the majority of its care under state agency contract. HB 2101, Fourkiller/Jolley, (Epinephrine injectors), for those schools that elect to maintain Epinephrine injectors, requires districts to amend their policies regarding epinephrine injectors to require parent notification, a waiver of liability to be on file, and the designation of an employee responsible Oklahoma D.O. | July/August 2013

for obtaining the injectors. A school employee must call 911 as soon as possible if a student is believed to be having an anaphylactic reaction. The State Board of Education must develop a model policy. SB 501, Simpson/Ownbey, (Tobacco Use), designates all state buildings and other property owned or operated by the state to be nonsmoking, and removes any options for smoking rooms. It also authorizes counties and municipalities to enact laws restricting smoking on their property. Effective date: Nov. 1, 2013. SB 765, Treat/Derby, (Oral Cancer Medication), requires any health benefit plan that provides coverage and benefits for cancer treatment provide coverage of prescribed orally administered anticancer medications on a basis no less favorable than intravenously administered or injected cancer medications. It also guarantees that orally administered anticancer medication shall not be subject to prior authorization, dollar limit, copayment, deductible, or other out-of-pocket expense that does not apply to intravenously administered or injected cancer medication, regardless of formulation or benefit category determination by the company administering the health benefit plan. Further, a health benefit plan shall not reclassify or increase any type of cost-sharing to the covered person for anticancer medications in order to achieve compliance and any change in health insurance coverage that otherwise increases an out-of-pocket expense to anticancer medications shall also be applied to the majority of comparable medical or pharmaceutical benefits covered by the health benefit plan. A health benefit plan limiting the total amount paid by a covered individual to no more than $100 per filled prescription shall be considered compliant.

HB 1783, Russ/Griffin, (Hydrocodone prescriptions), prohibits refills of hydrocodone-containing products (Lortab, Oklahoma D.O. | July/August 2013

HB 2188, Schwartz/David, (Medical Records Copy Costs), modifies the fees for paper and electronic copies of medical records as follows: • Paper records requested by doctors, hospitals and personal reps remain at a charge of $.50/page • Paper records requested from attorneys and insurance companies would be produced at a base charge of $10 and the existing $.50/page • Electronic records charges would move from the existing 12 cents per page rate to a rate of $.30/page, and the total charges would be capped at $200 if the entire request can be reproduced from an electronic health record in the specified format requested and may be delivered electronically • Establishes a flat fee of $5 for each x-ray, photo graph, image, or pathology slide by deleting the actual cost of reproduction requirement, and, • Prohibits health care providers and business associates from charging a person who requests their own record for searching, retrieving, reviewing and preparing the record. Effective date: Nov. 1, 2013. HB 2191, Schwartz/Stanislawski, (Employee Wellness), amends the Small Employer’s Health Insurance Reform Act to permit offering wellness programs to employees including smoking cessation. This provision is also included in HB 1512 and SB 911. HB 1113, Rousselot/Garrison, (County Wellness Programs), authorizes county commissioners to provide incentive awards to employees for participating in voluntary wellness programs which result in improved health. HB 1403, Johnson/Sykes, (Creates the Nondiscrimination in Treatment Act), establishes a mandate to provide surrogate-requested “life-preserving health care services” even when those services are non-beneficial or even harmful to the patient. HB 1403 requires that the same life-saving treatment be provided to elderly and disabled patients as would be


HB 1781, Russ/Griffin, (Anti-Drug Diversion Act Repository), allows the Department of Mental Health to compile data to target prescription drug trends in the goal of curbing drug overdoses. To facilitate the study of the illegal use of hydrocodone, the bill allows ODMHSAS and the State Board of Health to have access to information collected at the central repository.

HB 1419, Morrissette/Standridge, (Unlawful Prescriptions), directs the director of the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control to notify a health care provider if a patient is possibly unlawfully obtaining prescription drugs. The Bureau is authorized to enter into agreements and contracts with vendors as necessary to facilitate the electronic transmission of data contained within the central repository to registrants and other persons.

Oklahoma D.O.

HB 1347, Kirby/David, (Pulse Oximetry Screening), directs the State Department of Health to require each birthing facility to perform a pulse oximetry screening on every newborn. The screening is a noninvasive test that measures the percentage of hemoglobin in blood that is saturated with oxygen. Requiring these screenings will ensure more newborns survive their first weeks of life and have fewer health problems as they continue to grow and develop. Bill was initiated by the American Heart Association.

Vicotin, etc.). Earlier versions allowed a refill and addressed those with chronic illnesses. Unfortunately, those with chronic illnesses will now be required to schedule another appointment to a doctor which may result in additional co-pays, taking time off work, etc.

provided to a person without a disability or who is younger. Further, it provides that a cause of action for injunctive relief may be maintained against any health care provider who could be reasonably believed to have violated or about to violate the act. Currently, all hospitals with Medicare contracts comply with the Federal Civil Rights Act, which does not permit discrimination. Critics opposed this legislation as unnecessary and confusing. This bill was modeled after legislation written by the National Right to Life Committee and pushed by Oklahomans for Life. OOA was not in support of this legislation as it was written.

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SB 945, Bingman/Martin, (Intercept), current law excludes a state agency from filing a claim to collect debt owed to the agency for health care or medical services via a deduction from a taxpayer’s state income tax refund. SB 945 removes this exclusion. Supporters state it will help OU Medical Center collect on unpaid medical bills. Officials expect the legislation will result in the collection of millions in unpaid medical bills every year. Exceptions to this garnishment are those 65 years and older and those receiving a refund under the Sales Tax Relief Act. SB 1062, Bingman/Shannon, (Creates the Administrative Workers’ Compensation Act), which restructures the workers’ compensation court-based system to an administrative one beginning Feb. 1, 2014, allows employers to bypass the state workers compensation system altogether by covering workers with a form of self-insurance, and with a 30% reduction in long-term benefits, significantly reduces compensation to injured workers who experience permanent partial disability. Compensation also will be stopped once an employee returns to work. Other notable provisions include: Mental injury or illness is not compensable unless cause by a physical injury; Heart attacks, strokes, respiratory arrest are removed as a compensable injury unless the treatment is related to other factors contributing to physical harm in the course and scope of employment; Hernias are not compensable unless a preponderance of evidence can be met that it is a work related injury; Injured employees must give oral or written notice within 30 days of injury. Effective date: Jan. 1, 2014. 2009 Lawsuit Reform overturned: On June 4, 2013, the Oklahoma Supreme Court overturned the 2009 Comprehensive Lawsuit Reform Act finding the statutes violate the Oklahoma Constitution. The court based its ruling on two issues: (1) the statute requiring an affidavit of merit in professional negligence actions was a “special law” which only applies to a certain class of persons; and, (2) the law violated the “single subject” rule of the Oklahoma Constitution by “logrolling” unrelated statutes into one bill. HB 1603, Sullivan/Coffee, created the Comprehensive Lawsuit Reform Act of 2009. Two provisions that are superseded by 2011 legislation and are not overturned are the Elimination of Joint &

Several Liability (SB 862), which makes a defendant responsible for the portion of damages that the defendant actually caused, and the Cap on NonEconomic Damages (HB 2128), which lowers the cap recoverable in a civil action for bodily injury from $400,000 to $350,000.

SB 460, Griffin/Nelson, (Child Abuse Reporting Penalties), requires the Department of Human Services to record all incoming calls to the child abuse and neglect hotline and keep on file for a period of 90 days. Language added in conference states that any person with “prolonged knowledge,” meaning at least six months, of ongoing child abuse or neglect who knowingly and willfully fails to promptly report to authorities could be found guilty of a felony. Per the bill’s author, this provision is in response to extreme situations, such as the Jerry Sandusky case, but some critics had concerns about the timeframe wherein knowing of abuse for 6+ months is a felony but being aware for 5 months is only a misdemeanor. HB 1641, Jordan/David, (Risk Exposure), allows Good Samaritans (EMTs, paramedics, fire fighters, health care workers, funeral directors, peace officers, and any person who in good faith renders aid) to be notified of any blood-borne diseases they may have been exposed to when rendering aid during health care activities, emergency response activities or funeral preparations. HB 2217, Derby/Brooks, (Uniform Controlled Dangerous Substances Act), seeks to curb the use of bath salts and the adverse impact of harmful synthetic drugs. It adds numerous chemical compounds to the list of Scheduled drugs and provides that if certain compounds are dispensed in a pharmacy, an attestation by the person receiving the compound that the person is not subject to the Methamphetamine Offender Registry must be included. It requires OBNDD to promulgate rules regarding the requirement that notice be given to persons subject to the methamphetamine offender registry. Bill requested by the OBNDD. SB 27, Brecheen/Hulbert, (Fraud Reporting), directs the Oklahoma Health Care Authority to require providers to display information about how to report providers suspected of fraudulent activity relating to the Oklahoma Medicaid program. SB 272, David/Cox, (Dual-Eligible Study), requires the Oklahoma Health Care Authority to conduct a feasibility study of current and potential care coordination models that could be implemented for dually-eligible persons by Dec. 31, 2013. The bill defines dual-eligible persons as low-income seniors and younger persons with disabilities who are enrolled in both the Medicare and Medicaid programs. Oklahoma D.O. | July/August 2013

HB 1109, Coody/David, (Assessment), changes from “convicted” to “accused” that a mental health and/or substance abuse assessment may occur. Also clarifies the definition of a recovery support specialist and where they may operate. HB 2165, Echols/Standridge, (Lifeline Program), per the bill’s author, this measure seeks to curtail fraud in the Lifeline program by empowering the Corporation Commission to impose fines on companies that violate rules of the program. Violations of the program have resulted in low-income individuals receiving phones using fake names and addresses as well as receiving multiple free cell phones. The Corporation Commission is authorized to impose fines up to $10,000 per violation per day. HB 1672, Blackwell/Holt, (60-Day Notice on Prescription Deletions), requires that any health benefit plan that provides prescription drug coverage or contracts with a third-party for prescription drug services, must notify enrollees presently taking a prescription drug at least 60 days prior to any deletions, other than generic substitutions, in the health benefit plan’s prescription drug formulary. HCR 1019, Schwartz/Marlatt, (Telemedicine), requests the Corporation Commission continue to permit funding from the Oklahoma Universal Service Fund for not-for-profit mental health and substance abuse facilities. Effective date is not required as the HCR expressed legislative intent. HB 1745, Wright/Ivester, (Assisted Living), requires a resident of an assisted living facility to disclose any third party provider of medical services or supplies prior to delivery. SB 587, Justice/Wright, (Electronic Monitoring – Nursing Homes), allows for the voluntary authorized electronic monitoring of a resident’s room. Effective date: Nov. 1, 2013. SB 629, Simpson/Hardin, (Nursing Homes – Veterans), makes nursing facilities operated by the Oklahoma Department of Veterans Affairs once again subject to the requirements of the Nursing Home Act.

SB 369, Ivester/Sherrer, (Mental Health Evaluations), requires a copy of powers of attorney and advance health care directives accompany an individual to a pre-commitment mental health evaluation related to involuntary commitment. Records of proceedings will be open to inspection by the person’s treatment advocate. If the individual is unable to understand the written materials pertaining to the order requiring the examination or the written explanation of the examination, copies will be provided to the person’s treatment advocate. SB 250, Bingman/Derby, (Workers’ Compensation MRI Fix), defines reimbursement for MRI stating that no reimbursement will be applied unless the MRI is provided by an entity that meets the Medicare requirement for payment or is accredited by certain organizations. This legislation was necessary to correct a provision in the 2011 workers’ compensation reform bill that restricted the payment for open MRI procedures. The provisions are included in SB 1062. SB 725, David/Derby, (Mental Health), authorizes licensed drug and alcohol and mental health counselors to serve as mental health professionals. HB 1343, Kirby/Brown, (Native American Owned Insurance Company), clarifies that such entities are not considered a foreign insurance company and may apply for a license to conduct insurance business in Oklahoma. Tribal governments that issue policies will submit to the jurisdiction of the state, as they currently do in the banking business. HB 1782, Russ/Griffin, (EMS - Opiate Antagonists), allows first responders to administer opiate antagonists without prescription when encountering signs of an opiate overdose and will be covered under the Good Samaritan Act. Additionally, upon request of an individual, a provider may prescribe an opiate antagonist to a family member of that individual when the family member is exhibiting signs of an opiate overdose.


Oklahoma D.O. | July/August 2013

HB 1461, Ownbey/Jolley, (Nurse Practice Act), seeks to make it easier for Advanced Practice Registered Nurses coming from other states to practice in Oklahoma. HB 1461 requires all individuals seeking a license to submit a criminal background check, but also allows the Oklahoma Board of Nursing to issue prescriptive authority to APRN-CNPs, APRN-CNSs and APRN-CNMs of another state if they meet Oklahoma’s requirements.

Oklahoma D.O.

SB 302, Jolley/Grau, (Board of Podiatric Medical Examiners), allows the Board to utilize the National Board of Podiatric Examiners’ National Board Examination Part III as the written portion of the state licensing exam. Increases from 30 to 60 hours the amount of continuing education required for renewal of an individual license to practice podiatric medicine. Extends from annually to every two years the timeframe in which a license must be renewed (by June 30 of even-numbered years.) It allows a training license, renewable annually, for applicants who have completed all the requirements for full and unrestricted licensure except graduate education and/ or the licensing examination.

SB 181, David/Ortega, (Oklahoma Suicide Prevention Council), extends from January 2015, to January 2020, and increases its membership from 21 to 27. Two licensed medical providers or hospital administrators, appointed by the governor are among the new members.

SB 755, Ivester/Sherrer, (Treatment Advocate), provides a person holding a power of attorney, advance health care directive or guardianship of a patient be deemed as the treatment advocate for the patient. SB 581, Ivester/Sherrer, (Petition for Treatment), removes hospital administrators and executive directors of facilities from those able to file petitions to determine whether an individual is in need of treatment at a mental health facility. Mental health professionals, treatment advocates, and family, among others, may file a petition to determine need of treatment. The bill requires notice of the petition to be provided to the treatment advocate, a person having a valid power of attorney with health care decision-making authority; a person having valid guardianship with health care decision-making authority; a person having an advance health care directive; or a person having an attorney-in-fact as designated in a valid mental health advance directive, unless specifically indicated otherwise by the instrument or court order. SB 292, Crain/Sanders, (OHCA Liens), states that county treasurers will provide the Oklahoma Health Care Authority with a list of properties in each county that will be sold at tax resales and the OHCA will produce a list of each county property with OHCA liens which will be made available to potential buyers. Prohibits the filing of a lien release to extinguish debt owed to OHCA. This bill was requested by the County Treasurers, seeking to move real estate from county ownership back to the tax rolls

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HB 1399, Johnson/Sykes, (Sales Tax), authorizes individuals purchasing medicine, medical equipment and prosthetic devices, which are reimbursed by Medicare or Medicaid, to directly remit sales tax to the Oklahoma Tax Commission and allows these individuals to file a report and remit sales tax quarterly if the sales tax owed averages less than $500 each month. Currently, only vendors purchasing more than $800,000 annually in taxable items for use in Oklahoma enterprises qualify for the direct payment permit. HB 1083, Ownby/Simpson, (Oklahoma Emergency Response Systems Development Act), modifies the Oklahoma Emergency Response Systems Development Act and updates several definitions and requires the Commissioner of Health to maintain a registry of critical care paramedics. Furthermore, only paramedic training programs accredited or under review by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions may enroll new paramedic students. Additionally, licensed specialty care ambulance providers can only be used for interhospital transport if the patient requires specialized en route medical monitoring and advanced life support that exceeds the capabilities of paramedic life support. It repeals the Commissioner’s ability to issue a temporary emergency medical

technician license without an examination. This bill is a request from the Department of Health to ensure responders meet national standards. HB 1467, Murphey/Griffin, (Oklahoma Public Health Advisory Council Modernization Act), consolidates numerous boards and committees, to include: Trauma and Emergency Response Advisory Council, under the Board of Health, is now the entity that assumes the duties of the Oklahoma Emergency Response systems Development Advisory Committee, the Medical Audit Committee and the Trauma Systems Improvement and Development Advisory Committee; and, a new Board of Behavioral Health Licensure is now the entity that assumes the duties of the Licensed Behavioral Practitioners Advisory Board, the Licensed Marital and Family Therapists Advisory Board and the Licensed Professional Counselor’s Advisory Board. The State Board of Health transfers all responsibility to the new board. SB 853, Treat/Moore, (Tumor Registry Reporting), exempts ambulatory service centers from Health Department reporting requirements of cancerous or precancerous conditions upon submission of a signed affidavit that the ambulatory service center utilizes a sole source pathology laboratory to report any or all data and information necessary for the purposes of this act. According to the bill’s author this will streamline the information flow to the Department of Health, reducing duplication. Critics voiced concerns that this will create a loophole for pathology entities outside Oklahoma, in that the language as written will allow those who don’t want to report information, to simply sign an affidavit that they use a sole source pathology facility. HB 1107, Mulready/Brecheen, (State Employee Insurance), allows for tax warrant intercept against individual income tax refunds claims for medical services rendered, induced, or otherwise obtained as a result of fraud, breach of contract, error, ineligibility or any illegal or unauthorized means. It also permits an active state employee to opt out of the health and dental basic plan options only and retain the life and disability plan benefits. State employees must have other health insurance to opt out. It was requested by OMES-EGID. Personal Medical Infringement Bills HB 2226, Schwartz/Griffin, makes the “morning-after” emergency contraceptive unavailable to women under the age of 17 unless they have a prescription from a doctor. With the enactment of this bill, young women, including victims of rape and incest, would have to see a physician or go to an emergency room in order to prevent an unwanted pregnancy. A $400 emergency room visit (plus physician fee) is a financial deterrent for low-income females. Oklahoma D.O. | July/August 2013

An Oklahoma County judge issued a temporary injunction on August 19, 2013, saying it violates the single-subject rule. the law will be suspended until further court rulings are made. HB 1361, Grau/Treat, (Parental Notification), requires a parent be provided notice and consent for an abortion by an un-emancipated minor, among other provisions including that a parent provide the physician a copy of a governmentissued proof of identification, and written documentation that establishes that he or she is the lawful parent of the pregnant female. Effective date: Nov. 1, 2013. HB 1588, Hamilton/Griffin,( Parental Notification), requires 48 hours to pass after a request of written informed consent of a pending abortion has been delivered to a parent or guardian, before an abortion is performed on an un-emancipated minor. In a medical emergency, the parent or guardian must be verbally informed and sent a written notice within 24 hours after the abortion is performed. A notice is not required if the parent has stated in a notarized writing that they have been informed, or if the pregnant female declares she is a victim of sexual or physical abuse by a parent. Effective date: Nov. 1, 2013. HB 2015, Roberts/Loveless, (Individual Abortion Form), modifies the form to include among other provisions the number of abortions performed for each hospital at which the health care provider had hospital privileges at the time of the abortion. Effective date: Nov. 1, 2013.

SB 36, Simpson/Cox, (Restore Local Rights), repeals Oklahoma’s tobacco preemption law which does not allow cities to regulate smoking. Status: Voted down in Senate committee 5-2. SB 640, Crain/Cox, (Insure Oklahoma), amends language of the Oklahoma Medicaid Program Reform Act of 2003 to address premium assistance. The authors intended to use SB 640 as a vehicle to address accepting federal funds to expand Insure Oklahoma. Status: In Joint Conference Committee. SB 777, Burrage, (Medicaid Expansion), requires the state to expand the Medicaid program as provided in the Affordable Care Act. Status: Did not receive a hearing in Senate committee. HB 1021, Ritze/Dahm, (ACA), declares the Affordable Care Act invalid in Oklahoma. Status: Passed the House and did not receive a Senate committee hearing. HB 2073, Fisher, SB 93, Anderson, SB 203, Dahm, are similar legislation. SB 691, Aldridge/Nelson, (Compulsory Insurance Law) is amended so that if an insured motorist is at fault in a car accident with an uninsured motorist who is in need of medical care due to the accident, the uninsured motorist is not entitled to medical coverage under the insured motorist’s policy unless the insured motorist is driving under the influence of drugs and/or alcohol or involved in the commission of a crime. Status: Passed the Senate and House committee and did not receive a House floor hearing. HB 1549, McCullough/Brecheen, (Federal Overreach Act), specifies that any rule of the OHCA or Department of Human Services must be approved by the Legislature. Status: Passed House committee and did not receive a House floor hearing. HB 1892, Cockroft, (Immunization Exemption), provides that a health care facility permit a religious exemption for flu immunizations. Status: Did not receive a hearing in House committee. HB 1918, Shannon, (ACA–Taxes), amends the Oklahoma tax code to subtract from Oklahoma income any fine to a federal agency imposed pursuant to the ACA, for a business that


Oklahoma D.O. | July/August 2013

Carryover Bills of Interest/Concern

Oklahoma D.O.

SB 900, Standridge/Grau, created the “Prioritization of Public Funding in the Purchasing of Family Planning and Counseling Services Act”, which could further restrict Oklahoma women’s access to health care. The legislative intent of SB 900 is to block patients from accessing a range of preventive health care services provided by Planned Parenthood. Planned Parenthood health centers in Oklahoma provide crucial services such as breast and cervical cancer screenings, and may be the only place where some patients, particularly those in the lowincome bracket, can obtain these life-saving cancer screening exams. As for OHCA, it didn’t consider a hierarchy of paying claims prior to the passage of SB 900. OHCA administers Medicaid funds and must adhere to the Medicaid requirement of “freedom of choice.” This regulation states that Medicaid beneficiaries may obtain medical services “from any institution, agency, community pharmacy, or person, qualified to perform the service or services required . . . who undertakes to provide him such services.” This federal regulation means that any willing provider of Medicaid services, excluding those that commit fraud or criminal acts, is entitled to payment and can’t be excluded because of the medical services they provide. Following SB 900 would put OHCA in direct conflict with this federal regulation because some Medicaid providers may

not fit within the prioritized list. According to agency spokesman Carter Kimble, nothing will change as to the way a clean claim is paid going forward. Planned Parenthood remains a vital provider of reproductive and women’s health services in Oklahoma. Effective date: Nov. 1, 2013.

does not offer contraceptives, sterilization and abortifacients in the health plan. Status: Did not receive a hearing in House committee. SB 219, Dahm, (Repeals OHIET), restricts funding to the Oklahoma Health Information Exchange Trust as of 2014. The result is the same as repealing the trust. Status: Defeated in Senate committee 4-4. Interim Studies The most important interim study (IS-H13-006) for the OOA was requested from Rep. Arthur Hulbert. It will review patient direct access for physical therapists. Rep. Hulbert claims this issue addresses rising health care costs as well as improves health care access issues by allowing individuals to access physical therapy services without physician referral. A bill with the same intent was authored by Rep. Hulbert this past legislative session, but was not heard. Other Interim Studies of Interest: IS-H13-004: Sports related injuries-Requested by Rep. Dan Kirby. Study will review heat and concussion related injuries and available specialized insurance coverage. IS-H13-0025: CPR-Requested by Rep. Emily Virgin. Study will review the benefit of learning CPR in school between 7th and 12th grade and the possible requirement that students receive instructions on resuscitation.

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IS-H13-031: How to reform state welfare programs to improve family health-Requested by Rep. T.W. Shannon. Study will review potential options for reducing the marriage penalty of welfare programs. IS-H13-036: Services at the Northern Oklahoma Resource Center-Requested by Rep. Mike Jackson. Study will review the transition of clients from the Northern Oklahoma Resource Center of Enid and the Southern Oklahoma Resource Center of Pauls Valley. It will investigate the need for a public safety net for Oklahoma citizens challenged with severe developmental disabilities and medical complications. IS-H13-080: Leveraging technology to improve health care outcomes-Requested by Rep. Glen Mulready. Study will review options to use emerging technologies while maintaining the safety of our citizens. IS-H13-083: Regulation of vapor and nicotine productsRequested by Rep. David Derby. Study will investigate appropriate regulation of vapor and other emerging nicotine products.

IS-H13-118: Chloramine-Requested by Rep. Mike Ritze and Rep. Seneca Scott. Study will review usage of chloramine as a water filtration in municipal water systems. IS-S13-001: Physician Advertising-Requested by Sen. Al McAffrey. Study will review physician advertisement of board certification in Oklahoma specifically regarding SB 298. IS-S13-0009: Health Insurance Premium Assistance-Requested by Sen. Brian Crain. Study will review how Oklahoma can continue to provide health insurance premium assistance with tobacco tax revenue. IS-S13-010: Redirection of Tobacco Settlement FundsRequested by Sen. Brian Crain. Study will review possible redirection of the monies contained in the Tobacco Settlement Endowment Trust for a state-sponsored health insurance premium assistance program. IS-S13-011: City/County Health Departments-Requested by Sen. Brian Crain. Study will review the efficacy of City/ County Health Department structure in Tulsa and Oklahoma counties vs. the County Health Department structure in the remaining 75 counties. IS-S13-012: Alzheimerâ&#x20AC;&#x2122;s Task Force Findings-Requested by Sen. Brian Crain. Study will review the findings of the Alzheimerâ&#x20AC;&#x2122;s Task Force, established by the previous provisions of SB 2186 in 2008. IS-S13-017: CPR Training in Schools-Requested by Sen. John Sparks. Study will determine the benefit of learning CPR in school, specifically grades 7-12. (Mirrors House study by Rep. Virgin) IS-S13-20: Prenatal testing for Downs Syndrome-Requested by Sen. Rob Standridge. Study will review prenatal testing for Downs Syndrome. IS-S13-021: Insure Oklahoma-Requested by Sen. Kim David. Study will review Insure Oklahoma and how the program might be reconstituted to be funded only with state dollars. IS-S13-022: Dialysis Centers Certification-Requested by Sen. Kim David. Study will review certification process for Dialysis Centers. IS-S13-047: Medicaid Changes-Requested by Sen. Rob Standridge. Study will review possible changes to Medicaid in Oklahoma including updates and improvements by providing holistic, patient centered care while providing tools to allow people to transition out of the program. Oklahoma D.O. | July/August 2013

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Oklahoma D.O. | July/August 2013





Friday, October 11, 2013 8:00 a.m. Registration 9:00 a.m. Shot Gun Start Tee Off Lunch served immediately following Million Dollar Shootout after the tournament

COURS E Coffee Creek Golf Course 4000 North Kelley Avenue Edmond, Oklahoma 73003

E NT RY F E E $150 per player Includes: • One player registration • Green fees & golf cart • Continental breakfast & lunch • On-course refreshments • Goody bag valued at over $100! • Complimentary golf shirt

• Hybrid Golf Club or Wedge*

S P ONS ORS HI P L E VELS Hole-in-One Sponsor $2,000

Includes team of four players, signage at all beverage carts and listing on all marketing material

Birdie Sponsor $1,000

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Friday, October 11, 2013 Coffee Creek Golf Course Edmond, Oklahoma

Golf Classic Chair: C. Michael Ogle, DO

Sponsored by:

Includes two free players, custom sign with your logo at one hole and listing on all marketing material

Hole Sponsor $500

Includes one free player, custom sign with your logo at one hole and listing on all marketing material

TEE Sponsor $100

Includes custom sign with your logo at one hole and listing on all marketing material

Oklahoma D.O. | July/August 2013

PRIZES Awards will be given to the 1st, 2nd and 3rd place teams, as well as the winners of the closest to the hole and longest drive contests! Each member of the top three teams will be invited to compete at a regional round of â&#x20AC;&#x153;The BIG Tournament.â&#x20AC;? At the regional events, teams will compete for $1,000 that will come back to the OEFOM. If teams advance to the finals, they will compete for $10,000 that will come back to the OEFOM! You can read more about this tournament at


RE GI S T RAT I ON F ORM Please mail completed form, along with credit card information or check made payable to the OEFOM, 4848 N Lincoln Blvd, Oklahoma City, OK 73105-3335 by October 15. Contributions to the OEFOM are tax deductible. Fed ID# 736113605


Shirt Size

Address City, State, Zip Phone Number

Mulligan packages are $40 each and include two Mulligans, entry into drawings for fabulous gifts and prizes, as well as a chance to compete in the Million Dollar Shootout! At the end of the tournament, one lucky Mulligan Package holder will be drawn and have the chance to win $1,000,000: $500,000 going to the winning golfer and $500,000 going to the OEFOM!

Player One

Shirt Size

Player Two

Shirt Size

(Please note those drawn for the Shootout cannot substitute another golfer.)

Player Three

Shirt Size

Player Four

Shirt Size


Email Address



Each registered player will receive access to participate in the Dixon Challenege. Each player will receive a free hybrid golf club or wedge and a sleeve of golf balls if they are able to hit either ball on the green. Each participant will also receive a mulligan at the Dixon hole, along with an automatic birdie for yourscore to maintain pace of play. If the player gets a hole in one, they will receive a 2 night, 3 day stay at The MGM Grand in Las Vegas!


Mulligan Packages - $40 (includes two mulligans and entry in drawings, as well as the Million Dollar Shootout!)

Total Credit Card Number Name on Credit Card Billing Address Billing City, State, Zip Expiration Date Signature


Oklahoma D.O. | July/August 2013

Sponsor Level: Hole-in-One Sponsor - $2,000 Birdie Sponsor - $1,000 Hole Sponsor - $500 Tee Sponsor - $100

Oklahoma D.O.

It is an optional $20 donation to play in this challenge. The donating golfer will receive a raffle ticket, that will enter them into a chance to win a custom $350 Aurelius Driver or a custom $500 Zovatti watch. Participants will receive a second shot to test the Dixon Driver, over $150 in gift certificates, and if the entire group participates they will get to improve their lie on our hole. If only one member of the group donates they will get to keep the best of two drives on our hole. In addition there will also be 10 hula-hoops placed between 150 yards and 300 yards. If one of the two shots lands in a hula-hoop the golfer will receive a certificate for a custom $350 Aurelius Driver or a custom $500 Zovatti watch.

Players: Individual - $150 Two Players - $300 Three Players - $450 Four Players - $600

What DO’s Need To


Don’t Miss Your Opportunity to Rate Your MAC Have you registered to participate in the Medicare Administrative Contractor (MAC) Satisfaction Indicator (MSI) yet? If not then you are missing a great opportunity to let your voice be heard! This is your opportunity to share your satisfaction with specific services your MAC provides including: • Claims processing • Medicare enrollment • Educational opportunities • Responsiveness to inquiries CMS needs your participation. If you are a Medicare Fee-For-Service (FFS) provider, or work on behalf of a Medicare FFS provider (such as a billing agency), and would like the chance to share your thoughts with CMS, complete the MSI Participant Registration form. Don’t miss your opportunity to provide feedback on your MAC. CMS Seeks Comments on Proposals to Update QIO Regulations Proposed Rule Open for Comment until September 6 CMS is pleased to offer an opportunity to provide feedback on a proposed rule that makes revisions to the Medicare Quality Improvement Organization (QIO) program. What proposals did CMS make? In the CY 2014 proposed rule for the Outpatient Prospective Payment System (OPPS), displayed at the Federal Register on July 8, CMS proposed changes to the QIO regulations, including: • Expanding the eligibility criteria for QIO contracts. • Emphasizing the value of multi-disciplinary care teams in the composition of QIO staffs, as well as the role of patients and families in informing QIO operations. • Modernizing the structure of the program to allow flexibility in the geographic areas that could be served by QIOs and organizing QIOs by function. How can you access the proposed rule? The full CY 2014 OPPS notice of proposed rulemaking is available online. In particular, QIO stakeholders may find detail about the QIO-specific regulations in section XVII of the preamble, titled, “Proposed Revisions to the Quality Improvement Organization (QIO) Regulations.” Supporting regulation text is featured towards the end of the rule, and is listed as applicable to 42 CFR 475 and 476.

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How can you comment? Commenters may respond online through Thursday, September 6. We look forward to your feedback about this critical program in the CMS clinical quality improvement portfolio.

CMS Announces New “OPEN PAYMENTS” Mobile Applications to Assist Physicians and Industry in Tracking Financial Relationships Use of app technology helps to bring greater transparency to payments and other financial interactions between doctors and health care industry On July 17, CMS introduced two free mobile device applications (apps) to help physicians and health care industry users to track their payments and other financial transfers the industry will report under the OPEN PAYMENTS program (Physician Payments Sunshine Act). Created by a provision of the Affordable Care Act, OPEN PAYMENTS creates greater public transparency about the financial transactions between doctors, teaching hospitals, drug and device manufacturers, and other health care businesses. CMS has made these apps available to facilitate accurate reporting of required information, which will be available to the public and will be published annually on the OPEN PAYMENTS website. To support the “OPEN PAYMENTS” program, CMS designed the mobile applications (one each for physicians and health care industry users) merging this proven and efficient format with real-time 24-hour tracking technology. The apps offer on-the-go convenience for users to track financial data. Both apps are compatible with the iOS (Apple™) and Android platforms; they are available free through the iOS Apple™ Store and Google Play™ Store.

Oklahoma D.O. | July/August 2013

Data Show Electronic Health Records Empower Patients and Equip Doctors More patients and doctors are using health information technology to communicate data and reduce errors On July 17, CMS released new data that demonstrate that doctors and hospitals are using electronic health records (EHRs) to provide more information securely to patients and are using that information to help manage their patients’ care. Doctors, hospitals, and other eligible health care providers that have adopted or meaningfully used certified EHRs can receive incentive payments through the Medicare and Medicaid EHR Incentive Programs . Already, approximately 80 percent of eligible hospitals and more than 50 percent of eligible professionals have adopted EHRs and received incentive payments from Medicare or Medicaid. By meaningfully using EHRs, doctors and other health care providers prove they have been able to increase efficiency while safeguarding privacy and improving care for millions of patients nationwide. Since the EHR Incentive Programs began in 2011: • More than 190 million electronic prescriptions have been sent by doctors, physician’s assistants and other health care providers using EHRs, reducing the chances of medication errors. • Health care professionals sent 4.6 million patients an electronic copy of their health information from their EHRs. • More than 13 million reminders about appointments, required tests, or check-ups were sent to patients using EHRs. • Providers have checked drug and medication interactions to ensure patient safety more than 40 million times through the use of EHRs. • Providers shared more than 4.3 million care summaries with other providers when patients moved between care settings resulting in better outcomes for their patients. The Obama administration has encouraged the adoption of health information technology starting with the passage of the Recovery Act in 2009. The Act has been a critical factor in improving the quality of health care and lowering costs, and ultimately transforming our health care delivery system. Update on Medicare Demand Letters and Medicare Claim Cancellations Associated with an Item or Service Provided to Incarcerated Beneficiaries Recently, the Centers for Medicare & Medicaid Services (CMS) initiated recoveries from providers and suppliers based on data that indicated a beneficiary was incarcerated on the date of service. Medicare will generally not pay for medical items and services furnished to a beneficiary who was incarcerated when the items and services were furnished. A beneficiary may be “incarcerated” even when the individual is not confined within a penal facility, such as a beneficiary who is on a supervised release, on medical furlough, residing in a halfway house, or other similar situation. Medicare identified previously paid claims that contain a date of service partially or fully overlapping a period when a beneficiary was apparently incarcerated based on information CMS receives from the Social Security Administration (SSA). As a result, a large number of overpayments were identified, demand letters released, and, in many cases, automatic recoupment of overpayments made. CMS has since learned that the information related to these periods of incarcerations was, in some cases, incomplete for CMS purposes. CMS is actively reviewing these data and will be taking action to improve the process used to identify periods of incarceration. As part of this effort, CMS is working to quickly identify claims that resulted in our recent recovery actions and take steps, as appropriate, to correct any inappropriate overpayment recoveries. CMS will continue to issue messages about this topic, including timeframes for resolution, to keep the provider and supplier community informed. Information will also be posted on the All-Fee-For-Service-Providers page on the CMS website. In the interim, providers and suppliers should no longer encourage beneficiaries to contact their local Social Security office in order to have their records updated as a result of this recent issue. Providers also should no longer fax information to their local CMS Regional Offices as CMS is currently working to develop processes to resolve this issue. “Medicare Quarterly Provider Compliance Newsletter [Volume 3, Issue 4]” Educational Tool — Released The “Medicare Quarterly Provider Compliance Newsletter [Volume 3, Issue 4]” Educational Tool (ICN 908787) was released and is now available in downloadable format. This educational tool is designed to provide education on how to avoid common billing errors and other erroneous activities when dealing with the Medicare Program. It includes information on corrective actions that health care professionals can use to address and avoid the top issues of the particular Quarter.

“Medicare Ambulance Transports” Booklet — Revised The “Medicare Ambulance Transports” Booklet (ICN 903194) was revised and is now available in downloadable format. This booklet is designed to provide education on Medicare ambulance transports. It includes the following information: the ambulance transport benefit, ambulance transports, ground and air ambulance providers and suppliers, ground and air ambulance vehicles and personnel requirements, covered destinations, ambulance transport coverage requirements, and payments for ambulance transports.

Oklahoma D.O. | July/August 2013


“Opting out of Medicare and/or Electing to Order and Refer Services” MLN Matters® Article — Released MLN Matters® Special Edition Article #SE1311, “Opting out of Medicare and/or Electing to Order and Refer Services” has been released and is now available in downloadable format. This article is designed to provide education on the necessity to file an affidavit with Medicare to opt-out of Medicare. It also clarifies the difference between providers who are permitted to opt-out and providers who opt-out and elect to order and refer services.

Oklahoma D.O.

An index of Recovery Audit and Comprehensive Error Rate Testing (CERT) findings from current and previous newsletters is available. This index is customized by provider type to identify those findings that impact specific providers. Visit the Medicare Quarterly Provider Compliance Newsletter Archive page to download the index and view an archive of previous newsletters.

New MLN Educational Web Guides Fast Fact A new fast fact is now available on the MLN Educational Web Guides web page. This web page provides information on Evaluation and Management services; Guided Pathways that contain resources and topics of interest; lists of health care management products; and easy-to-understand billing and coding educational products. It is designed to provide educational and informational resources related to certain CMS initiatives. Please bookmark this page and check back often as a new fast fact is added each month.


The AOA Clinical Assessment Program for Physician Quality Reporting System (AOA CAP for PQRD) The AOA developed the CAP for PQRS to provide physicians with an opportunity to receive enhanced payment from the Centers for Medicare and Medicaid Services (CMS) and understand how patients are doing using evidence-based process and outcome measures. The AOA CAP for PQRS provides a stream-lined web-based portal for members to enter patient data in an effort to receive a bonus incentive. Of physicians choose not to participate in the 2013 CME PQRS they will face a penalty of 1.5% in 2015.


The majority of patients selected for data entry must be Medicare Part B patients for the measure group reporting option. All patients must be Medicare Part B patients for the individual measures reporting option.

Time Frame:

AOA CAP for PQRS closes January 31, 2014


Osteopathic Physicians

Contact: AOA Department of Quality and Research Angi Baranek, MPA, Manager, Division of Clinical Quality 312-202-8198

From the American Osteopathic Association Communications Department

Oklahoma D.O. PAGE 42


Now recruiting Physicians, PA's, and NP's interested in working a flexible schedule. Convenient, Quality Healthcare in Your Home is Available Today with Physician HouseCalls. Please contact Kathrine Kopec at 405-896-8058 for more information.

DOs and other members of the profession consider the American Osteopathic Association’s “Health for the Whole Family” series a great way to promote the profession and educate patients about a variety of health topics. To use this month’s article, you have permission to simply make copies of the article (see page 43).

Oklahoma D.O. | July/August 2013

How to Beat Heat Rash Summer’s unbearable temperatures can lead to something even more uncomfortable-heat rash, also known as prickly heat, an itchy red rash that causes a stinging or prickly sensation. Though it's common in infants, heat rash can affect adults, too, especially during hot, humid weather. Robert I. Danoff, DO, an osteopathic family physician from Philadelphia, tells us what we need to know in order to prevent heat rash this summer. Symptoms of Heat Rash Heat rash, which is characterized by tiny bumps surrounded by a zone of red skin, usually develops in folds of skin and wherever clothing causes friction. According to Dr. Danoff, heat rash develops when your sweat ducts become blocked and perspiration is trapped under your skin. The blocked sweat then tends to seep into the nearby tissue, irritating the skin and causing rashes. Symptoms can typically include: • Red bumps • Itchy or prickly feeling in the affected area • Little or no sweating in the affected areas Who is at risk? “Babies are prone to the condition because their sweat glands are not fully developed,” says Dr. Danoff. “Also adults who are overweight, on bed rest, or live in a hot, humid climate are particularly susceptible. Heat rash usually appears when you perspire excessively and it can occur anywhere on your body. For children, you will typically find the rash on their neck, shoulders and chest, armpits, elbow creases, or groin; while in adults, it usually occurs on clothed parts of the body, such as the back, abdomen, neck, upper chest, groin, or armpits.” When You Should See Your Doctor “Most heat rash cases do not require medical care,” says Dr. Danoff. “The best way to treat the rash is to cool your skin and prevent sweating,” he continues. Heat rash tends to clear quickly on its own, usually disappearing within a matter of hours or a day once skin is cool. However, severe forms may need medical care. Dr. Danoff recommends visiting a physician if you or your child has symptoms that last longer than a few days or observe signs of infection, such as: • Increased pain, swelling, redness or warmth around the affected area • Golden yellow crust formation or pus draining from lesions • Swollen lymph nodes in the armpit, neck or groin • A fever or chills “Severe forms of heat rash may require topical therapies, like lotions containing calamine, colloidal oatmeal, or cortisone cream to soothe itching. Also, creams containing anhydrous lanolin may help to prevent blockage of the sweat ducts. However, if you are sensitive to wool, please avoid this ingredient,” Dr. Danoff explains. If your rash is severe, Dr. Danoff advises scheduling an appointment with your primary care physician or a physician who specializes in skin disorders so they can properly diagnose and treat your symptoms before they worsen.

Staying Cool and Clear of Heat Rashes “Keeping your skin cool and dry is the best measure to prevent rashes,” says Dr. Danoff. “Allow your skin to breathe. Limit tight clothes that cling to skin, wear “breathable” clothes that will allow your sweat to evaporate, and avoid pore-clogging products. Your skin lasts a lifetime. Taking the time to take care of it always pays off.”

Oklahoma D.O. | July/August 2013


Preventive medicine is just one aspect of care osteopathic physicians provide. DOs are fully licensed to prescribe medicine and practice in all specialty areas, including surgery. DOs are trained to consider the health of the whole person and use their hands to help diagnose and treat their patients.

Oklahoma D.O.

Tips to Prevent Heat Rash To help protect yourself or your child from heat rash in the summer, Dr. Danoff recommends that you: • Dress in loose, lightweight clothing that wicks moisture away from your skin. • Bathe in cool water with a non-drying soap that doesn't contain fragrances or dyes. • Stay in the shade or in an air-conditioned building when it's hot. • Keep your sleeping area cool and well ventilated. • Avoid creams or ointments with petroleum or mineral oil ingredients which can block pores.

BAND-AID JUST A COVER UP! By Angela Wall PMP Education

Drug abuse cannot simply be fixed with a Band-Aid. As a society, it seems to be easier to ignore a problem and let someone else handle it instead of realizing if everyone did their part it would make a big issue smaller. According to the Centers for Disease Control and Prevention, prescription drug abuse has become an epidemic and Oklahoma is the #1 state in the nation with this problem. So what has been done?

Oklahoma D.O. PAGE 44

Innovative and intelligent people at the Oklahoma Bureau of Narcotics (OBN) have created a way to help deter the use of prescription drugs for illegal purposes. The system created is called the Prescription Monitoring Program (PMP). In 1990, Oklahoma became the first state in the US to implement a computerized prescription monitoring program. OBN has continued improving the system to make it more effective and efficient for their registrants. Although many states have since created their own version of the PMP, Oklahoma is still the only state that has the “Real Time” reporting benefit – information of time. This report can be checked for any unusual prescribing a controlled dangerous substance (CDS) being reported within activity and fraud. Remember, employee fraud can also occur. 5 minutes of being dispensed. So how can the system be used? If all OBN registrants register for the PMP, use it regularly, By all dispensers accurately reporting information into the and dispensers enter information accurately, then prescripsystem, Health Care Professionals (HCPs) that are autho- tion drug abuse will be reduced in Oklahoma. It doesn’t matrized to use the system can receive patient-specific reports ter how much or how little is prescribed or dispensed, a drug along with their own prescribing reports. These reports seeker will try to get whatever they can from whomever they can help determine those with a legitimate use for prescrip- can. No HCP wants to be taken advantage of, so using the tion drugs and guard against those using them illegally. PMP will not only help guard against diversion, but it will ultimately safeguard the HCP, their name, and their reputation. By using the “Patient Report,” HCPs can receive dispensed CDS data on people they have a doctor/patient relationship In the end, many patients need to understand that pain with, including new patients that have scheduled an appoint- is their body’s way of saying something is wrong and pills ment. The HCP can use the report to check for any prescription can’t fix everything. HCPs need to all realize it is time to fraud, including “Doctor Shopping,” and to see what CDS have rip off the Band-Aid and expose prescription drug abuse for been prescribed in order to not overprescribe. The information what it really is-a big problem. Those who have questions can also be discussed with the patient to verify accuracy but about PMP registration may contact the Help Desk at 877may not be given to the patient or placed in their medical file. 627-2674. If any groups (large or small) need PMP training, please contact Angela Wall at 800-522-8031 ext. 162. By using the “Prescriber Report,” all prescribing activity under the prescriber’s DEA# can be compiled for a specified period of Oklahoma D.O. | July/August 2013

Trace Heavener, OMS-II Student Government Association President 2013 – 2014

OSU-CHS STUDENT UPDATE Second year OSU-COM students are just now finishing up various summer learning experiences from far away countries such as Uganda, Egypt, Nicaragua and Guatemala to hundreds of sites throughout our great state of Oklahoma. About 30 students from the second year class completed a Summer Rural Externship program through the Center for Rural Health at OSU-COM. This program allowed students to shadow various physician specialties with an emphasis on primary care. Students were also required to shadow healthcare workers in other careers such as pharmacists, nurses, EMTs or registration/billing employees. The Summer Rural Externship began just a few years ago with five initial students and has expanded into a grand and privileged experience for students transitioning from first to second year of medical school. The students would like to thank all those physicians and other employees who opened up their offices, businesses, jobs, and lives to invest in the nascent careers of medical students.

OSU-COM sent two delegates to the national AOA conven-

Orientation week began on Sunday, August 4, with the white coat ceremony for the Class of 2017. The class consists of 115 new students eager to experience medical school first hand. They will have the privilege of learning from a restructured curriculum. This will teach the same concepts that has produced successful medical students and physicians, just in a more efficient order. Also, the new curriculum will include more team-based and experience-based learning. For instance, the class entitled “Focus on the Patient” will include aspects such as a student-created service learning project, elderly patient mentoring, physician shadowing and support staff shadowing. Please join me in welcoming this newest class of medical students as they embark on their journey.

Oklahoma D.O.

Medical students, residents, physicians and staff recognized Governor Mary Fallin for supporting the OSU Medical Center at an event this summer. This previous spring the Governor worked with state legislators to allocate $13 million of the state budget directly toward the sustenance of one of Oklahoma’s largest teaching hospitals for medical students and residents.

tion in Chicago. At this meeting, one of our delegates provided a valuable amendment to a resolution. The representation of OSU-COM at this national level would not have been possible without the organizing, sponsorship, and mentoring of the OOA. Further, OSU-COM sent delegations to various other student organization conventions throughout the United States.


Oklahoma D.O. | July/August 2013

George Nigh Has Long Been ‘Four’ Oklahoma

by Bryan Painter, a columnist and staff writer for the Oklahoman

Nigh was sworn in as Oklahoma's governor four times, served four terms as lieutenant governor and four terms as a state representative. It was George Nigh's rule of thumb No. 2. Brad Henry, who served as a summer intern for Nigh in 1982, had just been elected governor the first time. At a benefit, Nigh, who had four times been sworn in as governor, had five rules of thumb derived from his experience to share with Henry, who was seated next to the lectern. “Two, read the language when people are talking to you, not just what they are saying, but what they mean,” Nigh said. “When they say, ‘I’ve always voted for you,’ stop and listen to the music, because they really want to talk to you.

Oklahoma D.O. PAGE 46

“When they start by saying, ‘I’m a taxpayer,’ run, because you’re getting ready to have a royal a-- chewing right then and there.” After showing a video clip of Nigh reciting his rules, Henry said rule of thumb No. 2 proved true many times in his two terms as governor. The two governors were among those at a symposium on “The Governorship and Legacy of George Nigh.” The symposium was the second in a series featuring Oklahoma governors and is sponsored by the Oklahoma Historical Society, the University of Oklahoma Center for Studies in Democracy and Culture, and the OU Center for Political Communication. The first, held in 2012, recognized the late J. Howard Edmond-

son. Next year’s seminar is scheduled to focus on the late Henry Bellmon. State Supreme Court Justice Steven Taylor, who grew up in McAlester admiring Nigh, spoke of Nigh’s ongoing public service. Nigh is 85. “If you go back to the United States Navy, it’s nearly 70 years of public service to the state and to the nation,” Taylor said. “United States Navy, state representative, lieutenant governor, governor, president of the University of Central Oklahoma and since that time, statesman. And that is what he is today as a public servant, a statesman.” Throughout the symposium, those Nigh has worked with, as well as family members, talked of someone with a knack for handling situations with the betterment of all in mind. Sometimes that meant not allowing a potentially explosive situation to ignite. Enough said Neal McCaleb was the House Minority Floor Leader in Nigh’s first term. McCaleb said it was tough because of the small Republican contingent in the Legislature. He said about all they could do was toss “vocal grenades” the way of the Democrats, including the governor. McCaleb remembers one day when Nigh made some kind of a statement in a news conference. Oklahoma D.O. | July/August 2013

“I came out immediately with a rebuttal,” McCaleb said at the symposium with Nigh in attendance. “It was a slow news day, George, and the reporters ran up to you to get a response to my rebuttal. “I never will forget George’s classic retort. He said, ‘Well, if you stop at every barking dog you’ll never get to town.’” Among finest hours John Greiner, a longtime Capitol reporter for The Oklahoman, said he feels one of Nigh’s finest hours occurred when Nigh was lieutenant governor, and the governor was out of state. Students at Langston University, worried about not getting enough funding for their university, went to the state Capitol in droves, Greiner said. They made their way to the fourth floor and the fifth floor and sat in front of the doors so that the House of Representatives couldn’t get out, and neither could the reporters.

“He wanted to include women in government. He wanted to include minorities. He helped reorganize boards and commissions. He created some diversity we’d never had before.” Some speakers noted how Nigh led the state in times of boom and in bust and adjusted appropriately. “It wasn’t just ideology, it wasn’t governing by the next headlines. It was governing for what’s the greatest good for the greatest number of people,” Blackburn said. The lucky one Even when he wasn’t in office, Nigh was winning people over. Bob Burke, in “Good Guys Wear White Hats: The Life of George Nigh,” wrote that on Jan. 14, 1963, Bellmon was sworn in as governor. Nigh was out of government and out of a job.

They wanted to persuade the House to give Langston more funding.

So Nigh started a public relations firm and opened offices in downtown Oklahoma City. It was there he met Donna Mashburn, who worked for Trans World Airlines as a ticket agent at its desk in the Skirvin Hotel.

With the governor out of state, Nigh was acting as governor. Greiner was covering the Senate, so he was able to walk around and observe.

Donna was a single parent with a 10-year-old son from a previous marriage. Nigh, known as an eligible bachelor, was introduced to Donna.

“It’s kind of like fate said, ‘Tag, you’re it, and there he is,’” Greiner said. “I felt his approach to things had pretty much saved the day, because that could have been a very explosive situation.”

They began dating.

Nigh told Greiner years later that as governor that day, he got the Capitol police together and told them, “I do not want to see a New York Times tomorrow morning with a picture of a Capitol police officer slugging one of these Langston students.” “So Nigh set the tone,” Greiner said. “The kids were very polite. I just felt like he acted very responsibly, and he really made sure nothing happened that day that would have caused harm to anybody, and then of course I found out later why I felt that way.

“Everybody kept telling me how lucky I was, and I thought ‘Well, OK, maybe I better do this,’” Donna Nigh said. “But then later, when we married, I kept trying to figure out where this lucky stuff came in, because he had just finished a campaign and was a hundred thousand dollars in debt. “He did not have a house and he did not have a car. I had a house, I had a car, and I wasn’t in debt. “I never could figure out why I was the lucky one. But as it turned out, I really was the lucky one.”

“I thought it was one of his finest hours, and he hadn’t even become governor yet.”

Oklahoma D.O.

Unity Bob Blackburn, executive director of the Oklahoma Historical Society, said the symposium speakers took him back to the 1960s, ‘70s and ‘80s.

“I think George Nigh was a force for unity in the state, and I think he did it through his policies. He wanted to serve everyone in the state. Oklahoma D.O. | July/August 2013

In attendance, was Thomas J. Carlile, DO and Glenda Carlile, pictured here with George Nigh


“In looking at those times, it was a time of division,” Blackburn said. “There was Watergate, riots across the country and the Vietnam War splitting us apart. It was a period of division.

The OOA wishes a happy birthday to all of our DOs born in September! Sept 1 Jana N. Baker Bruce E. Baugher Michael A. Baxter Paul M. Dichter Tammie L. Koehler Erich H. Muckala Thelma L. Peery Stacey Thao Phan Ross E. Pope Sept 2 Debra A. Crawford Gary E. Gramolini Timothy E. King James D. McKay Robert R. Merwick Gary L. Patzkowsky Sept 3 J. William Anthamatten Peter P. Chan David C. Jennings Dawn M. Lovins Michael J. Pace Jr. Harry J. Whetstone

Oklahoma D.O. PAGE 48

Sept 4 John T. Main Michael G. Maline Susanne P. Thompson Sept 5 Kevin G. Baker David W. Dillow Andrea S. Hakimi Madhuri J. Lad Michael E. Lenhart Uyen Nguyen

Sept 6 Andrew R. Briggeman Jim Davis Steven D. King Christy J. Mareshie Victoria Mills Kendall W. Southern Sept 7 James R. Beymer Megan A. Meyer Hanner Ruth E. Moore William B. Price Jr. Lawrence E. Vark Nathan A. Voise Arthur G. Wallace Jr. Sept 8 Brendon D. McCollom Douglas M. Vaughn John P. Weddle Jeffrey M. Williams John R. Zanovich Sept 9 G. Davin Haraway David S. Krug Todd L. Mapes Rajendra K. Motwani Carolyn J. Pimsler Paul S. Ruble Dale Smith Sept 10 Cynthia K. Bruns Sarah L. Carter-Layman Laren W. Hightower Colin A. Marouk

Sept 11 Stephen R. Barnes G. Raymond Denny Jerry M. Quiring Sept 12 Scott A. Cordray John S. Dennis Michael J. Durham Dawna L. McCreight Samuel W. Price D. Brent Rotton Sept 13 Donald M. Dushay Ronnie L. Keith John C. Stepanek A. Carson Todd Tyson R. Trimble Joy C. Wethern Sept 14 Michele M. Coutler Tony A. Little Eric W. Mix Robert L. Winter Sept 15 Jay C. Belt Jim D. Blunk Alfred C. Husen Peter C. Lafon Thomas V. Nunn Sept 16 Brandon D. Bloxham James A. Coder III Steve S. Kim Duane A. Lukasek Judy L. Magnusson Stuart W. Schrader

Oklahoma D.O. | July/August 2013

Sept 17 Rebecca Dawn Lewis Hal D. Martin R. Gene Moult Michael R. Schiesel Sept 18 Kevin D. Dare Michael A. Lee Ryan W. Oden Sept 19 John C. Mannahan Sarah L. Oberste Scott A. Williams Sept 20 Ronnie L. Carr Randall D. Estep Carole C. Howard Patrick B. O’Hayre Dale K. Williams III Sept 21 Kimberly D. Carter Richard L. Cooper Thomas L. Harrison Jim R. Herndon R. Brent Jackson Patrick J. O’Neill Brian D. Pratt Christopher C. Schmidt Jeffrey L. Shipman Gregory J. Zeiders

Sept 22 Richard D. Brock Lydia J. Dennis Tammi M. Lahr Jason A. McElyea Samuel J. Pangburn

Sept 26 Elizabeth D. Dunlap Mitchell L. Earley Afsar Emery Michael W. Griffin Frederick H. Northrop

Sept 23 David W. Behm Arthur G. Coder Emma Beth Harp Frances M. Horn Pamela Jo Hyde John D. McCuistion Lance E. Rosson Michael P. Souter Philip J. Traino Jr. Joe A. Witten

Sept 27 Gary K. Goforth JoeBob Kirk Melinda S. Powers Steve P. Sanders Robert L. Shepler James Trina

Sept 24 Melinda I. Dandridge John D. DeWitt Ashley N. Estep John B. Hughes Kathy D. Johnson Sheryl A. Price Sept 25 L. Faye Buchanan Manuel O. Crespo Dale Derby Kenneth Jerome Hamby Elizabeth A. Nettles Caryn J. Roelofs

Sept 28 Harvey A. Drapkin Kris Parchuri Michael H. Whitworth Chad D. Willis Sept 29 Robert V. Hensley William H. A. Martin Martin D. McBee Eric S. Mills Katrina S. Silva Sept 30 Jeremy D. Bearden William H. Chesser Kathleen Murray Bob J. Thompson

Oklahoma D.O. PAGE 49

Oklahoma D.O. | July/August 2013

You will Bemissed Sibyl W. Anderson, DO (January 29, 1923 - June 19, 2013)

Dr. Sibyl Wesson Anderson, age 90, passed away on June 19, 2013 at Grace Living Center in Jenks, Oklahoma. She was a long- time resident of Jenks. Sibyl was born in Stigler, Oklahoma, on January 29, 1923, the youngest of eight children. After Sibylâ&#x20AC;&#x2122;s birth, her mother was ill for many years. The help her mother received from a local doctor inspired Sibyl at age 12 to choose osteopathic medicine as her lifeâ&#x20AC;&#x2122;s work. She graduated from Kansas City School of Osteopathic Medicine in 1946. In 1945 she married Leon Anderson. Leon was inspired to become an osteopathic doctor. While he was studying at Kirksville College of Osteopathic Medicine, Sibyl taught in the department of obstetrics. After practicing medicine briefly

in Chelsea, Tulsa, and Beggs, she opened a practice in Jenks, Oklahoma, where Dr. Leon soon joined her. They were available to their patients at all hours, made house calls, and took a variety of payments including ironing and German chocolate cake. Dr. Sibyl practiced in Jenks until her retirement. The Anderson family was deeply involved at First Baptist Church, Jenks, from 1958 until they moved to Mounds in 1997 and joined Picket Prairie Baptist Church. Dr. Sibyl loved to host church events, especially showers. She created an atmosphere of celebration and welcome in her home. Even during her busiest days, Dr. Anderson began her day with the Lord. Loving Jesus and helping others gave her joy. She was preceded in death by her husband, Dr. Leon Anderson and is survived by: her four children, James, Sandie, Martha, and Harry; as well as nine grandchildren; and fifteen great-grandchildren. Dr. Anderson was a life member of the Oklahoma Osteopathic Association and a shining example of a truly gifted osteopathic physician.

Oklahoma D.O. PAGE 50

n OEFOM Memorials n Contributing Dr. Bill and Marnie Pettit Dr. Gilbert and Karen Rogers Don and Lynette McLain Charles and Debra Sexton Dr. Thomas and Glenda Carlile Dr. Thomas and Glenda Carlile Dr. Thomas and Glenda Carlile Dr. Thomas and Flo Conklin Oklahoma Osteopathic Association Dr. Walter and Bettty Wilson Dr. Thomas and Glenda Carlile

In Memory of Diana Bost Mary Whitfill Mary Whitfill Mary Whitfill Wendy Flynn Florence Arnold Clarence Rogers James G. Huggins Sibyl W. Anderson, DO Sibyl W. Anderson, DO Henry Hicks, Jr.

Oklahoma D.O. | July/August 2013

Classified Advertising OFFICE FOR RENT: 1,500 square feet in an excellent area with high traffic count. Established location. Completely remodeled, very nice. Easy access from all areas of town, 7300 S Western, OKC. Rent is $1250 per month with all utilities paid. Please call Dr. Buddy Shadid 405.833.4684 or 405.843.1709. OFFICE BUILDING FOR SALE: 6501 S. Western, OKC, OK 73139. Over 1 1/2 acres total size, 10,000 sq ft building divided into 3 doctors offices. 1200 sq foot private office upstairs with private bathroom and shower. 2 double sided fireplaces, over a dozen chandeliers, rough wood cathedral ceilings. Alarm and phone system in place, double glass doors in entrance, back patio with separate storage building. Larger office is fully equipped with exam tables, Pap table, chairs, medical instruments, QBC (CBC) machine, autoclave, medical supplies, and much more. For information contact: Captain David Simpson at (405) 820-5360. CLINIC FOR SALE: By owner. Fully equipped: LAB, XRAY, EKG. Well established clinic, near Integris Southwest Medical Center is available for sale. Clinic is well equipped and is ideal for one or more physician practice as well as a variety of specialties. Clinic has: waiting room with refrigerated water cooler, wheelchair accessible restroom, reception and staff work stations, Nurses station, 5 - 7 exam rooms with sinks and running water, large multipurpose procedure room, 3 private offices with built-in bookcases, (One Office with 3/4 Bath), additional staff and patient restrooms, large upstairs (currently used for storage) and variety of other medical equipment. Misys Medical Software. Large Parking Lot. “Must See Inside” the all steel building located at 2716 S.W. 44th St. in OKC to appreciate the effort placed upon providing convenient and up to date medical care. PRICE IS NEGOTIABLE. Doctor prefers to sell, but would consider leasing. If interested, please call: Evelyn Francis at (405) 249-6945. DOCTORS WANTED: to perform physical exams for Social Security Disability. DO’s, MD’s, residents and retired. Set your own days and hours. Quality Medical Clinic-OKC, in business for 16 years. Call Jim or JoAnne at 405-632-5151. PHYSICIAN NEEDED: The practice of Terry L. Nickels, DO is currently seeking a part-time Family Physician with OMT Skills to help cover the office. If interested please contact Dr. Terry Nickels at (405) 301-6813.

September 5, 2013 OOA Bureaus & Board of Trustees Meetings & OEFOM Board of Trustees Meeting Oklahoma City, Oklahoma

October 10, 2013 OOA Bureaus & Board of Trustees Meetings & Oklahoma City, Oklahoma October 11, 2013 OEFOM Golf Classic Tournament Coffee Creek Golf Course November 6, 2013 Bureau on Legislation Dinner Bureau on Legislation Meeting

November 7, 2013 OOA Bureaus & Board of Trustees Meetings Oklahoma City, Oklahoma

December 5, 2013 OOA Bureaus & Board of Trustees Meetings & OEFOM Board of Trustees Meeting Oklahoma City, Oklahoma

January 31-February 2, 2014 Winter CME Seminar: "ABC’s of LABS: What’s New, What’s Hot and What’s Not" Hard Rock Hotel & Casino, Catoosa, Oklahoma


IMMEDIATE NEED: FP/ER/OB Physicians, FT,PT and Temp. Bimonthly pay. Paid malpractice and expenses including mileage. To join our fast growing team call Krystal @ 877-377-3627 or send CV to Oklahoma D.O. | July/August 2013

Calendar of Events

Oklahoma D.O.

IMMEDIATE OKLAHOMA OPPORTUNITY with largest family medicine clinic in Muskogee, Ok. Excellent opportunity to assume a practice that is up and running. Senior physician of four physician group leaving to pursue new career opportunities. 2,000 active patients need a physician. Two physicians currently practice OB. Surgical OB experience a plus. On site x-ray and CLIA certified lab. Nursing and support staff in place. Income guarantee. Be your own boss, work hard and practice family medicine in its historical tradition with respect and loyalty of small town patients. Contact Evan Cole, DO, 918-869-2456,, Brad McIntosh, MD, 918-869-7356, Jason Dansby, MD, 918-869-7387, or Judy Oliver, RN, practice administrator, 918869-7357. (leave a message if temporarily unavailable) Find us on the web at

JOB AVAILABILITY: A growing convenient care provider has parttime openings for licensed physicians (Family, internal, general, physical medicine & rehab, sports medicine, occupational, etc.) in our Tulsa and Oklahoma City area location. We provide primary care/immediate care medicine. Patients can drop in (no appointment necessary) to our locations and see a doctor for a wide range of primary care and family health needs, including diagnosis and treatment of common illnesses and injuries, inhouse, diagnostic testing, occupational therapy, and physicals. We provide quality health care for patients who have been injured on the job or may have some illness. Providing flexibility in scheduling to meet your lifestyle and income needs. Benefits: We are offering very competitive salaries. If interested please contact Arnita (405) 6815800 or email her at:

Prsrt Std US Postage Paid Okla City OK Permit #209

OKLAHOMA OSTEOPATHIC ASSOCIATION 4848 N. Lincoln Blvd. Oklahoma City, Oklahoma 73105-3335


The Oklahoma Osteopathic Association has endorsed Rich & Cartmill, Inc. and Medical Protective since 1999

Oklahoma D.O. PAGE 52

Please support your OOA and consider Rich & Cartmill, Inc. for your Professional Liability Insurance needs. For more information contact Scott Selman at 918-809-1461 or

2738 E 51st Street, Suite 400 | Tulsa, OK 74105-6228 | 918.743.8811 |




SPRINGFIELD, MO Oklahoma D.O. | July/August 2013

Oklahoma DO July/August 2013  

The July/August 2013 issue of the Oklahoma DO features highlights of the AOA House of Delegates and includes a recap of the 2013 legislative...

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