January/February 2013 • USA $1.95
What Lies Ahead for Health Care ALSO INSIDE
HIPAA Would Approve:
DocBookMD Keeps Physicians Connected
Advice from Former Lawmaker: Call Your Legislator
Training at Mayo Clinic:
Highly Integrated Health Care A Publication of the Metro Omaha Medical Society • www.OmahaMedical.com
Working with you for a
nebraskablue.com Blue Cross and Blue Shield of Nebraska is an Independent Licensee of the Blue Cross and Blue Shield Association.
How do you define “healing” in terms of end-of-life care? At Saint Jude Hospice, it’s a matter of bringing families together to honor someone they’ve loved for so long, to bring a spirit of peace to them all.
Call Saint Jude Hospice at 1-800-HOSPICE and let the healing wings take flight. www.saintjudehospice.org
And love? For that we simply turn to the words of Jesus Christ: “Love one another as I have loved you.” That, above all, is our mission. We adhere to Ethical and Religious Directives for Catholic Health Care Services.
4 Physicians Bulletin January/February 2013
Where love and healing flow
January/February 2013 Physicians Bulletin 5
features 8 1
Former Lawmaker Encourages Physicians to Call
Still Ahead of its Time
departments 1 0
Young Physician Report
Begging to Differ with the Governor What’s Going to Happen in 2013? Doctors, Dollars and Decisions Epic Super User and New Dad
HIPAA Would Approve: DocBookMD Keeps Physicians Connected
COVER: With All the Votes Counted: What This Means for Health Care
MOMS Coming Events
Member News & In Memoriam
New Member Update
6 Physicians Bulletin January/February 2013
Reviewing the Necessity of Common Medical Tests and Procedures
spend time with them. Leave your wealth management to us. It’s what we do. Learn about our approach. Call today.
www.bonnettwm.com 14710 West Dodge Road #203 Omaha, NE 68154 Wealth Management Personally Delivered.
Securities offered through Securities America, Inc., member FINRA/SIPC. Jerome P. Bonnett, Jr., CFP®, ChFC®, Registered Representative. Advisory services offered through BWM Advisors, LLC. Jerome P. Bonnett, Jr., Investment Advisor Representative. BWM Advisors, LLC (dba Bonnett Wealth Management) and Securities America companies are unaffiliated.
January/February 2013 Physicians Bulletin 7
NOVEMBER/DECEMBER 2012 VOLUME 33, NUMBER 6 A Publication of the
Metro Omaha Medical Society 7906 Davenport St. • Omaha, NE 68114 (402)393-1415 • www.omahamedical.com OFFICERS President | Marvin J. Bittner, M.D. President-Elect | Debra L. Esser, M.D. Secretary-Treasurer | David D. Ingvoldstad, M.D. Past President | Pierre J. Lavedan, M.D. Executive Director | Diane Parsons EXECUTIVE BOARD Marvin Bittner, M.D. Debra Esser, M.D. David Ingvoldstad, M.D. Pierre Lavedan, M.D. Mohammad Al-Turk, M.D. Jane Bailey, M.D. Lori Brunner-Buck, M.D. David Filipi, M.D. Harris Frankel, M.D. Sherrill Murphy, M.D., James Newland, M.D. William Orr, M.D. Laurel Prestridge, M.D. William Shiffermiller, M.D. Gamini Soori, M.D. Jeffry Strohmyer, M.D. EDITORIAL/ADVERTISING STAFF Publisher | Omaha Magazine, LTD Editor | Marvin Bittner, M.D. Art Director | John Gawley Senior Graphic Designer | Katie Anderson Junior Graphic Designer | Paul Lukes Director of Photography | Bill Sitzmann advertising sales Todd Lemke • Sandy Besch • Greg Bruns Gwen Lemke • Gil Cohen • Alicia Smith • Vicki Voet • Paige Edwards • Jessica Linhart for advertising information: 402-884-2000
LTD, P.O. Box 461208, Omaha NE 68046-1208. © 2012. No whole or part of contents herein may be reproduced without prior permission
e s s t o B u sin e
Physicians Bulletin is published bi-monthly by Omaha Magazine,
aha Maga z Om
2 012 • W
of Omaha Magazine or the Metro Omaha Medical Society, excepting individually copyrighted articles and photographs. Unsolicited manuscripts are accepted, however, no responsibility will be assumed for such solicitations. Omaha Magazine and the Metro Omaha Medical Society in no way endorse any opinions or statements in this publication except those accurately reflecting official MOMS actions.
8 Physicians Bulletin January/February 2013
MOMS MEDICAL LEGAL DINNER
Hosted by Metro Omaha Medical Society in Partnership with the Omaha Bar Association
Tuesday, March 19, 2013 Champions Run
MOMS members are invited to join your fellow physicians and area attorneys for an evening of dinner and networking. Featuring:
Lee G. Simmons, DVM
Chairman, Omaha Zoo Foundation
Please RSVP by March 15th. Call 402.393.1415 or email email@example.com
Metro maha Medical Society
April 12-13, 2013
A Premier Horse Jumping Competition! Men and women go head to head over 15 jumps in 80 seconds For tickets, log onto
The International Experience Exposition: unique educational interactive displays for all ages, shopping, food and beverage.
Daytime & Evening Competitions
Free During The Day
Music â€˘ Entertainment
www.internationalomaha.com January/February 2013 Physicians Bulletin 9
Marvin Bittner, M.D. President Metro Omaha Medical Society
Begging to Differ with the Governor
AST FALL THERE WAS a conflict. On one side
was the governor of Nebraska. The Nebraska Medical Association was on the other. The conflict involved this question: As part of health-care reform, should Nebraska operate its own health insurance exchange? The governor said “no.” The NMA said “yes.” I can’t speak for every member of the NMA. However, I can tell you my own thoughts about a Nebraska exchange and why, in the wake of the governor’s “no,” some Nebraska physicians will take actions they had thought unimaginable. The governor’s decision reflected two issues. The first was cost. The second was administration. The governor stated that the price tag of a Nebraska exchange was in the hundreds of millions of dollars. When I heard that statement, my thoughts could be summed in one word: suspicion. I was suspicious because the governor’s official statement failed to put that sum of hundreds of millions of dollars in context. What kind of sum is hundreds of millions of dollars, compared to Nebraska health spending? The governor’s official announcement didn’t say. That aroused my suspicion. According to my own rough calculations, that sum is less than a percent of all health-care spending for Nebraskans. That confirmed my suspicion: The governor’s statement tended to give the impression of an enormous cost of an exchange. In context, it’s not at all enormous. That brings up the next issue: The governor said that exchange administration would be largely dictated from D.C. Would the relatively small cost of the exchange be money well spent to improve those administrative aspects where Nebraska would have some input?
10 Physicians Bulletin January/February 2013
I understand why the governor would answer that question one way and why Nebraska physicians would answer that question another way. Nebraska physicians know that administrative aspects of health insurance are important. Our former MOMS president, Dave Filipi, M.D., devoted countless hours to working with the state government to rein in undesirable practices of certain health insurers. How much more difficult will it be to have an impact on the beltway bureaucrats! The federal exchange will be administered by the U.S. Department of Health and Human Services. Its track record leaves something to be desired. Its rules for coding evaluation and management services are a maelstrom of confusion. Even as public health experts in that department point out the need to deal with the rising impact of pertussis by routinely immunizing pregnant women, the FDA regulators in that department are poised to punish any vaccine manufacturer whose sales representatives promote immunizing pregnant women. With Nebraskans at the mercy of an exchange administered by such a dysfunctional part of the federal government, it will take a loud, strong voice for physicians to be heard in Washington. I know that many of my colleagues have concerns about joining the American Medical Association. Yet, I think some will do what had been for them unthinkable: Join the AMA – simply to get the attention of the beltway bureaucrats who, when it comes to the health of the public, have amassed a sad record in great need of improvement.
Your Best Choice
for Antibiotic Infusion Therapy Office Infusion Center for IV Antibiotics • Healthcare provider on site • Open 7 days a week
Infectious Disease Specialists
• Inpatient/outpatient comprehensive care
More than 50,000 successful infusions.
• for immunocompromised • for travelers
Learn more at www.idmidwest.com
Robert G. Penn MD, FACP, FSHEA, FIDSA
Board Certified: Infectious Diseases Douglas Penington, APRN Allison McLeay, APRN Stacey Shinaut, APRN Elizabeth Jacobsen, PA-C Courtney Sullivan, ACNP
Infectious Diseases Associates, PC 8111 Professional Building • 8111 Dodge Street, Suite 363 • Omaha, NE 68114 January/February 2013 Physicians Bulletin 11 Phone: 402.934.6504 • Fax: 402.934.6518 • www.idmidwest.com
Dale Mahlman Executive Vice President Nebraska Medical Association
What’s Going to Happen in 2013?
HE 2013 NEBRASKA LEGISLATURE includes
10 new senators and one returning former member to the body. With the new senators come new committee assignments and, this year, at least six of the standing committees will feature new chairpersons as a result of term limits. There is a new speaker, who replaced former Sen. Mike Flood, who held that role the past six years. Each year, MOMS does a great job in advance of the session of inviting the newly elected and returning senators to the table to discuss the issues of importance to medicine, as well as the issues of importance to the senators. The ability to have an open discussion is always appreciated and, while we don’t always walk away from the meetings in agreement, we better understand the issues and each side’s positions. Many thanks go out to the Omaha physicians who have made the 7 a.m. meetings, and thanks to the senators for their time as well. These meetings serve for some as introductions to their elected official and the start of a long-term relationship. For others, the chance to reacquaint one another with issues past and our ability to continue to educate the senators on our issues and positions is not lost, even at this early hour. This year will be no different than past years in that our issues will be included in the more than 600 bills expected to be introduced during this long session (90 legislative days), which began Jan. 9 and is scheduled to adjourn sine die June 5. We follow approximately 100 bills each session with the help of our lobbyist Ann Frohman. This is Ann’s first session representing the NMA and, based on our activity in advance
12 Physicians Bulletin January/February 2013
of the session, we feel good about our transition process. In addition to the staff of the NMA, we consider each of you as our most valuable resources when it comes to lobbying senators. We have made much progress in the past couple of years engaging our members in the political process and we thank each of you who have taken the time to get involved. You are the experts! While we expect the session to focus on the implementation of the Accountable Care Act at the state level, public health issues, scope of practice issues and budgetary issues affecting medicine, we never lose sight of others bills that may be of interest to our membership. Understanding your time restraints, having a physician present for a hearing is always appreciated and very well received by the committees. In addition to the hearings, taking the time to phone or write an email or note is always mentioned by our legislators as issues are discussed. Advocacy, like everything else, has become a year-round activity and open to everyone, including spouses and office staff. As we’ve documented in the past, other professions continue to raise their game and, fortunately, organized medicine has as well. Complacency is not an option and be assured the NMA, along with MOMS, remains positioned to keep the best interest of our physician members in our actions at all time. As the AMA marketing slogan suggests, “Together we are Stronger.” Never has that been more apparent as a profession, state or nation.
The Metro Omaha Medical Society Foundation identifies and provides support to community @
priorities where physician involvement can make a difference in improving the health of the
t wo successful companies, now operating as one, to offer you more products and services
Metro Omaha Community. MOMS Foundation 7906 Davenport St. Omaha, NE 68114 402-393-1415
omahafriendlyservices . com
s u n va l l e yo m a h a . c o m
Visit our landscape supply yard at 5 6 0 1 H a r r is on S tr ee t â€˘ Om a h a , N E 6 8 1 5 7
January/February 2013 Physicians Bulletin 13
Ross Polking lifeWealth Adviser The Foster Group
Doctors, Dollars and Decisions
READ AN ARTICLE RECENTLY suggesting medical students are apt to choose their study of medicine based on earnings potential. This conclusion was based on an 18-year study that collected feedback from students in their first and fourth years of school. The findings suggested that upward of 30 percent of students who entered school intending to become primary care physicians later elected to pursue a specialty career due to presumed increased compensation. Granted, the decision to specialize could be attributable to a number of criteria, but the study revealed the income disparity was rated at the top. We all want a career that compensates us well for pursuing our passions. The perfect blend is often difficult to come by, however. Considering the debt burden, stress level, uncertainty in the future of medicine, heightened liability, insurance costs, declining reimbursements and increasing medical technology costs (did I leave anything out???), who could blame any aspiring physician for choosing a path leading to more dollars. These hurdles usually increase inside specialty practices, though, so the added income tends to be more a need than a benefit. There’s an element of sheer survival here as much as a desire for a more affluent lifestyle. Regardless of one’s position in the medical landscape, no amount of income can erase the ramifications of poor decisions. Whether personal or professional decisions are involved, physicians are subject to a high degree of accountability. The resources required to demonstrate accountability are certain to be squeezed further in the future. Physician shortage and patient influx are in lock-step right now – not a good combination. Medical students and existing physicians choosing to continue in a life of medicine cannot afford
14 Physicians Bulletin January/February 2013
to stumble over poor decisions. The margin for error is small. They must insulate themselves from the complexity and pitfalls inherent when the title “doctor” precedes their last name. We recently helped conduct a survey of Nebraska physicians, and “accumulating wealth” ranked as one of the top concerns of all respondents. This seems to bear out the earlier article’s mention that students tend to shift career path based largely on income potential. Equipping oneself to effectively pursue this wealth goal is a challenge. Medical school does not offer any form of this curriculum. Our survey also showed that only 41 percent of Nebraska physicians are working on tax planning and a whopping 83 percent under the age of 55 are not confident the amount of money they’ve saved will allow them to retire when they’d like. We have a large population of physicians, both young and established, vastly underserved in the financial arena. This is the elephant in the room and a silent assassin to the well-being of physicians and, ultimately, the American health-care landscape. If physicians are unable to navigate their increasingly complex financial world, the motivation to pursue that career and lifestyle will diminish, leaving us with an unprecedented national dilemma. Our encouragement? Seek a trusted financial advisory relationship with someone committed to serve you as part of your team of professional advisers. The most successful physicians we serve surround themselves with experts in all facets of their life. Don’t delay – do the same. We’ve seen this approach prosper consistently during our 23 years of working with physicians and we believe it will continue to do so amid the uncertainty that lies ahead.
YOUNG physician report “As physicians, we have so many unknowns coming our way...
Epic Super User and New Dad
One thing I am certain about is my malpractice protection.”
Joel Strauch, M.D. Resident CUMC/UNMC Psychiatry Program
I Medicine is feeling the eﬀects of regulatory and legislative changes, increasing risk, and profitability demands—all contributing to an atmosphere of uncertainty and lack of control. What we do control as physicians: our choice of a liability partner. I selected ProAssurance because they stand behind my good medicine. In spite of the maelstrom of change, I am protected, respected, and heard. I believe in fair treatment—and I get it.
SIGNED UP TO TAKE a week’s vacation this past
August during my fourth year of psychiatry residency. This “vacation” would involve spending upward of 80 hours serving as a “super user” for the launch of the Epic electronic health records at the Nebraska Medical Center. Of course, I would be well compensated for this week’s work. During medical school (and during my wife’s time in medical school three years behind me), we had placed a lot of emphasis on work-life balance. You hear the words “work-life balance” bandied about in medicine all the time, but it seems that, more often than not, folks are just paying lip service to the idea before heading back in for another 12-hour shift or late-night study session. We had actually made a pretty good go of it. People who found out that we were both in medical school, or later in medical school and residency, would always say, “You must never see each other.” Not the case at all. We both did well enough and were able to spend as much time together as we did before. It did help that neither of us was aiming for a highly competitive residency and didn’t need to graduate with honors or top Step scores. We attempted to maintain this balance when we became pregnant with our first child. Purposely waiting until my fourth year of psychiatry residency and my wife’s final year of medical school, we thought we had the timing down pretty well. As the fates would have it, my daughter was born two days before the start of this intense week in August. Three weeks early. Due to my wife’s
placental abruption and subsequent Cesarean, it was a scary day but all turned out well. Our little 5-pound-3-ounce, 19-inch Summer Rayne had Apgars of 9 and 10 and was able to come home from the hospital with us three days later. In the meantime, I started my super user week with quite a bit of trepidation. How was I going to manage 12-hour days while taking some care of my post-op wife and new infant? So much for work-life balance. It worked out for two big reasons. First, my wife is a trooper. She took care of almost everything that first week, from the round-the-clock feeds and diaper changes to keeping things moving smoothly at home. Second, I served as a super user in the Adult Crisis Unit, which ended up needing me a lot fewer hours than originally scheduled. And someone was looking out for us. Due to the recent merger between Creighton and Alegent (dubbed “Cregent” by one of my colleagues), Creighton residents were allowed the four weeks of paternity leave given to Alegent employees. This was a godsend that allowed me to spend the next full month at home. I am now back at work and we have settled into a good routine. Although the PGY-IV year of psychiatry is more laid back than previous years, I am one of the chief residents for the program so am finding that I still have to work to maintain the balance I want between residency and home life. But it continues to be worth the effort to carve out the time for the most important things in my life.
Professional Liability Insurance & Risk Management Services ProAssurance Group is rated A (Excellent) by A.M. Best. ProAssurance.com • 800.279.8331
January/February 2013 Physicians Bulletin 15
Reviewing the Necessity of Common Medical Tests and Procedures COPIC’s Patient Safety and Risk Management Department Dr. Alan M. Lembitz Chief Medical Officer COPIC Insurance Co.
N 2012, THE ABIM Foundation, a not-for-profit
foundation established by the American Board of Internal Medicine (ABIM ), launched a project called “Choosing Wisely,” which seeks to encourage physicians and patients to follow evidence-based guidelines in managing health problems and avoiding medical procedures that are unlikely to be of real benefit. Recognizing that physicians often struggle with decisions about prescribing tests and procedures as a way of covering all possible bases, the ABIM Foundation joined with nine leading medical specialty societies1 to develop lists as guidelines. A master list of “45 Things Physicians and Patients Should Question” was developed as evidence-based suggestions that should be considered in the way you practice. These recommendations from the ABIM Foundation are guidelines and do not establish a standard of care. They also are not comprehensive for all clinical conditions. Reasonable care that is different from each of these selected guidelines is defensible with a carefully documented and comprehensive history, physical and thought process of clinical judgment. “These days, everyone is concerned about the cost of medical care, no matter whether you have insurance with a low co-pay and low deductible, one with a high deductible, or no insurance at all. As such, patients have begun to question the care they receive,” said Dan Rosenquist M.D., who is part of COPIC’s Patient Safety and Risk Management team. “Evidence-based medicine is a way to approach patient care in a safe, effective and more affordable manner. Additionally, the use of evidence-based medicine in decision making leads to improved patient safety and outcomes, while helping to manage your risks associated with unnecessary procedures and medications.” The following are selected excerpts from the master list:
1. Don’t order sinus computed tomography (CT) or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis. Viral infections cause the majority of acute rhinosinusitis and only 0.5 percent to 2 percent progress to bacterial infections. Most acute rhinosinusitis resolves without treatment in two weeks. Uncomplicated acute rhinosinusitis is generally diagnosed clinically and does not require a sinus CT scan or other imaging. Antibiotics are not recommended for patients with uncomplicated acute rhinosinusitis who have mild illness and assurance of follow-up. If a decision is made to treat, amoxicillin should be the first-line antibiotic treatment for most acute rhinosinsutis. 2. Don’t diagnose/manage asthma without spirometry. Clinicians often rely solely upon symptoms when diagnosing and managing asthma, but these symptoms may be misleading and be from alternate causes. Therefore, spirometry is essential to confirm the diagnosis in those patients who can perform this procedure. Recent guidelines highlight spirometry’s value in stratifying disease severity and monitoring control. History and physical exam alone may overor under-estimate asthma control. Beyond the increased costs of care, repercussions of misdiagnosing asthma include delaying a correct diagnosis and treatment. 3. Don’t perform annual stress cardiac imaging or advanced non-invasive imaging as part of routine followup in asymptomatic patients. Performing stress cardiac imaging or advanced noninvasive imaging in patients without symptoms on a serial or scheduled pattern (e.g., every one to two years or at a heart procedure anniversary) rarely results in any meaningful change in patient management. This practice may, in fact, lead to unnecessary invasive procedures and excess radiation exposure without any proven impact on patients’ outcomes. An exception to this rule would be for patients more than five years after a bypass operation.
16 Physicians Bulletin January/February 2013
4. In patients with low pretest probability of venous thromboembolism (VTE), obtain a high-sensitive Ddimer measurement as the initial diagnostic test; don’t obtain imaging studies as the initial diagnostic test. In patients with low pretest probability of VTE as defined by the Wells prediction rules, a negative high-sensitivity D-dimer measurement effectively excludes VTE and the need for further imaging studies. 5. Avoid nonsteroidal anti-inflammatory drugs (NSAIDS) in individuals with hypertension or heart failure or chronic kidney disease (CKD) of all causes, including diabetes. The use of NSAIDS, including cyclo-oxygenase type 2 (COX-2) inhibitors, for the pharmacological treatment of musculoskeletal pain can elevate blood pressure, make antihypertensive drugs less effective, cause fluid retention and worsen kidney function in these individuals. Other agents such as acetaminophen, tramadol or short-term use of narcotic analgesics may be safer than and as effective as NSAIDs. The goal of the “Choosing Wisely” campaign is to help physicians, patients and other health care stakeholders think and talk about overuse of health care resources in the United States. Hopefully, this will promote wise choices by clinicians in order to improve health care outcomes, provide patient-centered care that avoids unnecessary and even harmful interventions, and reduce the rapidly expanding costs of the health care system. For more information, visit the ABIM Foundation’s “Choosing Wisely” website at www.choosingwisely.org. 1 *Medical specialty societies that helped develop guidelines: American Academy of Allergy, Asthma & Immunology, American Academy of Family Physicians, American College of Cardiology, American College of Physicians, American College of Radiology, American Gastroenterological Association, American Society of Clinical Oncology, American Society of Nephrology, and American Society of Nuclear Cardiology.
January/February 2013 Physicians Bulletin 17
Kramer and his wife, Kim, at the State Dept.
Former Lawmaker Encourages Physicians to Call
S IOWA LAWMAKERS BEGAN discussing tort reform, Kent
Kramer expected physicians to come calling. As a first-term lawmaker in the Iowa House of Representatives in 2002, Kramer said, he looked for physicians to weigh in on the issue. Funny thing, he said, none appeared at his door. “I actually pursued some of them,” he said. Kramer’s name may be familiar to MOMS members on several accounts. He comes from a political family in Iowa. His mother, Mary, served as president of the Iowa Senate and was appointed ambassador to the eastern Caribbean by President George W. Bush “It was a great gig for my mother – live in Barbados and travel to eight other island nations, like St. Kitts.” Kramer serves as co-chief investment officer and partner at the Foster Group, which collaborates with MOMS. He recently participated in a panel discussion MOMS hosted with the Foster Group and Koley Jessen, “Preparing for 2013 and Beyond.” Kramer said he talked about potential changes in tax policy – “Fiscal cliff stuff.”
18 Physicians Bulletin January/February 2013
He decided to follow in his mother’s political footsteps for several reasons: “Public service is really important to me. You either put up or shut up. If you have a gripe and want things to change, do something about it. “Family-wise, I have been given many opportunities. And when you have the opportunity, there is responsibility.” So he ran for the Iowa House. The timing in 2002 was opportunistic. The seat was open in the largely Republican district. He won the fourway Republican primary, and easily defeated his opponent in the general election. In Iowa, the state legislature is geared toward farmers, who can be active from January to the end of March, Kramer explained. It’s a part-time job with part-time pay (although Iowa legislators earn more than their Nebraska counterparts).
az ag sin
e s s t o B u sin e
2 012 • W
2606 S. 156th Circle | Omaha, NE 68130 (402) 399-9233 | www.sparklingklean.com
aha Maga z Om
Commercial Construction Green Environments Disaster Recovery Industrial Medical Education
4 Consecutive Years
Kramer said his mother, Mary, a former U.S. ambassador, influenced his decision to get involved in government.
“I loved it (his two-year term). There is no better way to learn how state or federal government works than by doing it.” Kramer’s challenge came as he tried to juggle his work and family life (four daughters) and government service. Something had to give, he said, and the Iowa House was the choice for now. His two-year stint left him with stories and anecdotes that physicians should consider. When tort reform emerged during his time in the Iowa House, Kramer recalled, he was sure to examine the issue from all sides. He understood why attorneys and the bar association wouldn’t want caps on malpractice suits because patients should be compensated for their suffering, while physicians face escalating malpractice premiums, and explains that medicine is not an exact science. Things sometimes go wrong. Kramer said he was fortunate to have an attorney and a physician whom he considered friends. He turned to them for advice – when his constituents (both physicians and attorneys) failed to get involved. Which leads to Kramer’s advice to MOMS members: Befriend your state legislator. “You need to have a ‘coffee shop’ relationship with your legislator, if you can.” Outside of the annual lobbying effort and outside of the legislative session, take your legislator to coffee. “They’ll appreciate your expertise. They may at first see you as a fundraising source – that’s the honest truth. But it’s a great way to have real influence when issues come up in a session. Your legislator will take your call and read your email.”
Boys Town Ear, Nose & Throat Institute
Helping Your Patients Feel Better Again
Boys Town Medical Campus Pacific Street Clinic 14040 Hospital Road (139th & Pacific Street)
Our Board Certified physicians specialize in treating problems ranging from chronic ear, nose and throat illnesses to
complex head and neck disorders calling
Boys Town Medical Campus Downtown Clinic
for specialized surgical care.
555 North 30th Street
Ear, Nose and Throat Clinic
Ear, Nose & Throat Institute
320 McKenzie Avenue, Suite 202 Council Bluffs, Iowa 51503
January/February 2013 Physicians Bulletin 19
The Diesing File Hometown: Omaha Bachelor’s Degree: University of Nebraska Omaha in Biology Medical Degree: University of Nebraska Medical Center Residency: Mayo Clinic in Neurology Internship: Mayo Clinic in Preliminary Internal Medicine Specialty: General Neurology Location: Private Practice Hobbies: Fishing Why MOMS: “I believe that organized medicine is an essential part of practice.”
Training at Mayo Clinic: Close Interspecialty Teamwork
RACI JURRENS, M.D., STILL marvels at the situation she found herself in while
at Mayo Clinic. “I found myself giving presentations to people who give presentations all over the world,” she recalled. “It was daunting.” It was also an experience she felt was worth pursuing. Two Omaha physicians – Dr. Jurrens and T. Scott Diesing, M.D. – described their experiences at Mayo Clinic and talked about what distinguishes the highly integrated health-care organization. Both were trainees at Mayo Clinic – for Dr. Jurrens’ cardiology fellowship and for Dr. Diesing’s internship in preliminary internal medicine and his residency in neurology. Dr. Diesing said his time at Mayo Clinic instilled in him a strong work ethic and a respect for each patient’s needs. “No matter how busy you were with what was going on, you were to give patients all the time and attention they needed. We were reminded of this periodically as residents, but it was expected.” He said teaching did not suffer, either. “The staff – despite their reputations (as being among the best) – were humble and, almost to a one, made teaching residents and students a top priority.” Dr. Diesing said three things stuck out during his time at “one of the most efficient institutions I have ever seen.”:
20 Physicians Bulletin January/February 2013
The Jurrens File Hometown: Omaha
— Electronic health records were in place, with all the specialty departments using the same system . “Instantaneous communication and continuity.” All medical forms were standardized, which ensured that patient appointments did not conflict, tests and appointments were scheduled to avoid long delays for patients, and redundancy in testing was eliminated. — Communication flourished, whether it was via the telephone or conversation in the hallways. There was no disconnect between specialties or standing. “A resident could call up a professor emeritus and could talk to him just like the intern down the hall. There was a hierarchy, but not when it came to patient care.” —Work ethic. “Everyone took pride in working harder and giving more effort than was expected. If anybody was perceived as not giving 100 percent, there was no tolerance for slacking.” Expectations were high, Dr. Diesing recalled. “When you look around at the people you’re
with – they’re performing and achieving at high levels.” After an initial adjustment period, Dr. Jurrens said, she too realized how efficiently Mayo Clinic operated. What might have caused a patient to wait several weeks for all his or her appointments, this same patient would see all his or her tests and consultations conducted in several days. “Everything was so streamlined,” she recalled. “A patient would go from one test and get the results the same day. I think this was possible just because of the number of physicians. There were so many cardiologists and so many specialty clinics.” Dr. Jurrens said she too noticed the efficiency at Mayo Clinic, including its electronic medical record system. “No one wrote a note. Everything was dictated through the system. You could get all data at any computer screen. They were ahead of the game.”
Bachelor’s Degree: Creighton University in Chemistry Medical Degree: Creighton University Residency: Creighton in Internal Medicine Fellowship: Mayo Clinic in Cardiology Specialty: Cardiology Affiliation: The Heart Consultants at Methodist Hospital Family: Husband, Tom Jurrens, M.D.; three children, Elsa, Daniel and Molly Why MOMS: “To be connected with local physicians.”
January/February 2013 Physicians Bulletin 21
New Benefit for MOMS/NMA Members
HIPAA Would Approve: DocBookMD Keeps Physicians Connected
IS 5-YEAR-OLD SON HAD broken his foot while playing soccer on Thanks-
giving. “He missed the ball and basically stubbed his toe,” Todd Shepler, M.D., recalled. The Austin, Texas, ophthalmologist sent X-rays of his son’s foot to a pediatric orthopedist on Thanksgiving Day, who replied: “Meet me at the office at 9 a.m. Friday and we’ll put a cast on him.” Credit DocbookMD for carrying the message and connecting the two physicians. DocbookMD is a HIPAA-compliant messaging application for smartphone and tablet devices. Designed by and for physicians, it creates a secure network to share patient information and collaborate with medical colleagues. More than 10,000 physicians use DocbookMD, said Bryan Vela, director of operations. Physicians – through membership in their medical societies – have access to the free app for their iPhones, iPads and Androids, which was created by a physician couple from Texas who had their first-anniversary celebration dinner interrupted by a page from the emergency room. The page turned out to be not serious, but the physician couple – Tim Gueramy and Tracy Haas – decided there had to be a means for physicians to consult remotely. Dr. Haas said she and her husband decided to make their free app available to physicians through their medical society membership for two reasons: --Medical societies are trusted by their member physicians. --Medical societies have databases that are the “gold standard” of information sources. MOMS members have access through their membership in the Nebraska Medical Association. Christy Beckman, membership director for the NMA, said the Texas Medical
22 Physicians Bulletin January/February 2013
Association turned its Nebraska counterpart onto DocbookMD. “We are excited to offer this cutting-edge technology complimentary to our members,” she said. The app is available to all NMA members, and about 50 have signed up, she said. For the record, DocbookMD has partnerships with 280 distinct medical societies in 28 states, Dr. Haas said, including exclusives in 18 states. So what sets DocbookMD apart from its competitors? Dr. Haas lists several reasons: “We were first on the scene four years ago,” she said. Then, DocbookMD is physician-owned and operated. “We designed DocbookMD intuitively for physicians. We’re (Drs. Haas and Gueramy) involved in every design phase.” Then, Dr. Haas talks about how DocbookMD is HIPAA-compliant. The four security criteria are listed on its website – www.docbookmd.com/hipaa/compliancy/ Dr. Shepler said he originally turned to DocbookMD at Dr. Gueramy’s suggestion because he was tired of hauling medical directories with him as he made his rounds to five satellite offices in central Texas. DocbookMD provided
FINANCIAL EXPERTISE FOR THE HEALTH CARE INDUSTRY. To speak with a dedicated specialist from our Health Care Banking Division call Ed Finan at 402-399-5028.
www.anbank.com • 32 locations in Nebraska and Iowa. Call 402-457-1077 or 800-279-0007.
swollenachylegs leg ulcers varicose& spider
access to referring physicians and their address and telephone numbers. The spiral-bound books could remain at home, he said. Now, he uses it for sending messages – such as to seek clearance for surgery – to fellow physicians. DocbookMD’s HIPAA compliancy “was the biggest thing for me,” he said. He receives all his pages through his medical exchange via DocbookMD. On his wish list for DocbookMD is the ability to take messages and download them into electronic medical records “with just a push of the button. I think they’re (DocbookMD) working on that.” Dr. Haas said she and her husband are on a one-year sabbatical from their medical practices so they can devote their fulltime to DocbookMD. They look to third-party payers – such as medical liability companies – as revenue sources because the app is provided free to medical societies in exchange for their electronic membership directories. Dr. Haase said said DocbookMD has a team of nine developers that continually looks to improve the product. “We try to stay 10 steps ahead.” To learn more about DocbookMD, visit http:// docbookmd.com. Call the Nebraska Medical Association at (402) 474-4472 for more information.
HEARTLAND VEIN & VASCULAR INSTITUTE
heartlandvein.com January/February 2013 Physicians Bulletin 23
Too many patients, not enough time? Consider hiring a Physician Assistant PA’s practice medicine as a licensed professional with physician supervision. They exercise autonomy in medical decision-making and can: • take complete medical histories • perform physical examinations • order and interpret diagnostic studies • make diagnoses • order treatments • write prescriptions • assist with surgery • perform procedures such as stress electrocardiograms, sigmoldoscopic exams, lumbar punctures, suturing lacerations, and bone aspirations • apply casts and splints to fractures • provide emergency treatments for life-threatening situations
2012 GRANT RECIPIENTS Congratulations to the following organizations who awarded grants from Metro Omaha Medical Society Foundation in 2012.
ALS in the Heartland Children’s Respite Care Center Heartland Family Services Nebraska Children’s Home One World Community Health Center
1335 H Street, Ste. 100 Lincoln, NE 68508-3784 402-476-1528 firstname.lastname@example.org
Margaret Block, M.D. M. Salman Haroon, M.D.
Ralph J. Hauke, M.D. Timothy K. Huyck, M.D.
Robert M. Langdon, Jr., M.D. Kirsten M. Leu, M.D.
*Nationally Recognized in Clinical Trials and Oncology Research by the American Society of Clinical Oncology (ASCO) (402) 393-3110
Alegent Creighton Health Cancer Center - Bergan
Methodist Estabrook Cancer Center
Midwest Cancer Center Legacy
Midwest Cancer Center Papillion
(402) 941-7030 Fremont and West Point
John M. Longo, M.D. Patrick J. McKenna, M.D.
Geetha Palaniappan, M.D. David A. Silverberg, M.D.
Gamini S. Soori, M.D. Yungpo Bernard Su, M.D.
Stefano R. Tarantolo, M.D. Peter M. Townley, M.D.
24 Physicians Bulletin January/February 2013
Dr. Harris Frankel, left and Dr. Richard O’Brien.
With All the Votes Counted: What This Means for Health Care
HE 2012 PRESIDENTIAL ELECTION is past, and Richard O’Brien, M.D., and Harris Frankel,
M.D., hope for the best. Forecasting what President Obama’s re-election means for health care isn’t easy, they said, but will give them plenty to discuss in the coming years. The two longtime MOMS members took time recently to talk politics and health care. “Regardless of who occupies the Office of the President, I want that individual to be successful,” Dr. Frankel said. “That means sound policy, a bipartisan relationship with our Congress and transparency with the American people. Story continued on page 26.
January/February 2013 Physicians Bulletin 25
The O’Brien File Hometown: Shenandoah, Iowa Master’s Degree: Creighton University in physiology Medical degree: Creighton University Residency: Bellevue Hospital, Columbia Division, New York City Fellowship: The Enzyme Institute at the University of Wisconsin Specialty: General Medicine Position: Professor emeritus, Creighton University, and emeritus member, Center for Health Policy and Ethics. Family: wife, Joan; four children, Sheila, Kathleen, Michael and Patrick
Dr. O’Brien admitted he is optimistic, although somewhat cautiously so, that the president’s health-care reform will bring positive results. He said he drank the proverbial Kool-aid regarding health-care reform. “I like the sips I’ve had so far. But we haven’t taken the whole cup.” Here are Drs. O’Brien and Frankel’s responses to questions related to the 2012 election – and what it means for health care.
other providers get paid. Value-based purchasing and bundled payments will become the norm. Quality and outcomes will be the targets for success. Fee-for-service will wane. With impending change comes volatility and with volatility comes opportunity. Regarding the latter, we have an opportunity to be transformative and improve the delivery system and the health of our patients, albeit not without their participation.
When the votes were counted and President Obama was re-elected, what was your initial reaction? Dr. O’Brien: I first felt relief – that the health-care reform implementation will proceed as prescribed by the Affordable Care Act. I expect that there will be some revisions needed as it unfolds, as some parts will work better than others. Dr. Frankel: I was in bed asleep. In all honesty, I didn’t expect anything different. I knew we would face the same problems in health care and elsewhere regardless of who got elected. Regarding the former, I knew the ACA was here to stay.
Will this mean better care or care of a lesser quality? Please Explain: Dr. O’Brien: I hope it will mean better quality care. Implementation of more team care in medical homes should improve quality. And there are a number of incentives to improve quality. Dr. Frankel: I would like to believe the changes we make will be for the better. I think time will tell. Certainly, the goal is to provide better care, inclusive of improved quality and cost efficiency.
Why I Joined MOMS: “I thought it was an appropriate thing for a physician to do, particularly for one representing Creighton University as dean of the Medical School.”
Please look forward and describe how you believe the face of health care will change in the years to come. Dr. O’Brien: Many more people will be insured, though not all Americans. Hospitals and physicians and other providers will be relieved of some but not all of the burdens of unpaid care. Given the projected shortages of primary care and other physicians, there will be other providers, e.g. advanced practice nurses, who will be diagnosing and treating patients – more than currently is the case. Dr. Frankel: There will be more persons with insurance. However, insurance only guarantees some level of coverage for medical services. It does not guarantee appropriate access to care, quality care or cost-effective care. Additionally, there will be changes in how hospitals, physicians and
26 Physicians Bulletin January/February 2013
The Frankel File Hometown: Omaha Undergraduate Degree: University of California-San Diego in animal physiology Medical Degree: University of Nebraska Medical Center Residency: University of Texas Southwestern Medical Center in Dallas Specialty: Neurology Position: Medical Director Location: UNMC-Physicians Clinical Neurosciences Center. Family: wife, Dr. Janice Peterson Frankel; four children, Sarah, Emily, Hannah and Sam
What does this mean for physiWhy I Joined MOMS: cians? Will a career in health care “Because I was interested be less enticing in the years to come? in organized medicine and Dr. O’Brien: One thing it will being an advocate for my mean is that physicians will be profellow physicians.” viding less unpaid care. I think some physicians may find themselves with a heavier workload as people who lack access to care now gain access. It is also likely that more physicians will be working in large groups rather than in solo or small group practices because of the incentives to move to the medical home model as part of comprehensive care. Dr. Frankel: Physicians are going to be asked to make some changes and be part of a paradigm shift in a new delivery model. Those coming out of training will know no difference. Those in the early and middle stages of their careers – like myself – will need to adapt and make changes. There will be some at the end of their careers who may see change as a deal-
breaker and choose to bow out. Regardless, if you choose medicine as a career, for the right reasons, I think it will always be rewarding. Against a background of increasing regulatory burden and new reimbursement strategies, the enjoyment of practicing medicine may be lost for some. Nevertheless, I believe medicine will continue to be a noble profession. How must medical schools react? Dr. O’Brien: Medical schools and teaching hospitals will have to certainly expand their residency programs in primary care. Medical schools will need to stress to their students the importance of primary care in attempting to get them to select it as their career choice. Pressing forward in primary care is the most important thing medical schools can do. Dr. Frankel: Academic medical centers will have an increasing burden to address workforce shortages and, in particular, place a great emphasis on primary care. Curriculum will need to address population health management, team-based care and interdisciplinary training. I, too, believe there has to be greater opportunities for affordable medical education and retirement of educational debt as we bring health profession graduates into the workforce. Both are significant issues. What advice would you give a college student who is considering a career in medicine? Dr. O’Brien: If a student asks me, I would say give careful consideration to primary care and the development of team-building skills because more care is going to be provided by teams that include primary care physicians, specialty physicians and advanced practice nurses. There certainly is going to be a need for team building. Dr. Frankel: I have a daughter who is pre-med at Lincoln. I have been and will continue to be supportive of that decision. I have pointed out the need for primary care physicians, but will not attempt to dissuade her from a medical/surgical subspecialty. In the interest of full disclosure, we have also talked about the opportunities for PAs and APRNs. Any career in medicine is a privilege and, in my mind, remains one of the most rewarding professional opportunities. Had Mitt Romney been elected, what would we be talking about? Dr. O’Brien: That’s hard to know. He wasn’t specific about his plans. He did say he would repeal and replace Obamacare, but didn’t say with what. He did say he would replace Obamacare on Day 1. We know the president doesn’t have power to do that. Article 2 of the U.S. Constitution imposes on the president the responsibility to ensure that “Laws are faithfully executed.” Dr. Frankel: The same issues we were talking about before the election: Health care, the economy and jobs, and the effects of other global affairs on American and our role and response thereof. I don’t think the issues would have been any different, our policies likely.
Molly Maid clean is now green! Trust Molly Maid to clean your home so thoroughly, people are guaranteed to notice!
5 Reasons why it makes sense.
Molly Maid’s private label cleaning products are environmentally safe, biodegradable and non-toxic.
It’s healthier for my family, the products are all natural cleaners and disinfectants, I don’t worry about fumes,
For a Cleaning Plan designed around your home and your lifestyle Call your Local
residue or build up.
I’m doing my part to help the environment. Even the smallest contributions can make a big difference over time. Molly Maid’s “Small Efforts. Big Results.” brochure provide additional information about creating a more green friendly home.
People always notice how clean and fresh my home is, now I’m proud to tell them it’s also a Molly Maid Green Home!
MOLLY MAID OF CENTRAL OMAHA/COUNCIL BLUFFS
402.932.MAID (6243) A clean you can trust!
Each franchise independently owned and operated
January/February 2013 Physicians Bulletin 27
MOMS events MOMS NETWORKING EVENT
A networking event was held Nov. 8 at Roja in Legacy. Attendees included several of MOMS’ newest members. New MOMS Member, Dr. Sean Langenfeld (left), a colon and rectal surgeon at UNMC, gets to know longtime member and MOMS board member, Dr. Mohammad Al-Turk. 2. Dr. Jeff Cooper (left), who recently moved to Omaha, talks with Ross Polking of the Foster Group, which sponsored the evening. Dr. Cooper serves as an assistant professor for the Department of Emergency Medicine, as well as medical director of the Hyperbaric Medicine Center at UNMC. 3. Attending the event were (from left) MOMS immediate past president Dr. Pierre Lavedan, Dr. Eric Phillips and Dr. Gary Gorby.
28 Physicians Bulletin January/February 2013
Regain the Joy of Reading Vision Helpers has modern solutions to help you.
New HD Reading Machines Lighted Magnifiers Large Print
Coming Events MARCH 19 MEDICAL/LEGAL DINNER CHAMPION’S RUN
Held in partnership with the Omaha Bar Association. Enjoy dinner and a presentation from Dr. Lee Simmons, chairman of the Omaha Zoo Foundation.
FREE Showroom or In Home Demo: Call 402-491-3191 11110 Fort St. |Omaha, NE | 68164 www.visionhelpers.com
APRIL 26 MEDICAL MESS CLUB PERFORMANCE JOSLYN ART MUSEUM WITHERSPOON HALL
JUNE 9 MOMS MEMBER EVENT AT STORM CHASERS WERNER PARK - PAPILLION
SEPTEMBER 20NMA ANNUAL MEETING & HOUSE OF DELEGATES
Dr. Kevin Nohner (MOMS Member) will be installed at NMA President.
Dedicated to providing wellness solutions to the communities we serve in the form of state of the art treatment options, education and products.
• Lift Chairs • Portable Oxygen • Wheelchairs • Power Chairs & Scooters
• CPAP & BiPAP • Trilogy Ventilators • Ramps • Stairlifts
877-592-2435 • 402-592-6914 (fax) www.midwestrespiratory.com
Serving Omaha/LaVista, Lincoln, Grand Island, Blair January/February 2013 Physicians Bulletin 29
1983 - 2013 METRO OMAHA MEDICAL SOCIETY PRESENTS:
MEDICAL MESS CLUB
Friday, April 26, 2013
CELEBRATING 30 YEARS OF OMAHA’S FACES & SPACES!
Joslyn Art Museum Witherspoon Hall
a subscription to
What is Medical MESS Club? It’s a unique evening of entertainment featuring MOMS member physicians performing musical parodies of popular songs that they have rewritten with a medical theme.
me • Ho
t • Din • ar
B ell e Ba ll s
• Ho me
• ar t•
Fun mer a Sum In Omofahth e
ka bras s cs Ne mpi Year
ly ial O g 40 Spec ratin A k-
g S arst Celeb -Binen C or esa ilaatTa La M at Tequ on Fine C ha ir s io n
Ponzu S Rest ushi & au rant
h a’s oma
r• 20 12
IT NO. VER, 5377 CO
Story: Cover t Projecaith Interf
AG CR OVE OVER C G MA aha
Cle th Cir
NO. , CO PERMIT DENVER
PRSRT POSTAG U.S. STD
P u bl
Revi rill ew
2-Years (twelve issues) for only $12.95 savings of 73% enter code ‘omag2year’
vi Encha B val of nted Anne enson Cott Kenned age Condoy’s
PRSR T STD U.S. POS TAGE
12 • 20
AN H M en P I T Cly T h e is W il
30 Physicians Bulletin January/February 2013
Reservations accepted beginning in March. Call 393-1415 for reservations.
(Medical community, friends, family and anyone with a sense of humor.)
ATTENDANCE IS OPEN TO EVERYONE!
AG CO VER
Followed by Medical MESS Club Performance
R OVE GC MA
Reception with Hors D’oeuvres and Cash Bar
Omaha’s Premier Magazine Publisher, Family-Owned & Operated, supporting & promoting Omaha for over a quarter of a century.
Our MESS performers will once again be led by Chuck Penington, Orchestra Conductor for Mannheim Steamroller.
1-Year (six issues) for only $9.95 savings of 58% enter code ‘omag1year’
ART • DINING • EVENTS • FACES • HOME • STYLE
Customed Tailored TO FIT
It’s Time to Renew Your MOMS/NMA Memberships for 2013
F YOU ARE CURRENTLY a member of the Metro Omaha Medical Society
Professional and Friendly Service
and the Nebraska Medical Association, you should have received your notice for 2013 membership renewal.
Why Join or Continue to be a Member of MOMS/NMA? We keep you informed: Members receive the latest in local, regional and national health-care news through the MOMS eBulletin and NMA STAT email newsletters, as well as the Physicians Bulletin, and Nebraska Medicine magazines and the NMA News. We keep you connected: Members have unique opportunities through local MOMS events to network with their peers, interact with local medical students and communicate with community leaders. Members also have a wide variety of opportunities to make a difference by serving on MOMS and NMA Committees and through involvement with our many local health carerelated partners. We represent physicians and patients: MOMS and NMA work diligently to monitor state legislation that will impact the future of health care. Together, our cumulative voice is heard by those who make decisions impacting Medicaid, Medicare, professional liability, insurance, rural health and public health ... just to name a few. Other valuable member benefits: • Access to the NMA Blue Cross Blue Shield health and dental plans for physicians, their family and staff. • Premium reductions for all members using COPIC. • Access to services provide by Foster Group Wealth Management. • Savings on your annual AAA membership renewals with no initiation fee for new members • Member pricing on credit-card processing through TSYS Merchant Solutions If you would like more information on MOMS membership, call (402) 393-1415 or email Laura@omahamedical.com.
Convenient Scheduling and Location 501 N 87th Street Omaha, NE 68114 (P) 402-397-7100 (F): 402-505-6949 www.omahaimaging.com
LEGAL TECHNOLOGY WITH PERSONAL SERVICE
We are dedicated to legal innovation, and have taken steps to make the practice of law a more streamlined, accurate and interactive experience.
• Asset Protection Planning • Business Succession Planning • Estate Planning • Business Structure & Transactions • Retirement Plan Design & Tax Planning • Health Care Law Blogs, Videos, Legal Articles & Information can all be found at:
CONTACT US 402.504.1300 5332 S. 138TH ST, SUITE 100 OMAHA, NE 68137-2974
January/February 2013 Physicians Bulletin 31
Mike Feilmeier, M.D.
Robert Dunlay, M.D.
Dr. Feilmeier Dr. Dunlay tabbed as tabbed interim dean outstanding young C professional
REIGHTON HAS NAMED ROBERT DUNLAY, M.D., as interim dean of its School
IKE FEILMEIER, M.D., an ophthalmologist and cornea
specialist at Midwest Eye Care, was recognized by the Midlands Business Journal as one of the Omaha area’s outstanding young professionals under age 40. Dr. Feilmeier also serves as an assistant professor at UNMC and founded its International Division of Ophthalmology. He is slated to lead a team later this year that will provide hundreds of cataract surgeries in Ethiopia, Ghana, Haiti and, locally, at the Rosebud Indian Reservation. The Midlands Business Journal annually honors 40 entrepreneuers, executives and professional men and women under age 40 from the greater Omaha, Sarpy County and Council Bluffs area. He graduated from Nebraska Wesleyan University with a bachelor’s degree in biochemistry and molecular biology. He earned his medical degree from UNMC, completed his internal medicine internship at the University of California San Diego, his residency at Bascom Palmer Eye Institute in Miami, and fellowship at John A. Moran Eye Center in Salt Lake City. The international division, for which Dr. Feilmeier serves as medical director, teaches surgeons how to provide quality eye care and surgery in developing nations.
of Medicine. Dr. Dunlay, chief medical officer of Alegent Creighton Health Creighton University Medical Center and professor of medicine and pharmacology in the School of Medicine, is a Creighton-educated nephrologist who has served as a clinician and educator since 1990. He appointment became effective Jan. 1. He completed his premedical studies at Creighton in 1977 and went on to earn his medical degree from the School of Medicine in 1981. He then fulfilled his internship and residency in internal medicine, also at Creighton. Dr. Dunlay completed fellowships in nephrology at Oklahoma University Health Sciences Center in Oklahoma City, and in nephrology research at Jewish Hospital at Washington University Medical Center in St. Louis. In 2008, he earned an MBA from the University of Massachusetts at Amherst. “ I am confident that Dunlay’s experience, commitment to education and proven ability to lead will be key for a successful transition during the search for a permanent dean as Dean Rowen Zetterman steps down from the role. His vision and energy will be instrumental in continuing to provide exceptional education for our students and strengthening our academic partnerships with Alegent Creighton Health, St. Joseph’s Hospital and Medical Center in Phoenix, and all of our academic partners,” said Donald R. Frey, M. D., vice president for health sciences.
IN memoriam Howard Poepsel, M.D. May 11, 1936 – Nov. 24, 2012
32 Physicians Bulletin January/February 2013
Julie Fedderson, M.D.
Kristine McVea, M.D.
Dr. Fedderson assumes Dr. McVea receives role of chief quality and COPIC award outcomes officer
ULIE FEDDERSON, M.D., assistant professor in the Division of General Internal
Medicine, was recently appointed as the chief quality and outcomes officer for The Nebraska Medical Center. She will be in charge of just that, outcomes and quality, in connection with the new tools available through One Chart by EPIC. Along with Carisa Schweitzer-Masek, executive director of Enterprise Applications, and Mark Weiss, executive director of Information Technology, Dr. Fedderson is a member of the newly formed Enterprise Services team. A fourth member, a chief process officer, will be selected from a nationwide search. Dr. Fedderson emphasized that these new tools will provide opportunities for looking at various aspects of quality assurance and outcomes from new perspectives across the continuum of care. She said the system is capable of tracking the patient’s experience from outpatient clinic, to the hospital admission process, to the inpatient experience, and, when the patient is discharged, back to their primary care physician, whether in Omaha or a care facility in rural Nebraska. The team now can look at processes throughout the system as a whole. Since moving beyond the implementation phase, the team is now concentrating on setting up a model for stabilization and optimization. Team members want to find the best solutions to support people who need the data to be able to get it when it is needed. Dr. Fedderson said it was previously a challenge to get data out of the old system and then understand how it related to the care provider.
RISTINE MCVEA, M.D., who serves as medical director for
OneWorld Community Health Centers, is the recipient of the Nebraska Harold E. Williamson Award, given by COPIC. “We honor Dr. McVea for her volunteer medical services and contributions to her community,” COPIC said in announcing the award. Dr. McVea’s affiliation with OneWorld began in 1995 when it was called the Indian Chicano Health Center, and she was a part-time volunteer. Now, with Dr. McVea as medical director, the organization serves more than 22,000 patients each year, more than one-half of which are uninsured. Dr. McVea serves as a board member of the March of Dimes and as chair of its Advocacy Committee. Each year, she represents the organization by educating state senators about issues that affect the health of babies in Nebraska. Last year, she was honored as “Private Citizen of the Year” by the Nebraska Association of Social Workers for her efforts on behalf of the health of unborn children. She is also a board member for Pixan Ixim, a group that supports Guatemalan immigrants living in Omaha. The COPIC Medical Foundation annually awards a physician with a $10,000 grant for a 501 (c)(3) organization of their choosing – on his or her behalf – to fund ongoing efforts to deliver and improve health care in their community.
January/February 2013 Physicians Bulletin 33
Clinic named ‘Points of Light’ recipient
REIGHTON’S MAGIS CLINIC WAS
honored with the Governor’s Points of Light group award from Lt. Gov. Rick Sheehy and First Lady Sally Ganem at a ceremony in the Warner Chamber at the State Capitol. The awards are sponsored by ServeNebraska, Nebraska Volunteer Service Commission and presented quarterly in recognition of volunteers who give their time, talent and energy to help Nebraskans build stronger communities. Creighton University medical students founded and run the Magis Clinic, located at the Siena Francis House. The outpatient clinic offers free, walk-in health services on Saturdays to Omaha’s homeless, uninsured and underinsured. Magis currently offers three regularly scheduled clinics:
Acute Care Clinic, Psychiatry Clinic and Sexual Health Clinic. Additionally, at various times, the specialty clinics provide diabetic care, pediatric vaccinations, influenza vaccinations and other services to patients. Medical students and physicians volunteer at the clinic, seeing more than 20 patients each Saturday. Physician supervision is provided by more than 60 physician volunteers from Creighton University in the Omaha practice community.
Study advances stroke recovery treatment
NEW STUDY, WHICH INCLUDED Creighton’s
School of Medicine, using brevetoxin-2, a compound produced naturally by marine algae, stimulated nerve cell growth and plasticity in cultured mouse neurons. This research advances a potentially new pharmacological treatment to aid recovery of brain function following a stroke or other traumatic brain injury. “Our research suggests that compounds like brevetoxin-2 can augment neuronal plasticity potentially providing a neural repair therapy for stroke recovery. If that outcome can be supported by further studies in animals and subsequently
Poynter Hall is located on the southwest corner of 42nd and Dewey streets. Sixteen psychiatry faculty and 31 staff members moved into the building, which features a new entrance on the east side. The entrance brings people into the building on the second floor.
Psychiatry returns to UNMC campus
NMC’S DEPARTMENT OF PSYCHIATRY
has come home after 13 years of being located more than a mile east of the main UNMC campus at 515 S. 25th St. in the former Lutheran Hospital, the department has moved into newly renovated Poynter Hall. “We are thrilled to be returning to campus,” said Steve Wengel, M.D., professor and chairman of the department. “Psychiatry is an important area of medicine, as mental illness affects every family. “Mental illness has a direct correlation to many different health conditions. By being back on campus, it will greatly enhance our visibility and allow us to better collaborate with clinicians and researchers in other departments. We couldn’t be more excited.”
Dr. Nguyen to lead Department of Ophthalmology UAN DONG NGUYEN, M.D., a retina
and uveitis specialist from the Johns Hopkins School of Medicine, has been named McGaw professor and chairman of the Department of Ophthalmology and Visual Sciences and Director of the Stanley M. Truhlsen Eye Institute. Dr. Nguyen’s appointment is effective March 1, said Brad Britigan, M.D., dean of the UNMC College of Medicine, and will coincide with the opening of the Truhlsen Eye Institute next spring. Born in Saigon, Vietnam, Dr. Nguyen immigrated with his parents and three brothers to the United States in 1980. He is an associate professor of ophthalmology at the Wilmer Eye
34 Physicians Bulletin January/February 2013
humans, it could have a profound impact on a currently non-treatable condition,” said Thomas F. Murray, Ph.D. associate vice president for Health Science Research and professor and chairman of the Department of Pharmacology. The research team, which also included the University of North Carolina Wilmington and Scripps Institution of Oceanography, published its findings in the Nov. 12 online edition of the journal Proceedings of the National Academy of Sciences (PNAS). The tiny marine dinoflagellate Karenia brevis produces brevetoxin, which in high concentrations is responsible for the harmful algal blooms known as red tides that occur in the waters off the west coast of Florida. The neurotoxin-laden red tide causes respiratory irritation in humans and central nervous system paralysis in fish. “Brevetoxin is a neurotoxin that is known to activate nerves cells to fire spontaneously,” said Dan Baden, Ph.D. Director of the Center for Marine Science is a founding member and Executive Principal of MARBIONC at University of North Carolina Wilmington. “It’s a great advancement to show that this naturally occurring ocean compound can stimulate nerve cell growth in cultured mouse cells.”
Institute, specializing in uveitis and diseases of the retina and vitreous. “The opportunity to lead a department that has been in existence since 1898 when Dr. Harold Gifford first established it and to make the Truhlsen Eye Institute into one of the leading academic ophthalmology centers in the United States is truly exceptional,” Dr. Nguyen said. Dr. Nguyen’s wife, Diana V. Do, M.D., is also a retina specialist at the Wilmer Eye Institute at Johns Hopkins and will be joining the UNMC faculty as an associate professor and director of the Center for Innovative Clinical Trials in Ophthalmology. “It’s estimated that by the year 2020 age-related eye diseases will increase by 30 percent in the U.S.,” Dr. Britigan said, “so the timing is perfect to bring on these two outstanding physicians and further elevate our research, education and clinical programs.” A graduate of the Phillips Exeter Academy, Dr. Nguyen received simultaneously his bachelor’s and master’s degrees in molecular biophysics and biochemistry from Yale University. He earned his medical degree from the University of Pennsylvania School of Medicine.
Metro maha Medical Society
STRATEGIC PARTNERS The Metro Omaha Medical Society Strategic Partners offer products and services that are of value to our member physicians. Many of MOMS member events and membership benefits are made possible by these partner organizations. We encourage you to talk with our Strategic Partners when making decisions for yourself or your practice.
PLATINUM PARTNERS www.callcopic.com
on CompANioN CAre CountVNA Built on our tradition of skilled care, VNA delivers a new level of nursingsupported care to your patients. VNA Companion Care, part of our complete line of in-home care services, delivers the highest quality homemaker, companion and personal care services â€” providing the right care at the right time. And as your patientsâ€™ needs change, you can count on VNA to be there with them.
Complete In-Home Care
Companion Care Skilled Home Care iV Therapy Home Health Technology Hospice and palliative Care
GOLD PARTNER www.YourFutureCounts.com
SILVER PARTNERS www.KoleyJessen.com
BRONZE PARTNERS www.LutzCPA.com
For more information on out Strategic Parnters, visit www.omahamedical.com January/February 2013 Physicians Bulletin 35
Application for Membership This application serves as my request for membership in the Metro Omaha Medical Society (MOMS) and the Nebraska Medical Association (NMA). I hereby consent and authorize MOMS to use my application information that has been provided to the MOMS credentialing program, referred to as the Nebraska Credentials Verification Organization (NCVO), in order to complete the MOMS membership process.
Personal Information Last Name: _____________________________ First Name: _______________________ Middle Initial: ______ Birthdate: _________________________________________________ Gender: Male or Female Clinic/Group: __________________________________________________________________________________ Office Address: ________________________________________________________________ Zip: __________ Office Phone: ____________________ Office Fax: ___________________ Email: _________________________ Office Manager: _______________________________________ Office Mgr. Email: ________________________ Home Address: ____________________________________________________ Zip: ________________________ Home Phone: __________________________________________ Name of Spouse: ________________________ Preferred Mailing Address: Annual Dues Invoice: Event Notices & Bulletin Magazine:
Home Other: __________________________________
Home Other: __________________________________
Educational and Professional Information Medical School Graduated From: __________________________________________________________________ Medical School Graduation Date: ____________________ Official Medical Degree: (MD, DO, MBBS, etc.) _______ Residency Location: _____________________________________________ Inclusive Dates: _________________ Fellowship Location: _____________________________________________ Inclusive Dates: _________________ Primary Specialty: ______________________________________________________________________________
Membership Eligibility Questions YES
(If you answer “Yes” to any of these questions, please attach a letter giving full details for each.)
Have you ever been convicted of a fraud or felony?
Have you ever been the subject of any disciplinary action by any medical society, hospital medical staff or a State Board of Medical Examiners? Has any action, in any jurisdiction, ever been taken regarding your license to practice medicine? (Including revocation, suspension, limitation, probation or any other imposed sanctions or conditions.) Have judgments been made or settlements required in professional liability cases against you?
I certify that the information provided in this application is accurate and complete to the best of my knowledge.
Fax Application to: 402-393-3216
Mail Application to: Metro Omaha Medical Society 7906 Davenport Street Omaha, NE 68114
36 Physicians Bulletin January/February 2013
Apply Online: www.omahamedical.com
NEW MEMBER update
NEW MEMBERS Matthew Brumm, M.D. Ophthalmology Christopher Glowacki, M.D. Obstetrics & Gynecology
Ruby Satpathy, MBBS
Marc Scheer, M.D.
Medical School: SCB Medical College
Medical School: Nova Southeastern University
Specialty: Interventional Cardiology
Location: Alegent Creighton Bergan Mercy Medical Center
Location: Midwest Gastroenterology Associates
Dr. Satpathy completed an internship at SCB Medical College, residency at MKCG Medical College and Hospital, as well as Creighton University and fellowships at Creighton University and William Beaumont Hospital. She travels frequently and enjoys playing tennis and spending time with her children, daughters ages 6 and 1. She enjoys rocking and singing to her youngest. With her 6-year-old, she enjoys dancing, reading together, playing board games and watching ballets.
Rajkumar Yarlagadda, M.D. Radiology
Dr. Scheer was born and raised in Toledo, Ohio. He completed his internship and residency in internal medicine at Northwestern University (Evanston Hospital) before moving to Omaha where he recently completed his fellowship at UNMC. In his free time, he enjoys shortand long-distance running, including marathons. He also plays a defensive position on a recreational ice hockey team and pitches for the Midwest GI slow-pitch softball team. He and his wife enjoy spending time with their three children, taking them to the zoo or going to the Orpheum Theater for plays and musicals.
Interested in becoming a MOMS Member? Call 402-393-1415, apply online at www.OmahaMedical.com or complete the application on page 36.
January/February 2013 Physicians Bulletin 37
Your home...your builder.
Selecting a builder is as much an expression of taste as it is a statement of confidence. No one understands this better than Curt Hofer & Associates. As one of the area’s most respected custom homebuilders, we provide a one-of-a-kind experience in creating your once-in-a-lifetime home. Your wants, your needs, your style, your preferences – everything we do at Curt Hofer & Associates is advanced with the thought of you in mind. That means spending time with you, from the very beginning and at every step along the way. From individual rooms, to how these rooms come together to create a home, to the landscape and exteriors that immediately bid you welcome, the team at Curt Hofer & Associates knows how to bring the best ideas to life – yours. The result? Your home...your builder. Exceptional.
Your home...your builder. Exceptional.
2332 Bob Boozer Drive Omaha, NE 68130 Phone: 402.758.0440 n
38 Physicians Bulletin January/February 2013
THIS IS ONE OF THE FEW TIMES
“ WO R L D C L ASS ” AC T UA L LY M E A N S
“ W O R L D C L A S S. ” Alegent Creighton Health is the only health system in the world to be accredited for chest pain and heart failure and certified in atrial fibrillation by the Society of Cardiovascular Patient Care. With a heart program that features excellent outcomes, lower mortality rates and fewer complications, we are on a mission to make healthcare healthier.
Creighton University Medical Center
Metropolitan Omaha Medical Society 7906 Davenport Street Omaha, NE 68114
ADDRESS SERVICE REQUESTED
One number accesses neonatal and pediatric transport, any problem, anytime.
Physiciansâ€™ PriOrity Line
your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport service.
PRSRT STD U.S. POSTAGE
PERMIT NO. 838 OMAHA, NE