Page 1

New President to Take Hands-on Approach

January/February 2014 • USA $1.95

ALSO INSIDE

Douglas County Community Health Improvement Plan Scope of Practice Under Scrutiny

WIC: Clearing Up Confusion about Baby Formula

A Publication of the Metro Omaha Medical Society • www.OmahaMedical.com


THIS Issue

Januar y/Februar y 2014

14

16

18

22

features

departments

14

CHIP: Everyone

6

Editor’s Desk

16

Scope of Practice

8

NMA Message

18

COVER: New President

10

Finance Update

2 2

WIC: Clearing Up Confusion

11

Young Physician

12

Clinical Update

26

MOMS Events

27

MOMS Coming Events

2 8

Member News

31

Campus Update

33

New Member Update

Can Play a Role Under Scrutiny

to Take Hands-on Approach about Baby Formula

2 Physicians Bulletin January/February 2014

A Call for Critical Thinking Advocacy is Our Top Priority Giving Wisely

Celebrating New Beginnings, Opportunities Reducing the Risk of Failure to Rescue


Working with you for a

healthy Nebraska

nebraskablue.com Blue Cross and Blue Shield of Nebraska is an Independent Licensee of the Blue Cross and Blue Shield Association.


Nebraska Spine Hospital

The best at what we do because it is all we do Dr. Timothy Burd • Dr. Jonathan Fuller • Dr. Brian Gill • Dr. John Hain Dr. Michael Longley • Dr. John McClellan • Dr. Eric Phillips • Dr. Randal Woodward 2014 VOLUME 37, NUMBER 1

Only spine specialty hospital within a hospital in Nebraska ensuring the highest level of patient safety 2.3 days average length of stay

98th percentile for overall patient satisfaction and likelihood to recommend

1 Board Certified Neurosurgeon

7 Board Certified Orthopaedic Spine Surgeons

1 Nurse Navigator to guide patients through their healing process Over 4000 Spine Surgeries Performed

877-959-1001 NebraskaSpineHospital.com

A Publication of the

Metro Omaha Medical Society 7906 Davenport St. • Omaha, NE 68114 (402)393-1415 • www.omahamedical.com OFFICERS President | Debra L. Esser, M.D. President-Elect | David D. Ingvoldstad, M.D. Secretary-Treasurer | Lori Brunner-Buck, M.D. Past President | Marvin J. Bittner, M.D. Executive Director | Carol Wang EXECUTIVE BOARD Debra L. Esser, M.D. David D. Ingvoldstad, M.D. Lori Brunner-Buck, M.D. Marvin J. Bittner, M.D. Mohammad Al-Turk, M.D. Jane Bailey, M.D. David Filipi, M.D. Harris Frankel, M.D. Michelle Knolla, M.D. Jason Lambrecht, M.D. William Orr, 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 Junior Graphic Designer | Marti Latka 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 • Dawn Dennis

8 01 C HOPHOUSE AT T H E PA X T O N

U.S.D.A. Prime Grade Beef and Jet Fresh Seafood 1403 FARNAM ST. | DOWNTOWN OMAHA 402.341.1222 | 801RESTAURANTGROUP.COM

for advertising information: 402-884-2000 Physicians Bulletin is published bi-monthly by Omaha Magazine, LTD, P.O. Box 461208, Omaha NE 68046-1208. © 2014. No whole or part of contents herein may be reproduced without prior permission of Omaha Magazine or the Metro Omaha Medical Society, excepting individually copyrighted articles and photographs. Unsolicited manuscripts

DINNER: MON-SAT 5-10 | SUNDAY 5-9 GIFT CARDS • PRIVATE DINING • HAPPY HOUR M-F 4-6 SUNDAY PRIX FIXE $33

4 Physicians Bulletin January/February 2014

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.


spend time with them.

Leave your wealth management to us. It’s what we do. Learn about our approach. Call today.

We have lots of ideas, and you can read them online. Go to bonnettwm.com. Click on “Wealth Talk.”

14710 West Dodge Road #203 Omaha, NE 68154 Wealth Management Personally Delivered.

(402) 556-8858

2014 Physicians Bulletin Securities offered through Securities America, Inc., member FINRA/SIPC. Jerome P. Bonnett, Jr., CFP®, ChFC®,January/February 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.

5


EDITOR’S desk

A Call for Marvin Bittner, M.D. Editor

Critical Thinking

N

OT LONG AGO, A friend asked me about

a physician whom I’ll call “Dr. X.” However, it had been years since I’d seen Dr. X. I hardly remembered Dr. X. So I turned to the Internet. What would a Google search reveal about Dr. X? Some physician-rating websites popped up. I’ll call them “DoctorRater1” and “DoctorRater2.” DoctorRater1 gave Dr. X four stars for patient satisfaction (out of a possible four stars). DoctorRater2 gave Dr. X five stars out of a possible five. Wouldn’t you love to be Dr. X? Well, my search also turned up more facts about Dr. X: a license revocation and two prison sentences. There’s a lesson. Uncritical use of physician rating websites may be misleading. Many people, lay and professional, recognize this. Critical thinking must be a part of Internet use – at least when it involves medicine. A few years ago, I learned that I could locate key medicine articles much faster with Google than with PubMed. After that experience, I mentioned my new opinion of Google to a non-physician acquaintance. That acquaintance was skeptical. He knew that a Google search might obtain valuable information – and a lot of misleading information. Considering my subsequent experience with my search for information about Dr. X, I can say that my acquaintance was absolutely right about the dangers of encountering misleading information on the Internet. Would you want your mother to rely on Dr. X’s four- and five-star ratings from DoctorRater1 and DoctorRater2? However, I was able to point out a key fact to my acquaintance: I am a physician, and I am not an uncritical user of the Internet. Critical thinking is a key part of medical training. Critical thinking is what I

6 Physicians Bulletin January/February 2014

do to decide whether to trust DoctorRater1 and DoctorRater2, on the one hand, or online news reports of repeated prison sentences. Critical thinking goes on throughout my professional work. I order a test. A wildly abnormal result is reported. A member of the lay public might say: “My goodness! What a serious abnormality! The patient must be in grave danger! It’s important to order all sorts of follow-up tests and treatments immediately!” Physicians, as critical thinkers, will approach the result differently. We will assess the possibility of immediate danger – but ask ourselves the critical thinker’s question: “Does this make sense?” Some people question some of the need for physicians in an era when they can access all sorts of information on the Internet. Some people seek a broader scope of practice for non-physician health professionals. But I have a question for them: Can these alternatives to physicians replace the individual who has completed extensive medical training and – in particular – has been imbued with the need for critical thinking about medicine? That’s one reason our partners in the Nebraska Medical Association work so diligently when the state government considers expanding the scope of practice of non-physicians whose training is dwarfed by that of physicians. That’s a reason MOMS and the NMA need the support of all of us.


Patients with ID Problems? We provide team-based care for: • Infectious Diseases Inpatient/ Outpatient Consultations • Office Infusion Therapy • Vaccine Management

FOR ASSISTAnCE AnD COnSulTATIOn COnTACT uS AT

402-934-6504 OR

www.idmidwest.com

Robert G. Penn MD, FACP, FSHEA, FIDSA

Board Certified: Infectious Diseases Douglas Penington, APRN Stacey Shinaut, APRN Elizabeth Jacobsen, PA-C Courtney Sullivan, ACNP Erin Thoman, APRN

January/February 2014 Physicians 8111 Professional Building • 8111 Dodge Street, Suite 363 • Omaha, NE 68114Bulletin 7


NMA message

Dale Mahlman Executive Vice President

Advocacy is Our Top Priority

Nebraska Medical Association

A

S THE SEASON CHANGED from fall to

winter, football to basketball, interim to active legislative session, it’s time to reflect on where the time has gone. Too fast in most cases, but regardless 2014 is here and let’s get going. With advocacy as our No. 1 priority, our mission “To serve our physician member as advocates for our profession, for our patients and for the health of all Nebraskans” is once again put to the test with the return of the Nebraska Legislature on Jan. 8. This short session (60-day) is sure to see many issues of interest to Nebraska physicians, whether affecting their patients, practice or themselves personally. As I have mentioned in previous Bulletin columns, this will be the final session for 17 term-limited state senators and we have really appreciated the service of these individuals and look forward to one final opportunity to collaborate. MOMS does an excellent job meeting with the metro-area legislators in advance of the session, and that interaction serves as a good introduction to our issues of interest. Again, it’s all about the relationship, so many thanks to the physicians who took their time to attend the Senator Breakfasts. We are well into our 2014 dues cycle. Many thanks to those of you who have already chosen to support your local and state medical associations. We believe it’s a privilege to serve the physicians of Omaha and the state of Nebraska, but your continued confidence and financial support does not go unnoticed. While we always view advocacy as our No. 1 priority, other efforts don’t follow far behind in importance. Our continued monitoring of the medical liability environment is always on our list and this year is no different. We believe Nebraska physicians have one of the better environments to practice medicine due in part to our Hospital Medical Liability Act,

8 Physicians Bulletin January/February 2014

which passed in 1976. The NMA was actively involved in passage of that important legislation and remains steadfast in our support of the Act and any attempts to amend. As a result of this legislation, Nebraska physicians pay significantly less in premiums for coverage as documented in the October 2013 edition of the Medical Liability Monitor. Just as an example, Nebraska OB/GYNs pay $18,600 compared to $27,200 for their colleagues in Iowa and $54,500 in Colorado. Nebraska internists pay $4,000 compared to $6,000 for their colleagues in Iowa and $12,600 in Colorado. Finally, our Nebraska general surgeons pay $12,500 compared to $17,800 in Iowa and $60,500 in Colorado. These significant savings are largely due to the effects of having a strong, well-functioning Hospital Medical Liability Act. By supporting MOMS and the NMA, you help us in our efforts to continue to support this important legislation. We look forward to working with new MOMS President Deb Esser, M.D., who assumed her role in January. Dr. Esser has been active with the NMA in her role as medical director for Coventry and we know she will be a great face and leader for organized medicine in the metroOmaha area. Her involvement with our public health initiatives, legislative efforts, practicerelated issues and others will continue to make the relationship between MOMS and the NMA a strong and productive one. Finally, as I’ve urged in the past and will continue to do so in the future, please get involved. Make a phone call, write a letter or email, attend a fundraiser. In short, make your voice heard. With all the interest in scope of practice expansion, organized medicine cannot stand on the sidelines. This requires active participation by all and you are our best resources.


Molly Maid clean is now green! Molly cleanisisnow nowgreen! green! Molly Maid clean lean is now green!

e’s in

IN

in e ag

Bu

ER

sin

e s s t o B u sin e

ss

M

2 012 • W

ER

s

a’

W

ah

N

2606 S. 156th Circle | Omaha, NE 68130 (402) 399-9233 | www.sparklingklean.com

az

Om

A+ Rating

N

5 5 5

aha Maga z Om

B2 B

our le

g ,

Commercial Construction Green Environments Disaster Recovery Industrial Medical Education

Trust Molly Maid to clean your home soMolly thoroughly, Trust Maid to people clean your Molly Maid clean your home so thoroughly, people areTrust guaranteed to to notice! home so thoroughly, people are guaranteed to notice! are guaranteed to notice!

IN

4 Consecutive Years

For aa Cleaning Cleaning Plan around For Plandesigned designed around your home and your lifestyle For a Cleaning Plan designed your home and your lifestylearound your Call homeyour andLocal your lifestyle Call your Local For a 1Cleaning Plan designed around products are environmentally biodegradable and non-toxic. Molly Maid’s private label safe, cleaning Call your Local biodegradable and non-toxic. products are environmentally safe, It’sand healthier for my lifestyle family, the products your 1home your biodegradable and non-toxic. are all natural andproducts disinIt’s healthier for mycleaners family, the 2Call yourIcleaners Local don’t worry about fumes, natural and disinhealthier for my family, the products 2 are allIt’sfectants, Reasonswhy why Reasons it makes sense. Reasons why it makes sense. Molly Maid’s private label cleaning it makes sense. Molly Maid’s private label cleaning safe, 1 products are environmentally

2

We’ll take the night shift

residue or build up.

fectants, worry about fumes, are allI don’t natural cleaners and disinI’mordoing my partworry to help the environment. residue build up. fectants, I don’t about fumes, Even the smallest contributions can make residue or build up. a bigmy difference I’m doing part to over helptime. the environment.

3

y Maid Maid34clean clean isis now now green! green!. . . and weekends and holidays! 402.932.MAID (6243)

ducts

s,

nment. make

3

4

Even the smallest contributions can make I’m doing my part to help the environment. Molly Maid’sover “Small Efforts. Big Results.” a big difference time. Even the smallest contributions can make MOLLY MAID OF CENTRAL OMAHA/COUNCIL BLUFFS provide additional a brochure big difference over time. information about creating a more green friendly MOLLY MAID OF CENTRAL OMAHA/COUNCIL BLUFFS Molly Maid’s “Small Efforts. Big Results.” home. brochure additional informaMolly provide Maid’s “Small Efforts. Big Results.” MOLLY MAID OF CENTRAL OMAHA/COUNCIL BLUFFS tion brochure about creating a additional more green friendly provide informaPeople always notice how clean and home. fresh my home is, now I’m proud to friendly tion about creating a more green

A clean you can 402.932.MAID (6243) 402.932.MAID (6243) MOLLY MAID OF CENTRAL OMAHA/COUNCIL BLUFFS trust! A clean you can A clean. you can 5 402.932.MAID (6243) trust! 5 olly y Maid Maid toto clean clean your your cathy.tichy@mollymaid.com trust! A clean you can o thoroughly, thoroughly, people people . franchise independently owned and operated aranteed anteed toto notice! notice! . trust!Eachcathy.tichy@mollymaid.com Each franchise independently owned and operated

cleanisisnow now green! green! ean

ults.” ma-

friendly

and o en

45

home. tell them it’s also a Molly Maid Green People always notice how clean and Home! freshPeople my home is, now I’m how proud to and always notice clean tell them a Molly Maid Greentoindependently owned and operated fresh it’s myalso home is, now I’mfranchise proud Each tell them it’s also a Molly Maid Green Home! Home!

cathy.tichy@mollymaid.com

an your eople e independently owned and operated ur ice! eichy@mollymaid.com

.

5 5

ForFora aCleaning CleaningPlan Plandesigned designedaround around your yourhome homeand andyour yourlifestyle lifestyle We can help care for your patients For acleaning Cleaning Plan designed around yyaid’s Maid’s private private label label cleaning Call Call your yourLocal Local after hours. The report will be

Reasons easons why why makes makessense. sense.

se.

your home and your lifestyle

ts ucts areare environmentally environmentally safe, safe, egradable adable and and non-toxic. non-toxic.

yourdesigned Local For a CleaningCallPlan around your home and your lifestyle ants, s, Iproducts don’t I don’t worry worry about about fumes, fumes, he Call your Local ue or build or build up.up. disin-

eaning y safe, ealthier thier for for mymy family, family, thethe products products ic. all atural natural cleaners cleaners and and disindisin-

Boys Town Pediatrics Pacific Street Clinic

waiting for you in the morning.

Same Day Pediatrics offers t fumes, scheduled sick appointments 7 days oing g mymy part part to help to help thethe environment. environment. ethe smallest smallest contributions contributions can can make make cts a week. It’s not an urgent care ference difference over over time. time. environment. ns can make center, yaid’s Maid’s “Small “Small Efforts. Efforts. BigBig Results.” Results.” MOLLY MOLLY MAID MAID OFOF CENTRAL CENTRAL OMAHA/COUNCIL OMAHA/COUNCIL BLUFFS BLUFFS but a real pediatric clinic hure e provide provide additional additional informainformag Results.” MOLLY MAID OF CENTRAL OMAHA/COUNCIL BLUFFS for all Omaha children. out about creating creating a more a more green green friendly friendly

informament. e. green friendly ake

402.932.MAID 402.932.MAID(6243) (6243)

402.932.MAID (6243) ple always always notice notice how how clean clean and and AAclean cleanyou youcan can A clean you can ymy home home is, now is, now I’mI’m proud proud to to s.” MOLLY MAID OFGreen CENTRAL OMAHA/COUNCILtrust! BLUFFS m hem it’s it’s also also a Molly a Molly Maid Maid Green trust! trust! e!

lean and oud to id Green

402.932.MAID (6243). . . owned Each Each franchise franchise independently independently owned and and operated operated A clean you can cathy.tichy@mollymaid.com cathy.tichy@mollymaid.com hy.tichy@mollymaid.com trust!

BOYS TOWN

d

n

. independently owned and operated

14080 Boys Town Hospital Road (139th & Pacific, on Boys Town Campus)

Boys Town Pediatrics 88th Street Clinic 88th & Center

(402) 334-SICK BOYS TOWN

Pediatrics

endly

anchise independently owned and operated

Same Day Pediatrics at two locations:

®

boystownpediatrics.org

®

January/February 2014 Physicians Bulletin 9


FINANCE update

Ross Polking lifeWealth Adviser

Giving Wisely

The Foster Group

P

HYSICIANS, BY AND LARGE, are very

philanthropic, and this time of the year always brings out the giving spirit. Maybe you’re someone who really enjoys giving. If you’re like many others, one of the first things you reach for is your wallet. While cash or checks are meaningful, you can achieve your charitable goals in a way that allows your money to go further by instead giving appreciated securities you’ve held longer than 12 months. Here’s a simple example: You purchased stock a few years back for $10 a share. Now it’s worth $30 a share. If you give these shares away, you can deduct their full market value on your tax return, while the charity pays no tax at all and receives the full market value of the gift. What’s more, you pay no capital gains taxes. If you think about it, with no tax on either side, larger gifts are created as well as greater opportunity for impact. When you give appreciated securities instead of cash, you can buy the same securities back immediately. By so doing, you’ll maintain your position in the market and establish a higher cost basis than what existed with the gifted securities, resulting in potentially lower taxable gains in the future. The IRS deduction limit for charitable cash gifts is 50 percent of your adjusted gross income (AGI); gifts of appreciated securities are deductible up to 30 percent of AGI. If your AGI was $500,000, you could give $250,000 in cash or,

10 Physicians Bulletin January/February 2014

instead, deduct 30 percent with appreciated securities and the difference in cash, if you want the full deduction in one tax year. What if you give appreciated securities equaling 40 percent of your AGI? Well, 10 percent can be claimed the following year or carried over for up to five years total. If you happen to give a lot relative to your income, you’ll want to discuss additional strategies with your tax consultant. It’s not difficult to gift appreciated securities. Ownership of the security must be transferred directly to the charitable entity. You can’t sell the security and give the resulting cash. Charities often have brokerage accounts established to receive transfers from other financial institutions. Another great option is gifting securities through a Donor Advised Fund (DAF), a functional and easy-to-use tool that offers ease of administration and the ability to direct gifts to more than one charity. By transferring shares from your investment account to a DAF, your subsequent gifts to charities are then tax-free. DAFs can be set up at financial institutions, community foundations, and other supporting entities. Giving appreciated securities is a simple way to meet your charitable goals with tax advantages that benefit both you and the recipient of your gift. If you’re looking to maximize the effect of your charitable giving, donating appreciated securities is a real “win-win” for you and the non-profits and charities you care about the most.


YOUNG PHYSICIAN repor t “As physicians, we have so many unknowns coming our way...

One thing I am certain about is my malpractice protection.”

Celebrating New Beginnings, Opportunities

W

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.

ITH THE START OF a new year, we celebrate

new beginnings and opportunities. It is a time to re-evaluate priorities and make a concerted effort towards positive change. It is also a time to set personal goals and work toward achieving them. As chair of the MOMS Young Physicians Group, I am excited. We have a lot of things planned. You may ask, what is a MOMS young physician? For those who are still young at heart, you will always be a young physician in my book. However for MOMS, a young physician is someone who is 40 years of age or less or in his or her first five years out of training. This group is designed to provide young physicians a voice and the tools to start their career with success. While participating in this valuable network, its focus is to engage and meet the needs of young physicians, connect with other Omaha young professionals and come together to make a positive difference in our community. Throughout the coming year, the Young Physicians Group will have unique opportunities to network with their peers as well as other young professional groups, including their counterparts

Jason E. Lambrecht, PharmD, M.D. Chair, MOMS Young Physicians

at the Omaha Bar Association. There will be educational events to provide you with vital information outside of patient care to ensure success in your personal and professional lives including financial management, contract negotiations, leadership and the business of medicine. There will be opportunities to spearhead efforts to give back to our community through philanthropy. These include, but aren’t limited to, a Habitat for Humanity build event in the spring and providing essential health education to high school students at the Omaha Street School. As chairman of your Young Physicians Group, I am here to serve you and your needs. I am excited for this new opportunity and what it will bring and invite all of my peers to get involved, attend a meeting and discover what the MOMS Young Physicians group has to offer. I look forward to meeting you and wish you the best in your medical practice. For more information on membership or the MOMS Young Physicians group, contact Laura Polak at 402-393-1415 or Laura@OmahaMedical.com

Professional Liability Insurance & Risk Management Services ProAssurance Group is rated A+ (Superior) by A.M. Best. ProAssurance.com • 800.282.6242

January/February 2014 Physicians Bulletin 11


CLINICAL update

Dan Rosenquist, M.D. COPIC’s Patient Safety and

Reducing the Risk of Failure to Rescue

Risk Management Department

W

HILE THERE IS MUCH we can do to

reduce the risk of complications after procedures in medicine, it is unlikely that our complication rate will ever be zero. Thus, it is important to strive for recognition of unanticipated outcomes as quickly as possible and to initiate rescue efforts and mitigate the effects of those complications for our patients. Atul Gawande, a professor of surgery at Harvard Medical School, discussed this issue in a commencement address published for The New Yorker1 and pointed out that the major differences in morbidity rates among hospitals is not in the frequency of complication rates, but rather in the success the better institutions have in rescuing their patients when things do not go as planned after a procedure. One study, published by the Bulletin of the American College of Surgeons2, is a retrospective review of a large claims database from a national professional liability company, which obviously has the limitation of identifying only events that have led to lawsuits. Nonetheless, the study identified the primary cause of delayed recognition was inadequate patient assessment, whether it was failure to order necessary tests, failure to consider the importance of those tests or other information or over-reliance on negative tests when patients did not improve. Second,

failure of communication among providers was the cause of many delays, not only regarding the patient’s current condition, but also regarding follow-up of incidental findings that fell through the cracks. These communications should not only include covering partners, but hospitalists, nurses, primary care providers and family members as well. The second study appeared in the Annals of Surgery3 and was observational, following 50 surgical patients in the postoperative period, watching for process failures and other errors in their care. The study highlighted the number of “non-routine” events that occur in day-to-day practice that do not necessarily lead to patient harm, but that could be considered latent threats. There was an average of six of these non-routine events per patient, of which, a median of 4.5 were considered process failures. One-half of the process failures led to some form of patient harm, with many due to medication errors, management of lines and drains, and pain management modes of delivery. Inadequate patient assessment, as in the claims study, also had a higher likelihood of patient harm due to delays in rescue. What can we learn from these studies? First, one should understand that a procedure on a patient is never without risk. We must accept the possibility of failure, and be prepared to

12 Physicians Bulletin January/February 2014

admit it, recognize it and take appropriate action. Second, due to the complexity of our medical system, failures of the processes we have put into place are common, probably more so than we are aware. We should be cognizant of the high-risk systems (such as management of lines and drains, and of pain medication) and take extra measures to ensure they are functioning smoothly. Third, we should be aware that most of these malfunctions result from communication failures among providers. We should smooth the way for input from colleagues, nurses, patients, office staff and others – and make use of that information as we continually assess our patients for progress in the postoperative period. There is no substitute for a careful bedside assessment of the patient who is not doing well, and for careful and urgent consideration of further testing when indicated. In short, we should anticipate success, but should plan for failure, to maximize the likelihood of a successful outcome for our patients. 1 http://www.newyorker.com/online/blogs/ newsdesk/2012/06/atul-gawande-failureandrescue.html 2 http://bulletin.facs.org/2013/06/symptomsofnormal-recovery/ 3 Annals of Surgery. 257(1):1-5, January 2013.


There’s a reason patients come from 45 states.

Other hOspitals save lives. We rebuild them. Briana was 21 when her spine was fractured in an

team meets to discuss the progress of their patients – progress that helps them rebuild their lives. This 360-degree approach means our patient

auto accident. When doctors told her to prepare

satisfaction scores are among the highest in our field,

for life in a wheelchair, she said, “No.” She came to

and our outcomes are ranked among the best in the nation.

Madonna Rehabilitation Hospital, the only hospital in Nebraska that specializes in one area of advanced medicine: rehabilitation. Today, Briana walks her rounds as a nurse healing others. And helping us all to believe in what’ s possible. a team Of true specialists. Madonna’s doctors, therapists and nurses have devoted their careers to rehabilitation and take pride in being among the top in their fields. Our rehabilitation teams are united in one cause: to achieve the best outcome for those recovering from catastrophic injury or illness. Every day, each program

Lincoln, NE www.madonna.org 800.676.5448

YOu have a chOice. Madonna is the only hospital in the country that has all levels of rehabilitation under one roof, ensuring consistent quality care. If you or someone you love is ever faced with the “What now?” that comes after catastrophic injury or illness, insist on the very best in care, from Madonna – the experts setting new standards for excellence. chOOse a better OutcOme. chOOse madONNa.


feature

Access to Care

The Schaefer File Hometown: San Dimas, Calif. Undergraduate Degree: Cal State Fullerton in biology Medical Degree: Creighton University Medical Center Residency: CUMC in family medicine Title: Vice president and chief medical officer Company: Blue Cross Blue Shield of Nebraska Hobbies: Singing, running and painting Family: husband, Phil Haines Why She Joined MOMS: “To have greater impact on the lives of people we serve.”

Everyone Can Play a Role

C

ONSIDER THIS JOANN SCHAEFER’S challenge

to fellow members of the Metro Omaha Medical Society: Get involved in the Douglas County Community Health Improvement Plan, better known as CHIP. “Change is upon us. This is my call-out to get everyone involved,” the former chief medical officer for Nebraska and current Blue Cross-Blue Shield Nebraska chief medical officer said. “Everyone can play a role somehow to make the system better.” The whole process started in 2011 with a Community Health Needs Assessment of the adult population, followed by a similar assessment of the children and adolescent population one year later. Two years later and with the input from representatives of 164 organizations, four initiatives have emerged that

14 Physicians Bulletin January/February 2014

will provide the focus for the next three years, explained Douglas County Health Director Adi Pour, Ph.D. They are: •• Assure sufficient resources that promote proper nutrition, health weight-weight maintenance, and increase the likelihood of healthy habits through maximizing a supportive environment. One objective calls for an increase in access to healthy foods through enhanced recruitment and service delivery strategies for food assistance and nutrition educational programs – as measured by a 10 percent increase in participation. •• Ensure equity in safety and health by reducing violence, injury and traumatic experiences through childhood to prevent morbidity and mortality.


feature

Objective calls for using intervention strategies – as measured by the adoption of a crisis response plan in 10 faith-based, higher education or community-based organizations – that reduce the effects of traumatic childhood experiences. •• Ensure that all citizens have knowledge of and access to a fully integrated system of sufficient behavioral health and primary care services and resources. An objective calls for a 5 percent increase in the behavioral health workforce to ensure a workforce that meets or exceeds the demands of the community as determined by workforce analysis, findings and recommendations with short- and long-term goals The remaining initiative, according to Drs. Pour and Schaefer, could be where MOMS members can have the greatest impact. The initiative focuses on improving access to health care. The objectives call for decreasing by 5 percent the number of residents who report difficulty or delay in obtaining health services and a decrease by 2 percent the number of Douglas County residents who are uninsured. The time for physician involvement is now, Dr. Schaefer said. “This is our chance for our community to come together and solve the issues in front of us – based on the data.” It’s an exciting and ambitious undertaking, admits Dr. Pour. “We do numerous needs assessments and collect data – but we never do the next step.” And this one comes with measurements for success. Within each undertaking are percentagepoint changes to achieve. Dr. Pour is counting on representatives from healthcare and other related organizations to create a roadmap for meeting these goals. Area hospitals are involved, as are participants from Pottawattamie and Sarpy counties. “This is a community plan and we need everyone to play a part,” she said. “We need widespread involvement if we want to become a healthier community. “I am thankful that MOMS is at the table.” To engage the public and chart progress, there’s even a page created on the www.douglascohealth.org site. If you want to find out how you can take part in the process, please contact the MOMS office.

Relax. Discover solutions that put you at ease.

At MMIC, we believe patients get the best care when their doctors feel calm and confident. So we put our energy into creating risk solutions designed to eliminate worry. Solutions such as medical liability insurance, physician well being, health IT support and patient safety consulting. It’s our own quiet way of revolutionizing health care. To join the Peace of Mind Movement, give us a call at 1.800.328.5532 or visit MMICgroup.com.

January/February 2014 Physicians Bulletin 15


feature

The Zetterman File Hometown: Shickley, Neb. Bachelor’s Degree: Nebraska Wesleyan in biology Medical Degree: University of Nebraska Medical Center Residency: UNMC in internal medicine and gastroenterology; New Jersey Medical School in hepatology Fellowship: UNMC in gastroenterology and New Jersey Medical School in hepatology Title: Director of faculty mentorship programs at UNMC Family: wife, Emily Jones Zetterman; sons, David, Justin and Corey; six grandchildren Why I Joined MOMS: “The reason, more than anything else, is I felt it important to work in organized medicine to improve patient care.”

Scope of Practice Under Scrutiny

W

HETHER NURSE PRACTITIONERS RECEIVE more

independence while providing patient care appears headed toward a showdown in the Nebraska Legislature. They’re seeking out support from state senators to remove the Integrated Practice Agreement (IPA) with physicians that is law according to the Nebraska Nurse Practitioner Practice Act. The intention, according to Kathy Hoebelheinrich, executive secretary of Nebraska Nurse Practitioners, is that it will allow NPs who cannot secure an agreement with a physician to be able to practice and to not be subject to physician fees.

16 Physicians Bulletin January/February 2014

This comes on the heels of a decision recently made in which the state’s Chief Medical Officer and Director of Nebraska’s Division of Public Health Joseph Acierno, M.D., came out in support of the current law where nurse practitioners have practice agreements with physicians in place. That’s despite the recommendations of two review panels earlier this year. Both endorsed autonomous practice privileges for nurse practitioners in Nebraska. A seven-person review committee initially recommended that nurse practitioners be allowed to practice without a


feature

collaborative agreement with a physician. The Nebraska State Board of Health concurred. Dr. Acierno noted that he discovered no evidence that the public suffers from the current practice agreement, and no evidence that many nurse practitioners can’t find a physician willing to sign a practice agreement. The whole issue of scope of practice has heated up in recent years, both in Nebraska and nationally. Here at home, it’s largely been optometrists asking review committees and lawmakers in the state to allow them to perform surgeries and prescribe drugs. Ophthalmologists argue the drugs being considered are too dangerous and worry that optometrists lack the training to diagnose underlying conditions. So far, the battle for nurse practitioners has taken place outside the state. To date, 17 states and the District of Columbia allow NPs to practice with full autonomy, according to the American Association of Nurse Practitioners. Three of Nebraska’s neighbors are included on that list: Colorado, Iowa and Wyoming. Nurse practitioner proponents believe the increased ability for NPs to have their own practices elsewhere will lure them away. One of the big points of contention from doctors remains training. Physicians fear the lack of clinical hours and knowledge base means that nurse practitioners will misdiagnose or not recognize when something should be referred to a specialist. Hoebelheinrich said there is movement to establish a nursing residency program in the state. Right now, she explained, the whole concept of nurse practitioner residencies is in early development and standards for curriculum need to be created. She adds: “Nurse practitioners are the most studied health-care professional,” she said. “Four decades of clinical research has consistently identified nurse practitioners as highly qualified health-care providers with outcomes that are the same or better than physicians for equivalent services in multiple settings.”  Hoebelheinrich points to the growing demand for health care as proof of the need for nurse practitioners to be able to do more. With 42 percent of Nebraska’s population living in rural areas, according to Nebraska’s Health Workforce Planning Project’s final report, that means nearly two-thirds of Nebraska’s counties are federally labeled Health Professional Shortage Designations. According to her numbers, 44 percent of primary care NPs practice in rural areas. And the pipeline of NPs is

outpacing physicians – their population has increased 33 percent between 2007 and 2011. The Nebraska Nurse Practitioner Practice Act and the Integrated Practice Agreement with physicians is a barrier to nurse practitioners throughout the state, Hoebelheinrich said. “Practice agreements are difficult to acquire and maintain, particularly in rural communities with no or relatively few physicians,” she said. Rowan Zetterman, M.D., former MOMS president and former dean of the Creighton University School of Medicine, said he believes nurse practitioners play a valuable role in health care and will continue to do so. In many practices, he said, the NPs see the most common illnesses and conditions, freeing up doctors to treat patients with bigger, more serious concerns that need more time and expertise. In looking forward to the changing landscape of health care, he said he believes a team-based approach to wellness and treatment will hold the answer. He currently sits on a committee working with lawmakers to evaluate the future model of care. Zetterman also sees the health-care team of the future including additional players – health coaches and those who work with the health registry to identify preventative measures for the patient. “The question is how can we add more members to the health-care team to use their special expertise?” At the end of the day, though, he noted a report from the American College of Physicians that states in the majority of circumstances, ideally the physician is the leader of the team, except in rare circumstances. “I think that’s a reasonable approach,” Dr. Zetterman said. He said he believes going this route also has a distinct advantage for nurse practitioners because it allows them to remain covered under a physician’s malpractice insurance and also protected as part of the medical liability cap. The one area where both freely admit that there is a great demand and opportunity for nurse practitioners is in the area of mental health. Ninety-four percent of Nebraska counties are considered to have a shortage in mental health and psychiatric services. The Nebraska Medical Association, according to Executive Vice President Dale Mahlman, wants to work with Hoebelheinrich and other NP leaders to collaborate and look at the Integrated Practice Agreement. The hope is by working together with a patient’s best interests at heart, they will find common ground.

Kathy Hoebelheinrich executive secretary of Nebraska Nurse Practitioners

January/February 2014 Physicians Bulletin 17


COVER feature

18 Physicians Bulletin January/February 2014


COVER feature

New President to Take Hands-on Approach A S ITS NEW PRESIDENT,

Deb Esser, M.D., wants members of the Metro Omaha Medical Society to get their hands dirty. “I would like to see MOMS get back to more community involvement,” said Dr. Esser, who started her two-year term as president in January 2014. “More outreach with our community for our members.” She believes that, in turn, will help MOMS be more visible and its members more engaged. MOMS’ new president originally wasn’t planning on a career in medicine. Dr. Esser said her grandfather and her mother inspired her to be a physician – but only after she took a detour. First, her grandfather. Alfred Andersen, M.D., was a family practice physician at Bergan Hospital. “He was always an inspiration to me.” As a child, Dr. Esser recalled thinking how smart her grandfather was – “He knew everything.” – and how profes-

sional he looked – “He looked sharp in his white coat. He was comfortable in all situations. Nothing flustered him.” “He was always so busy. But he was always willing to show you things. He had a lot of books and texts. If we had questions, he would take the time to go over things with you.” Next, her mother. Margaret Basgaard returned to nursing school after raising her children into their high school years. “She said ‘I always wanted to be a nurse. I am going to start.’” Her mother put her education on hold when she started having children. “She spent all of her time, raising us. I’m sure we were a handful.” Dr. Esser noted that she graduated from medical school at the same ceremony her mother received her bachelor’s degree of nursing. Dr. Esser said she enjoyed science and mathematics in high school – and decided to study chemical engineering at Nebraska. “I liked chemistry

The Esser File Hometown: Omaha

Bachelor’s Degree: Attended University of Nebraska Lincoln, studying chemical engineering Master’s Degree: Master’s Degree in Medical Management from Tulane University in New Orleans Medical Degree: University of Nebraska Medical Center Title: Vice President, Medical Affairs for Coventry Cares of Nebraska Family: husband, Bruce Esser; two daughters, Sara Jansen and Beth Esser Hobbies: Cooking, gardening and photography Why She Joined MOMS: “I saw the opportunity MOMS gives us to make a difference in the medical community and the community at large.”

January/February 2014 Physicians Bulletin 19


COVER feature

Dr. Esser, her husband, Bruce, and daughters Sara Jansen and Beth Esser, hone their shooting skills at Fremont Izaak Walton Valley Trap Range.

YOU’RE SPECIALIZED. SO ARE WE. LET OUR PRIVATE BANKERS SHOW YOU SOLUTIONS SPECIFICALLY TAILORED TO YOU AND YOUR PRACTICE.

and I liked math. Chemical engineering was right down my alley.” She recalled competing in engineer fairs held each year in Nebraska City – and earning a scholarship from UNL. “I don’t think my project placed, but there were university representatives there scouting things out – and they said they thought I would do well in engineering.” “I was always interested in medicine, but also wanted something as a back up, because you never know if medical school is in your future. I decided to apply to medical school my junior year in college to see what the process would be like and was surprised when I was accepted. Entering medical school a year early, she recalled, was daunting. She figured she’d be behind, and realized she was correct, but underestimated how far. “Do you realize that people entering medical school had their master’s degree in histology – or biology? I had math and some engineering classes. I wasn’t a little bit behind. I was three stories underground.” Her first year was a challenge. While the material was new to her, it was a review for her classmates. Thankfully, her classmates helped her catch up, she said.

Bruce Plath, SVP (402) 449-0929

As she worked through medical school, she eventually gravitated toward family practice. Initially, however, her passions changed every time she started a new rotation. But family practice, she later realized, allowed her to have variety in her medical career. Dr. Esser’s path took another focus while at Physician’s Clinic and Methodist Hospital She had become more involved in the administrative side of medicine and, in 1998, decided to pursue a master’s degree in medical management. “As I got more into the medical management side, I found it fascinating.” At about the same time, United Healthcare was looking for a part-time medical director. She enjoyed the work, and became the full-time medical director by the end of that year. She returned to Physician’s Clinic in 2001, in charge of quality. And her transition to medical administration was complete. “I miss the patients. But I think there are things we can do on the insurer’s side. You can’t change the insurance business if you’re not willing to get in and do it.” Now as vice president of Medical Affairs for CoventryCares of Nebraska, Dr. Esser works with Medicaid patients. CoventryCares is a state Medicaid

Specializing in Spine & Brain Surgery Adult & Pediatric

Leslie Volk, VP (402) 449-0904

Best of B2B eight years in a row.

Jim Sterling, SVP (402) 221-0125

Omaha -andCouncil Bluffs Main: 402-398-9243 Toll Free: 866-870-0078

1120 S. 101st St., Omaha, NE 68124 (402) 344.7300 | snbconnect.com

Dee Nadrchal, FVP (402) 449-0957

20 Physicians Bulletin January/February 2014

www.MidwestNeuroSurgery.com


COVER feature vendor. “We have the responsibility to care for and educate the Medicaid population in the state.” Her responsibilities include reviewing prior authorization requests, assisting patients with discharge planning, case management and assisting Patient Centered Medical Homes. “When I was in practice, I had 1,500 patients I saw regularly. Now I have 100,000 members – who at some point come in contact with the system and we’re trying to guide them and educate them. She has realized that Medicaid patients aren’t always comfortable talking with their physicians. “We try to help them make the most of their doctor visit. We have to empower them to ask the right questions.” Dr. Esser said she has been a MOMS member for years, but became more involved in the early 2000s when smoking became a hot topic. She chaired the Public Health Committee. “MOMS got involved to say that this (smoking cessation laws) was a public health issue. It may be a personal freedom issue, but it’s also a public health issue because the costs of smoking are tremendous.” Now, she’s entering her first year as president, and is asking the question: “What is it that MOMS should do? MOMS does many things for our physicians, but many docs still don’t know what we do.

We host Senator breakfasts and work on legislative issues. We have an active Young Physicians Committee and Women in Medicine Committee, but we could do more. One way to connect members to the community would be to tackle a hands-on project, such as working on a Habitat for Humanity house, she said. “I think that would be a fabulous way for us to give back. Many of the physicians I have spoken with are quite handy. They say ‘I could do that for a day.’” The support given to Omaha Street School is another example. MOMS members and the MOMS Foundation are providing financial support. In addition, MOMS members will help the nonprofit organization strengthen the health and wellness curriculum it offers its students. “Letting people see that physicians are not just in their offices seeing patients. I want to give our members an outlet to do something out of their ordinary day.” Finally, she plans to invite the Women in Medicine members to join her trap shooting. Her husband, Bruce, coaches the Marian High School trap team. Their daughters shoot and so does Dr. Esser. “I think they will enjoy it.”

IN THE WEST, AWARD ACCEPTANCE SPEECHES ARE SHORT AND SWEET: B THANK YOU. Speak to: Monte Schatz, Market Leader at 402.918.5407 Erin Murnan, Sr. Private Client Advisor at 402.918.5473 Brandon Burns, Sr. Private Client Advisor at 402.918.2744 Troy Arthur, Sr. Private Client Advisor at 402.918.5433 or visit bankofthewest.com/wm

ank of the West would like to thank our clients for helping us gain recognition for doing what we love. It’s an honor to be named “Best Private Bank US West 2013” by World Finance magazine.

©2013 Bank of the West. Member FDIC.

January/February 2014 Physicians Bulletin 21


feature

The Scott-Mordhorst File Hometown: Omaha Bachelor’s Degree: University of Nebraska Omaha in science Medical Degree: University of Nebraska Medical Center Residency: UNMC-Creighton’s joint pediatric program Specialty: Pediatrics Location: Children’s Physicians in Plattsmouth; clinical professor, UNMC’s Department of Pediatrics Hobbies: Cooking and reading Family: husband, Ron Mordhorst; sons, Jacob Mordhorst and Benjamin Mordhorst Why I Joined MOMS: “I joined because I wanted a place where I could connect with other physicians in the area and learn about issues coming before the Legislature. And, I think it’s fun to be a member of MOMS.”

WIC: Clearing Up Confusion about Baby Formula

T

INA SCOTT-MORDHORST, M.D., SOMETIMES finds

herself clearing up some misperceptions among new parents about baby formula. “All formula is basically the same,” the pediatrician explained. “New parents sometimes don’t realize this.” The misperception has created confusion among new mothers who receive support from WIC, the Special Supplemental Nutrition Program for Women, Infants, and Children that provides federal grants to states for supplemental foods, health-care referrals and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and

22 Physicians Bulletin January/February 2014

children up to age 5 who are found to be at nutritional risk. New parents may receive one brand of formula at the hospital for their newborns and a different brand through the WIC program, Dr. Scott-Mordhorst said. They don’t realize that brands such as Enfamil and Similac are basically the same, she said. Mary Balluff, division chief for the Douglas County Department of Health, provided an overview of the WIC Program with the hope of clearing up any questions new parents and their physicians may have: The WIC Program serves low-income pregnant, postpartum and breastfeeding women. Pregnant women may


Let me manage your fiscal health so you can focus on your patients’ physical health. Doctors enter the workforce later than the average person and need retirement strategies to help them catch up and save enough to maintain the lifestyle they want. Call me today for information on: n Strategies to reduce current taxable income n Small business retirement plans n Lifetime retirement income strategies

There’s Wealth in Our Approach.TM

Bob Kenny First Vice President - Financial Advisor 1120 South 101 Street, Suite 300 Omaha, NE 68124-1088 (402) 392-6105 bob.kenny@rbc.com

© 2013 RBC Wealth Management, a division of RBC Capital Markets, LLC, Member NYSE/FINRA/SIPC.

Receive the Highest Level of Cancer Care for your Patients.

NEBRASKA CANCER SPECIALISTS IS NOW QOPI® CERTIFIED! Nebraska Cancer Specialists was recently awarded QOPI® Certification for our outpatient oncology-hematology practice by ASCO, the largest oncology society in the U.S. Based on careful analysis and on-site inspections, we met core standards in all areas of treatment, including:

• • • • • •

Alegent Creighton Health Cancer Center - Bergan (402) 393-3110 Methodist Estabrook Cancer Center (402) 354-8124 Midwest Cancer Center Papillion (402) 593-3141 Midwest Cancer Center Legacy (402) 334-4773 Fremont (FAMC) (402) 941-7030

Treatment planning Staff training and education Chemotherapy orders and drug preparation Patient consent and education Safe chemotherapy administration Monitoring and assessment of patient well-being

This certification is an honor, a testament to our high standard of care — and a reminder that we must always strive to exceed our own expectations in order to better care for our patients.

Give your patients the opportunity to benefit from everything we can offer as the largest independent QOPI-certified cancer practice in Nebraska. Refer them to Nebraska Cancer Specialists today. 23 Physicians Bulletin January/February 2014

January/February 2014 Physicians Bulletin 23


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 our 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

www.FosterGrp.com

THE CARE AND COMFORT PATIENTS WANT, THE QUALITY AND CONVENIENCE PHYSICIANS NEED Open MRI • CT • Ultrasound •Convenient, Spa-Like Atmosphere •Same Day Appointments •Up To 60% Savings Vs. Hospitals

•Front Door Parking

•All Major Insurances Accepted

•Results Within 4 Hours

Open Monday-Friday, 8AM-6PM | Saturday by Appointment p:402.502.SCAN[7226] | f:402.502.7098

www.villagepointeimaging.com 302 N 168th Circle, Suite 202 | Omaha, NE 68118 LIKE US ON FACEBOOK

GOLD PARTNER www.YourFutureCounts.com

www.nebraskamed.com

SILVER PARTNERS www.AlegentCreighton.com

www.ClineWilliams.com

www.KoleyJessen.com

www.BestCare.org

www.SeimJohnson.com

BRONZE PARTNERS www.GoNines.com

www.LutzCPA.com

www.NebMed.org

For more information on our Strategic Partners, visit www.omahamedical.com 24 Physicians Bulletin January/February 2014

METRO OMAHA MEDICAL SOCIETY

HOME BUILDING EVENT - MAY 8-10 It’s much more than swinging a hammer and building homes . . . it’s about coming together and making a difference. MOMS invites member physicians and their families to volunteer. No previous construction experience necessary. There are jobs for all skill levels (painting, landscaping, drywall, etc.) Shifts start at 8:30 a.m. and Noon. Lunch and beverages provided.

VOLUNTEERS NEEDED! Visit www.OmahaMedical.com Make a Difference, Take Action & Volunteer! January/February 2014 Physicians Bulletin 24


feature be on the program from the time they determine they are pregnant until six months post-partum. If a post-partum woman is exclusively breastfeeding, she may stay on the program up to one year after the infant is born. Infants may be on the WIC Program from the time they are born until the month they turn 5. After they turn 1, they must be recertified every six months to determine if they still qualify for the WIC Program. During their first year, infants on the WIC program and using formula will receive the contract formula unless they need a special formula. The state of Nebraska currently is in the second year of a three-year contract with Mead Johnson and the formula is Enfamil. The WIC Program serves 3,500 women and 6,500 infants participants in Douglas County, Balluff said. Program participants receive Enfamil unless a physician certifies the child needs a different brand, Balluf said. To receive a different brand of formula, a WIC mother must have her physician fill out a Physicians Authorization Form. The physician may fax the form to the WIC office or have the mother bring it to the WIC clinic when she comes for her appointment. The form may be found on the State WIC site www.dhhs.ne.gov/publichealth/WIC or on the Resources page of the MOMS website at www.omahamedical.com, or call the Douglas County WIC Administrative office at (402) 444-1770 and have a form faxed or e-mailed. Balluf said WIC counselors encourage new mothers to breastfeed. Those who do receive additional benefits (see sidebar), she said.

Food Package for Breastfeeding Women:

• 1 pound cheese • 1 can salmon or tuna • 1 loaf whole wheat bread • 2 dozen eggs • Beans and peanut butter • 3 cans juice • 6 gallons milk • 38 oz. cereal • $10 coupon for fruit and vegetables

Food Package for Post-partum Women:

• 1 dozen eggs • Peanut butter • 2 cans juice • 4 gallons milk • 38 oz. cereal • $10 coupon for fruits and vegetables

WE’LL TAKE CARE OF YOUR BILLING FOR A FR E E C ON S U LT AT ION C AL L 858 - 731 -6057

SO YOU CAN TAKE CARE OF YOUR PATIENTS

FE W ER HE AD ACHE S . BE T TE R HE AL THC ARE

Real-time insurance verification Web based performance dashboards Web based patient bill pay W W W .S C OU TR E VE N U E .C OM

January/February 2014 Physicians Bulletin 25


MOMS events WOMEN IN MEDICINE

The MOMS Women in Medicine group met in November for dinner, networking and to gain tips and tricks to “Get Organized and Reclaim Your Space.� 1. Christine Insinger, with Heritage Financial, (right), talks with Drs. Kim Haynes-Henson (middle) and Susan Scheryl. 2. Drs. Michele Marsh (left) and Jennifer Cyr network. 3. Jennifer Bartelt, a certified professional organizer with Reclaim Your Space, provides tips on organization techniques and products.

1

2

3

4

5

6

7

8

STATE SENATOR MEETINGS

MOMS facilitated face-to-face meetings between member physicians and many Omahaarea state lawmakers during the past several The meetings provide physicians the opportunity to discuss vital legislative issues with our state lawmakers. Topics discussed included continuation of effective Medical Liability Act, scope of practice, Medicaid expansion, the Skin Care Cancer Prevention Act, mandatory motorcycle helmet law, and e-Cigarettes. As of early January, member physicians had met with State Sen. Sue Crawford, District 45; State Sen. Burke Harr, District 8; State Sen. Sara Howard, District 9; State Sen. Beau McCoy, District 39; and State Sen. Heath Mellow, District 12. 4. Dr. David Watts, greets State Sen. Sue Crawford. 5. Drs. Rowen Zetterman (front left), John Peters (back left) and Kevin Nohner (front right) meet with State Sen Burke Harr. 6. Dr. George Hemstreet (left) welcomes State Sen. Heath Mello. Dr. Kevin Nohner also attended. ANNUAL MEETING & INAUGURAL DINNER

MOMS hosted its Annual Meeting & Inaugural Dinner on January 7 at the Happy Hollow Country Club. The evening featured a networking reception with silent auction and recognition of MOMS Strategic Partners, outgoing and incoming board members and MOMS Foundation grant recipients. Highlights included the farewell address by outgoing MOMS Board President Dr. Marvin Bittner and the inauguration of Dr. Deb Esser, MOMS board president for 2014/2015. 7. Enjoying the networking reception are Drs. Tina Scott-Mordhorst, Gary Gorby and Jane Bailey. 8. New this year, MOMS offered on-site childcare. A child and one of the caregivers color together.

26 Physicians Bulletin January/February 2014


COMING events 9

10

Coming Events 11

12

WOMEN IN MEDICINE FEB. 4 6:00 - 8:00 P.M. UNCORKED 12100 W. CENTER ROAD., STE. 706 Express your creative side as you join your fellow women physicians for an evening of wine and painting. During this twohour class, a local artist will instruct you step-by-step through creating an original, one-of-a-kind painting (no previous painting experience or skill required). Advanced RSVP is required for this event. Call (402) 393-1415 to RSVP.

13 9.

10.

11.

12.

13.

14.

MOMS 2012/2013 Executive Committee members completing their terms are (from left) Drs. Deb Esser, president-elect; Pierre Lavedan, past-president; Marvin Bittner, president; and David Ingvoldstad, secretary/treasurer. MOMS 2014/2015 Executive Committee members are (from left) Drs. Lori Brunner-Buck, secretary/treasurer; David Ingvoldstad, president-elect; Marvin Bittner, past-president; and Deb Esser, president. The MOMS Foundation presented a check for $12,300.00, proceeds from the Match Program donations, to the Omaha Street School. On hand for the presentation were (from left) Shelley Pool, director of education; John and Lorri Parsons, cofounders; Dr. Michelle Knolla, MOMS Foundation chair; and Dr. Deb Esser, MOMS president. Outgoing MOMS President Dr. Marvin Bittner was presented an award in recognition of his service. Incoming 2014/2015 MOMS President Dr. Deb Esser addresses members urging them to reconnect with MOMS, with each other, and with the community. Two boys dive into a game of SorryÂŽ in the kids activity room at the event.

MEDICAL LEGAL DINNER MARCH 18 CHAMPIONS 13800 EAGLE RUN DRIVE Enjoy an evening with your fellow physicians and members of the Omaha Bar Association. The evening will feature Stuart Dornan, president of the OBA, speaking about Obamacare.

14

HABITAT FOR HUMANITY BUILD EVENT MAY 8-10 8:30 A.M. – 3:30 P.M. Member physicians and their families are invited to roll their sleeves up, grab some tools and get involved with the MOMS Habitat for Humanity event. Work could include framing, drywall, painting, installations, landscaping, etc. No previous building experience required. Working alongside MOMS members will be representatives from MOMS Strategic Partner organizations. Mark your calendar, then visit www.omahamedical.com to volunteer and make a difference.

January/February 2014 Physicians Bulletin 27


MEMBER news

Dr. Gorby

Dr. Fuller

honored as distinguished CME educator

recognized by OneWorld Community Health Centers

G

O

ARY GORBY, M.D., ASSOCIATE professor

of medicine and medical microbiology and immunology, is the 2013 recipient of Creighton University School of Medicine’s Distinguished CME Educator Award. Dr. Gorby serves on the Creighton University Biosafety Committee and has an active interest in applying computer technology for designing interactive lectures and websites. He has previously received the Innovative Use of Instructional Technology Award from Creighton University. Dr. Gorby has been the program director and presenter for the Infectious Diseases Symposium for many years. This symposium is recognized for its excellent content that is directed to health-care professionals throughout the region. He is also the program director for the Biopreparedness Symposium that is held in various locations throughout Nebraska, and teaches health professionals the current techniques for managing a crisis situation. He receives consistently high evaluations for his presentations and is a respected speaker by his colleagues and symposium attendees. Dr. Gorby earned his bachelor’s degree from Youngstown State University in Youngstown, Ohio, and his medical degree from Northeastern Ohio Universities College of Medicine, Rootstown, Ohio. He completed a residency in internal medicine at North Carolina Baptist Hospital/Bowman Gray School of Medicine in Winston-Salem, N.C., and a post-doctoral fellowship in infectious diseases with the Department of Medicine, Section of Infectious Diseases, at the University of Utah Medical Center in Salt Lake City. He also completed a U.S. West Fellowship Faculty Development at Creighton University.

28 Physicians Bulletin January/February 2014

NEWORLD COMMUNITY HEALTH CENTERS recently recognized Jonathan Fuller,

M.D., at its annual Milagro Dinner and Auction. Dr. Fuller, an orthopedic surgeon, with 22 years of experience, has been coming to OneWorld every other month since 2007 and provides care to patients through Hope Medical Outreach Coalition. While introducing him, Andrea Skolkin, OneWorld executive director, pointed out that Dr. Fuller has special expertise in several areas, including cervical herniated discs, degenerative spine, and lumbar degenerative disc disease. He graduated from Columbia College and Columbia University of Physicians and Surgeons, completing his residency at Dartmouth Hitchcock Medical Center and a fellowship at the Twin Cities Spine Center in Minneapolis. Prior to his work with The Nebraska Spine Center, he was a U.S. Air Force major and officer in charge for orthopedic spine surgery at Landstuhl Regional Medical Center in Germany. Being actively engaged in research he is also a published author and sought after speaker. “His outstanding credentials transform patient lives not only from the surgery and procedures he performs but in the hearts and minds of patients,” Skolkin said. “Having received the ‘Patients’ Choice Award,’ ‘Compassionate Doctor Recognition’ as well as ‘On-time Doctor Award,’ it is no wonder that his OneWorld patients call him the miracle worker. OneWorld also recognized the late Daniel Dietrich, M.D., who was OneWorld’s first volunteer medical director and directly responsible for the OneWorld that exists today, Skolkin said. He died in 2013. He was born in Lincoln and lived in Wilber graduating from Wilber High School, later the University of Nebraska-Lincoln and the University of Nebraska Medical Center; the very same year OneWorld was incorporated. He was co-founder and practitioner at the Omaha Family Practice Clinic, and also worked for Alegent and Methodist health systems. An active member of the American and Nebraska Medical Associations, MOMS and the American Academy of Family Practice, Dr. Dietrich was also board certified and a Diplomat of Family Practice. He was a volunteer faculty member of the Nebraska Medical Center and was awarded Doctor of the Year from the NMA in 2001. For 20 years he was the medical director for Quality Living. “What most people don’t know about Dr. Dietrich is that the OneWorld Community Health Centers we see today is a direct result of his commitment to volunteerism,” Skolkin said. “For many years, Dr. Dietrich commandeered a very ill-equipped mobile van known as the Hopemobile, which brought very basic health care to the homeless and immigrant families. Dr. Dietrich didn’t care that he had no running water on the mobile or that the mobile was falling apart. He was determined to do what it took to bring health care to the community.”


MEMBER news

Dr. Stanley

honored by Midlands Business Journal

G

ERARD STANLEY, M.D., HAS been recognized as one of the Midlands

Business Journal’s “40 Under 40,” which recognizes entrepreneurs, executives and professionals from the Omaha-Council Bluffs area. All honorees are 40 or younger. The publication noted that Dr. Stanley brought cutting-edge procedures and devices to Omaha that were previously only available on the coasts. He is one of two physicians in the country to offer Signature LipoSculpture. He also offers Vampire procedures – a process that uses platelets and fibrin extracted from a patient’s own blood to promote new tissue growth. Dr. Stanley completed his residency in rural family medicine and surgery at the North Colorado Medical Center. After his initial training, he worked for the National Health Services Corps for four years doing charitable work in low-income and critically underserved areas in the Midwest. He graduated from Creighton University Medical School and is a graduate of Leadership Omaha Class 35. He has received the Spirit of Creighton Award and the North Colorado Family Practice Medicine Leadership Award. Nearly 500 young professionals have been recognized for their entrepreneurship and leadership skills since 2002 as part of the 40 Under 40 program.

IN memoriam JOHN C. DAVIS, III, M.D. OCT. 12, 1931 – OCT. 29, 2013 IRA A. PRILUCK, M.D. FEB. 22, 1947 – NOV. 14, 2013 PETER M. TOWNLEY, M.D. NOV. 26, 1958 – DEC. 15, 2013

Bringing help Complete In-Home Care Companion Care

Skilled Home Care IV Therapy Home Health Technology Hospice and Palliative Care

www.theVNAcares.org

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 Metro Omaha Community. MOMS Foundation 7906 Davenport St. Omaha, NE 68114 402-393-1415 January/February 2014 Physicians Bulletin 29


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 • 33 locations in Nebraska and Iowa. Call 402-457-1077 or 800-279-0007.

FALL 2013 • SEPT/OCT/NOV

Mark Hasebroock DUNDEE VENTURE

CAPITAL

If your patients suffer from swollen, achy, painful, discolored legs

We can help!

BEVERLY KRACHER, PH.D. Takes Omaha Ethics Worldwide

THE VESPARADOS

Leaders of the Scootin’ Pack Omaha’s Business-To-Business Magazine

U.S. $3.25

1 0>

0

74470 63856

8

DENVER, CO PERMIT NO. 5377

PAID U.S. POSTAGE

OMAHA MAGAZINE • 5921 S. 118TH CIRCLE • OMAHA, NE 68137

PRSRT STD

OMAHA’S

BUSINESS-TO-BUSINESS MAGAZINE

Check out the new look! Find recent content at:

Call (402) 298-5727 to further relieve your patient’s condition Revealing God’s Love Through Excellence in Healthcare 12702 Westport Parkway, Ste. 101 LaVista, NE 68138 www.heartlandvein.com

30 Physicians Bulletin January/February 2014

Thomas B. Whittle, M.D. Vascular Surgeon


CAMPUS update

Alegent Creighton Health to Move Academic Medical Center to Bergan The Network Board of Directors for Alegent Creighton Health/Catholic Health Initiatives (CHI) is moving forward with the creation of a new academic medical center on the Bergan Mercy Medical Center campus, complete with a Level One trauma program. The move will take two to three years, and require an investment of $145 million to $157 million. “This monumental decision demonstrates the trust the Network Board has in Alegent Creighton Health and Creighton University to create something better and provide the best possible healthcare services for the communities we serve

UNMC’s next chancellor comes from Ohio UNMC’s next chanceller – Jeffrey Gold, M.D. – will be expected to lead the development of a vision and plan for the academic institution’s future, continue the important work of creating an integrated clinical enterprise, continue to strengthen the work of UNMC and its partners in offering the highest-quality health care; enhance UNMC’s research and academic profile and capacity and cultivate a highly collaborative, supportive and diverse workplace. “I’m delighted to welcome Jeff Gold to the University of Nebraska. Many share my view that Dr. Gold’s achievements and experience make him the right person to serve as UNMC’s next chancellor,” said University of Nebraska President James B. Milliken. “I’m looking forward to his leadership of an enterprise that is so critical to the future of Nebraska and the health of its people.”

in an ever-changing healthcare environment,” said Richard Hachten II, Alegent Creighton Health president and chief executive officer. “This bold vision provides a roadmap for our future as we navigate healthcare reform, mounting pressures for more affordable health care and the call for greater efficiencies in higher education.” Alegent Creighton Health and Creighton University established their affiliation in 2012 with the goal of creating a new and better model for health sciences education and patient care delivery supported by the best academic medical center in the region. “We will depend on academic and campus leaders, physicians and service line workers and our community to help us to design a transformational academic medical center that provide excellent patient care but continued quality education,” said the Rev. Timothy Lannon, S.J., Creighton University president. In making their decision, the Network Board reaffirmed its commitment to all the communities served and pledges to work with those same communities to design a new ambulatory center to meet the needs of residents at, or near, the

current 30th and Cuming streets location. The new facility will include primary care, specialty care, wellness services and a freestanding emergency center. Alegent Creighton Health and the university will partner on providing the needed services for the area. For students, the new academic medical center will provide opportunities for expanded clinical, research and training capabilities. “Medical students at Creighton don’t just want to have the best possible learning environment; we want to have that coupled with the Jesuit values of caring for those most in need. Those are why we exist as an institution, and they energize me every morning when I get out of bed. While the Bergan Mercy campus positions us to grow and expand our educational opportunities to make us outstanding candidates for residencies and beyond, I also want to ensure our continued commitment to the values that brought me into medicine,” said Steve Brannan, a third-year medical student and president of the Creighton Medical Government.

Dr. Gold currently serves as chancellor and executive vice president of biosciences and health affairs and executive dean of the College of Medicine at the University of Toledo in Toledo, Ohio. He has been at that university since 2005. His appointment recently was approved by the NU Board of Regents and is effective Feb. 1. Tim Clare, chairman of the NU Board of Regents, said: “We are extremely pleased to have someone as talented, passionate and experienced as Dr. Gold to lead UNMC. We are confident that, with his proven track record in health care, he can build on the successes of his predecessor, Dr. Hal Maurer, and lead UNMC to new heights in the competitive health care industry of the 21st century.” Dr. Gold also will chair the board of the recently announced integrated clinical enterprise, a unified leadership structure between The Nebraska Medical Center, Bellevue Medical Center and UNMC Physicians.

The project, the Primary Care Faculty Development Initiative (PCFDI), brings together three key disciplines – family medicine, internal medicine and pediatrics – in a coordinated effort to better prepare physicians for the rapidly evolving health care system. The PCFDI is funded by the Health Services Resource Administration (HRSA) and sponsored by the certification boards for those three specialties. UNMC was selected from a highly competitive pool of 48 applicants. The other three institutions selected were Ohio State University, the University of Minnesota and Advocate Lutheran General Hospital, Park Ridge, Ill. “This is an opportunity for UNMC to define how residents are trained in the future,” said Kelly Caverzagie, M.D., assistant professor, internal medicine, and coordinator of the PCFDI project at UNMC. “With health care reform, the patient-centered medical home will become the model for effective health care delivery. This will be a ‘train the trainer’ endeavor. We are going to have to train our faculty on how to train our residents in the medical home setting.” The pilot project will span approximately 18 months, Dr. Caverzagie said. Over the past six months, UNMC has been in the planning and preparation stage.

UNMC included in pilot program UNMC has been selected as one of four institutions to participate in a pilot program designed to transform the way resident physicians are trained in primary care.

January/February 2014 Physicians Bulletin 31


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: ˆ Male or ˆ 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:

ˆ Office

ˆ Home ˆ Other: __________________________________

ˆ Office

ˆ Home ˆ 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

NO

(If you answer “Yes” to any of these questions, please attach a letter giving full details for each.)

ˆ ˆ

ˆ ˆ

Have you ever been convicted of a fraud or felony?

ˆ

ˆ

ˆ

ˆ

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.

_____________________________________

Signature

___________ Date

B

Fax Application to: 402-393-3216

Mail Application to: Metro Omaha Medical Society 7906 Davenport Street Omaha, NE 68114

32 Physicians Bulletin January/February 2014

Apply Online: www.omahamedical.com


NEW MEMBER update

MEMBER benefits

MOMS Member Pricing On Credit Card Processing Through a partnership with TSYS Merchant Solutions, MOMS offers member physicians and their practices substantial savings on processing fees.

This program, designed specifically for MOMS members, offers: • Substantial savings on payment processing fees • No Hidden Fees • Over 55 years of experience in the industry

$500 Savings Guarantee:

Provide three consecutive months of current statements for comparison and if TSYS Merchant Solutions can’t save you money on your credit card acceptance, they will pay you up to $500.*

Call for a free price comparison and start saving. To learn more: Contact Sarah Ficenec At (402) 536-0513 or sficenec@tsys.com or visit www.tsys.com/tms *Three consecutive months of current statements required to verify current price. Payouts are calculated by TSYS Merchant Solutions on a sliding scale according to the estimated annual MasterCard® and Visa® transaction volume projected from your three most recent consecutive months processing statements. Offer may expire at any time. (4/13)TSYS Merchant Solutions is a registered ISO/ MSP of both First National Bank of Omaha, Omaha, Nebraska, and Synovus Bank, Columbus, Georgia.

Noelle Bertelson, M.D.

Benjamin Young, M.D.

Medical School: University of Washington School of Medicine

Medical School: Creighton University School of Medicine

Residency in General Surgery: Rush University Medical Center/ Cook County Integrated Program

Residency in Orthopaedic Surgery: University of Kansas-Wichita Fellowship in Orthopaedic Oncology: Johns Hopkins University

Fellowship in Laproscopic Colorectal Surgery: Mayo Clinic Specialty: Colon & Rectal Surgery

Specialty: Adult Orthopaedic Reconstructive Surgery (Hip & Knee)

Location: Colon & Rectal Surgery, Inc.

Location: OrthoWest, PC

After six years in Chicago and three years in Arizona, Dr. Bertelson has moved to Omaha to join her husband, a plastic surgery fellow at UNMC. Although she grew up in North Pole, Alaska, three years in Arizona made her a softy and she is nervous about the Omaha winter. Her passion outside of surgery is fine arts and travel. She was thrilled to discover, after receiving tickets to “Carmen,” that Opera Omaha lives up to its reputation as an outstanding regional opera company. As a classically trained singer, she is looking forward to more theater experiences in Omaha and, perhaps, even participating someday.

Dr. Young returns to Omaha after a brief tour of the country for residency and fellowships. He enjoys backpacking, woodworking and water sports. He can be found spending much of his free time swinging his kids at the park or spending quality time with the jogging stroller.

NEW MEMBERS Erin Bundren, M.D. Gastroenterology

Cynthia Paul, M.D. Psychiatry

Rebecca Ehlers, M.D. Gastroenterology

Hemant Satpathy, M.D. Obstetrics and Gynecology

Scott Haughawout, D.O. Physical Medicine and Rehabilitation

Joseph Wolpert, M.D. General Surgery

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 2014 Physicians Bulletin 33


Your home...your builder.

Exceptional.

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.

CURT

HOFER

& ASSOCIATES

Your home...your builder. Exceptional.

2332 Bob Boozer Drive Omaha, NE 68130 Phone: 402.758.0440 n

www.cur thofer.com

34 Physicians Bulletin January/February 2014


Metropolitan Omaha Medical Society 7906 Davenport Street Omaha, NE 68114

PRSRT STD U.S. POSTAGE

PAID

PERMIT NO. 838 OMAHA, NE

ADDRESS SERVICE REQUESTED

We are the most experienced, full-service, family-owned real estate company in America.

npdodge.com

January/February 2014 Physicians Bulletin  

January/February 2014 Physicians Bulletin

Read more
Read more
Similar to
Popular now
Just for you