July/August 2014 Physicians Bulletin

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ICD 10: What a Difference One Number Can Make

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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. David Filipi, M.D. Harris Frankel, M.D. Jason Lambrecht, M.D. Kris McVea, M.D. Lindsay Northam, M.D. William Orr, M.D. Laurel Prestridge, M.D. Jill Reel, M.D. William Shiffermiller, M.D. Gamini Soori, M.D. Jeffry Strohmyer, M.D. James Tracy, M.D. David Watts, M.D. EDITORIAL/ADVERTISING STAFF Publisher | Omaha Magazine, LTD Editor | Marvin Bittner, M.D. Art Director | John Gawley Director of Photography | Bill Sitzmann Senior Graphic Designer | Kristen Hoffman Graphic Designer | Rachel Joy advertising sales Todd Lemke • Greg Bruns Gwen Lemke • Gil Cohen • Vicki Voet Sandy Besch • Alicia Smith • Sydney Stander Jessica Linhart • Dawn Dennis for advertising information: 402-884-2000

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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 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.

4 Physicians Bulletin July/August 2014

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July/August 2014 Physicians Bulletin 5

THIS Issue 18

May/June 2014 20

22

27

ICD-10 FEATURES

DE PA RTM E NTS

18

8

Point vs. Counterpoint ICD 10: What a Difference One Number Can Make

2 0

We Want You! Medical M.E.S.S. Club is More Than a Fundraiser

2 2

10 12

Taking the Message to Those at Risk

6 Physicians Bulletin July/August 2014

Financial Update Redefining Successful Investing

3 0

Member Benefits

31

New Members

33

Member News

3 4

MOMS Events

Young Physician Report

3 5

Coming Events

Take Care of Your Patients, Take Care of Yourself

36

Campus & Health Systems Update

Risk Management Disaster Recovery Planning for Medical Practices

15

17

NMA Message The Importance of Collaboration

14

Legal Update Six Things Physicians — and their Patients — Should Know About Health-care Reform

MOMS Message Building a Legacy of Giving

DocBuild COVER: STDs:

16

Being Informed Leads to Informed Debate

Swapping Stethoscopes for Hammers

27

Editor’s Desk

Patients with ID Problems?

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

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

EDITOR’S desk

Being Informed Marvin Bittner, M.D. Editor

Leads to Informed Debate

Physicians Bulletin

T

HIS SPRING I HAD 33 years’ worth of personal

reasons to be fascinated by the news. The news this spring had report after report about secret waiting lists at Veterans Affairs medical centers, and I have worked at the Omaha VA for 33 years.

I viewed the reports from my own perspective, and that was not always the perspective of the general public. In fact, there were two ways in which I was disturbed by the reaction of the general public.

Some public reaction to the secret waiting lists made sense, at least at first glance. I’m thinking about those members of the public who asked a logical question: Why are there veterans who have to wait to get medical care? Those members of the public had specific proposals to end the delays.

I saw one proposal to deal with delays in seeing physicians by doing the obvious: Hire more physicians. Specifically, the proposal called for setting up a loan repayment program to make VA employment more appealing to physicians.

I saw a number of proposals to send veterans to non-VA physicians if the VA cannot provide care promptly.

From my perspective, the proposals for a loan repayment program and an outside care program had problems: The VA had adopted those proposals already. The VA already has a loan repayment program and an outside care program. Apparently, there was a lack of awareness of these programs on the part of those advocating the proposals.

The public debate, I was disturbed to realize, was not well-informed.

8 Physicians Bulletin July/August 2014

A more subtle, yet more disturbing, problem with the general public reaction became strikingly apparent early in June. That’s when The New England Journal of Medicine published a trio of essays about the VA. The journal highlighted a characteristic of VA care that had gotten little attention in the public debate: The scholarly literature has found, in general, that the quality of medical care is better inside the VA than outside the VA. That concerned me greatly. The public debate about the VA was intense. Yet in the discussion among the general public, unlike the medical community, little was heard from scholarly voices on the quality of care.

The VA debate has messages for us in the medical community of both failure and opportunity. There was a failure to inform the debate with facts, like the fact of the existence of a loan repayment program. There was a failure to elevate quality to the top of the agenda. These failures have identified an opportunity for us as physicians. We have an opportunity to address the public and to speak out clearly, promptly and frequently on the facts of medicine and the facts of systems of medical care. We have an opportunity to speak out clearly, promptly and frequently on quality of care.

The Executive Committee of MOMS has discussed ways that we can speak to the general public about medicine. The VA debate shows why this is important. Will you join in this effort?

MOMS message

Building a Legacy Michelle Knolla, M.D. Chairwoman

of Giving

MOMS Foundation

T

HE METRO OMAHA MEDICAL Society

(MOMS) Foundation was formed in 1981 when Charlie Bressman, M.D., was president of MOMS. (He was the physician who took out my tonsils in 1968). Funds were slow to accrue until 2002 when the Omaha Mid-West Clinical Society was dissolved and its funds ($300,000) were transferred to the MOMS Foundation. When Richard Meissner, M.D., then the MOMS Foundation president, died in 2003, he left the foundation $100,000. Beginning in 2002, we began awarding grants to various nonprofit organizations.

Today, the MOMS Foundation Board consists of eight physician members and three lay members. We meet quarterly and are charged with the fiduciary responsibility in collection, distribution and growth of your charitable contributions. We have an annual grant review process that begins in August. There can be anywhere from 15 to 20 grant applications to sort through. We are always seeking charities and causes where our dollars will go the distance to help “real people” and not overhead. We also try to diversify so we are not concentrating on any specific demographic.

(Last year we were skewed toward children. This year, we’re more balanced with the elderly). In the past, we have supported HOPE Medical Outreach Coalition, Lasting Hope Recovery Center, Josie Harper Hospice House, the Food Bank of the Heartland, plus many small charities.

Last year, we distributed $33,891, which included individual grants to nonprofits totaling $21,246. The remaining $12,300, which was comprised of $7,300 from physician donations and a $5,000 match from the foundation, was part of the annual MOMS Foundation Donation Match Program and was distributed to the Omaha Street School. The many docs who attended the MOMS Annual Meeting this past January were able to hear firsthand from the Omaha Street School

10 Physicians Bulletin July/August 2014

director how the school was formed and some of the obstacles the organization has overcome.

This group services kids (current enrollment is 24) who are often from broken and single parent homes, and may have serious social and medical issues. Some of these extraordinary issues include needing dentures, extreme anxiety issues, really bad eating habits, drug abuse and ADHD. Besides the obvious donation, its grant request wanted to build an ongoing partnership with the physicians at MOMS. Specifically, the organization wanted to build a platform for a continued wellness educational program. Already, several of our physicians have taught courses on basic health issues. We have received great feedback from the school in that the students are enthused and talking among themselves long after the course is over. The students enjoy having an opportunity to ask questions plus they are listening and absorbing, the information they are being presented. If we can make a difference in turning someone’s life around, this is the gift that keeps on giving!

These students have few positive role models so when our docs take the time to actually go and interact with them; it broadens their perspective of the health-care community.

We will be reaching out in the coming months for support from our physicians. When the Women’s Alliance dissolved several years ago, that left a void in one of our larger fundraisers.

The alliance worked hard compiling the silent auction items for the Medical Mess Club. This income helped bolster our foundation assets tremendously. Now we really have to rely on our physician members for continued donations to the foundation. There is a box on your dues renewal forms for your foundation contribution.

We hope you don’t leave it blank. Memorials also offer a fitting tribute to our colleagues. It sounds trite, but together we can make a difference.

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NMA message

Dale Mahlman Executive Vice President

The Importance of Collaboration

Nebraska Medical Association

A

S I RECENTLY RETURNED from the 2014

American Medical Association Annual meeting in Chicago, I took time to pause and digest exactly what I heard and saw in action.

Regardless of your impression of the AMA, this meeting is clearly democracy in action.

For those who have attended, you know what I’m talking about.

This was the 12th AMA Annual meeting I’ve attended in Chicago. By now, I recognize many of the physicians from other states and can just about recite what they are likely to say on certain issues. Is that good or bad? You be the judge.

Seeing more than 1,000 physicians representing all 50 states and nearly every specialty imaginable gathered in a basement ballroom for five days discussing issues makes me realize this is still a profession worthy of the utmost respect.

Hot button issues are usually the norm and you are usually not disappointed by the discussion, regardless of which side of an issue you may be on. With Nebraska participating as a member of the six-state North Central Medical Conference (which also includes North Dakota, South Dakota, Iowa, Minnesota and Wisconsin), our consensus position is not usually without some interactive debate. I can assure you your Nebraska delegates and alternate delegates are well-prepared and well-spoken.

My takeaway from the meeting this year is that while we all have the same problems from 30,000 feet, our ability to interact with our payers, regulators and legislators seems to be better than many of our fellow state associations. We have

12 Physicians Bulletin July/August 2014

regular meetings with representatives of the insurance companies on many issues involving reimbursement, medical policy and regulations. We also have regular meetings with our state and federal agencies, and, along with our county medical societies, we have the ability to regularly interact with our legislators at the state and federal level. Generally speaking, those are productive collegial meetings and help both sides understand the issues and desired outcomes.

I am extremely proud of our ability to collaborate with our active county medical societies. As the AMA slogan says, “Together we are stronger” and, in my opinion, our ability to collaborate with MOMS in Omaha and LCMS in Lincoln is a blessing and something that benefits our membership.

Listening to my colleagues talk about their struggles with membership and other issues makes me aware that the future of our organization will look much different than it did 12 years ago when I started, but I remain optimistic the physicians of MOMS and Nebraska will continue to support organized medicine and their profession because it’s the right thing to do. With health-care reform in full swing and payment reform underway, our ability to adapt to change will be tested like never before. I’m confident our leadership and membership will keep the patient in the forefront with all their efforts. As I’ve said many times before, the staff of the NMA is here to support our physician members who are “Advocating for Physicians and the Health of all Nebraskans” in everything they do.

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July/August 2014 Physicians Bulletin 13

RISK management

Disaster Recovery Planning for Medical Practices: An Ounce of Prevention is Worth A Pound of Cure Laurie K. Baedke Chief Brand Officer Core Bank

T

HE RECENT OUTBREAK OF severe summer

storms in Nebraska is a healthy reminder of how important a disaster recovery plan can be. If a tornado was to destroy your practice’s physical location, would you be prepared?

Patients’ lives can depend on systems being up and running. To that end, federal regulations require health-care organizations to maintain up-to-date disaster recovery plans. The plan must detail how the provider will protect and restore access to electronic data during and after unforeseen circumstances. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates healthcare entities analyze emergency risks to patient records, employee information, insurance documentation and other data. Practices should develop policies and procedures to maintain, back up, and recover their data that “adequately and reasonably” addresses those risks.

But, patient information is only part of the equation.

Anticipate the worst, and create a disaster recovery plan that can be the difference between staying in business and shutting the doors, should the unthinkable occur. By developing contingency plans around each major operational area of the practice, you will be well-positioned to weather any disruption.

CONDUCT AN OPERATIONAL RISK ASSESSMENT: An operational risk assessment is a proactive investment aimed at mitigating the

risks associated with a potentially devastating business event. Before you begin to develop a disaster recovery plan, it’s helpful to understand the scope of your operations and identify primary and secondary areas of exposure and priority.

This will guide the development of a plan that can comprehensively address a potential future need.

CONSIDER THESE KEY AREAS OF FOCUS:

• Clinical (patient scheduling, medical record access, triage of patient appointments) • Employee (HR records, payroll information and processing, back-up staff coverage options) • Facilities (options for alternate patient care locations) • Cash flow (strategy to ensure uninterrupted cash flow, revenue cycle | accounts receivable, accounts payable, payroll, access to bank accounts, line of credit) • Communication (employee communication, patient communication, alternate phone communication portals, temporarily accessing medical records | practice management information through alternate channels, media strategy) DEVELOP A DISASTER RECOVERY PLAN: The development of a disaster recovery plan is a critical piece in any strategic business plan and could be the key to survival for a practice hit by an unexpected, adverse natural or man-made event. Preparing for a hypothetical event may not seem essential, given the more pressing challenges that your practice faces daily. However,

14 Physicians Bulletin July/August 2014

in order to ensure business continuity – clinical and financial – the value of a robust plan cannot be understated.

IDENTIFY A PROGRAM CHAMPION: This is the individual, or team, who will lead the risk assessment and development of a plan, and is charged with implementing the plan if disaster strikes. Because one or two employees can be critical to maintaining ongoing operations in any organization, practices should identify these individuals ahead of time and list in detail their mission-critical responsibilities in the event of a disaster.

TEST AND MAINTAIN THE PLAN: A plan may sound swell on paper, but the best way to test its mettle is to actually test it. Engage your team to execute a disaster drill to put your plan through the paces. A mock event allows you to identify unmet needs, make necessary adjustments and anticipate likely scenarios – before a crisis is at hand and decisions can become emotionally driven.

A routine review of the plan on an annual basis or otherwise agreed upon schedule, is prudent to ensure accuracy and readiness. And, communication of the plan to practice staff, including training and orientation to the role(s) they play in execution of the plan is recommended.

With a little preparation, groups can avoid a frantic, exhausting scramble to recover in the event of disaster.

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the CEO to the environmental service employee who cleans the cafeteria at 2 a.m. Because when you’re working an especially brutal overnight shift, having that sweet lady cleaning off the tables ask you about your kids or sneak you an extra cookie might be the only thing to bring a smile to your face. Back when we all started this journey of medicine, we did it because we like people, but somewhere a lot of us forgot that this includes the ones who aren’t on the operating table or in the hospital bed. Connecting with those around us brings back the humanity that we lose in the day-to-day chaos of residency.

EVERYTHING IN DUE TIME: You’re just starting your medical career so you can’t expect that you’re going to know as much as your attending, or your senior supervisor or even the residents in the class above yours. This is expected. I know that around December of last year, when I looked at our senior residents, the knowledge they had floored me. “I will never get there,” I thought.

But six months later, I know I’m closer to that point today than I was back then, and I have confidence that in another six months I’ll be even closer. This is what residency is all about. Don’t expect the knowledge to somehow appear the day you start. It takes work, both inside and outside the hospital, to gain the skills to provide the best care to your patients. If you can’t remember the half-life of morphine or how to tie a figure-eight stitch, ask. Helping you learn is part of the job of those above you, and one they should be happy to do. Be confident that next July some brand new intern will be asking the same question, and you’ll be the one with the answer.

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July/August 2014 Physicians Bulletin 15

LEGAL update

Autumn Long Attorney McGrath North Attorneys

A

S THE AFFORDABLE CARE Act (ACA)

continues to roll out, let us recap some of the highlights.

EVERYONE IS DOING IT: The ACA includes a provision requiring almost all Americans to have health insurance or pay a penalty. The idea behind this requirement is to get as many people in the insurance market as possible – young, old, men, women, healthy, sick – in order to best balance the insurance risk pool. As a result, individuals with a gap in coverage for a continuous threemonth period or more will likely be subject to a penalty. For the 2014 tax year, the penalty is $95 for each adult ($47.50 for children) up to $285 per family or 1.0 percent of household income, whichever is greater. (Most individuals will be subject to the income-based penalty.)

EVERYONE CAN GET IT: To balance the above individual mandate, the ACA seeks to make coverage more accessible. For starters, the ACA requires insurance companies to issue a health plan to any applicant regardless of the applicant’s health. Additionally, insurers must renew coverage going forward. In other words, they can’t refuse to cover individuals or refuse to renew coverage simply because a person is sick.

In furtherance of the idea of making coverage more accessible, the ACA imposes penalties ranging from $2,000 to $3,000 per full-time employee for large employers that fail to offer health insurance coverage to their employees or who offer coverage that is too expensive or fails to meet minimum standards. For individuals

Six Things Physicians – and Their Patients – Should Know About Health-care Reform without access to employer-based health coverage, the ACA created insurance exchanges where individuals can login, evaluate and compare health insurance options.

IF YOU NEED HELP, YOU CAN GET THAT TOO:

Individuals purchasing coverage on the exchange could get assistance, in the form of subsidies or credits, from the government to make coverage more affordable. Subsidies are based upon family size and income levels. For instance, subsidies may be available to single individuals making between $11,670 to $46,680 and families of four earning between $23,850 to $95,400. Subsidy eligibility will hinge on whether the individual has access to affordable coverage through their employer or whether that coverage meets certain standards.

SOME OF IT IS FREE (WELL, SORT OF): The ACA created a class of preventive benefits that health plans must cover in-network without cost-sharing (co-payments or coinsurance). The preventive care requirements vary for men, women and children, and include various immunizations and vaccinations as well as screenings for common illnesses. The standards are updated regularly to keep track with developments in preventive medicine. The ACA has also established a class of “essential” benefits for which plans cannot impose annual limits. These essential benefits include: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment;

16 Physicians Bulletin July/August 2014

prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

THE GOVERNMENT CARES ABOUT HOW WELL YOU ARE DOING IT: In an attempt to improve

the quality of care patients receive, the ACA implemented certain quality care reporting obligations.Under the Hospital Value-based Purchasing Program, the government will make incentive payments to acute care hospitals, based either on how well the hospitals perform on certain quality measures or how much the hospitals’ performance improves on certain quality measures.The higher a hospital performs or improves, the higher the hospital’s value-based incentive payment for the fiscal year will be.

INFORMATION IS KEY: The ACA is an extremely complex body of law. This article summarizes very generally some of its key elements. In order to best prepare for and understand the impact of the ACA on your medical practice and patients, we recommend contacting your ERISA attorney or health-care counsel for more information.

The exchanges are available at HealthCare.gov.

29 F.R. 3593 (Jan. 22, 2014).

3 For the complete list of preventive care benefits visit: https://www.healthcare.gov/what-are-mypreventive-care-benefits/ 1

2

FINANCIAL update

Redefining Successful Investing

Ross Polking lifeWealth Adviser The Foster Group

M

OST INVESTORS BELIEVE SUCCESSFUL

investing involves outperforming the market. Forget the fact that for investing to be truly successful, it must help you achieve your goals, not merely be a number with no context or simply better than some benchmark…that’s an entire topic for another day. Many investors attempt to outperform the market through an active management approach. Bad news for those in this camp – overwhelming evidence demonstrates that this strategy fails much more often than it wins. The continuous trading of securities and trying to find what’s hot while avoiding what’s not, for the purpose of generating gains, adds significant risk and expense while frequently delivering lower overall return. Sounds like a lot of work for no reward.

Dalbar, Inc., one of the most-recognized national financial market research firms, facilitates an ongoing study of investment returns versus investor returns (note that these are different).

The study results continue to highlight a daunting disparity not in favor of the average investor.

The primary driver for this disparity is investor behavior and most investors’ penchant to buy high and sell low driven by their emotions over current market conditions, what they read in the paper that morning or what their good friend’s brother heard in his workplace lunchroom.

Per Dalbar’s findings, during the past 30 years, the S&P 500 has returned over 11 percent per

year while individual investors have averaged somewhere in the range of 3.5 percent – barely above the level of inflation. During this time, a $10,000 initial investment for a buy-and-hold S&P index fund would amount to an approximate ending balance of $267,000, while the average investor would bank less than $29,000.

This wide gap is, again, attributable to most investors’ excessive trading and timing efforts and the significant expenses that accompany such tactics. Of course, you might be saying, “That’s not me. I’ve held the same mutual funds for years.” What many investors may not realize in this situation, though, is that the fund managers, themselves, are actively trading the stocks held in their fund, resulting in added costs and, potentially, increased taxes and lower returns.

Do your homework and ask your adviser direct questions about how your funds are managed.

Could be a game-changer for you.

Some food for thought as you wrestle with the context of these numbers: Research initially conducted by Gary Brinson, L. Randolph Hood and Gilbert Beebower in 1986, and confirmed again in 1991, demonstrates that focusing on asset allocation is the key determinant driving portfolio performance. Asset allocation is the decision – or series of decisions – an investor makes to determine the strategic mix of asset classes (i.e., stocks, bonds and cash) employed in their portfolio. In this groundbreaking study,

allocation decisions explained more than 90 percent of the difference in return earned by the investors studied – while an investor’s ability to select the “right” stocks and time markets accounted for only 5 percent and 2 percent, respectively. Again, active management strategies endure a black eye.

Disciplined asset allocation enhances returns, whereas attempts at individual stock selection and market timing detract from performance, more frequently than not. And the appropriate allocation? Completely determined by one’s goals, priorities, preferences and circumstances.

Investors must financially plan, not just invest.

Otherwise, how does one know the answer to the question 99 percent of Americans have: How much do I need in order to retire comfortably?

Long-term, disciplined investing in alignment with one’s goals and plan creates the highest probability for success. That’s the formula.

Stay diversified.

The information and material provided in this article is for informational purposes and is intended to be educational in nature. We recommend that individuals consult with a professional adviser familiar with their particular situation for advice concerning specific investment, accounting, tax, and legal matters before taking any action.

July/August 2014 Physicians Bulletin 17

feature

POINT / COUNTERPOINT: Time to Move On: One Step at a Time

By Carla Dirkschneider, M.S., RHIA Michelle Ilsley, RHIT, CCS Theresa Rihanek, MHA, RHIA, CCS NHIMA ICD-10 Taskforce Committee Members

T

HE INTERNATIONAL CLASSIFICATION OF

Diseases, or ICD, is the standard tool for capturing data regarding health management, epidemiology and clinical information. ICD-10 (World Health Organization version) was adopted in 1990 and implemented in other countries as early as 1994. ICD-11 is currently in beta version and is scheduled to be voted for adoption by the World Health Assembly in 2015.

Following past trends, it would be at least 2025 until ICD-11 would be ready for adoption in the United States. Leapfrogging ICD-10-CM/PCS would mean that the United States would continue to use ICD-9-CM for at least the next 10 years making the classification system more than 50 years old. Waiting for ICD-11 seems out of context with the reality of the pace at which other payment and regulatory changes occur. The enormous investments being made in accountable care organizations, meaningful use of electronic

health records and value-based purchasing is predicated on having more precise and detailed information, which is available in ICD-10-CM/PCS.1 ICD-10-CM/PCS was designed to convert EHR data into secondary data for a variety of uses such as health research and treatment development, public health monitoring, health information exchange, quality measures, and health policy including cost analysis and reimbursement.2 ICD-10-CM/PCS provides the level of detail to meet these needs by capturing patient conditions and providing more choices to accurately reflect the severity of the diagnosis. ICD-10-CM/ PCS utilizes current medical terminology and can reflect technological advancements that cannot be adequately captured using the antiquated ICD-9-CM system. The continued use of ICD-9-CM limits our nation’s ability to describe specific diagnoses, procedures, severity, quality and technology.

The increased level of detail in ICD-10-CM/PCS will capture this data adequately. For example, laser and laparoscopic surgeries are commonplace today, but were not when ICD-9-CM was implemented. Often, procedures such as these are assigned to a code developed for an older procedure or captured in a nonspecific category.3 The data that will become available with ICD-10-CM/PCS implementa-

18 Physicians Bulletin July/August 2014

tion could be used to determine whether a laparoscopic or open surgery yields a better patient outcome for a particular injury or disease.

There are clinical and administrative benefits of having greater detail provided by ICD-10-CM/PCS. A few benefits include the ability to determine severity of illness and prove medical necessity, reducing audits and decreasing the number of rejected claims.

One of the anticipated benefits of ICD-10 is a smoother claims transaction. To illustrate, consider a patient who was diagnosed with Crohn’s disease of the large intestine via colonoscopy six months ago. The patient now presents with a flare up and requires a second colonoscopy which reveals an abscess in the large intestine with hemorrhage.

In ICD-9-CM the same code would be reported for both the initial colonoscopy and the subsequent colonoscopy.

However, ICD-10-CM can reflect the acuity of the abscess and hemorrhage (K50.114).

The severity that is reflected in the ICD-10-CM code for the second colonoscopy likely will prevent claim edits or a denial due to frequency restriction for diagnostic colonoscopy.4 Streamlining the coding process with technology is already happening. Implementation of EHRs as well as computer assisted coding applications

(CAC) is transforming the process of code assignment. Text analysis is being performed on EHR documentation to generate codes for data capture. This analysis depends on accurate provider documentation as well as classifications and terminology (like SNOMED CT) in order to be able to use the data in meaningful ways.

CAC applications allow individuals who understand the terminology and classification systems to focus the analysis of the data.

1

Averill, R. & Bowman, S. There

are Critical Reasons for Not Further Delaying the Implementation of the New ICD-10 Coding System. http:// journal.ahima.org/wp-content/uploads/ Critical-Reasons-for-Not-FurtherDelaying-ICD10.pdf 2

AHIMA. US Must Adopt &

Implement

ICD-10-CM

and

ICD-10-PCS: Immediate Action to Upgrade Medical Code Set Standards Needed. http://library.ahima.org/xpedio/groups/ public/documents/ahima/bok1_034662. hcsp?dDocName=bok1_034662 3

Bowman, S. Why ICD-10 Is

Worth the Trouble. http://library. ahima.org/xpedio/groups/public/ documents/ahima/bok1_036866. hcsp?dDocName=bok1_036866.

4

Medical Practice Insider. Applying

ICD-10 to Crohn’s disease. http:// www.medicalpracticeinsider.com/ best-practices/compliance/applyingicd-10-crohns-disease.

feature

ICD-10 : The U.S. Healthcare System Should Catch Up

By Jason Lambrecht, M.D., Pharm.D.

What a difference one number can make

T

HE ORIGINS OF THE

International Classification of Disease, or ICD, date to the 19th century and even earlier.

Eventually, in the 1940s, the World Health Organization was directed to further enhance and develop the ICD system, which has resulted in multiple revisions over the years. Currently, it is in its 11th revision from a worldwide perspective. In the United States, however, we are currently using the ninth revision (ICD-9) and on the verge of implementing ICD-10.

Is it really worth adopting ICD-10 in 2015 when the WHO will be adopting ICD-11 in 2017?

I think it would make more sense to implement ICD-11, and skip ICD-10.

What benefit does ICD-10 provide physicians and the health-care system as a whole?

ICD-10 makes diagnosis more complex, adding more than 76,000 new codes. If a patient is admitted with heart failure, with ICD-10, I need to know the type of heart failure, systolic or diastolic. Why, I ask? Will they reimburse more if it is systolic?

What if I don’t know the type?

Will reimbursement be less?

Is the level of detail provided in ICD-10 important? Most of

the benefits of ICD-10 are for researchers in the field of the delivery of health services, but not for most physicians.

Will ICD-10 improve the “health” of our patients or the “health” of our nation? I believe the answer is “no.”

Instead, ICD-10 will perpetuate bureaucratic waste. The ICD-10 system will add to the requests for more “needed” documentation. But stop and ask: Does my patient’s outcome change based on the specificity of code indicating which phalanx he or she broke? What outcomes data support the need for such documentation? I believe physicians need to spend more time on the “health” of our patients and less time on their “health care system.”

The ICD coding system needs to go away. I apologize to the current coders, managers and assistants, and various systems and machines that have been created to assist, collect, tally, obsess and report the data that go with and support the ICD coding system. However, to be blunt, it is a waste of time and money.

If the government were to step aside, I believe we could come up with a simple, feasible

billing and coding system. The ICD-10 system is an obsessivecompulsive micromanagement of a simple process gone wild.

For example, physicians will be able to document when patients have been injured while knitting, or struck by a turtle, or injured by a spacecraft.

We need to look to a system of care that forgoes the minutia and focuses on the “health” of our patients. We need to stop worrying about documenting every little detail so we can bill at a higher level. We need to spend time with our patients in ways that help them fight the diseases and problems they have. If we continue to spend more time documenting, defending, and worrying about lawsuits than worrying about our patients, then we are missing the big picture of “health” in “health care”. Whatever it is called, ICD-10, 11, 12 or future revisions, my call is: “You are out. Let’s play ball!”

July/August 2014 Physicians Bulletin 19

feature

On Stage: M.E.S.S. Club is More Than a Fundraiser

By Jennifer Hill, M.D., and Emily Kean, M.D.

O

UR MOTIVATION FOR WRITING about

being part of the Medical M.E.S.S. Club is simple: We want you to join us. In return, you will gain a sense of camaraderie, grow your abilities and discover a great stress-reliever.

The M.E.S.S. Club was started in 1998 by a group of talented, motivated physicians as a fundraiser for the Metro Omaha Medical Society Foundation. Rick Collins, M.D., along with Sandy Johnson, then MOMS director, started the ball rolling aided by MESS Club mainstays Drs. Paul and Audrey Paulman. It was meant to parallel the Omaha Press Club’s annual show as a performance with parody songs, dancing, skits and jokes, but pertaining to the medical profession. It has been held at several venues in Omaha including The Rose Theater, UNO’s Strauss Performing Arts Center, the Durham Western Heritage Museum and, most recently, the Joslyn Art Museum’s Witherspoon Hall.

Many of the physicians who are still involved started at the beginning and were joined by

plenty of other enthusiastic people along the way.

We are some of the newer members of M.E.S.S and wanted to share with you the rich experiences we’ve gained by jumping in and joining these productions.

JEN’S STORY: I was raised in a musical family and spent most of my childhood singing, dancing and making up skits. In college I competed in the Miss America program, performing my talent on stage. When I started medical school, that creative outlet was put on hold as I focused on my studies. I learned of the Medical M.E.S.S. Club as a second-year medical student and remember performing a parody of “Rubber Ducky” from “Sesame Street.” I took the stage among 15 other medical students for “Rubber Glovie” and was hooked. It was a great experience and a perfect way to blow off steam in the middle of studying for exams. I just remember the dress rehearsal, practicing our songs between making-up acronyms for the diseases we were studying that week in class.

I had another opportunity to join the M.E.S.S. Club as a resident with Clarkson Family Medicine

NEXT M.E.S.S. CLUB April 17, 2015 M.E.S.S. Club is not just about performers, although if you want to sing or act, we can find a place for you. Have a skit idea or an issue that should be parodied? We’d love to hear your ideas. We need writers, actors, costume and prop designers, musicians and singers. If your talents are untapped, please contact Carol at the MOMS office or email her at cwang @ omahamedical.com.

The time commitment varies, but we’ll welcome whatever you want to give.

Think about it. We’d love to have you. You won’t regret it.

Jennifer Hill, M.D. (left) and Emily Kean, M.D.

20 Physicians Bulletin May/June 2014

feature

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and was glad to participate. Everyone was so welcoming.

Nearly a decade later after completing residency and practicing rural family medicine, I returned to the Omaha area and quickly rejoined M.E.S.S. Club. I made new friendships and reconnected with others.

In 2013, I tried my hand at writing for the first time. I spoofed Amy Winehouse’s “Rehab” into “Epic” – about the woes of learning our new EMR. I enjoyed the process and opportunity to have more ownership of the show.

I think not taking myself so seriously and allowing myself to have fun helps me to be a better doctor. It allows me to be more relatable to my patients.

I can’t wait to see what’s in store for M.E.S.S. Club in 2015 and invite you to join in.

EMILY’S STORY: I grew up in theater, but gave it up when I started college. Then as a resident, I attended my first M.E.S.S. Club show and in an instant, all of my memories of theater life came flooding back. The camaraderie, excitement, fear and the thrill of the applause filled my soul. I knew I needed to do it again. However, life got in the way and children, practice and other obligations derailed my intentions. In 2013, I decided to stop making excuses and get involved. From the first rehearsal to the cast party, I loved every minute.

The M.E.S.S. Club had added another layer of joy and fulfillment to my life – as it will for you.

The reason so many of the cast members continue to perform every year is that this is a unique experience. Many of us have met physicians in other specialties or who practice at other institutions, with whom we may have never interacted otherwise. The camaraderie is unlike anything we’ve felt since residency. It provides us with an opportunity to forget about the stresses of medicine for a while.

M.E.S.S. Club rehearsals are a time to discuss things other than medicine and allow us to form friendships and bonds separate from our usual collegial interactions.

Our hope is you’ll find what we did, a welcoming group motivated to put on a good show and a fun experience.

For our efforts, we hope to help the foundation continue to fund important initiatives in this community.

Gain the information and specialized skills necessary to lead - whether you are in academics, employed by a health system or in private practice.

• Utilize the Gallup StrengthsFinder and how to apply that information to your advantage • Understanding Financial Reports, ROI & Profitability • Personal Branding: Successfully Marketing Yourself • Establishing & Maintaining Work/Life Balance • Communicating for Leadership Success

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Omaha Magazine 6_24_14.indd 1

July/August 2014 Physicians Bulletin 21 6/25/2014 2:08:49 PM

feature

DocBuild: Swapping Stethoscopes for Hammers

A

SHA WURDEMAN, D.O., WASN’T sure she

could hammer nails while standing on a ladder. She can.

David Crotzer, M.D., now knows when installing vinyl siding that exact placement of product matters. “Every piece must be level and connected. Not overlaid or under-laid.”

And Marin Broucek, M.D., understands that adjusting a saw’s blade depth is important when Continued on page 24.

22 Physicians Bulletin July/August 2014

feature Broucek File Hometown: Huron, S.D. Undergraduate Degree: Northern State University in Aberdeen, S.D., in biology Medical Degree: University of South Dakota Residency: Currently in UNMC-CUMC combined program in psychiatry Specialty: Adult psychiatry Hobbies: Home improvement projects, horseback riding and dog agility training Why I joined MOMS: “It’s good for networking – and I like the community services projects.”

Coleman File Hometown: Minneapolis Undergraduate Degree: University of Minnesota in chemical and electrical engineering Medical Degree: University of Minnesota Residency: University of Nebraska Medical Center in radiology Fellowship: UNMC in body imaging Speciality: Diagnostic radiology (retired) Hobbies: Playing guitar and singing Family: wife, Kim Coleman; son, Peter Coleman; daughter, Sylvia Coleman Why I joined MOMS: “I joined MOMS because I wanted to network with other physicians.”

July/August 2014 Physicians Bulletin 23

feature

Crotzer File Hometown: Indianapolis Undergraduate Degree: University of Tulsa in biology Medical Degree: Indiana University School of Medicine Residency: Ohio State University in obstetrics and gynecology Fellowship: University of Texas MD Anderson Cancer Center in Houston in gynecologic oncology Specialty: Gynecologic oncology Location: Midwest Gynecologic Oncology Hobbies: Tennis and reading Family: wife, Rebecca McCrery, M.D.; daughters, Ellen, Cecilia and Julia Why I joined MOMS: “It was a chance for my wife and me to network with other physicians.”

making cuts on plywood. “Adjust the blade depth or the saw has to work too much.”

Finally, Paul Coleman, M.D., can tell his friends he helped build a garage.

“I just wanted to help somebody out.”

The four were among a contingent of 60 MOMS members and staff, and their families and friends who spent parts of three days in May helping build three garages at a Habitat for Humanity build site. Only the foundations for the garages were poured when the participants arrived at the work site.

The community service project – called DocBuild – was the brainchild of MOMS president, Deb Esser, M.D., who challenged her peers to step out of their comfort zone and help others at the same time. Participants, among other tasks, hauled lumber, framed walls and installed roof trusses.

Members of an extended family from Nepal live in the three homes situated near 37th and Ames streets (pictured on page 22). They were on-site throughout the work project, and expressed their gratitude.

The reasons the four participants gave for their involvement centered on combining an opportunity to help others with working with their peers – away from the job. All four said they walked away feeling good about the experience.

Dr. Crotzer said he and his wife, Rebecca McCrery, M.D., decided to participate together. “We felt proud that we helped out. It was a satisfying experience and gratifying.”

Said Dr. Coleman: “I enjoyed working

24 Physicians Bulletin July/August 2014

with others to help someone in need.”

The four participants joined the project with various degrees of carpentry skills – which they uniformly contended weren’t a prerequisite for signing up.

Said Dr. Broucek: “I like construction projects and home improvement projects.

I grew up on a farm – when you have to fix fence, you fix fence.” She explained that she recently bought a foreclosure house – and was redoing the interior herself, including tiling and flooring.

Added Dr. Coleman: “I have no carpentry skills. I do know how to use power tools. I just wanted to help out.”

Replied Dr. Crotzer: “The information sent to participants made it clear that there were plenty of tasks for people with no experience.”

The project supervisors were adept at teaching and demonstrating the tasks at hand, the participants said. They also were patient.

When MOMS schedules another DocBuild event, the four participants said, sign them up.

“It was great. I walked away with no formal injuries and lots of good stories to share. I also saw improvement in my hammering skills,” Dr. Wurdeman said.

“I can’t wait to do it again.”

Now that he knows how to install vinyl siding, the remaining question for Dr. Crotzer is whether he would ever attempt to use his new skill on his own home: “I probably would leave it to someone who has done it more than once before.”

Wurdeman File Hometown: Mission Viejo, Calif.

Undergraduate Degree: UCLA in molecular cell developmental biology Medical Degree: Arizona College of Osteopathic Medicine Residency: St. Joseph Hospital in Phoenix in family medicine Fellowship: Kaiser Permanete in Los Angeles Medical Center in geriatric medicine, and hospice and palliative care Specialty: Palliative care Location: Alegent Creighton Health Bergan Mercy Medical Center Hobbies: Playing with her daughter and watching football Family: husband, Shane Wurdeman; daughter, Uma. The Wurdemans are expecting their second child in September Why I joined MOMS: “I have always been involved in organized medicine. It’s an important part of our community and our profession. It is important that we advocate for our profession and our patients.”

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

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26 Physicians Bulletin July/August 2014

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feature

STDs: Taking the Message to Those at Risk

J

ANE CARNAZZO, M.D., DOESN’T waver when she

explains to parents her approach for screening their teenage children for STDs. “I tell them we screen everyone,” said Dr. Carnazzo, a pediatrician at the Children’s Physicians Clinic Spring Valley Clinic. “It’s that simple.”

July/August 2014 Physicians Bulletin 27

feature Carnazzo File Hometown: Omaha Undergraduate Degree: Creighton University in chemistry Medical Degree: Creighton University School of Medicine Residency: University of Nebraska Medical Center in pediatrics Specialty: Pediatrics Location: Children’s Physicians Spring Valley Why I Joined MOMS: “I believe it’s important to be involved in the medical community in Omaha and Nebraska.”

This illustration depicts a three-dimensional (3D) computer-generated image of a number of drug-resistant Neisseria gonorrhoeae diplococcal bacteria. Image courtesy of the Department of Health and Human Services Centers for Disease Control and Prevention Public Health Image Library.

The approach allows her to reassure parents – who are vehement that their child isn’t sexually active – that the teen isn’t being singled out. It also lets the test results do the talking, she said.

While this approach results in Dr. Carnazzo treating several teens for sexually transmitted diseases each month, her statistics don’t replicate those found in Douglas County.

In 2003, the Douglas County Health Department set a goal to reduce chlamydia and gonorrhea rates by 10 percent by 2013. Adi Pour, Ph.D., health department director, said the results were a mixed bag:

28 Physicians Bulletin July/August 2014

• The chlamydia rate decreased slightly in 2013, down 2.3 percent from an all-time high rate of 617.6 per 100,000 population in 2012. The rate for 2013 was 603.3., but an increase of 16 percent from the 520.1 rate in 2003. The national and state rates for 2012 – the most recent figures available – were 456.7 and 366.2 respectively.

• The gonorrhea rate decreased 36 percent from 2003 to 2013, from 244.8 per 100,000 population to 156.8. The decrease from 2012 to 2013 was less dramatic – 158.3 per 100,000 population to 156.8. “A slight

decrease is better than a slight increase.”

The national and state rates for 2012: 107.5 and 77.6 respectively.

Dr. Pour said her department is providing opportunities for young adults – the highest age group for STDs in Douglas County is those 15 to 24 years old – in a nonthreatening environment: public libraries. “Young people feel comfortable coming to libraries to get tested.” Those who test positive, Dr. Pour said, are referred for treatment at a Douglas County clinic site.

In 2013, the county health department provided 1,440 tests in nontraditional sites, such

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Free one-to-one support for Crohn’s and ulcerative colitis

The Crohn’s and Colitis Advocate Program* from AbbVie is here for you if you have Crohn’s or ulcerative colitis. Sign up and get: as libraries. Dr. Pour said 7.8 percent tested positive for an STD. These sites provide another service: education. “Sometimes young people just want to talk.”

Dr. Pour said her department promotes the testing sites through its Facebook page, but mostly relies on word-of-mouth. “Young people know where they can get tested.”

A drastic increase in syphilis in 2013 causes Dr. Pour to pause. “Syphillis is making a comeback in Douglas County and nationwide,” she said.

Typically, Douglas County reports a half-dozen cases per year. In 2013, 30 cases were reported.

“You look at the number and it is small. But it is a significant increase.” A report issued by the Center for Disease Control, she said, stated there was no obvious explanation for an increase, but speculated that those inflicted were participating in risky sexual behavior with anonymous and multiple partners. “That is the CDC’s speculation, and I think it is as good as any,” Dr. Pour said.

Douglas County saw a 275 percent increase from 2012 to 2013, with the 30 cases reported last year. Twenty-five of the 30 cases were in people 20 to 39 years old, and 47 percent of the 30 were infected with HIV. Men accounted for 27 of the 30 cases, and 14 of 30 cases involved men who reported having sex with other men.

To increase awareness, the health department has taken its message of practicing safe sex and getting tested to where people at risk congregate: placing coasters that promote the need to get testing in gay bars.

“We are taking the message to those who may be at risk,” she said.

• Personalized support from a specially trained Patient Advocate • Educational resources and information • Useful tools to have more productive conversations with your doctor Simply visit CDandUC.com to learn more and sign up. *Advocates can provide you with education and resources and offer support but cannot provide medical advice or replace your conversations with your health care provider.

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July/August 2014 Physicians Bulletin 29

MEMBER benefits

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.

Did You Know? www.anbank.com • 33 locations in Nebraska and Iowa. Call 402-457-1077 or 800-279-0007.

As a MOMS/NMA Member, you are eligible for COPIC premium reductions of up to 10 percent.

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

We can help!

Members with COPIC medical liability insurance receive an automatic 5 percent premium reduction. Combine it with another 5 percent reduction for participating in risk management education through COPIC.

Contact Kristin Stepien, director of sales at COPIC, at (800) 421-1834, or kstepien@COPIC.com for more information on the premium credit or a premium indication.

For many members this savings nearly or completely offsets the annual MOMS/NMA membership dues.

Not currently a MOMS/NMA member but would like to start taking advantage

Call (402) 298-5727 to further relieve your patient’s condition

of our many membership benefits?

Contact Laura Polak at the Metro Omaha Medical Society if you have

Revealing God’s Love Through Excellence in Healthcare 12702 Westport Parkway, Ste. 101 LaVista, NE 68138 www.heartlandvein.com 30 Physicians Bulletin July/August 2014

Thomas B. Whittle, M.D. Vascular Surgeon

any questions – phone: (402) 393-1415 or email: laura@omahamedical.com

NEW MEMBER update

Jai Bikhchandani, M.B.B.S.

Mahliqha Qasimyar, M.D.

Aleem Siddique, M.D.

Annie Zimmer, M.D.

Medical School: Maulana Azad Medical College, India

Medical School: University of Nebraska College of Medicine

Medical School: Aga Khan University Medical College

Medical School: University of Nebraska School of Medicine

Residency in General Surgery: Creighton University Medical Center

Residency in Internal Medicine: University of Nebraska Medical Center

Fellowship in Colon and Rectal Surgery: Mayo Clinic, Rochester, Minn.

Specialty: Internal Medicine, Hospitalist Location: University of Nebraska Medical Center

Specialty: Colon and Rectal Surgery Location: Colon and Rectal Surgery, Inc.

Dr. Bikhchandani played college basketball in India with good success in college tournaments.

He also enjoys swimming and loves to spend time with his two children in the pool. He also enjoys sleeping (when he gets the chance) and catching a movie with his wife, Priyanka.

Dr. Qasimyar was born in Kabul, Afghanistan, moved to New Delhi, India, at the age of 6 months, and has lived in Omaha since she was 10 years old.

As an academic hospitalist, she has a strong interest in resident and medical student education, and loves the roles of physician and teacher.

Outside of work, she enjoys tending to her creative side – dabbling in everything from party planning and hand-made crafts to refurbishing old furniture, to baking new dessert recipes that she tests out on her parents and two sisters.

Residency in General Surgery: University of Texas Southwestern Medical Center Residency in Cardiothoracic Surgery: University of Arizona Health Sciences Center Fellowship in Cardiopulmonary Transplantation & Mechanical Circulatory Support: Freeman Hospital, United Kingdom Specialty: Thoracic Surgery

Residency in Pediatrics: Northwestern University, Chicago Specialty: Pediatrics Location: Children’s Physicians-Plattsmouth

Dr. Zimmer and her husband, Nathaniel, are expecting their third child this summer. When they can, they enjoy time outdoors camping, hiking and kayaking, but usually chasing the kids.

Location: University of Nebraska Medical Center

Dr. Siddique likes to read, but does not have as much opportunity recently as he would like.

On the suggestion of a friend, he recently started to listen to audio books during his commute to and from work.

OTHER NEW MEMBERS:

Interested in becoming a MOMS Member?

Lacia Chapman, M.D. Family Practice

Stephen Leslie, M.D. Urology

Libby Crockett, M.D. Obstetrics and Gynecology

Brian Lubberstedt, M.D. Child and Adolescent Psychiatry

Samuel Dubrow, M.D. Orthopedic Surgery

Joshua Priluck, M.D. Ophthalmology

Jeffrey Gold, M.D. (UNMC Chancellor) Thoracic Surgery

Daniel Surdell, M.D. Neurological Surgery

Call 402-393-1415, apply online at www.OmahaMedical.com or complete the application on page 32.

July/August 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: 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:

Office

Home Other: __________________________________

Office

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

NO

(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.

_____________________________________

Signature

___________ Date

B

Fax Application to: 402-393-3216

32 Physicians Bulletin July/August 2014

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

Apply Online: www.omahamedical.com

MEMBER news

Dr. Armitage honored for achievements, service

J

AMES ARMITAGE, M.D., HAS received the 2014 American Society of

Clinical Oncology’s Special Recognition Award for major accomplishments in the fields of oncology and hematology, as well as his many years of ASCO service.

The award honors individuals for major contributions in areas of clinical oncology, cancer research, clinical trials, reimbursement, and patient advocacy activities, who have given long-term service to ASCO and to clinical oncology.

“It’s an honor to receive this award,” said Dr. Armitage, Professor of Internal Medicine in the UNMC Division of Oncology/Hematology. “My association with ASCO over the last 35 years has been a rewarding part of my career. ASCO has never wavered from its commitment to cancer patients in getting patients the best possible treatment and care.”

Dr. Armitage is globally recognized as a leading expert on non-Hodgkin lymphoma and played a critical role in advancing bone marrow transplantation.

He developed and directed the bone marrow transplant programs at the University of Iowa and later at UNMC, where he also served as vice chair of internal medicine, chief of the section of oncology and hematology, chair of the Department of Internal Medicine, and dean of the College of Medicine.

Dr. Armitage’s contributions span well beyond his work at UNMC and the University of Iowa. He has held many leadership roles at ASCO and other hematology and oncology associations, including ASCO president and president of the American Society for Blood and Marrow Transplantation.

He contributed to ASCO in many other capacities, including serving multiple terms on the board of directors and chairing the Cancer Education Committee, the Ethics Committee, and the Hematology-Oncology Task Force. Dr. Armitage is presently a member of the Journal of Clinical Oncology editorial board and is editor of The ASCO Post.

Dr. Gold Recognized by Becker’s Hospital Review

U

NIVERSITY OF NEBRASKA MEDICAL Center Chancellor Jeffrey P.

Gold, M.D., was selected as one of 25 recipients of the Becker’s Healthcare 2014 Leadership Awards by Becker’s Hospital Review.

The awards recognize men and women who have made remarkable contributions and will leave lasting legacies to their respective health systems, hospitals and communities.

Dr. Gold became UNMC’s chancellor on Feb. 1. He came to UNMC from Ohio, where he served as chancellor and executive vice president of biosciences and health affairs, and executive dean of the College of Medicine at the University of Toledo. He had been at the University of Toledo since 2005.

While in Ohio, Dr. Gold, who received his medical degree from Weill Cornell College of Medicine, was involved as a member of the Leadership Council for the Toledo Lucas County Academy of Medicine and as chairman of the Ohio Council of Medical Deans.

The Becker’s announcement references his “previous accomplishments as chancellor of the University of Toledo’s health science campus,” adding that his work there suggests his leadership skills and vision for health care delivery will serve him and the University of Nebraska well.

The award announcement notes that under Dr. Gold’s leadership, the University of Toledo opened the Eleanor N. Dana Cancer Center and the Gardner-McMaster Parkinson Center, as well as added an orthopedic center, minimally invasive surgery center, medical pavilion and student library.

IN memoriam Richard W. Booth, M.D. March 17, 1924 – May 24, 2014

July/August 2014 Physicians Bulletin 33

MOMS events WOMEN IN MEDICINE

The Women in Medicine took on the sport of trapshooting on June 11 at Valley Trap Range.

Providing instruction and guidance were the coaches and members of the Marian High School trap team.

1. Marian High School trap team coach Bruce Esser (husband of Dr. Deb Esser), discusses gun safety and the history of competitive trapshooting.

2. Dr. Katie Norton, left, accompanied by trap team member Delaney Thomas and Dr. Jill Reel.

3. Dr. Lindsey Northam, chair of the Women in Medicine group, was assisted by trap team member Hannah Knight.

4. The Women in Medicine group was joined by the Marian High School trap team, coaches and volunteers.

1

3

2

4

YOUNG PHYSICIANS

Nearly 40 young physicians and young attorneys from the Omaha Bar Association competed in a battle of wits at a pub quiz on June 24 at Liv Lounge.

5. “Docs and Pro Hocs,” a team of one resident and three attorneys, were Pub Quiz champions by one point. From left, attorney Homero Vela, Dr. Marin Broucek, and attorneys Nickie Hanson and Brian Bartels.

6. From left, Drs. Brianne Kling, David Ingvoldstad, Jennifer Hill and Katie Honz, along with attorney Patrick McNamara and Laurie Baedke, chief brand officer of Core Bank, (both not pictured) made up team “OK Smarties.”

7. Team “Doctors Dictums” included (from left) Dr. Kristin Sholes, Dr. Missy Deer, Dr. Kilie Donovan, attorneys Justin Hochstein and Kate Fitzgerald, Dr. Karisa Hajek and attorney James Boesen.

8. Quizmasters Dr. Julie Fedderson (left) and JoAnna Thomas of the OBA queried and entertained the pub quiz competitors.

34 Physicians Bulletin July/August 2014

5

7

6

8

COMING events NETWORKING EVENT JAZZ ON THE GREEN AUG. 7 CANTINA LAREDO (MIDTOWN CROSSING) 6 – 7:30 P.M.

Join your peers for networking and sample Mexico City-style cuisine, then head out onto the grass and enjoy Jazz on the Green.

RSVP by Aug. 5.

SPEED DATING FOR YOUR SPECIALTY CREIGHTON: AUG 26 - HARPER BALLROOM UNMC: SEPT. 8 - TRUHLSEN EVENT CENTER 1000A BOTH EVENTS: 6-7:30 P.M.

This event allows medical students to visit face-to-face with MOMS member physicians, rotating every few minutes, to discuss their specific fields of medicine, and the related challenges and opportunities. Students gain valuable insight into at least six potential specialties of their choice (20+ specialties represented). Medical students and physicians who wish to volunteer may register at www.omahamedical.com.

Metro maha Medical Society STRATEGIC PARTNERS

The Metro Omaha Medical Society Strategic Partners offer a variety of expertise, products and services to assist physicians and practices in addressing their needs and achieving success.

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

http://tmsassocgen.com

GOLD PARTNERS

NMA ANNUAL MEETING & HOUSE OF DELEGATES SEPT. 12

www.corebank.com

www.YourFutureCounts.com

www.nebraskamed.com

COMMUNITY INTERNSHIP OCT. 21 – WELCOME RECEPTION OCT. 22 AND 23 – INTERN SHADOWING OCT. 23 – BANQUET DINNER

MOMS invites lawmakers, members of the media, community leaders and business representatives who work closely with the health-care community to shadow physicians and witness all aspects of care, including patient examinations and procedures, consultations and even behind the scenes. Physicians willing to be shadowed and participate in the program should contact MOMS.

MOMS & FOSTER GROUP MEMBER NIGHT AT UNO MAVERICKS HOCKEY

www.nebraskaspinehospital.com

SILVER PARTNERS www.AlegentCreighton.com

www.ClineWilliams.com

www.KoleyJessen.com

www.BestCare.org

NOV. 21 GATES OPEN 6:30 P.M.; PUCK DROPS 7:37 P.M.

MOMS and Foster Group invite members and their families out for a night of hockey. Stop by the hospitality room for beverages and a bite to eat before or during the game. Advance reservations required.

Call (402) 393-1415 or email Laura@OmahaMedical.com for more information or to RSVP for any of these events.

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 July/August 2014 Physicians Bulletin 35

CAMPUS & HEALTH SYSTEMS update

Boys Town National Research Hospital receives five-year NIH grant

Children’s Hospital & Medical Center nationally ranked in four specialties

T

U

HE NATIONAL INSTITUTES OF Health has

awarded Boys Town National Research Hospital a five-year Centers of Biological Research Excellence (COBRE) grant. The focus of the $11.3 million grant is to develop a center of excellence devoted to understanding the consequences of childhood hearing loss.

The grant will fund five research laboratories and will support 14 full-time staff. In addition, a $300,000 supplement will allow building renovation for the construction of a unique facility for testing children in simulated real-world environments, such as classrooms.

“Boys Town National Research Hospital is recognized internationally as a leader in research on childhood deafness, vision and speech disorders,” said John Arch, executive vice president of health care and hospital director. “The COBRE grant will allow our scientists to further explore the best methods for helping children everywhere who have hearing loss to achieve their potential. “ Research projects will study how to better optimize communication development for children with hearing loss across multiple settings, such as parent-child communications, bilingual backgrounds and educational settings.

.S. NEWS & WORLD Report has ranked

Children’s Hospital & Medical Center in four specialties in the new 2014-15 Best Children’s Hospitals rankings.

Children’s ranked No. 29 in orthopedics, No. 41 in pulmonology, No. 42 in gastroenterology and GI surgery, and No. 48 in cardiology and heart surgery.

The Best Children’s Hospitals rankings highlight U.S. News’s top 50 U.S. pediatric facilities in cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and GI surgery, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology. Eighty-nine hospitals ranked in at least one specialty, based on a combination of clinical data and reputation with pediatric specialists.

“This is our highest level of recognition to date.

We believe it reflects our ongoing commitment to high quality, subspecialty care that makes a difference in the lives of children and their families,” said Carl Gumbiner, M.D., senior vice president of medical affairs and Children’s chief medical officer. “We’re honored to be among this elite group of pediatric centers, and we’ll continue to challenge ourselves to further improve quality, processes and the delivery of care to the benefit of children from across the region.”

Five-sixths of each hospital’s score relied on patient outcomes and the care-related resources each hospital makes available.To gather clinical data, U.S. News sent a clinical questionnaire to 183 pediatric hospitals. The remaining onesixth of the score derived from a survey of 450 pediatric specialists and subspecialists in each specialty over three years.

“Every Best Children’s Hospital deserves high praise,” said U.S. News Health Rankings editor Avery Comarow. “We know how important it is to parents to have confidence in pediatric centers that show dedication and expertise in caring for a child facing a life-threatening, rare or demanding illness.”

36 Physicians Bulletin July/August 2014

Creighton opens expanded simulation center

C

REIGHTON UNIVERSITY HAS UNVEILED

its newly renovated Clinical Education and Simulation Center, located within Creighton University Medical Center. The expanded and renovated space allows students studying medicine, dentistry, nursing, physical therapy and occupational therapy to practice interdisciplinary care in a structured environment. The design of the space will allow for the continued development of students in procedures and team-based care.

CAMPUS & HEALTH SYSTEMS update

New Methodist G.I. Endoscopy Center technologies enhance patient care

T

HE METHODIST HOSPITAL G.I. Endoscopy

Center is now situated on the hospital’s second floor and has doubled its space. The move was spurred by the expansion and renovation of the hospital’s surgical suites.

The area features a waiting area, nine pre-op and post-op recovery rooms, private consultation space for doctors and families, three procedure rooms and the latest in endoscopic technology.

“With new video processors and high definition scopes, we have much clearer pictures and can pick things up much more easily,” said Mary Hawkins, the center’s team leader. “They offer a wider range of view and more flexibility.”

Among the many endoscopic procedures offered, Methodist is the only place in the state where patients can receive trans-rectal and transanal ultrasounds, as well as anal manometries.

Physicians are also exploring other new procedures to help diagnose the most complicated cases.

“Our doctors are finding a lot more cancers and can see how deep some of these cancers go,” Hawkins said. “Everything we need is right here.”

Academy recognizes UNMC College of Medicine

T

HE UNIVERSITY OF NEBRASKA Medical Center

College of Medicine has been recognized by the American Academy of Family Physicians as one of the top 10 programs in the country in producing family physicians.

The award was presented at a conference of the Society of Teachers of Family Medicine in San Antonio. The award honors medical schools that – during a consecutive three-year period – graduated the greatest percentage of students who chose first-year family medicine residency positions.

“We are pleased to be honored by our peers.

This award is a testament of the contributions by many at UNMC, by the full-time and volunteer faculty, the students who ultimately choose family medicine as a career and our health care partners across Nebraska,” said Michael Sitorius, M.D., chairman of the UNMC Department of Family Medicine. “The department has a long-standing commitment to training future family physicians and will continue its efforts to increase the family medicine workforce for all of Nebraska.”

At a time when the United States is facing a shortage of primary care physicians, filling the family physician workforce pipeline is vital to the health of Americans, AAFP President Reid Blackwelder, M.D., said.

Awardees were recognized for employing a variety of initiatives that support students interested in becoming family physicians. These include student outreach, faculty involvement in medical school committees, admissions policies that target students from rural and medically underserved areas, and financial aid packages that minimize student debt.

July/August 2014 Physicians Bulletin 37

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38 Physicians Bulletin July/August 2014

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