September/October 2011 Physicians Bulletin

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NMA Message . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 The Campaign Season

E S

Confronting the Paperwork Tsunami

Paying It Forward . . . . . . . . . . . . . . . . . . . . . 21

R

Editor’s Desk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Cover story: . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Passing the test: NCVO Founder Dr. John Sage

Clinical Update . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Social Networking and Medicine

Resident Report . . . . . . . . . . . . . . . . . . . . . . . . . 22 Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Member News. . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Campus Updates . . . . . . . . . . . . . . . . . . . . . . . . . 35

6 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

A T

Digital Immortality

U

Legal Update. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

“Speed Dating for Your Speciality” leads to mentoring

How to Testify Before

F E

D E P A R T M E N T S

Table of Contents: September/October

Immunization Task Force. . . . . . . . . . . . . . . 30 Physicians Perspective

the Nebraska State Legislature. . . . . . . . . 27

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402-884-2000 Physicians Bulletin is published bi-monthly by Omaha Magazine, LTD, P.O. Box 461208, Omaha NE 68046-1208. © 2010. 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.

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editor’sdesk

Marvin Bittner, M.D.

Confronting

the paperwork tsunami

About two years ago I wrote a column about buying a car. I was

another. As I signed document after docu-

laden with paperwork while failing to see

struck by the paperwork involved. I was

ment dealing with issue after issue, I could

the big picture!

struck that bureaucracy and paperwork had

understand why the process had become so

As physicians of the 21st century, how-

descended not only on medicine, but also on

complex. At sometime in the past, Problem

ever, we may find this failing easy to under-

car dealers.

A developed with a transaction. Response:

stand. Have you never heard of bureaucratic

Have the parties in the sale complete a doc-

demands on medicine that address periph-

price was far more than the price of my

ument addressing the possibility of Problem

eral issues yet fail to confront the big prob-

car—and the paperwork as well was far

A. At another time, Problem B developed.

lems in health?

more than what was involved in buying

Response: Make sure the parties sign an

the car! I had been told by others about

agreement that covers Problem B. The ulti-

Chakraborty, MD, describes his epiphany:

the stacks of papers to be signed at closing.

mate result is a process that addresses poten-

our elected officials who make health care

They were right. All that, of course, was in

tial problems from A to Z. That, however, is

policy are not the experts on health care.

addition to the papers initialed and signed

what seemed so ironic to me.

We are. If we let the elected officials go their

This summer I bought a residence. The

to apply for the loan. In our Internet age,

On the one hand, property transactions

In this issue, a young physician, Amit

own way, they will replicate the disaster in

naturally, there were still more documents to

occur amid a complex set of documents

the housing market. We’ll see a burgeoning

be signed electronically.

addressing many possible problems. On the

of regulations addressing peripheral issues

Dear readers, you could have responded

other hand, the current recession was trig-

and a failure to cope with the problems that

to my column about car buying with com-

gered by a collapse of the housing market,

we physicians know are so important.

ments like: “Oh, you think the paperwork

a collapse due in large part to lenders who

is out of line for buying a car. Well, that’s

made imprudent loans. What an odd situ-

yourself what you will do. Will you join Dr.

nothing compared to buying a house.”

ation! The lenders developed a byzantine

Chakraborty in taking an active role in mak-

However, you were kind to me. You

process involving multiple documents and

ing the voice of medicine audible to the pol-

refrained from making negative comments

multiple signatures to address multiple

icy makers? Or will you remain silent as the

about my car column.

potential problems. Yet they neglected a fun-

deluge of bureaucracy suffocates medicine

damental issue: restricting loans to borrow-

while the tsunami of fundamental issues in

tity of signatures—both ink and electron-

ers capable of paying what was owed. How

health care is ignored?

ic—involved in buying housing. There was

odd of them to develop a complex process

That was one reaction I had to the quan-

10 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

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By Dale Mahlman, Executive Vice President, Nebraska Medical Association

The Campaign Season

As football season

is in full swing, I am reminded that there is another season drawing a lot of attention: campaign season.

The 2012 campaigns are off and running.

Fundraising is underway and the political jabs have already turned into full contact sports. Regardless of your political affiliation, this will be an interesting and important election for medicine.

At the national level, the names of Republican candidates hoping to replace President Obama continue to change. With the Iowa straw poll in the books, candidates can now focus on the remaining straw polls and caucuses in the next year.

The race for the United States Senate continues to provide insight into the discontent with business as usual. There are at least four known Republican candidates opposing Senator Ben Nelson in 2012. Both Senator Nelson and Senator Mike Johanns were invited to attend the Nebraska Medical Association Annual Session on Sept. 30; Senator Nelson being the only one able to attend. I predict he will be met by an interested and engaged audience with questions on health care reform, the national debt and repeal of the Sustainable Growth Rate for Medicare reimbursement.

At the state level, the 2012 legislative campaigns have begun as well with fundraisers for incumbents and candidates sprinkling the calendar. In 2012, term limits will end the

legislative careers of nine current senators, including the Speaker of the Legislature and five current committee chairs. In addition, 16 senators will face re-election for their second and last possible four-year term. Term limits have created both opportunities for new people to be elected, but the loss of legislators after only serving eight years seems premature in many cases.

As incoming president, Chuck Gregorius, MD, is placing a high importance on physician advocacy, which is critical if physicians want their voice to be heard. Our annual board retreat in July was the beginning of these efforts and included presentations by representatives from the American Society of Anesthesiologists who have been successful in political advocacy. I can’t stress enough that it’s important for ALL NMA members to understand the issues, be able to communicate their position and most importantly, form a relationship with their representative both during campaign season and during their term in office. Physicians can and need to do a better job in the political arena.

The NMA is committed to providing our members with the information needed to succeed at political advocacy. Let’s work together and make sure physicians are able to do what they ultimately do best, take care of their patients.

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Legalupdate

By Jim Wegner and Tom Kelley, Partners in the Tax Practice Group of McGrath North Mullin & Kratz, PC LLO

Digital Immortality: Estate Planning for Digital Assets

and Online Financial Accounts

Dave and Sue

had a modest estate, one well below the $10 million value they could pass to their children free of federal estate tax under current law. They had a comprehensive estate plan in effect to ensure proper management of their property if they became incapacitated, and to address the disposition of their property upon their deaths. Even though they didn’t need to worry about estate taxes, they periodically reviewed their estate plans with their attorney and amended their plans as necessary to ensure that their property would be distributed as they intended.

The periodic reviews gave them comfort that the clarity of their written plans would minimize disagreements and stress for their children when Dave and Sue passed.

Since our last estate planning meeting, Sue and Dave “went digital.” Their daughter Megan went away to college, and in order to keep in contact, Sue and Dave each opened an email account, Sue joined Facebook and friended Megan, they Skyped with Megan regularly, and they shared photos on Flickr. Dave connected with his colleagues and clients on LinkedIn. From there, their digital lives mushroomed. They decided to maintain their brokerage accounts online with their brokerage firms, eliminating all the paper they received in the mail. They maintained and stored their bank accounts and credit card accounts online as well. Their health savings accounts and medical insurance claims were made and maintained online, and monthly records were stored in digital (pdf ) format on their administrator’s server. They scanned any paper they still received and stored it on their computer or in “the cloud.” In short, Sue and Dave fully

14 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

embraced the digital age. What Sue and Dave didn’t realize was that, as their lives became digital, the dynamics of their estate plans changed as well.

Why consider digital property in estate plans?

As Sue and Dave learned, digital storage and digital communication are quickly replacing physical document storage, letters and regular mail. However, current contract, property and probate laws have not kept up with the rapid expansion of digital property and online accounts. It appears that only a few states have enacted digital estate laws. For example, Oklahoma and Idaho have enacted laws which allow a personal representative to take control of a decedent’s accounts on any social networking website, any blogging or short message service website, or any email service website. Practically, these laws may be helpful to show that the personal representative has authority to act on behalf of the decedent, but they may be contrary to the terms of the service contract that the decedent agreed to when signing onto the account.

Many online accounts in their terms of service provide that the online account is the property of the provider, so even though the statutes give the personal representative the right to access the deceased user’s information, the provider may deny the request, potentially resulting in litigation to decide who has rights in the account.

Additionally, virtually every service provider requires a username and password to access their accounts. Unless survivors are informed that the accounts exist, and are given the username and password, the survi-

vors may need to resort to the courts to gain access. Thus, these and similar laws may not provide the necessary rights to control online accounts after death or incapacity. So, until laws are enacted that clarify survivors’ rights in digital assets, everyone should establish a separate plan to deal with their digital property, whether on computer or online, when they die or become incapacitated.

What is Digital Property?

Digital property includes any data or digital material stored on your computer or on other digital media, such as CDs, DVDs, flash drives, or other media (photos, video and audio files). These types of digital property may be difficult to find after the owner dies unless the survivors know where to look for them. Digital property also includes any online accounts, such as email, Internet accounts, and other data stored on remote servers, including domain names, online brokerage and credit accounts, financial records, blogs, or social networking accounts such as Facebook, LinkedIn, MySpace, or Twitter. A username and password are normally required to access online accounts, so personal representatives will need such information to carry out the decedent’s desires. While many digital assets do not have monetary value, many have sentimental value to family members. Therefore, it is important to consider every category of digital assets when drafting an estate plan.

continued on page 16

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Legalupdate What should I do to implement my digital estate plan?

The goals of digital estate planning are to protect the existence of your digital property after death, to prevent sites from destroying the property before your digital personal representative can access and save the property if desired, and to transfer any assets of sentimental or real value to your heirs. To do so, digital estate planning normally includes the following steps: 1. Identify Your Digital Assets.

Generally, the first step in estate planning for your tangible assets, such as real and tangible personal property, is to inventory all of your property to determine how it is owned, where it is located and how and when you would like it to be distributed to your heirs at death. Identifying your property will help your personal representative or trustee ensure your assets are distributed as intended.

Similarly, creating a list of your digital property will help your “digital personal representative or trustee� to identify your many digital assets so that they can be archived, deleted, or passed on (if possible) in accordance with your intentions. This may be more challenging than it first appears.

Therefore, it may be helpful to categorize your property. a. Hardware. Identify all of your hardware, such as your home computer, office computer, laptop, iPad, smartphone, backup devices, and summarize the locations of important information on each, such as computer folders and places you keep personal, financial and customer documents.

16 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

b. Software. List important software programs you use, such as tax preparation software, Word or Excel documents, or financial data in Quicken, and locations of saved documents and files for each. c. Online Information and Accounts. List your social media accounts, such as Facebook, Twitter, MySpace; email accounts; websites, blogs; online backup sites; online sites on which you store documents, photos or other files; and other sites to which you belong. You also should list all your accounts that store your credit information, such as shopping sites; and list online brokerage accounts, bank accounts or other accounts that store your information digitally rather than send you paper statements. For each of these accounts, you should give detailed instructions regarding how you access the account, the domain name, and username and password.

2. Designate Your Digital Personal Representative or Trustee. In estate planning for your tangible property, a personal representative or trustee is designated to administer your estate after death. Typically, your spouse or another trusted person is designated. However, the personal representative of your estate of tangible property may not be the right person to administer your digital estate. Therefore, you should consider each of your digital assets,

decide who is most appropriate to manage them after your death, designate specific knowledgeable people and give them authority to manage your digital assets. Your digital executor or trustee should be somewhat technologically literate. You also need to be comfortable with the person having access to your digital information after your death. For example, you may prefer to designate a separate person to access certain private emails or confidential digital information instead of the personal representative administrating your tangible assets. That person could be designated as a co-personal representative, or co-trustee, with specific responsibility for your digital property; or instead could be an advisor to your personal representative, depending on how much authority you want your digital personal representative to have.

3. List Your Desires for Each Account. The investments and money summarized in your digital financial accounts, such as online bank and brokerage accounts, generally will pass according to your Will or Trust documents. For the information in those accounts, and for your other digital assets, you should provide detailed instructions for what you want to happen to the account and its content. Do you want your Facebook friends or LinkedIn connections to be notified of your passing? Do you want your digital account to be archived, frozen, continued or closed? Do you want the site information to be downloaded so that it can be preserved after your death? Is there value to the

Legalupdate account information that may be realized by your estate after you pass away? Depending on the site, there may be a number of choices that you can consider and designate in your digital estate plan. Keep in mind that it may not be possible to implement all of your choices, depending on the policies of the applicable online provider.

4. Create a Separate Document with Digital Asset Information. All of the above information may be maintained in a separate document, printed and kept in a safe place with your other estate plan documents, or it may be stored on a computer or other digital media. Alternatively, you could inform your attorney or trustee where the list is kept and have him or her disclose the location following your death or incapacity.

A more formal approach would be to place the information in your Will or Revocable Living Trust. When a Will is admitted to probate, the information becomes public information and can be viewed by anyone. Therefore, it would be preferable to document your account information in a trust. Digital property could be titled in the trust during your lifetime, and at your death, your digital property held by the trust would be viewed as owned by the

trust, so it would avoid the probate process and should not become public. A trust also could incorporate by reference an existing list that describes digital assets and designates the recipients. Another option would be to create a specific “digital asset trust� to hold your digital property and the information on how to deal with it. The trust could be the owner of your digital property and would survive death, thus allowing others to access the information.

As more people become comfortable with the ease and convenience of moving important documents and information onto their computers or online, it is necessary to establish a safe and secure method to access digital property following incapacity or death. The probate process and laws have not kept pace with the development of digital assets. Therefore, it is important to incorporate your digital assets in your estate plan. An estate plan that specifically addresses digital assets can help to ensure that your wishes are followed and minimize disagreements and stress for your heirs.

SEPTEMBER/OCTOBER 2011 PHYSICIANS BULLETIN 17

clinicalupdate

By Dr. Alan M. Lembitz, COPIC Vice President of Risk Management

Social Networking and Medicine

When Using Online Communication, Be Aware of a Few Potential Risk Areas...

Physicians and medical practices are using social networks to connect with their patients, market their practices, and recruit new employees. You, your employees, and your patients might expect to communicate via e-mail and text message. Love it or hate it, times have changed.

Even if you only signed up for a Facebook account to see pictures of your grandkids and wouldn’t know a tweet from a poke, know that social media isn’t going away. Here’s what you need to know in order to be safe in this arena.

The good news On the upside, social media can be a great way to promote your practice and provide timely information to your audiences.

Pediatricians can instantly inform their patients when a specific disease is endemic; primary care physicians can remind patients to get important annual screenings; and all physicians can communicate new medication alerts. Recently, a COPIC insured physician told us that a whopping 40 percent of her patients came to her via the internet. By using social media and her web site, she can promote all aspects of her practice.

Promotions on your own web site can be targeted to the patients you want to attract. You can design your web site to meet the interests of patients who are searching for their optimal medical care online. And it can definitely be of value to your existing patients, either by allowing easier medication refills or making appointments.

Additionally, blogging about areas you’re passionate about can be a great way of educating patients about conditions that you are interested in or relate to your specialty.

AMA guidelines The American Medical Association recently published guidelines for social media, addressing physician behavior and professionalism.

These are primarily aimed at physicians and emphasize respecting patient privacy and confidentiality. Pay special attention to separating personal and professional boundaries as you would in any context of your practice.

Other risk issues Facebook. Facebook is certainly the major force in social networking, boasting 500 million active users worldwide. A recent article in Journal of General Internal Medicine (JGIM 23:954957) found that 44 percent of medical students and residents had a Facebook account. Of these only 37 percent opted to keep their pages private. This was problematic as researchers saw photos and words that suggested excessive drinking and potentially sexist comments. Facebook offers the illusion of confidentiality, until your “friend” passes along whatever you post. If you are going to use Facebook, you should keep a personal page with appropriate privacy settings and a separate page for the practice.

HIPAA. Always consider HIPAA when addressing patient issues in any social networking site. Do not discuss individual patients or answer personal questions on any of these as none are HIPAAcompliant. Even email can pose HIPAA issues. Can you be certain that the patient and not the patient’s family will look at your email response? Keep personal information personal.

Staff. The AMA article doesn’t mention the risks associated with the online habits of your staff. For example, employees may assume that personal email written or checked at work is private.

This is often not the case. You should establish guidelines that address privacy of personal email at work and how much personal email and web surfing is allowed. Employees should not assume any email is private if done at work. In addition, practices should clearly outline a policy that forbids online discussion of personal health information.

E-discovery. Practices should be aware of the principles of e-discovery and consider a policy around record retention. Keep what is required and set time frames for deleting unnecessary information whether electronic or handwritten. If a patient is emailing you with clinical questions, the answers should be preserved as you would a written phone record. Remember to educate staff about e-discovery rules, as something as simple as deleting an email can be problematic.

Continued on page 20 18 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

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“Rate your physician” web sites.

Physician rating web sites allow people to rate their physicians as they would the restaurant they ate at last night. The vexing side of this phenomenon occurs when an angry patient complains or makes a negative comment. Some sites allow physicians to respond to negative posts. Rarely does responding to such posts serve your interests. What does work is to develop an approach that improves patient satisfaction and helps deal with negative patient experiences. Be aware of your patient satisfaction levels, treating patients with respect and courtesy and asking your staff do the same. If an employee wants to disagree with what the patient has said, he or she may do that. Employees need to clearly be identified as such when responding to these sites. Be aware, however, if employees do not disclose the fact that they are an employee, this may be considered deceptive and may violate Federal Trade Commission guidelines.

Bottom line? Be proactive about your online presence to protect yourself and your practice from the associated risks. Many consumers start their research on the internet when they are seeking medical care, so it makes sense to use social media and other online communication to reach your audiences. Just keep in mind that once you post something online, it is there forever.

Also be sure that you review the guidelines set for under the Colorado Consumer Protection Act about truth in advertising.

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feature

Photo by minorwhitestudios.com

Dr. Feldman, right, with med student Michael Jose.

Paying It Forward

“Speed Dating for your Specialty” Leads to Mentoring

Dr. Alicia Feldman

remembers her decision to pursue physiatry and what led her down that path. She discovered a love of science and an interest in medicine while pursuing her undergraduate education at Emory University in Georgia.

Evaluating her options while in medical school at Creighton, she discovered a passion for musculoskeletal medicine. That’s when Dr. James Devney entered the picture and introduced her to physiatry. The ability to perform procedures, yet still being able to spend time with patients proved to be the perfect mix.

But introducing her to this field was only the beginning of the impact Dr. Devney would have on the future of her medical career.

From allowing her to shadow him in his practice showing her first-hand what this field had to offer, to providing guidance, explaining the business aspect of medicine and eventually even recruiting her after residency to join him and his peers in practice, Dr. Devney was an invaluable resource for Dr. Feldman.

“Having a mentor is so important. Dr. Devney exposed me to this field and its pros and cons. He helped me to get started, discussed residency options, provided The Feldman File: Hometown: Undergrad: Medical School: Residency: Specialty: Family: Activities: Why I joined MOMS:

guidance on contract negotiations and the administrative side of medicine. Critical things you don’t learn in medical school,” said Feldman.

After joining the Metro Omaha Medical Society during her first year of practice, Dr. Feldman discovered a way to pay it forward through the Society’s “Speed Dating for Your Specialty.” The event, hosted by the Metro Omaha Medical Society, provides local medical students the unique ability to speak face-to-face with a physician about his or her specialty and ask questions, then rotate several times to discuss other specialties.

Speaking about her motivation to participate she said “I wanted to give back.” She enjoys her field of medicine and embraced the opportunity to expose more students to her specialty.

Whether the students decide to choose rehabilitation or another specialty, she wanted to increase their awareness of its benefits.

“I was impressed by the knowledge of the students and surprised at how many were not only familiar with physiatry but were already interested in the field,” she explained. She enjoyed how the questions posed by the medical students forced her to sometimes look at

Columbia, Maryland Emory University Creighton University University of Colorado Physical Medicine & Rehabilitation Husband Damien Running, Travel, Dance To meet and network with other Omaha physicians.

things in a different way.

Having participated in the “Speed Dating for Your Specialty” event for two years, Dr. Feldman has continued communication with a handful of medical students she met. She has provided guidance through ongoing communication as well as opportunities to shadow her.

Michael Jose, currently a second-year medical student at Creighton is one of those individuals. The combined influence of his father, a radiologist in Minnesota, and hearing his brother-in-law regale his experiences while attending medical school, he decided to pursue medicine midway through his undergraduate degree at Seattle Pacific University. He immediately began shadowing physicians and volunteering at a local hospital before going on to enroll in medical school at Creighton.

During his first year, with no particular specialty in mind and eager to explore his options, Michael attended the “Speed Dating for Your Specialty” event.

“It was a really great experience, a quick way to see if your personality fits with different fields and hear about specialties you aren’t familiar with or haven’t had exposure to,” said Jose. After meeting Dr. Feldman and hearing about physiatry, the specialty piqued his interest. The two communicated periodically after the event and this past summer Michael spent time shadowing at her practice.

Speaking of his experience, Jose said “I was interested in physical medicine, but shadowing Dr. Feldman over the summer and seeing her scope of practice, her work environment and the patients she sees, I am now really interested in this field.”

He went on to say the event and meeting Dr. Feldman provided him the opportunity to learn more about a specialty he would not have had the opportunity to experience.

With no physiatry residency programs in the area and no rotations for it in medical school – he found the knowledge he has gained to be invaluable.

As his studies continue and his focus narrows, he is quick to say physiatry is a distinct possibility in his future.

The Jose File: Hometown: Undergrad: Medical School: Family:

North Oaks, Minnesota Seattle Pacific University Creighton University – M2 Wife Hilary SEPTEMBER/OCTOBER 2011 PHYSICIANS BULLETIN 21

RESIDENTreport

By Amit Chakraborty, M.D.

A Call to Physicians:

Get Involved in Organized Medicine After experiences with the American Medical Association and Nebraska Medical Association during medical school, my intent was to continue with organized medicine as a resident. As of May of my second year, however, I hadn’t involved myself at any level despite the need for informed physicians with the actively changing outlook for medicine. I remained uninvolved, that is, until I attended the American College of Radiology annual meeting in May, 2011. Prior to resuming my interest in organized medicine, my assessment was our health care system incentivized profits for physicians rather than the overall health of our society. Moreover, I felt I was training to work in a health care system that was susceptible to exploitation by the pharmaceutical industry, device manufacturers, hospitals, insurance companies and physicians. The system either disenfranchised patients or lacked patient accountability.

For physicians, I specifically felt that our fee-for-service system was the primary culprit allowing certain physicians to exploit our Medicare and Medicaid programs.

When reform efforts did not substantively reform these issues and rather seemingly preferentially cut reimbursement to physicians in favor of hospitals, the pharmaceutical industry and insurance companies, I lost my enthusiasm for what seemed like an exciting debate to reconstruct our health care system. Furthermore, the process itself was overwhelming, specifically the legislative process and regulations involved in cre-

22 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

ating the new health care bill. Admittedly, my education is limited to science and medicine, not business or law. Fortunately, my perceived ignorance of the political process and health care legislation is similar to our legislators’ understanding of health care. In speaking with our state and federal legislators, there are gross mischaracterizations of how medicine is practiced, how our health care framework shapes the practice of medicine and what reforms are necessary to effect proper health care delivery. I now realize that we (physicians) are indeed the experts on this debate. While there is discrepancy among physicians as to the structure of an ideal health care system, the only vehicle available is lobbying efforts via organized medicine. If Nurse Anesthetists or Physicians Assistants are indeed “mini physicians”, why shouldn’t their roles expand? If a Radiologist’s report is a commodity, why shouldn’t tele-radiology be utilized? And, if physicians stand pat while measures aimed to control health care such as the independent payment advisory board and sustainable growth rate expand, then we should ready ourselves for such a health care system. My intent is not to marginalize allied health or demonize tele-radiology, but rather emphasize organized medicine, in its many forms, as our only option, as the experts in medicine, to change health care policy. Despite busy medical school curricula, residency training and daily medical practices, physicians must involve themselves in organized medi-

cine. I was recruited to write this article while attending the Nebraska Medical Association annual retreat. My lasting impression was that every physician should choose at least one medical society with which to participate, if even at its lowest level – annual membership dues. Groups such as MOMS, the NMA and the ACR each have different missions. The ACR boasts five pillars: Education, Government Relations, Quality & Safety, Patient Safety and Clinical Research. While preservation of reimbursement for imaging and self-referral of imaging were two prevailing issues at the past ACR meeting, the most passionate arguments of the assembly arose when addressing the poor job market for graduating residents. The ACR’s obligation towards newly trained Radiologists was evident. My interests are deeply aligned with the ACR on this matter and, as such, I plan to attend many future annual meetings. As a native Nebraskan, I’ve also rejoined the Nebraska Medical Association in an attempt to affect our state’s health care policy towards my idealized health care system. I encourage my fellow residents and medical student colleagues to find a medical society that suits your passion and join.

Amit Chakraborty is a UNMC radiology resident.

cover story

Photos by www.minorwhitestudios.com

Passing The Test

NCVO founder Dr. John Sage lead the way in streamlining the credentialing process Twenty years after its inception, the Nebraska Credentials Verification Organization continues to grow and provide a vital service to health care providers.

Founded in 1991, the brainchild of former Metro Omaha Medical Society president Dr. John Sage, NCVO centralized and streamlined the credentialing process in the metro Omaha area. continued on next page

The Sage File: Hometown: Undergrad: Medical School: Residency: Specialty: Family: Activities:

Omaha, NE Carleton College University of Nebraska College of Medicine Temple University Internal Medicine Wife Ruth, sons Jay and Peter Tennis, biking, volunteering at Lauritzen Gardens September/october 2011 PvHYSICIANS BULLETIN 23

cover story Sage, who has been retired since 2000 but continues to consult for NCVO, has been a visible and active member of the Omaha medical community.

After completing his Internal Medicine Residency in 1962, he joined a private practice group associated with Methodist Hospital. In 1967, he began serving on the Nebraska Board of Medical Examiners board of directors, which he continued until 1986, serving as president four times. In addition, Dr. Sage was on the board of directors for The Federation of State Medical Boards from 1980-1985 and appointed president in 1986, where he gained great insight into the challenges in evaluating the training of foreign medical graduates. He gained further experience with credentialing when he served as the Medical Staff President at Methodist Hospital from 1988-1990.

With his knowledge of credentialing and the processes’ inherent challenges and redundancies, Dr. Sage embarked on an idea to centralize and simplify the verification/ credentialing process.

Dr. Sage partnered with Sandy Johnson, the MOMS executive director at the time, and the two set out to achieve his goal. Sage says Sandy was a strong and vital advocate for the new credentialing system.

“She was an aggressive individual and really worked to get this done,” he says.

Sage says the impetus for the new credentialing system stemmed for an influx of physicians with prior history of malpractice. “Several physicians on the East Coast had been the subject of malpractice cases and would move to another state and set up a practice,” he says. “It caused all sorts of problems”.

“By virtue of that, hospitals felt that if they were going to have adequate physicians, they would have to make sure they were properly licensed,” he says.

“This started in about 1988, when Arizona developed a credentialing system. They would look at all applying physicians and make sure they had appropriate credentials.”

Prior to the founding of the Nebraska Credentials Verification Organization 20 years ago, credentialing for doctors was a bit like the Wild West.

Physicians practicing at multiple hospitals had to apply for privileges at each health care system and there was no system in place to adequately verify a physician’s training and past medical history, including a history of malpractice in other states. The redundancies were overwhelming for the medical staff offices and any institution that was providing the primary source verification.

The creation of NCVO significantly reduced redundancies in the application process for area providers. Prior to NCVO, providers wanting privileges at several area hospitals, were required to contact each hospital and complete their individual application process.

Each hospital would then in turn have to contact the providers numerous education and training facilities to verify all categories on each application.

The goal of this comprehensive credentialing program was and is to ensure that participating providers meet specific standards of professional qualification. The verification of a practitioner’s credentials is a distinct labor-intensive process which NCVO performs, and acts as “clearinghouse” for the collection, verification and distribution of

Prior to the founding of the Nebraska Credentials Verification Organization

20 years ago, credentialing for doctors was a bit like the Wild West.

24 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

the practitioner’s information for its contracted entities.

Once NCVO was created, providers were able to complete one universal application and NCVO would serve as a centralized entity to collect all of the verifications and share this information with as many entities that the provider requested. This resulted in reduced cost, time and frustration both in regards to the providers as well as the training programs who previously would have been contacted numerous times for the same information.

According to Sage, Omaha was a leader in the Midwest and NCVO quickly expanded into other areas of Nebraska and into Iowa.

Over the years, the amount of practitioner information within the NCVO office expanded and an electronic process was implemented. Currently, the majority of practitioner files are stored electronically for confidentiality and easier access. The growth of NCVO also warranted purchasing a new database program to streamline the credentialing process. This enabled the NCVO staff to perform many of their daily functions in bulk or globally which resulted in a more efficient process. An encryption program was also just recently purchased so NCVO could electronically send provider information safely and securely.

Prior NCVO director and current Metro Omaha Medical Society executive director, Diane Parsons says the organization has made the lives of virtually everyone in the local medical community easier.

“The redundancies we’ve eliminated for all the providers and medical staff offices are extreme,” she says. “The Metro Omaha Medical Society and NCVO are so blessed to have someone as knowledgeable and devoted as Dr. Sage throughout the years.

His continued involvement in the credentialing world is a key component to NCVO’s success”.

Now, on the 20th anniversary of NCVO’s inception, challenges aside, Sage says the process continues to greatly improve, is better than ever and remains vital to the maintenance of ensuring sound medical practice.

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feature Story by John D. Peters, M.D.

How to Testify Before the Nebraska State Legislature Prepare Know your senators, their district, their occupation, why they are on this committee, and any special concerns/issues they harbor. Pre-existing relationships with senators tend to draw a far more receptive ear. You can meet with them by individual appointment, through their campaign offices, at one of the MOMS Senator Breakfasts, or perhaps informally The Peters File: at real-world events.

Know your topic. Read the legislative bill comHometown: Lincoln, NE pletely and discuss it with your colleagues, the NMA, Undergrad: Creighton University legal counsel, lobbyists and other involved parties to Medical School: Creighton University gain perspective.

Residency: University of Nebraska Medical Center Do your research. Be able to substantiate your comFellowship: University of Florida ments with data when appropriate and/or necessary. This Specialty: Ophthalmology–Corneal diseases is especially important on highly-disputed “hot-button” Activities: Bicycling, hiking, weight-lifting, landscaping, reading topics. (i.e. if you can’t prove it, don’t say it). Submitting and writing incorrect elements weakens the whole of your argument.

Why I joined MOMS: “All politics is local” is a fairly accurate adage.

Anticipate the opposition’s comments and potential disInvolvement in the local medical community has a large impact on how I putes and be prepared to counter with evidence. Facts provide care to my patients and how they receive it. If you want to influence are far more important than opinions. these issues, you need to roll up your sleeves and participate. Some days you Rehearse. Read your testimony out loud and time it. can help more patients by doing these things than you can seeing patients in Be certain you are within the imposed limit given for the office. the hearing. Consider reading your testimony in front of

I was asked by MOMS to prepare this article, and in doing so, thought it might be more useful to readers if presented in more of an outline fashion rather than a traditional letter style. I hope that you find it useful and refer to it as you represent your profession and your patients.

SEPTEMBER/OCTOBER 2011 PHYSICIANS BULLETIN 27

feature others for practice.

Edit. Have the other interested parties mentioned above review your testimony and offer suggestions. Avoid unnecessary repetition of testimony or arguments submitted by others in your group by sharing your testimonies and strategizing as a team to deliver your message most effectively.

Punctual The shoe is now on the other foot.

Senators may be late. You may not be late.

They may come and go even during active testimony. This is normal so do not be disturbed when it occurs.

You arrive a few minutes early. You stay until all testimony is complete. This conveys how important this issue is to you, and informs you as to what other testimony is submitted.

Venue At the State Capitol at the front left of the hearing room you will sign in. Have a seat in the gallery with your colleagues.

The Senators’ arc-like elevated desk for approximately seven senators faces the gallery. The chairman, seated centrally, will announce the bill and the sponsoring senator will introduce it. One at a time, testifiers will come to the central table before the committee. Testimony proceeds with proponents first, then opponents, then neutrals. A copy of your testimony should be given to one of the legal assistants at your right. You will have a microphone before your seat and the crowd behind you. No PowerPoint presentations, large diagrams or easels are allowed. A lighting system in front of your microphone has a green light when you are speaking which turns to yellow with one minute left, and red when your allotted time has ended. At the completion of your testimony, thank the committee, and answer any questions they pose to you. If you do not know the answer, offer to obtain it and deliver it as soon as possible.

What’s the pulse on your retirement?

Materials Copies of testimony, graphs, articles, maps, diagrams, brochures are to be made beforehand and are given to a legislative assistant often seated to your right at the end of the senators’ desk. Have enough copies for all people involved. Do NOT overwhelm senators with material. They won’t read it all and may find excessive material submissions annoying. Your lobbyist and the NMA can assist you with this determination. Offer to provide senators with more information upon request and do so promptly when asked.

Appearance Suit and tie, Business suit/slacks/dress, “Professional” (Leave your Three Stooges tie at home. Dress as you would for an important job interview).

Manner Professional, Knowledgeable, Objective, Unflappable, Kind. Be Yourself (unless this contradicts what I just suggested, in

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feature which case maybe someone else should be the messenger).

Speak clearly. Enunciate. Speak in laymen’s terms as much as possible. Are you here to impress someone, or communicate a message? How do you feel when your mechanic yammers endlessly about exhaust manifolds and rear-differential gearing when you have to get kids to a soccer game? Same thing.

Introduce yourself. They ask that you spell your last name for the record. (e.g.

“Good afternoon, ladies and gentlemen of the Health & Human Services Committee.

My name is John Peters. P-E-T-E-R-S. I am a physician from Omaha, Nebraska where I practice ophthalmology as a solo, private practitioner. I have been in practice there for 18 years. I appreciate the opportunity to speak to you today in support of Legislative Bill 999”). Be concise. They have a multitude of meetings and legislative bills to address. Give examples from your experience! This is meaningful to them. The experience of your patients is very impor-

Q

tant as well. These examples hit home and are frequently remembered by senators.

Presentation Make eye contact with the senators. This is evidence of your command of the issue and conveys sincerity. It requires rehearsal.

No drama. There is no reason to raise your voice, pound the table, cry out, or point fingers. You are a professional. Your facts are sufficient evidence for the senators.

Deliver that message. It carries more weight than the drama.

Record The testimonies may be recorded on audiotape and/or by scribe and your submitted written testimony remains on file for all to review.

Follow-Up Discuss the hearing with your colleagues and critique your performances as necessary. Determine necessary tasks with your team and the NMA and lobbyists will

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discuss the continued procedural protocol regarding the legislation. Follow their lead. Archive your testimonies and data for future reference. As deemed appropriate, you may need to continue personal contact with senators as they consider the legislation. Always offer to be a prompt, reliable resource for them.

I cannot overemphasize the importance of your participation in these processes.

If you prefer not to present, then participate in other ways to assist the team.

Remember that the overall effect of legislation pervades everyday experience for you and your patients from this day forward.

Non-participation is a default to the wishes of others, and at the least dramatically increases the burden upon your colleagues who are making sacrifices for you. Are you still not interested? At the end of the day you should ask yourself the simple question often posed to reluctant negotiation participants: “Do you want to be at the table…or on the table”? Belly up!

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feature Story by Sandy Lemke

Physicians Perspective

on the Immunization Task Force of Metro Omaha With a Ph.D. in microbiology and an immunology fellowship from the National Institutes of Health, Dr. Richard Baltaro, a MOMS member, can speak with authority on the subject of immunizations -- and he is a “big believer” in them. He serves on the Immunization Task Force of Metro Omaha, which is celebrating its 20th anniversary this year. Baltaro, along with other MOMS members serving on the committee, contribute much to the public health by volunteering their time and effort to benefit the community.

Of the Task Force, Baltaro said, “I think they have raised the awareness of vaccinations within the community. They have increased the percentage of people immunized…and have made the whole community safer.”

30 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

feature

Richard Baltaro, M.D.

Dr. Debra Esser became a member of the Task Force in 1999. She said, “I have always been interested in immunization statistics and feel in Nebraska we should rank among the best for immunization rates. We have made great strides in this goal over the years, but can always do better. The ITF is currently involved in encouraging Hepatitis B vaccine at birth and promoting the flu vaccines to all age groups. While I have been part of the ITF, we have started a daycare flu education program in which the ITF sends all daycares in the metro are (including Council Bluffs) the latest information on the flu vaccine. We send posters and parent education sheets the daycares can copy and give to their parents, and we promote all daycare workers be immunized.”

Baltaro feels that, as a native Spanish-speaking physician, the only Deb Esser, M.D. one on the Task Force, he provides a voice for the Hispanic community. He said, “I raise concerns and issues. Many times the average [Hispanic] per capita income -- and this is before the recession -- is $10,000. Often people don’t vaccinate because they have to make a choice because of practical concerns. Mothers who would love to vaccinate their children sometimes are working many jobs that are not very highly paying.

They also may have language barriers. I bring these concerns to the Task Force.”

As the recipient of a full scholarship to medical school, Baltaro feels a moral obligation to help the less fortunate. He said, “Not everyone I speak for can speak for themselves.” Baltaro added, “I am a big believer in vaccinations. It is easier to prevent disease by vaccines.

Dr. Sheryl Pitner, a member of the Immunization Task Force Steering Committee, is Assistant Professor in Pediatrics at the Nebraska Medical Center. She said, “As a pediatrician, immunization is an integral part of my practice to keep children healthy.” She added, “There needs to be ongoing education in the community for all ages and in all medical specialties on the importance of immunizing yourself and your children. Periodically there are changes in the immunization schedule with new recommendations on already-existing vaccines or new vaccines. The Task Force is an avenue to educate both the community and my fellow physicians on these issues, to reach a wider audience than just my practice. There is also a lot of misinformation on vaccines and vaccine safety that can be addressed through education programs in the community and in the legislature when issues arise.”

Eight years ago, the group started the Annual Nebraska Immunization conference. Each year it features speakers to educate over 150 health care professionals and state legislators about immunization issues such as thimerisol. “We have been successful every year in blocking thimerisol legislation,” said Esser. She added, “We have supported a state immunization information systems for years and were strong advocates for NeSIIS (the Nebraska State Immunization Information System) where over 1 million Nebraska immunizations are now recorded.”

Pitner said that other MOMS members can become involved if they wish to help. She said, “Having a wide representation of specialties and of health care systems helps to make sure we are aware of the needs of the community and health care professionals, so new members are welcome.” Those interested can contact Patsy Nowatzke (patricianowatzke@creighton.edu) for a new member packet.

The Baltaro File: Medical School: Catholic University - Italy Residency: Brown University Fellowship: George Washington University &

The National Institute of Health Specialties: Clinical Pathology, Immunopathology,

Chemistry, Microbiology and Immunology Family: Wife Laura.

Why I joined MOMS: “I believe in organized medicine and I have been a believer for a long time. I have joined other societies (I am an AMA member) so, when I came to Omaha I thought it was a natural.”

The Esser File: Medical School: University of Nebraska Medical Center Residency: University of Nebraska Medical Center Specialty: Family Practice Family: Husband Bruce, daughters Sara and Beth Activities: Gardening, photography Why I joined MOMS: Wanted to be more involved in policy decision making and promotion of public health.

The Pitner File: Medical School: University of Nebraska Medical Center Residency: UNMC-CUMC-Children’s Hospital Joint

Pediatric Residency Program.

Fellowship: University of Texas Health Centers San Antonio.

Specialty: Pediatrics Why I joined MOMS: “To gain and share information to be a better advocate for patients and to get to know colleagues in my own as well as other specialties.”

SEPTEMBER/OCTOBER 2011 PHYSICIANS BULLETIN 31

MOMSevents

memberbenefits

Did You Know?

MOMS/NMA Members Have a Voice in the Future of Medicine Members of the Metropolitan Omaha Medical Society and Nebraska Medical Associations have a powerful voice in shaping the future of medicine. Your membership ensures you are up to date with legislative activities that impact local, state and national health care.

MOMS hosted its annual Past Presidents Luncheon on Thursday, July 21st at Happy Hollow. Pictured are: Michelle Knolla, M.D., John Sage, M.D. and John Mitchell, M.D.

If you are a member – we encourage you to get involved. Each fall, face-to-face legislative meetings are held with the state senators that represent the metro Omaha area.

All members are welcomed and encouraged to participate in these meetings. View the meeting schedule on the legislative page of our website at www.omahamedical.com.

Not currently a member? You owe it to yourself to make your voice heard joining your peers as a member of MOMS/NMA.

The MOMS Retired Physicians group gathered on July 27th to hear a presentation by Don Igo with the Omaha Nighthawks.

Call 402-393-1415 for more information on membership or complete the membership application located in the back of this Bulletin issue and return it to the Metro Omaha Medical Society. It’s that simple.

It’s that important.

MOMS/NMA member physicians who utilize COPIC Insurance are eligible for up to a

10% premium reduction

(5% for membership; 5% for participation in risk management education)

Cristina Fernandez, M.D., a pediatrician specializing in childhood obesity, speaks with two medical students at MOMS “Speed Dating For Your Specialty” event held Aug. 23rd.

32 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

Contact Laura Polak at the Metro Omaha Medical Society - 402-393-1415 or laura@omahamedical.com if you are interested in membership.

Or contact Ms. Pat Zimmer, Director of Sales at COPIC, at (800) 421-1834, ext. 6186 or pzimmer@COPIC.com for more information on the premium credit or a premium indication.

Another great benefit of membership!

membernews

Rowen Zetterman, M.D.

Pierre Fayad, M.D.

Zetterman Named to Accrediation Council Rowen Zetterman, M.D., dean of Creighton University School of Medicine, has been appointed to the Accreditation Council for Graduate Medical Education for a three-year term.

The private, nonprofit council is responsible for evaluating and accrediting more than 8,700 U.S. medical residency programs, representing approximately 130 specialties and subspecialties. Its mission is to improve health care by advancing the quality of education for resident physicians.

Zetterman has served as Creighton’s medical dean since 2009.

In 2008, he earned the Berk/Fise Clinical Achievement Award, the highest award from the American College of Gastroenterology (ACG). In 2007, he received the Alfred Stengel Memorial Award for Outstanding Service from the American College of Physicians (ACP), the nation’s largest medical specialty organization.

inmemoriam Fred J. “Doc” Pettid, M.D. Dec. 10, 1942 – Aug. 24, 2011

Fayad elected president of AHA’s Midwest Affiliate, which includes 11 states Neurologist, Pierre Fayad, M.D., has been elected president of the American Heart Association Midwest Affiliate board of directors. He will serve a one-year term that began July 1.

Dr. Fayad, a longtime volunteer for the American Heart Association and American Stroke Association, was named Physician of the Year for the two associations in 2008. He is the Reynolds Centennial Professor at UNMC and director of the Stroke Center at The Nebraska Medical Center.

“Dr. Fayad has been a strong leader for the American Heart Association for years, and it is an honor for the Midwest Affiliate to at last have him in the role as board president. He has the medical knowledge, the association experience, and genuine passion for the cause that will keep us on track to reach our aggressive goals,” said Kevin Harker, executive vice president of the American Heart Association Midwest Affiliate.

Dr. Fayad began his relationship with the American Heart Association while pursuing a fellowship in vascular neurology and stroke at Yale University School of Medicine in New Haven, Conn.

(Taken from UNMC email newsletter - August 26, 2011 )

Patrick Brookhouser, M.D. Dec. 3, 1940 – Sept. 3, 2011

John Roy Mitchell, M.D. Jan. 30, 1921 – Sept. 13, 2011

SEPTEMBER/OCTOBER 2011 PHYSICIANS BULLETIN 33

campusupdates Creighton heart surgeons earned a top rating in Consumer Reports September 2011 issue Using data from the Society of Thoracic Surgeons (STS), the consumer publication made a state-by-state comparison of how well surgical groups performed heartbypass surgery between July 1, 2009, and July 30, 2010. The ratings were based on overall performance, complications and other quality measures.

STS gathers information from more than 90 percent of about 1,100 U.S. surgical groups performing cardiac surgery. A total of 324 group practices, including Creighton’s, agreed to allow Consumer Reports to publish their results. Of those, Creighton and 80 other groups were above the national average with the top ranking of three stars. Alegent Health Bergan Mercy Medical Center and Nebraska Heart Institute and Heart Hospital in Lincoln also received three stars.

The Creighton group was also cited for having fewer complications than the national average.

CUMC Campus Update

Creighton University’s Hereditary Cancer Center gets grant Creighton University’s Hereditary Cancer Center, has received a three-year, $731,278 grant from the U.S. Department of Defense to study the role heredity plays in prostate cancer among African Americans.

“Prostate cancer is the leading cause of cancer death among men in the United States,. African American men have two times the occurrence of prostate cancer as do Caucasian men and suffer a significantly higher mortality as well,” said Henry Lynch, M.D., principal investigator and Creighton Hereditary Cancer Center director.

Jackson State University in Mississippi is collaborating in the study. The goal is to involve 300 African American prostate cancer patients from the Omaha area and about 500 from Jackson, Miss., in the effort.

To learn more, contact, Carrie Snyder at at 402.280.2634 or e-mail csnyder@creighton. edu and include “prostate cancer study” in the subject line.

Creighton University researcher gets N1H grant Creighton University researcher Devendra K. Agrawal, Ph.D., holder of The Peekie Nash Carpenter Endowed Chair in Medicine, has received a $2.58 million, four-year grant from the National Institutes of Health.

He will explore a potential new treatment for a problem that plagues many cardiovascular disease patients – re-narrowing of the coronary arteries after angioplasty and the implantation of stents. The research ultimately could eliminate the need for stents in cardiovascular care.

Following angioplasty and intravascular stenting, Agrawal and his research team will deliver a novel gene involved in the regulation of inflammation at the site of the interventional procedure in coronary arteries in a pig model. The goal is to determine whether the administration of this gene can reduce or eliminate the occurrence of restenosis.

Study co-investigators are Michael G. Del Core, M.D., chief of interventional cardiology and William J. Hunter III, M.D., professor of pathology.

UNMC Campus Update UNMC names student plaza in honor of Ruth and Bill Scott For all they’ve done to transform the academic campus at the University of Nebraska Medical Center, Omaha philanthropists Ruth and Bill Scott were honored on Sept.

13 when the UNMC student plaza was named on their behalf. The Ruth and Bill Scott Student Plaza spans from 42nd Street to 38th Avenue and from Dewey Avenue to Jones Street.

UNMC Chancellor Harold M. Maurer, M.D., said the Scotts’ generosity has literally transformed the UNMC campus. “A decade ago, our campus was just a bunch of aging buildings with no green space. It didn’t have the feel of a college campus. Now, thanks to the Scotts, we have a real college campus with incredible new buildings and a beautiful student plaza. It’s amazing what they’ve done. They’ve given almost all of our students a new building.”

Over the past eight years, the Scotts have made multiple gifts to UNMC, including the lead gifts on new buildings for four UNMC colleges - medicine, nursing, public health and pharmacy. Hundreds of UNMC faculty, students and employees 34 PHYSICIANS BULLETIN SEPTEMBER/OCTOBER 2011

were on hand for the dedication event on the UNMC ice rink in the heart of the student plaza. A highlight of the event was Bill Scott, a longtime trumpet player and singer, leading an eight-member band called “Scotty & the Grateful Meds.”

As part of the ceremony, a plaque honoring the Scotts was unveiled. There are five nearly identical plaques located around the student plaza. They include a map of the academic campus and a listing of some of the points of interest. In addition, the plaques include a thank you message from the Scott family to Ruth and Bill Scott. On the evening of Sept. 13, the Scotts participated in the initial lighting ceremony for the Hope Tower located in front of the Harold M. and Beverly Maurer Center for Public Health. The tower - designed by internationally-renowned artist James Carpenter - is illuminated at night. It is surrounded by four black granite benches for people to sit on and reflect. The name of the tower was selected from more than 235 submissions made by UNMC faculty, staff and students.

Salzinger named to new post Fred Salzinger has been appointed director of health planning, policy and finance in the University of Nebraska Medical Center’s Business and Finance office.

Salzinger will report to Bradley Britigan, M.D., dean of the UNMC College of Medicine. He will focus on special projects and will be involved in strategic planning as well as assisting UNMC Physicians, the UNMC physician practice plan, with its compensation package.

“Fred has a wealth of experience in academic medicine and in the Omaha community,” said Don Leuenberger, vice chancellor for business and finance. “We look forward to his contributions to the continued success of UNMC.” Salzinger most recently worked at Creighton University Health Sciences Office as associate vice president for health science, where he concentrated on planning, finance, administration and government relations. He also served as associate dean for finance and administration in the Creighton University School of Medicine.

Have you been supporting the

MOMS Foundation?

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 Street Omaha, Nebraska 68114 402-393-1415

The physicians of Spine & Pain Centers of Nebraska, Liane Donovan, M.D., Phillip Essay, M.D., and John Massey, M.D. are Board Certified in Anesthesiology and Board Certified in Pain Medicine.

By utilizing an array of interventional pain management techniques along with contemporary imaging, nerve ablation, and neuromodulation technology, we are uniquely qualified to address a broad spectrum of pain conditions, including work and sport injuries. The physicians of Spine & Pain Centers of Nebraska, Liane Donovan, M.D., Phillip Essay, M.D., and John Massey, M.D., are Board Certified in Anesthesiology and Board Certified in Pain Medicine. James P. Devney, D.O. is Board Certified by the American Academy of PM&R (Physical Medicine & Rehabilitation) and the American Board of Electrodiagnostic Medicine.

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SEPTEMBER/OCTOBER 2011 PHYSICIANS BULLETIN 35

Application for Membership This application serves as my request for membership in the Metro Omaha Medical Society (MOMS) and the Nebraska Medical Association (NMA). I hereby consent and authorize MOMS to use my application information that has been provided to the MOMS credentialing program, referred to as the Nebraska Credentials Verification Organization (NCVO), in order to complete the MOMS membership process.

Personal Information Last Name: _____________________________ First Name: _______________________ Middle Initial: ______ Birthdate: _________________________________________________ Gender: Male or Female Clinic/Group: __________________________________________________________________________________ Office Address: ________________________________________________________________ Zip: __________ Office Phone: ____________________ Office Fax: ___________________ Email: _________________________ Office Manager: _______________________________________ Office Mgr. Email: ________________________ Home Address: ____________________________________________________ Zip: ________________________ Home Phone: __________________________________________ Name of Spouse: ________________________ Preferred Mailing Address: Annual Dues Invoice: Event Notices & Bulletin Magazine:

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

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

Apply Online: www.omahamedical.com

membersupdate New Members In Focus

Chelsea Chesen, MD

Medical School: University of Nebraska Medical Center Specialty: Psychiatry Location: Private, Out-patient practice Psychiatry is Dr. Chesen’s “family business” as her father is also a psychiatrist. When she is not working, she loves to garden, swim with her boyfriend and his son, and play with her two miniature poodles. Last November, she spent almost two weeks in China with a delegation of psychiatrists from all around the world. She also loves to read and collect old medical and psychiatric textbooks, as well as first edition hardback novels. She has played the violin since she was three years old, loves modern design and architecture, and is a huge Duke basketball fan.

Tricia Hultgren, MD

Medical School: University of Nebraska Medical Center Specialty: Dermatology Location: Dermatology Specialists of Omaha, LLC While living in Chicago, Dr. Hultgren and her husband developed a taste for fine dining.

She enjoys gourmet cooking at home, as well as spending time with her nearly 2 year-old son. She is also an avid long distance runner.

Charles Wakefield, MD

Ebrahim Shakir, MD

Dr. Wakefield enjoys being outdoors and has quite a green thumb. He has his own large organic vegetable and herb garden and recently built his own koi pond. He also collects tropical plants and has an eight foot coconut tree he started from seed five years ago.

Dr. Shakir loves to cook and experiment with new recipes. His favorite foods are Indian specialty dishes, such as spiced lamb with basmati rice and lentil stews.

Interested in becoming a MOMS Member?

Medical School: University of Nevada School of Medicine Specialty: Allergy & Immunology Location: Midwest Allergy & Asthma Clinic, P.C. Dr. Miyake was raised in a bilingual household on a potato farm in Nampa, Idaho. His background in conversational Japanese has come in handy – it enabled him to assist in the prenatal care of a vacationing patient from Japan while in medical school in Las Vegas. It also proved useful while doing a news interview on pollution and recycling while he was visiting family in Okayama, Japan.

Medical School: Medical College of Ohio Specialty: Urology Location: Adult & Pediatric Urology and Urogynecology

Medical School: Creighton University Specialty: Allergy & Immunology Location: Midwest Allergy & Asthma Clinic, P.C.

Bob Kyo Miyake, MD

NEW MEMBERS Traci Jurrens, MD Internal Medicine Henry Sakowski, II, MD Internal Medicine Katherine Van Demark, MD Anesthesiology

Call 402-393-1415, apply online at www.OmahaMedical.com or complete the application on page 34.

Rebecca Wester, MD Family Medicine SEPTEMBER/OCTOBER 2011 PHYSICIANS BULLETIN 37

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When a newborn is critically ill, a single call gives you instant access to our neonatal intensive care specialists and a full range of pediatric and surgical subspecialists, all supported by state-of-the-art technology and equipment. It can also link you to our neonatal transport service team, who will arrange for transport to Children’s Hospital & Medical Center based on the child’s needs. Twenty-four hours a day, seven days a week, one call links you to physician-to-physician consults, referrals and admissions. There’s no problem too large, no child too small. www.ChildrensOmaha.org

New - Physicans Bulletin Ad color, Sept.2011.indd 1

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