September/October 2012 Physicians Bulletin

September/October 2012 • USA $1.95

Public Health In Action

ALSO INSIDE

Making Medicine Not So Distant:

One Omaha Physician’s Experience with Telemedicine

Setting the Record Straight: Health Care in Canada Vs. US

Political Advocacy: A Participatory Sport Tips on How to Be An Advocate

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

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September/October 2012 Physicians Bulletin 5

THIS issue

SEPTEMBER/OCTOBER 2012

features

departments

1 8

1 0

2 0

22

2 5

Making Medicine Not So Distant

One Omaha Physician’s Experience with Telemedicne

Setting The Record Straight

1 2

Health Care in Canada Vs. US

1 4

Political Advocacy: A Participatory Sport

1 5

Tips on How to Be An Advocate

COVER: Public Health In Action MOMS Responds to Childhood Obesity

The Freedom to Vote

NMA Message

A Noble Commitment

Legal Update

What Do You Say When Asked for a Job Reference?

Young Physician Report Omaha is my Home-aha

1 6

Clinical Update

Recommended Approaches for Treating Youth Athletes Who Experience Concussions

3 0

31 3 2 3 4 3 7

6 Physicians Bulletin September/October 2012

Editors Desk

MOMS Events

Omaha Storm Chasers, Member Networking & Women in Medicine

MOMS Coming Events Member News & In Memoriam Campus Update New Member Update

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SEPTEMBER/OCTOBER 2012 VOLUME 33, NUMBER 5 A Publication of the

Metro Omaha Medical Society 7906 Davenport St. • Omaha, NE 68114 (402)393-1415 • www.omahamedical.com OFFICERS President | Marvin J. Bittner, M.D. President-Elect | Debra L. Esser, M.D. Secretary-Treasurer | David D. Ingvoldstad, M.D. Past President | Pierre J. Lavedan, M.D. Executive Director | Diane Parsons EXECUTIVE BOARD Marvin Bittner, M.D. Debra Esser, M.D. David Ingvoldstad, M.D. Pierre Lavedan, M.D. Mohammad Al-Turk, M.D. Jane Bailey, M.D. Richard Baltaro, M.D. David Filipi, M.D. Harris Frankel, M.D. Sherrill Murphy, M.D., James Newland, M.D. Kevin Nohner, M.D. William Orr, M.D. Laurel Prestridge, M.D. William Shiffermiller, M.D. Gamini Soori, M.D. Jeffry Strohmyer, M.D. EDITORIAL/ADVERTISING STAFF Publisher | Omaha Magazine, LTD Editor | Marvin Bittner, M.D. Art Director | John Gawley Senior Graphic Designer | Katie Anderson Assistant Graphic Designer | Paul Lukes Photographer | minorwhitestudios.com

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Physicians Bulletin is published bi-monthly by Omaha Magazine, LTD, P.O. Box 461208, Omaha NE 68046-1208. © 2012. 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.

8 Physicians Bulletin September/October 2012

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September/October 2012 Physicians Bulletin 9

EDITORS desk

Marvin Bittner, M.D., President, Metro Omaha Medical Society

The Freedom to Vote

I

N JANUARY, I SPENT a week in Cuba. The trip

was legal. The trade embargo with Cuba does permit religious missions, such as the trip I chose, a trip organized under the license of the Jewish Theological Seminary of America. Our group did bring goods to the Jewish community of Cuba. We did meet members of that community in Havana, Santa Clara and Cienfuegos. We did hear lectures about the community.

Despite the focus of our trip, another topic repeatedly intruded: Cuba’s government. One afternoon, we met the president of the Jewish community of Havana. She wryly commented that, as was the Cuban custom, her tenure as president was indefinite.

A knowledgeable guide, Raul, accompanied the group throughout the week. At times, members of the group challenged Raul with unfavorable comparisons of Cuba’s regime with that of the United States. Yet Raul had answers. At one point, he noted that only about 25 percent of the U.S. electorate had cast ballots for our president.

This was true. Only about one-half of the electorate showed up at the polls in 2008, and Obama garnered slightly more than half of the vote.

Raul contrasted this result with the outcome of Cuba’s most recent presidential election. In that election, the winner got the votes of 95 percent of the electorate.

For me, though, the most memorable conversation about Cuba’s regime came at the very end of the trip. I was seated in a jet at Jose Martí Airport.

10 Physicians Bulletin September/October 2012

I was waiting for the plane to depart. I struck up a conversation with a young man seated next to me. He was returning to his home in Miami.

He had spent a couple weeks in the western province of Pinar del Río. He had visited his family. He had emigrated from there to Miami about a dozen years earlier.

I asked him why he left Cuba then. He told me that he left when his father was released from prison. That piqued my interest. I asked him why his father had been in prison. He told me that his father was a political prisoner. That piqued my interest even more. I asked him what his father did to be put in prison. He answered me, but I couldn’t understand his answer at first. His answer was hard to understand, partly because of his accent and partly because his answer didn’t make sense. He repeated his answer a couple times, and I understood.

He told me that his father was imprisoned for putting up a Beatles poster. It had a picture of John Lennon and it said “Peace Love Freedom.”

I asked him how much time his father got for that crime. The answer: Two years.

I hope that everyone who reads this will recognize that we have many freedoms. I hope that all of us will take advantage of our freedoms.

I am not insisting that everyone who reads this go out and put up a Beatles poster.

I do think, though, that it is reasonable for me to expect all of you to do something else: Vote.

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NMA message

A Noble Commitment Dale Mahlman, Executive Vice President, Nebraska Medical Association

A

S YOU READ THIS article, the Nebraska

Medical Association will just recently have concluded our 2012 Annual Session and installation of our new president, Dan Noble, M.D., of Lincoln. I hope you all had the opportunity to attend and I hope we met your expectations.

Putting together an annual meeting is a labor of love for many of us.

One notable absence this year was our incoming president himself, Dr. Noble. Funny thing happened on his way to the top: He decided to join the Nebraska Air National Guard as well.

Every morning as I rise from my air conditioned home in a safe, quiet neighborhood, I think of our current NMA president, who is temporarily residing in Qatar serving a 90-day deployment as the chief of aerospace medicine for the 155th Air Refueling Wing. I usually check the weather in Qatar every few days just to check on his living conditions, 108 degrees today, 108 degrees yesterday, 108 degrees tomorrow. In addition to the temperature, widespread dust today and 0 percent chance of rain. Starting to see a pattern here?

In July 2010, Dr. Noble and I had a discussion about his future with the NMA in a leadership capacity given his recent commitment to the Guard. As you might expect, Dr. Noble has no problem making a commitment to an organization and no problem honoring a commitment either.

He mentioned he had several Guard-related requirements to get completed prior to him being eligible for deployment and at that time, if I recall our conversation correctly, he was thinking late 2013 would be the earliest he’d be eligible for deployment. In his usual fashion, he tackled his responsibilities as a soldier just like he does as a husband, father and physician, and to no one’s surprise, he finished his requirements before his colleagues who entered the Guard before him so his place in line changed dramatically.

In mid-May, Dr. Noble called me and mentioned he had a couple of things he’d like to visit about so we set aside some time on Friday, May 18, at 11 a.m. He arrives in my office wearing a flight suit, not unusual given he was on his way

12 Physicians Bulletin September/October 2012

to the base for an afternoon of responsibilities out there. The scenario he begins to lay out for me regarding his “new” opportunity and how that will affect him, his family and his practice about knocks me off my chair. I used to think I was OK handling change, but the scenario he described caused me to pause a bit but was typical of what I would expect from Dr. Noble.

He made a commitment to his country and he had figured out a way to honor it.

In addition to his many concerns that day for his family, his employees and his patients, he was concerned about the impact of his deployment on the NMA and our annual meeting that he was very involved with in planning. Our keynote speaker was someone he had heard several times before, Michael Durant, a fellow soldier who battled adversity beyond all our comprehension and Dr. Noble thought his message would resonate with our membership, in these uncertain times for medicine and physicians. Michael Durant is an expert in dealing with adversity.

Following our May discussion, which I could go on for pages about, Dr. Noble presented a statement to the NMA Board of Directors describing his situation and asking for its feedback regarding his continued role as president-elect of the NMA. Thankfully, almost to a person, our board supported his decision and offered their support during his absence relating to any NMA duties.

Dr. Noble isn’t the first Nebraska physician to be deployed and I feel badly not describing each of their situations in the same context.

My level of understanding of this scenario just happened to confirm my opinion of not only this physician, but also physicians of the NMA. As a voluntary membership organization, we always appreciate the sacrifices of time and effort of our member physicians to represent the NMA and the practice of medicine.

It’s because of people like Dr. Noble, along with those that came before him and those that will follow, that the NMA has been serving as an advocate for Nebraska physicians, for their profession, their patients and the health of all Nebraskans for more than 140 years.

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September/October 2012 Physicians Bulletin 13

LEGAL update

What Do You Say When Asked for a Job Reference?

Julie Schultz Self, Employment, Labor and Benefits Practice Group, Koley Jessen, P.C.

M

EDICAL GROUPS OFTEN WRESTLE with

complicated issues when contacted for an employment reference regarding a former employee. Employers must balance their interest in warning a subsequent employer of potential patient care or related issues with concerns regarding potential liability for providing a negative (but truthful) reference. Faced with such options, many medical groups error on the side of caution and provide only basic information (dates of employment and position held) in response to requests for information. Unfortunately, such responses likely do not provide adequate information to alert a hiring employer that the candidate may not be well-suited for the particular position. However, recent Nebraska legislation may allow employers to more comfortably provide reference information.

On April 10, Gov. Dave Heineman signed LB 959 into law. LB 959 allows employers to disclose specific information about a current or former employee to a prospective employer upon receipt of the employee’s written consent.

According to LB 959, the employee’s consent must be obtained on a separate form from the employment application or, if included as part of the employment application, the consent language must be in bold letters and in larger type than the remaining text. The consent form must contain specific statutory language and be signed and dated by the applicant.

Once appropriate consent is obtained, employers may disclose: • Dates and duration of employment.

• Pay rate and wage history.

• Job description and duties.

• Written performance evaluations (prepared prior to the date of the request and provided to the employee during employment).

• Attendance information.

• Results of drug or alcohol tests administered within one year prior to the request.

• Threats of violence, harassing acts or threatening behavior related to the workplace or directed at another employee.

• Whether the employee was voluntarily or

14 Physicians Bulletin September/October 2012

involuntarily separated from employment and the reasons for the separation.

• Whether the employee is eligible for rehire.

LB 959 provides immunity to employers by creating a rebuttable presumption that employers who disclose employment information in accordance with LB 959 are acting in good faith.

Such employers are immune from civil liability unless the employee can show, by a preponderance of the evidence, that the employer disclosed false information, had knowledge of its falsity or acted with malice or reckless disregard for the truth. Also, employers will not be immune from liability if the employer unlawfully discriminates or retaliates against an employee.

Medical groups should determine whether, and to what extent, they may want to take advantage of LB 959. Before providing reference information, employers should ensure that they have received a consent form that complies with LB 959. As an alternative, medical groups can also create their own consent form and insist that current or former employees sign the same before the medical group discloses any reference information. As part of such a consent form, employers should consider including a release by which the consent of former employee releases the employer from any liability related to the job reference. Medical groups should also carefully decide which categories of information that it will provide. For example, medical groups may decide that they will uniformly provide duration of employment, pay rate and wage history, job descriptions, performance evaluations and whether the employee is eligible for rehire. By responding to reference requests in a uniform manner, employers may be better able to defend against potential claims of discrimination or retaliation (related to reference information provided).

Medical groups should also consider drafting a reference policy to include in their employee handbook that specifies the group’s procedure or plan with respect to providing reference information. Finally, medical groups should consider tracking reference requests received and the information provided by the medical group.

YOUNG physician report “As physicians, we have so many unknowns coming our way...

Omaha is my Home-aha

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

Anthony Macdissi, Third-year Medical Student, University of Nebraska Medical Center

I Medicine is feeling the effects of regulatory and legislative changes, increasing risk, and profitability demands—all contributing to an atmosphere of uncertainty and lack of control.

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DIDN’T COME UP WITH the saying, but it’s

something I fully endorse. I’m even in the Facebook group for it. As a third-year resident inundated with advertisements about job opportunities across the United States, I’ve recently had to start weighing my options for where I should practice medicine. While there are certainly some understandable motives for leaving Omaha after residency, I think there’s a myriad of even better reasons Omaha is a popular place for residents to call home after finishing their training.

One of Omaha’s biggest advantages is the fact that it has not one, but two medical schools/ hospitals with residency programs. While this can tend to foster a friendly rivalry between everyone, the biggest benefit is the amount of research that takes place with two academic institutions.

We’re exposed to new, ground-breaking trials that have the potential to immediately affect patient care. We have physicians recognized worldwide for their expertise. I’ve personally worked with the hematologist who developed R-CHOP therapy for Non-Hodgkin lymphoma and the rheumatologist who literally wrote the book medical students learn from when they’re studying rheumatoid arthritis. When you factor in this kind of local expertise with the availability of cutting-edge technology and resources, it’s easy to say Omaha is as competitive as any city in providing world-class care.

Of course, something every budding new physician is going to be concerned about is paying off his or her student loans. Omaha is part of the North Central region in regards to geographic area, which is the region that ranks highest in overall physician compensation. Nebraska also boasts of one of the most physician-protective malpractice caps in the country. Coupled with

a cost of living 10 percent below the national average, and the No. 1 value city in Kiplinger’s 2011 report, Omaha makes a very attractive place to be employed.

There are some factors that weigh against Omaha when newly graduated residents are considering their options. Omaha isn’t by any kind of ocean or large bodies of water, and the Council Bluffs aren’t exactly the Rocky Mountains. It doesn’t have any major professional sports teams, and the mass transit leaves something to be desired.

There are four legitimate seasons, with extremes of blistering humid summers and winters with three feet of snow being the norm. Another issue a female resident pointed out to me was that Omaha doesn’t have a Macy’s or Nordstrom’s, which apparently is a must for any of the diehard shoppers. But what is probably one of the biggest reasons I think Omaha-trained residents would leave Omaha is probably a tribute to why it’s such a great place to stay – the job market is saturated and highly competitive, making it harder for the less-experienced graduate to find that first job.

At the end of the day, it’s all the intangibles Omaha has to offer that keep it on the top of my list. There’s Husker football and Creighton basketball. Yearly College World Series games and having the opportunity to watch the greatest Olympian of all-time at the Olympic swim trials. We have the CenturyLink Center with headliner concerts, and the Orpheum with all of Broadway’s plays. There’s a world-class zoo, a thriving Indie-rock scene, and an Old Market filled with history, character and charm. It’s no wonder that my family and friends have all planted their roots here, and I’m proud to say that Omaha is my home-aha.

September/October 2012 Physicians Bulletin 15

CLINICAL update

Recommended Approaches for Treating Youth Athletes Who Experience Concussions

Dr. Alan M. Lembitz, Chief Medical Officer, COPIC Insurance Co.

R

ECENT LEGISLATION IS TRANSFORMING

the way concussions in youth athletes are handled. Nebraska LB260 became effective on July and applies to scholastic and club sports involving student-athletes up to and including age 19 (excludes collegiate student athletes).

The new law consists of three primary components: 1. Education: (a) Concussion educational training must be made available to all coaches on how to recognize symptoms of a concussion, and how to seek proper medical treatment. (b) Athletes and parents must be provided concussion information prior to an athlete’s participation on an annual basis that includes (i) signs and symptoms of a concussion, (ii) risks posed by sustaining a concussion, and (iii) actions an athlete should take in response to sustaining a concussion—including informing their coaches.

2. Removal of Athlete: An athlete presenting with signs or symptoms of a concussion thereby being “reasonably suspected” of having sustained a concussion (a) must be removed from participation, and (b) may not return to participation until evaluated by an appropriate licensed health-care professional.

3. Written and Signed Clearance for Return to Play (RTP): An athlete having been removed from participation for the purpose of presenting with signs or symptoms or “reasonably suspected” of having sustained a concussion must have, before RTP or participation is allowed by a coach, (a) Written and signed clearance from an appropriate licensed health

care professional including physicians, athletic trainers, and neuropsychologists, and (b) Written and signed clearance from the athlete’s parents.

The process of returning an athlete to play requires careful documentation of both symptomatic and neuropsychological recovery. Therefore, it is unadvisable to write a note that allows the athlete to resume activity at an arbitrary date in the future because it is impossible to predict how a concussion will evolve and when that concussion will resolve.

Current best practices recommend a “multidisciplinary team approach,” meaning everyone who interacts with the student athlete should help manage the concussion and report their observations about the athlete’s recovery. Having multiple eyes on the concussed athlete can help assure that he or she has returned to full functionality.

Concussion Resources • The Nebraska Department of Health and Human Services website, http://dhhs.ne.gov/ publichealth/Pages/concussion.aspx, has multiple links to concussion education for practitioners.

• The Centers for Disease Control and Prevention (CDC) recommends using the Acute Concussion Evaluation (ACE) tool. The ACE and other useful information on managing concussions in sports can be found at http://www.cdc.gov/concussion/ HeadsUp/physicians_tool_kit.html.

• The Sports Concussion Assessment Tool (SCAT 2) is another concussion tracking tool.

There are many websites that post this tool—you can find it through a Web search of “SCAT 2.”

Returning the Youth Athlete to School Although the student athlete should not resume sports or activities that could cause re-injury to the vulnerable brain until fully recovered, the approach to returning to school is quite different. Every attempt should be made to transition the student back to school once the most severe symptoms have improved (usually within one to three days). The student, parent and physician may need to work with the school for specific accommodations so that symptoms can continue to improve while keeping the student engaged in

16 Physicians Bulletin September/October 2012

learning. Guidelines for return to school can be found on the CDC website at http://www.cdc.gov/ concussion/pdf/TBI_Returning_to_School-a.pdf.

Returning the Youth Athlete to Sports Returning an athlete to participate in a sport can only begin once he or she has fully recovered from the concussion. The athlete must be symptom-free and be returned to baseline regarding school performance (which means being able to tolerate a full school day with an age appropriate workload).

Neurocognitive testing may also be helpful to assess recovery, although neurocognitive recovery may lag behind symptom resolution, theoretically indicating an athlete whose brain is still at risk. Once the medical provider has determined that the athlete has fully recovered, it is time to begin the “Graduated Return- to-Play Protocol” as recommended by the Consensus Statement on Concussion in Sport published in 2008 (also available on multiple websites by searching “Graduated Return-to-Play Protocol”). Once the athlete successfully completes this graduated return-to-play process—which typically requires a minimum of six days—he or she can then receive final clearance to return to full participation.

Adolescents with concussions may have subtle neurometabolic derangements that may dramatically increase the risk of long-term and potentially severe or life threatening complications if re-injured before recovery. Because of this, the process of clearing a youth athlete to return to his or her sport after a concussion requires a systematic and thoughtful approach with thorough documentation of resolution of the symptomatic and neuropsychological consequences of the concussion. Even with this approach, every parent and youth athlete must individually weigh the risks and benefits of competitive sports after concussion.

Editor’s Note: This article was prepared by COPIC’s Patient Safety and Risk Management Department. Special thanks to Dr. Daniel J. Tomes for providing key information for this article.

September/October 2012 Physicians Bulletin 17

feature

Dr. Robert Beer

Making Medicine Not so Distant The Beer File Hometown: Grand Island, Neb Undergraduate: Kearney State College in biology and chemistry Medical degree: University of Nebraska Medical Center Residency: Iowa Luthern Hospital in Des Moines in family practice Specialty: Family practice Location: West Omaha Family Physicians Family: wife, Dorothy; and two grown children, Libby and Charlie Hobbies: Sailing, hunting, fishing and tennis Why I joined MOMS: I think collegiality. It’s networking with other physicians.

R

OBERT BEER, M.D., ENVISIONS the day when he sees a full regimen of patients without a single one walking through his clinic’s front door.

Should that day come, Dr. Beer, a family practitioner in west Omaha, said he’ll likely have mixed emotions.

On one hand, Dr. Beer said, he is intrigued with practicing telemedicine and understands its benefits. “You could examine a patient remotely from half-way across the world without being in the room.”

On the other hand, Dr. Beer said he chose medicine as his profession because he enjoys the personal contact it provides with patients. “I like people. That’s why I do what I do. I still enjoy sitting down and talking with patients.”

Dr. Beer currently consults long distance with patients through one “telehealth” provider and has consulted with more than 150 patients during the past 12 months. He is credentialed with a second – but the two must decide whose malpractice insurance will cover him.

Dr. Beer said he first became intrigued with telemedicine several years ago while attending a demonstration by AT&T. During the session, a physician demonstrated how he could treat patients – looking down their throats, examining their skin – by using a webcam. The physician also held a digital stethoscope to his chest and demonstrated how he could guide a patient through the examination.

“I was intrigued with this telemedicine thing – and the 16 devices you can use to examine a patient remotely,” Dr. Beer recalled.

He said his brother worked for a company that manufactured soundproof music rooms. He sold some to a California-based company

18 Physicians Bulletin September/October 2012

that installed them in pharmacies and at other locations. Patients insert their insurance cards, step inside, sit down and log into a computer.

A physician appears on the screen and asks the patient to describe his or her symptoms.

“They say pick up that stethoscope and hold it to your chest. Now, move it to the right. Now, to the left. Hold still. They’re (the physician) getting a digital recording of your heart sounds – half-way across the world.”

“The cool thing about these booths is when you leave, the room ‘mists’ itself – like a public restroom – and is ready for the next patient. It sanitizes itself.”

“That’s how I got interested in this.”

He later heard Kevin Friedman, M.D., talk about telemedicine on a news program. Dr. Friedman serves as medical director of Telemedicine Consulting Network.

Telemedicine Consulting Network describes itself as being in the business of connecting patients with “the care they need. The Telemedicine Consulting Network is a platform that allows doctors to expand their reach, improving patient access to care.” (www.telemedicinecn.com). A competitor, Teladocs, which was founded in 2002, bills itself as the first and largest telehealth provider in the nation. (www.teladoc.com).

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Dr. Beer said he contacted both providers and went through an extensive credentialing process before being accepted. He told both he wanted to use his Nebraska malpractice carrier -- because of its cap on awards -- as his primary insurance.

Teladocs agreed, while Telemedicine Consulting Network wants Dr. Beer on its malpractice carrier, which is preventing him from joining the network and receiving referrals.

With Teladocs, he receives a text or email from that a patient is waiting to talk with him on the telephone. He receives between 10 and 25 requests per month for lower-level consultations via the telephone. Teladocs recently contacted Dr. Beer to do his first video consultation.

Dr. Beer said he has mixed feelings about telemedicine. The benefit is for people who live in sparsely populated areas that are underserved by health-care professionals. What if their physician is unavailable? “They just want to talk to a doctor.” Telemedicine can save patients time and money, while alleviating a potentially stressful situation, he explained.

Dr. Beer said he is able to make some diagnoses – such as sore throats, urinary tract infections – via the telephone. He also sees vast potential for specialists, such as cardiologists, to hold clinics in rural areas using webcams which makes travel unnecessary.

The challenge begins with payment, although, he said, most insurance carriers recognize telemedicine providers. Currently, these providers charge significantly less for “telehealth” consultations than a regular clinic visit, which might entice some people to bypass a clinic visit when one is necessary, Dr. Beer said.

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September/October 2012 Physicians Bulletin 19

feature

The Forse File Hometown: Montreal, Quebec, Canada Bachelor’s Degree: McGill University in Montreal in biology and zoology

Dr. Armour Forse

Medical degree: McGill University Residency: Royal Victoria Hospital in Montreal Doctoral Degree: McGill University in experimental surgery Fellowship: Columbia University in surgical metabolism Position: Surgeon and Professor Location: Creighton Surgery, Creighton University Medical Center Hobbies: cycling, photography, ranching and farming Family: wife, Susan; three children, Alexander, Emily and James Why I joined MOMS: The reason to join I believe is for physicians is to be part of a community of physicians linked to the community they serve.

Setting the Record Straight

G

EORGE SOJKA, M.D., HAS a response for those who ques-

tion the quality of the Canadian health-care system: “They don’t know enough about it.” And Armour Forse, M.D., agrees.

The Omaha cardiologist explained: “If you have coverage and money is good, it’s better to be treated here. If money is tight, the Canadian system is better.”

Dr. Forse said the Canadian system makes seeing a patient simple. Cost doesn’t come into play. “The financial considerations from visit to visit are eliminated. Show your card, swipe it and there are no other financial considerations.”

Drs. Sojka and Forse, who both received their medical degrees from Canadian institutions and came to the United States in the late 1980s, explained what they see as the strong points about practicing medicine in Canada and the challenges that tag along.

Health care in Canada is delivered through a publicly funded health-care system, which is typically free at the time of use. Most services are provided by the public system.

Health care in Canada is guided by the 1984 Canada Health Act, which set federal standards for the quality of care. The government does not participate in daily care or collect any information about an individual’s health, which remains confidential between a person and his or her physician.

Canada’s provincially based Medicare systems are cost-effective

20 Physicians Bulletin September/October 2012

partly because of their administrative simplicity.

In each province, doctors handle insurance claims against the provincial insurer. The patient is not needed to be involved in billing and reclaim, with no co-pays necessary. Private insurance is only a minimal part of the overall health-care system.

Competitive practices such as advertising are kept to a minimum, thus maximizing the percentage of revenues that go directly towards care. In general, costs are paid through funding from income taxes, except in British Columbia, the only province to impose a fixed monthly premium, which is waived or reduced for those on low incomes Beside eliminating the hassle concerning cost, Dr. Forse said, another benefit of practicing medicine in Canada are that the costs associated with running a clinic are roughly 10 cents on a dollar, compared to 35 cents on the dollar in the United States.

“The number of people it takes to run an office in the United States is large. I think it’s excessive.”

Dr. Sojka added: “You deal with a single

feature

Dr. George Sojka

The Sojka File payer. You don’t have to have an entire staff calling to get things preauthorized. You get paid for what you see.”

Another benefit of practicing medicine in Canada is low malpractice costs. The prevailing approach, Dr. Forse said, is that physicians will practice medicine with their patients’ best interest in mind. That means physicians don’t have to be on the defensive when treating patients, he said. “You can talk to patients without having to overprotect yourself. If you are taking care of the patient within the standard of care, you wouldn’t have to worry.”

The overarching benefit of the Canadian health-care system is accessibility, Dr. Sojka said. All people are covered – employment status and pre-existing conditions don’t come into play. “Everyone is covered from day 1 – from the day they are born until the day they die. Cradle to grave.”

Now, the challenges.

Resources are limited. The number of procedures that surgeons can perform is limited. A patient may wait a year for hip replacement or cataract surgery. The wait time for open heart surgery may be six months. “If it’s elective, it waits. The waiting game can be a problem.”

Medical advancement is slower to come to the Canadian system, the MOMS members said. “Socialized systems are often underfunded to support infrastructure,” explained Dr. Forse, adding the medical facilities often go without being renovated or replaced.

Physicians are capped in what they can bill the government for services each year, Dr. Sojka said. Initially, physicians benefitted from the government-set fee structure. Now, the difference from

what they expect to earn and what they receive has grown, he said.

The government also regulates who can practice where. Dr. Sojka said he wanted to practice in the Toronto area because it lacked board-certified cardiologists. “They (the government) said I could go here, here and here, but they weren’t where I wanted to go.”

The government also has restricted the number of medical residents in certain specialty areas, which has created a shortage, Dr. Sojka said.

Challenges and opportunities aside, Drs. Sojka and Forse said they practice medicine in the United States for a reason.

“I can practice where I want here,” Dr. Sojka said.

Dr. Forse added: “I chose to come to the United States because there were more opportunities to do more things – more opportunities for innovation and discovery.”

Then, Dr. Forse pointed out that more physicians returned to Canada to practice medicine last year than left the country to practice in the United States.

“It’s getting to be more of a tossup – because of the uncertainty of what will happen to the American system.”

Hometown: Chicago Bachelor’s Degree: University of Manitoba in Winnipeg in chemistry Medical Degree: University of Toronto Residency: Queens University in Kingston, Ontario Fellowship: Queens University in cardiology Specialty: Cardiology Location: Heart Consultants in Omaha Hobbies: Traveling and sailing Family: wife, Sandra; children, Peter and Caroline Why I joined MOMS: Because it speaks for the physicians in the state.

September/October 2012 Physicians Bulletin 21

Congratulations

feature

and Thank You!

To David Buntain for being named a “Friend of Medicine” by the Nebraska Medical Association and for 28 years of service representing medicine and physicians in the Nebraska Legislature.

State Sen. Annette Dubas talks shop with Dr. Bob Rauner of Lincoln.

Metro Omaha Medical Society and its member physicians.

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22 Physicians Bulletin September/October 2012

P

HYSICIANS OFTEN VIEW THE political arena as a foreign world – and

avoid it at all costs, said David Buntain, longtime lobbyist for the Nebraska Medical Association. “Physicians who decide to set on the sidelines, do so at their peril.”

Lawmakers – at the state and national levels – daily make decisions that affect physicians and their practices, he explained, noting the health-care reform law and efforts to change the SGR payment system for Medicare at the national level and health profession licensing at the state level.

Buntain, who has represented physicians in the Nebraska Legislature for the past 28 years, said physicians have two sources of power in government: --They have valuable information to contribute to the legislative process.

“Whether it is making the case for our mandatory motorcycle helmet law or explaining the risks of allowing untrained, limited-scope practitioners to perform medical diagnoses and treatment, physicians’ expertise can be crucial in influencing policymakers’ decisions.”

--By getting to know their representatives, they can serve as trusted consultants and advisers on the range of health issues that confront lawmakers at every level of government. “Even when most major business and professional groups have paid lobbyists to advance their cause, elected officials still place great weight on the input they receive from their constituents in deciding what course of action to take.”

Physicians who have gotten involved in health issues have helped shape public policy, Buntain said. The past offers, he said, a blueprint for physicians who want to become better advocates for medicine: 1. Know the issue and how it affects the officeholder’s constituents. “With the benefit of your expertise, elected officials can make informed decisions that benefit the people they serve.” When Nebraska communi-

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David Buntain

ties were discussing smoking regulations, physicians helped educate the public. These efforts resulted in the legislation that banned smoking in all places of employment – a bill sponsored by Joel Johnson, M.D., a retired orthopedic surgeon from Kearney.

2. Know the players. Get to know your state senator – before the need arises to visit about a specific issue. Consider becoming involved in candidate’s campaign by donating time or money. “When I deal with a senator on a particular issue, I am always pleased when they say, ‘Well I’ve talked with my friend Dr. Smith and she says…’ or ‘I plan to visit with my friend Dr. Smith’ because I know the senator will trust the information from that physician.

3. Understand the legislative process. All levels of government follow a prescribed process.

Knowing the basic steps a legislative body follows, will enable you to know when you input will have the greatest impact.

4. Work with other physicians to maximize effort and strength. Look for allies – the NMA, MOMS, the Lancaster County Medical Society.

5. Understand that the political process is a marathon, not a sprint. Many issues that dominate the legislative agenda are actually repeats or variations on proposals from previous years. “Advocates must constantly ‘sharpen the saw’ by keeping up on the issues, getting to know the new players, and building coalitions with other like-minded persons and organizations.”

Now is a crucial time for getting involved in the political process, Buntain said, with the approaching national election and the 26 legislative districts that are contested.

“Medicine needs physicians to get off the bench and participate in the political process, which shapes their lives, now more than ever.”

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September/October 2012 Physicians Bulletin 23

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24 Physicians Bulletin September/October 2012

COVER feature

Public Health

M

in Action OMS PUBLIC HEALTH COMMITTEE has its sights set on generating awareness about the

dangers of childhood obesity.

At the same time, the committee is promoting the link that children who are breast fed are less likely to be obese, said David Filipi, M.D., who serves as chairman of the Douglas County Board of Health and the MOMS Public Health Committee.

“We see childhood obesity as a risk for children now – and down the road. Childhood obesity becomes a huge liability as these overweight children age and get diabetes.”

He added: “We’re looking to bend down the health cost curve. We need to figure out a way to get our kids healthier – so they become healthier adults. …With increased hypertension, with increased diabetes, that’s going to float up. It’s going to be more expensive to care for this population. ” Childhood obesity emerged as a hot topic at the state, county and local levels, Dr. Filipi said.

“Physicians in Omaha were saying ‘why aren’t we a part of this?’”

Enter the MOMS Public Health Committee.

The committee first formed nearly a decade ago to address the growing interest in anti-smoking legislation. The committee took a scientific approach to its work, Dr. Filipi said.

Quantifying the dangers of second-hand smoking in an outdoor environment was difficult, he explained. Pointing out the dangers of second-hand smoking in an indoors environment wasn’t, he said.

“We thought we needed to take a stand on this issue.”

The City of Omaha passed legislation banning smoking in the workplace. A statewide ban soon followed.

And the committee went on hiatus – until childhood obesity served as a call to action.

Dr. Filipi said it just made sense for the MOMS committee – and Omaha physicians – to get involved in this issue. “We have daily contact with pediatric patients – and those relationships run deep. So we decided to activate the committee – and put a real priority around pediatric obesity.”

The committee’s first step was identification. The committee has asked local pediatricians family Story continued on page 26.

The Filipi File Hometown: Omaha Bachelor’s Degree: University of Nebraska Lincoln in philosophy Master’s Degree: University of Nebraska Omaha, MBA Medical Degree: University of Nebraska Medical Center Residency: UNMC in family medicine Title: Chief Medical Officer, Blue Cross Blue Shield of Nebraska Family: wife, Jody; two grown children, James Filipi and Krys Marsh Why I Joined MOMS: “It was to reinforce my network with fellow physicians and to maintain professional contacts.”

September/October 2012 Physicians Bulletin 25

feature Dr. Nichelle Horton-Brown determines the BMI of her daughter Olivia

practitioners to chart the Body Mass Index percentages of their pediatric patients. The proof is in the percentiles, he said.

“It’s difficult to have conversations with parents about their kids being overweight because oftentimes the parents also are overweight. You have to show them the chart.”

The second step is to promote breastfeeding – as one way to prevent childhood obesity. Studies have shown that children who were breastfed have lower BMI. Part of this step is education. (Laura Wilwerding, M.D., a pediatrician and breastfeeding advocate, has provided a resource list. For a link to these resources, visit www.omahamedical.com and click “Resources” on the left side.)

The committee is encouraging health-care professionals to encourage women to consider breastfeeding their babies. It’s not too early for teenagers to hear that message so when they do have children the message will be familiar, Dr. Filipi said.

The third step is identifying the sources of treatment for childhood obesity. “Many programs have come and gone. We don’t know which ones are covered by insurance, and which ones cost.”

The goal is to catalog the treatment facilities and providers, and make the information available to the physicians and the public.

“You can identify obesity – but then you say, ‘what do you do next?’” Dr. Filipi said.

The next step will be monitoring to ensure that care is provided.

Dr. Filipi said his organization – Blue Cross Blue Shield – will monitor whether physicians are capturing the requested information, then whether they are acting on the results. Those who do will receive financial incentives. Other insurance carriers will be encouraged to provide similar incentives, Dr. Filipi said.

26 Physicians Bulletin September/October 2012

Dr. Filipi said the impact of public health initiatives in the 20th century – from better sanitation and controls of tuberculosis to safer water and the introduction of antibiotics – is still being felt today. “Now, we need to reinvent public health as we’re now in the 21st century.”

He added: “At this point in time, public health is the answer to bending that health cost curve downward. Individual therapies are expensive to administer. We’ve done a pretty good job of treating disease. What we haven’t done a good job is preventing disease.”

Sickness and disease capture the headlines, he explained. People get sick, money flows into the health-care system to treat it. “A life saved because a person didn’t get sick -- no one knows who that person is. There’s no story.”

In public health, the fewer the stories, the better, which means people didn’t get sick. “But that’s not the way our society works.

We need to change that perception.”

Other members of the MOMS Public Health Committee are Jane Carnazzo, M.D.; Deb Esser, M.D.; Cristina Fernandez, M.D.; Brett Kettelhut, M.D.; Quan Ly, M.D.; Diana Roberts; Tina Scott-Mordhorst, M.D.; Kari Simonsen, M.D.; and Thomas Tonniges, M.D.

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fashioncleaners.com | 402-342-3491 September/October 2012 Physicians Bulletin 29

MOMS events OMAHA STORM CHASERS

MOMS and Foster Group hosted a day at the ballpark on July 15th for members and their families. Despite 99 degree temperature, there was a great turnout as the Omaha Storm Chasers took on the Iowa Cubs.

1.

1

2

Dr. Beau Konigsberg finds a shady spot to enjoy some ice cream with his sons, Leo and Rex.

2. Dr. Wes Smeal and his family came out for the game. He’s pictured here with his son Trey.

3.

Langdon Caverzagie, son of Dr. Kelly and Robyn Caverzagie, prepares to throw the first pitch.

4.

While many stayed in the shade of the tent, Dr. Gary Anthone (right) braves the heat with his family to cheer on the Storm Chasers.

MEMBER NETWORKING

A Member Networking event was hosted by MOMS and Lutz & Company on July 26. For fun, the event was tied into national “All or Nothing” day.

3 5

4 6

5. Dr. Mark Kremen (right) and Connie Logan with Dr. Jim Newland.

6.

Dr. Bryan Bredthauer (right) and Dr. Gary Gorby were also in attendance and spent time plotting for the next Medical MESS Club (scheduled for April , 2013)

WOMEN IN MEDICINE

The MOMS Women in Medicine met Aug. 7 at Pasta Amoré. A panel discussion was held regarding available community health services and how physicians can assist patients in gaining access to these services.

7. Panel members included Andrea Skolkin, CEO OneWorld Community Health Centers; Richard Brown, Ph.D., CEO Charles Drew Health Center; and Beth Llewellyn, president HOPE Medical Outreach Coalition.

8.

7

Doctors Linda Head, (left) and Quan Ly, regularly attend the Women in Medicine events and enjoy the opportunity to network.

30 Physicians Bulletin September/October 2012

8

MOMS events

Call now for a free consultation

Coming Events OCTOBER 16 “PREPARING FOR 2013 & BEYOND” OMAHA MARRIOTT (REGENCY) 5:30 HORS D’OEUVRES & COCKTAILS; 6:00 PANEL DISCUSSION

A panel discussion with Q&A about the personal implications of Health Care Reform, estate law uncertainty, tax changes, and more.

Hosted by MOMS, NMA, Foster Group and Koley Jessen, PC, LLC.

OCTOBER 23 WOMEN IN MEDICINE MEETING BIAGGIS RESTAURANT 5:30 PM SOCIAL; 6:00 PM DINNER & SPEAKER

Hosted in partnership with the Creighton University Medical Center Women in Medicine & Science Featuring Dr. Susan R. Johnson, MD presents “Thriving Amidst Chaos: How to Improve Your Focus on High Priority Work” Sponsored in part by Foster Group.

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Networking Reception and Presentation of MOMS Foundation Grant Recipients.

More details to follow.

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Serving Omaha/LaVista, Lincoln, Grand Island, Blair September/October 2012 Physicians Bulletin 31

MEMBER news

Dr. Gamini Soori

Dr. Patrick Brookhouser

NMA Honors Three

T

HE NEBRASKA MEDICAL ASSOCIATION, during its annual

meeting in September, announced the recipients of its Distinguished Service to Medicine and Young Physician of the Year awards.

Gamini Soori, M.D., and Patrick Brookhouser, M.D. (awarded posthumously) received the Distinguished Dr. David Ingvoldstad Service to Medicine awards. The award is presented annually to physicians who have made medical contributions to the community.

David Ingvoldstad, M.D., was named Young Physician of the Year.

He received the recognition for his contributions of time and talent to the Nebraska Medical Association and the community, and was described as an example of the finest in a young physician.

Faculty members coordinate international leadership course

U

NMC HOSTED THE U.S.-SINO Family Medicine Leadership Course

in August. UNMC physicians provided training programs in family medicine for 14 leading physicians from China. The medical system in China relies almost exclusively on specialists and the country is severely lacking in family medicine.

The UNMC Department of Family Medicine partnered with universities in Shanghai and Xi’an, on the training program. Paul Paulman, M.D., Audrey Paulman, M.D., and Mike Sitorius, M.D., were among the faculty members who coordinated the course. The work is being done through the Primary Care Center, which was established by the UNMC Department of Family Medicine to promote primary care across the UNMC campus while also gathering practicing primary care providers’ opinions across the state of Nebraska. The Primary Care Center Steering Committee is chaired by Dr. Sitorius and Tom Tape, M.D., division chief of General Internal Medicine, and is composed of representatives from various disciplines across UNMC.

32 Physicians Bulletin September/October 2012

Natasha Pyfrom

Creighton student is recognized by the AMA

N

ATASHA PYFROM, A CREIGHTON University medical student from

Omaha, received a Physicians of Tomorrow Award and Foundation Scholarship from the American Medical Association. The honor is based on academics, financial need and community involvement and is available to fourth-year medical students nominated by their respective medical schools.

Community and university service activities have been an integral part of Pyfrom’s education. She was a teacher at the Health Careers Opportunity Program Summer Academy at Creighton for high school and undergraduate students. She has volunteered at Siena Francis House since 1997, Kid’s Kingdom since 2008, and supported numerous other tutoring, mentoring and health-care activities. She has participated in Creighton Medical United in Relief Assistance mission trips to India and the Pine Ridge Reservation.

A member of Delta Sigma Theta Sorority, Inc., a private, nonprofit organization which provides assistance and support through local communities throughout the world, she also has held leadership roles in several University committees. She is a past president of the Student National Medical Association and is a member of the school’s admissions committee.

While at Creighton Pyfrom has been recognized with other scholarships including the Dean’s Diversity Scholarship, the Nebraska Medical Foundation Student Leadership Scholarship and the National Coalition Black Women Education Scholarship. In 2010 and 2011 Pyfrom was the recipient of the Dr. William Hines Scholarship for her academic achievement.

Pyfrom, a mother of two, expects to graduate with a medical degree in the spring of 2013 and plans to become a urologist. Before entering medical school, she was a certified family teacher for two years at Boys Town. She received her bachelor’s in biology from the University of Nebraska at Omaha.

The AMA Foundation focuses on assisting medical students with the rising cost of medical education. The Physicians of Tomorrow Award was created in 2004 to provide financial assistance to medical students facing medical school debt.

IN memoriam James F. Kelly Jr., M.D. Jul7 25, 1919 – Aug. 9, 2012

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September/October 2012 Physicians Bulletin 33

CAMPUS update

Partnership means new name

T

HE PARTNERSHIP BETWEEN ALEGENT Health

and Creighton University will be reflected in hospitals and clinics across the region. Effective Sept. 1, a new name solidified the partnership that is built on their shared faith-based Missions: Alegent Creighton Health.

“This was a very big decision supported by research and based on our patients’ and communities’ expectations,” said Richard A. Hachten II, president and chief executive officer of Alegent Health. “The reason Alegent and Creighton are coming together is for our community, so what they think is important.”

“As the new names reflect, these new healthcare entities will further the missions of both faith-based organizations by improving local

A

Number of uninsured Nebraskans rises UNMC STUDY HAS FOUND that the number

of uninsured people under the age of 65 in Nebraska increased by 67.4 percent,from 8.9 percent (156,300 people) in 2000 to 14.9 percent (217,100 people) in 2010.

“This might seem somewhat alarming,” said Jim Stimpson, Ph.D., associate professor in the Center for Health Policy in the UNMC College of Public Health and co-author of the report.

“However, the uninsured numbers in Nebraska are in line with what is happening in other Midwest states.”

In the Midwest region, which includes Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, North Dakota, Ohio, South Dakota and Wisconsin, the uninsured rate in the past decade climbed from 10.5 percent to 14.8 percent, Dr. Stimpson said.

health care and transforming medical education for the benefit of physicians, students and the communities we serve,” said the Rev. Timothy R. Lannon, president of Creighton University.

The new name was approved by the Alegent Health Board of Directors and filed with the State of Nebraska on Aug. 2. Alegent is on track to “close” on the acquisition of Creighton University Medical Center (CUMC), the long-term strategic affiliation with Creighton University and the academic affiliation that made Alegent hospitals and clinics the primary teaching sites for the schools of health sciences.

As part of the strategic affiliation, Creighton University’s physician practice, Creighton Medical Associates (CMA), will become part of Alegent Creighton Clinic on Sept. 1.

“This new name personifies what this new physician practice will be – a multi-specialty clinic that offers physicians the best place to practice medicine, our staff the best place to care for patients, students the best place to learn and our community the best patient experience,” said Rick Rolston, M.D., president and chief executive officer of Alegent Health Clinic.

Additional key findings of the study included: • 16 Nebraska counties had a high uninsurance rate (21 percent to 31 percent) in 2009.

• In Nebraska, the number of individuals with employer-based insurance decreased by approximately 9.3 percent between 2000 and 2010, and the number of individuals who purchased insurance directly increased by approximately 16 percent.

• Three insurance carriers make up 91 percent of the private insurance market in 2011.

Harvard physician named chairman of otolaryngology/ head and neck surgery

D

WIGHT JONES, M.D., IS the new chairman

of UNMC’s Department of Otolaryngology – Head and Neck Surgery. He previously served as associate professor, otology and laryngology, for Harvard Medical School, and a full-time member of the medical staff of Boston Children’s Hospital. Dr. Jones served on the Harvard faculty for nearly 24 years. A pediatric otolaryngologist, his areas of research and clinical expertise include sinonasal disorders, cystic fibrosis and tonsillectomy complications.

34 Physicians Bulletin September/October 2012

White Coat Ceremony

O

NE HUNDRED AND FIFTY-TWO first-

year medical students at the Creighton University School of Medicine took their first official steps toward becoming physicians in August when they participated in the school’s 13th annual White Coat Ceremony.

During the event, each new medical student crossed a stage in the Joslyn Art Museum Witherspoon Concert Hall and a faculty member assisted the student in putting on a white coat – long a symbol of medical clinicians and researchers.

Rowen Zetterman, M.D., Creighton medical dean, led the class in reciting a special student physician’s oath. During the oath, students promised to give their lives and talents to the service of humanity and to treat patients, teachers and fellow students with respect and dignity.

More than 6,200 students applied, to become members of this year’s class. Some highlights of the class profile include: • Students came from 29 states and one foreign country.

• The median cumulative undergraduate gradepoint average was 3.76.

• There are more women than men – 78 to 74.

• Twenty are first-generation college students.

A 1983 graduate of the UNMC College of Medicine, Dr. Jones did his internship and residency in general surgery at Wesley Medical Center in Wichita, Kan. He then returned to UNMC to do his otolaryngology residency and served a year as chief resident before doing a pediatric fellowship at Boston Children’s Hospital.

Hospital ranked as state’s best

U

.S. NEWS AND WORLD Report ranked

The Nebraska Medical Center as the top hospital in the state, and the hospital also was ranked in five different specialties: cancer (No. 40); gastroenterology (No. 25); nephrology (No. 41); neurology and neurosurgery (No. 40); and orthopaedics (No. 36). Of the 16 specialties studied by U.S.News and World Report, The Nebraska Medical Center was ranked in 12.

The publication also rated the medical center as “high performing” in the following specialties: cardiology & heart surgery; diabetes & endocrinology; ear, nose & throat; geriatrics; gynecology; pulmonology; and urology.

“This is wonderful recognition of the outstanding work of our faculty, which is now being recognized across the country,” said UNMC Chancellor Harold M. Maurer, M.D.

Would Endoscopic Ultrasound Benefit Your Patient?

Trust the Endoscopic Ultrasound Specialists from MGI

Dr. Michael Schafer and Dr. Joshua Evans, Board Certified Gastroenterologists and endoscopic ultrasound specialists

The Metro Omaha Medical Society Foundation identifies and provides support to community priorities

MGI offers two highly trained Endoscopic Ultrasonography (EUS) specialists who are available to assist in the care of your patients. EUS permits examination of the linings of the esophagus and stomach, as well as the walls of the upper and lower gastrointestinal tract. The advantage of EUS is the ability to study the organs surrounding the gastrointestinal tract including lungs, liver, gallbladder and pancreas. EUS delivers a detailed image of lumps or lesions, enables real-time ultrasound guided needle biopsy and can help determine the origin of abnormalities, thus benefiting overall treatment decisions. Our EUS specialists strive to work collaboratively with you and your patient to evaluate abnormalities detected during endoscopy, ultrasound, or computed tomography (CT) scan.

where physician involvement can make a difference in

Please call 402.397.7057 or 402.504.3880 or complete a referral form found at midwestgi.com for an EUS consultation or procedure.

improving the health of the Metro Omaha Community.

MOMS Foundation 7906 Davenport St. Omaha, NE 68114 402-393-1415

NEW OFFICE OPEN SEPTEMBER 4TH • Certified by American Board of Pediatrics • Member of the American Academy of Pediatrics • Member of MOMS • Breastfeeding Specialist

Dr. Ann Russell 11602 West Center Road, Suite 150 Omaha, NE 68144

p.402.991.7337 f.402.991.7373

www.westcenterpediatrics.com

September/October 2012 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

36 Physicians Bulletin September/October 2012

Apply Online: www.omahamedical.com

NEW MEMBER update NEW MEMBERS Michael Moore, M.D. Pediatrics

Troy Rustad, M.D.

Todd Lovgren, M.D.

Joshua Evans, Sr., M.D.

Ann Russell, MD

Medical School: UNMC

Medical School: St. Louis University School of Medicine

Medical School: UNMC

Specialty: Maternal and Fetal Medicine

Specialty: Gastroenterology and Hepatology

Specialty: Pediatrics

Location: Methodist Women’s Hospital

Location: Midwest Gastrointestinal Assoc., PC

Location: West Center Pediatrics

Dr. Lovgren just moved back to Omaha after completing his fellowship in Maternal-Fetal Medicine.

He’s an avid Husker football fan and enjoys watching the games with his wife and three boys. When it’s not college football season, he likes to spend his time fly-fishing or pheasant hunting.

Dr. Evans was born in Omaha. In his free time, he enjoys spending quality time with his wife, Nicole, and their two children. He also enjoys exercising, a variety of athletic activities and traveling.

Dr. Russell enjoyed working parttime for 17 years while raising a son and volunteering in youth activities.

This summer they backpacked 100 miles with 10 Boy Scouts at Philmont Scout Ranch!

Her family encouraged her to spend more time doing what she loves, so she established a private practice clinic for primary care pediatrics and breastfeeding support.

Dr. Russell enjoys attending Husker football games with her husband (Dr. Doug Russell) and their son Miles.

Dermatology

Interested in becoming a MOMS Member?

Call 402-393-1415, apply online at www.OmahaMedical.com or complete the application on page 36.

September/October 2012 Physicians Bulletin 37

Your home...your builder.

Exceptional.

Selecting a builder is as much an expression of taste as it is a statement of confidence. No one understands this better than Curt Hofer & Associates. As one of the area’s most respected custom homebuilders, we provide a one-of-a-kind experience in creating your once-in-a-lifetime home.

Your wants, your needs, your style, your preferences – everything we do at Curt Hofer & Associates is advanced with the thought of you in mind. That means spending time with you, from the very beginning and at every step along the way.

From individual rooms, to how these rooms come together to create a home, to the landscape and exteriors that immediately bid you welcome, the team Curt Hofer & Associates knows how to bring the best ideas to life – yours. The result?

Your home...your builder. Exceptional.

38 Physicians Bulletin September/October 2012

CURT

HOFER

& ASSOCIATES

Your home...your builder. Exceptional.

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

www.cur thofer.com

announcing a landmark healthcare decision. alegent health and creighton university have joined forces.

Someone has to lead the way toward the future of healthcare. That’s why Alegent and Creighton have combined to make the community healthier, give patients better access and improve the healthcare experience for everyone. We now offer more specialists and train healthcare providers to deliver better patient care. It’s all part of our mission to make healthcare healthier.

www.AlegentCreighton.com 1-800-Alegent Bergan Mercy • Creighton University Medical Center • Immanuel • Lakeside • Mercy/Council Bluffs • Midlands/Papillion • Alegent Creighton Clinic

Metropolitan Omaha Medical Society 7906 Davenport Street Omaha, NE 68114

ADDRESS SERVICE REQUESTED

One number accesses neonatal and pediatric transport, any problem, anytime.

1.855.850.KIDS (5437)

Physicians’ PriOrity Line

your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport service.

ChildrensOmaha.org

PRSRT STD U.S. POSTAGE

PAID

PERMIT NO. 838 OMAHA, NE