November/December 2012 Physicians Bulletin

November/December 2012 • USA $1.95

Responding to a Need ALSO INSIDE

Patient-Centered Medical Homes: Taking Root in Omaha

Serving with Purpose:

Physicians on County Health Boards

It’s His Dream:

Dr. Ayoub on Employed vs. Private Practice A Publication of the Metro Omaha Medical Society • www.OmahaMedical.com

Physicians are leading the way when it comes to advancing life-changing and life-saving care. eir support of Methodist Hospital's Surgery Renovation Project will expand the busiest surgical center in the state of Nebraska. Once doctors commit $2.5 million towards the $40 million fundraising goal, a donor will match their gifts and all others up to $20 million dollars.

Methodist Hospital Foundation wants to thank the physicians below for their commitments of $5,000 and greater received between April 1, 2012 and November 8, 2012. ese doctors will be recognized on a beautiful donor wall located in the new Surgery Department. Contact Methodist Hospital Foundation at (402) 354-4825 to learn how you can reserve a spot on the donor wall and become a part of the legacy at Methodist Hospital.

Tyron Alli, M.D.

Carl L. Boschult, M.D.

Patrick J. McCarville, M.D.

Peter C. Morris, M.D.

Anton F. Piskac, M.D.

Anesthesia West, P.C.

Jessica N. Bracken, M.D.

Rebecca J. McCrery, M.D.

Mia Nagy, M.D.

Radiologic Center, Inc.

Chad Bauerly, M.D.

Douglas Brouillette, M.D.

Thomas McGinn, M.D.

Stephen M. Nielsen, M.D.

John J. Cannella, III, M.D.

Methodist Medical Staff

Thomas R. Ohrt, M.D.

Bradley B. Copple, D.P.M.

Methodist Physicians Clinic

G. William Orr, M.D.

David R. Crotzer, M.D.

Women's Center

D.R. Owen, M.D.

Monte Christo, M.D. Mark D’Agostino, M.D. Tad Freeburg, M.D. Michael Grubb, M.D. Gregg Hirz, M.D.

David A. Denman, M.D.

Stephen Hosman, M.D.

Elizabeth A. Denman, M.D.

Wes Hubka, M.D. Kent Hultquist, M.D. Kent Hutton, M.D. Paul Jacobsen, M.D. John Lindsey, III, M.D.

Craig Bassett, MD Paige Berryman, M.D. Julia Bishop, M.D.

Margarita A. Dickey, M.D.

Mark Carlson, M.D.

Tamara A. Doehner, M.D.

Sarah Gernhart, M.D.

Randall T. Duckert, M.D.

Lanette Guthmann, M.D.

George Emodi, M.D.

Kristen Hoffman, M.D.

Robert Moore, M.D.

Mark G. Franco, M.D.

Thomas Ohrt, M.D.

Les C. Hellbusch, M.D.

Rebecca Jacobi, M.D. Carolee Jones, M.D. Michelle Knolla, M.D.

John Peterson, M.D.

John J. Hoesing, M.D.

Kelli Peterson, M.D.

T. William Huang, M.D., Ph.D.

Nancy Mathews, M.D.

Ajoy K. Jana, M.D.

Mia Nagy, M.D.

Laura A. Jana, M.D.

Allison Phillips, M.D.

Josh Smith, M.D.

Michael Jones, M.D.

Judi Scott, D.O.

J. Kenneth Tiojanco, M.D.

F. William Karrer, M.D.

Mark Wilson, M.D.

Brady A. Kerr, M.D.

Hap Pocras, M.D. Douglas Rennels, M.D. Chris Robertson, M.D.

Gary J. Anthone, M.D.

Stephanie Koraleski, Ph.D.

Khalid A. Awad, M.D.

Rudolf Kotula, M.D.

Kenneth P. Barjenbruch, M.D. Russell E. Beran, M.D.

Jack Lewis, M.D. Douglas J. Long, M.D.

Thomas Martin, M.D.

Tifany Somer-Shely, M.D. William Weidner, M.D. Susan Westcott, M.D. Laura Millemon, M.D. Alireza Mirmiran, M.D. John C. Mitchell, II, M.D. Kathleen Mitchell, M.D.

Lisa A. Bladt, M.D. Kevin M. Cawley, M.D. Paul S. Christy, M.D. Ryan A. Dvorak, M.D. Merlyn D. Gibson, M.D.

Jeffrey A. Passer, M.D.

David J. Hilger, M.D.

The Pathology Center

Richard A. Kutilek, M.D.

Jiri Bedrnicek, M.D.

Van L. Marcus, M.D.

John Gentry, M.D.

Robert H. McIntire, M.D.

Christine Hans, M.D.

Nick L. Nelson, M.D.

Gene Herbek, M.D.

Kevin L. Nelson, M.D.

Teresa Karre, M.D.

Temple S. Rucker, M.D.

Shane Kohl, M.D.

Linda A. Sing, M.D.

Diana Nevins, M.D.

Kristofer A.Vander Zwaag, M.D.

Deborah Perry, M.D. Andrew Rasmussen, M.D. Gregory Smith, M.D. Alan Torell, M.D. Thomas Williams, M.D. Robert G. Penn, M.D. Perinatal Associates, PC

Eric J. Rodrigo, M.D. Kristin E. Rooney, M.D. Scott G. Rose, M.D. John C. Sage, M.D. Edwin Schafer, M.D. William A. Shiffermiller, M.D.

Robert Bonebrake, M.D.

Carol A. Stessman, M.D.

Neil Hamill, M.D.

Eugene A. Waltke, M.D.

Michael Levine, M.D.

Scott P. Wattenhofer, M.D.

Todd Lovgren, M.D. Andrew Robertson, M.D.

Ronald L. Wax, M.D.

Hemant Satpathy, M.D.

8401 West Dodge Road, Suite 225 • Omaha, NE 68114-3447 (402) 354-4825 • www.MethodistHospitalFoundation.org

Working with you for a

healthy Nebraska

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

Celebrating

lived a life well

Every man and woman is made up of experiences and memories that create a lasting legacy for their family members.

That’s why Saint Jude Hospice focuses on a patient’s whole life.

Our mission is to provide the love and compassion demonstrated by Jesus Christ, and to love one another as He has loved us.

We adhere to Ethical and Religious Directives for Catholic Health Care Services.

Call Saint Jude Hospice at 1-800-HOSPICE and let the healing wings take flight. www.saintjudehospice.org

4 Physicians Bulletin November/December 2012

Where love and healing flow

It’s powerful knowing that

we ALIGN.

It’s very rare to find what service is meant to be, but you find it with Cox. It takes one phone call, locally and no matter what we need, consider it done and out of our hands.

Offering a standardized solution for the infrastructure is a given. It’s more. They give us the ability to take the steps we need, quickly so we can continue to launch quality care clinics.

Fully electronic, no paper trail, connecting seven locations to our hospital, Cox responds…taking action to be involved so we can stay connected.

We’re connected…

with Cox Business…because of Cox Business.

Tim Pugsley IT Manager Nebraska Orthopaedic Hospital

Businesses all around the greater metro area make a connection with Cox.

November/December 2012 Physicians Bulletin 5

www.cox.com | 402.934.3222

this issue

features 8 1

Patient-Centered Medical Homes Take Root in Omaha

0 2

Serving with Purpose Physicians on County Health Boards

November/December 2012

departments 1 0

Editor’s Desk

1 2

NMA Message

1 4

Legal Update

1 5

Young Physician Report

Taking Aim at a Naysayer Looking Forwad

Year-End Tax-Planning In Uncertain Times The 21st Grade

2 2

It’s His Dream Dr. Ayoub on Employed vs. Private Practice

1 6

Clinical Update

5 2

COVER: Responding to a Need OneWorld Community Health Centers

2 8

MOMS Events

2 9

MOMS Coming Events

3 2

Member News & In Memoriam

3 4

Campus Update

3 7

New Member Update

6 Physicians Bulletin November/December 2012

Medications of Controversy: Opioids and Prescription Drug Abuse

spend time with them.

Leave your wealth management to us.

It’s what we do.

Learn about our approach.

Call today.

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

(402) 556-8858

Securities offered through Securities America, Inc., member FINRA/SIPC. Jerome P. Bonnett, Jr., CFP®,November/December ChFC®, Registered Representative. Advisory offered through BWM 7 2012services Physicians Bulletin Advisors, LLC. Jerome P. Bonnett, Jr., Investment Advisor Representative. BWM Advisors, LLC (dba Bonnett Wealth Management) and Securities America companies are unaffiliated.

November/December 2012 VOLUME 33, NUMBER 6 A Publication of the

Metro Omaha Medical Society 7906 Davenport St. • Omaha, NE 68114 (402)393-1415 • www.omahamedical.com Officers President | Marvin J. Bittner, M.D. President-Elect | Debra L. Esser, M.D. Secretary-Treasurer | David D. Ingvoldstad, M.D. Past President | Pierre J. Lavedan, M.D. Executive Director | Diane Parsons EXECUTIVE BOARD Marvin Bittner, M.D. Debra Esser, M.D. David Ingvoldstad, M.D. Pierre Lavedan, M.D. Mohammad Al-Turk, M.D. Jane Bailey, M.D. 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 Junior Graphic Designer | Paul Lukes Director of Photography | Bill Sitzmann

in e

B2 B

e’s in

aha Maga z Om

ER

ag

sin

•

e s s t o B u sin e

ss

M

ER

IN

Bu

N

s

a’

W

ah

az

Om

N

advertising sales Todd Lemke • Sandy Besch • Greg Bruns Gwen Lemke • Gil Cohen • Alicia Smith • Vicki Voet Stacy Penrod • Paige Edwards • Jessica Linhart for advertising information: 402-884-2000

2 012 • W

IN

DES MOINES | OMAHA | KANSAS CITY | LEAWOOD

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 November/December 2012

Approximately 70% of adult smokers want to quit.*

Nebraska Tobacco Quitline QuitNow.ne.gov

| 1-800-QUIT-NOW (784-8669)

Tobacco Free Nebraska • Nebraska Department of Health & Human Services • Division of Public Health *U.S. Centers for Disease Control & Prevention (CDC)

November/December 2012 Physicians Bulletin 9

editor’s desk

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

Take Aim at a Naysayer

H

ope is a message of this season. Hope is

a message of Christmas. Christian theology offers a message of hope for salvation, and Christmas celebrates the birth of the Savior. As Jews observe Chanukah, an event at the rededicated Temple in Jerusalem is recalled. The miracle of a one-day supply of lamp oil providing light for eight days is yet another message of hope.

For physicians, messages of hope may at times seem distant. The Metro Omaha Medical Society exists at a time when a book like “Race for Relevance” cites the example of general medical societies, like ours, as organizations that are failing and fading. Years ago, MOMS enjoyed sponsorship of many events from pharmaceutical companies. For nearly four years, the pharma code has put an end to that revenue stream. Do messages of hope ring hollow for MOMS? Well, I myself have reason to be hopeful. And I’m not counting on divine intervention, either.

Consider the situation of MOMS. Author Harrison Coerver does make some trenchant observations about nonprofit organizations like MOMS in “Race for Relevance.” He does indeed cite the American Medical Association’s plummeting membership as an example of the decline of organizations built around general interests.

Coerver does offer advice for a hopeful future for nonprofit organizations. One of his prescriptions is to focus on specialized interests. Indeed, he notes the continued strength of specialty societies in medicine.

Without hiring Coerver as our consultant, MOMS has been evolving into an organization that has benefited from his advice on the appeal of specialty societies. Under our umbrella are subgroups of physicians that focus on specialized interests. The writers, cast and crew of our MESS Club production comprise a spirited sort of medical specialty society. MESS Club responds to the vicissitudes of medicine with song, dance,

10 Physicians Bulletin November/December 2012

and wit. Some of our members make up what amounts to a medical specialty society that addresses policy challenges directly. They are the members who appear at our breakfast meetings with members of the Nebraska Legislature, who educate community leaders in our community internship programs, and who contribute to the work of the Nebraska Medical Association on health policy issues. Other specialized interests are evident in other gatherings of MOMS members. We don’t have general membership meetings on a monthly basis as we did decades ago.

Yet, we do have subgroup meetings of women in medicine, retired physicians, and MOMS Foundation leaders. We attract people to special events like our networking receptions, legal and financial briefings, technical seminars for staff, and baseball outings.

True, we no longer get money from pharmaceutical manufacturers. Yet, other sources of support have emerged. Our executive director, Diane Parsons, has nurtured programs of sponsorship from non-pharmaceutical entities. Our baseball outing, for example, was sponsored by the NMA’s endorsed financial adviser, the Foster Group.

Our membership is not skyrocketing–but neither is it plummeting. Coerver may be pessimistic about general medical societies’ ability to maintain their membership, but I don’t know that he has met someone as dedicated as Laura Polak, the MOMS staffer with primary responsibility for membership. Nor does he know Gwen Martins, whom many members have seen at the front desk and who also does a great deal behind the scenes.

This is a season of hope, and a look at what we have been doing in MOMS–despite the challenges we face–should make all of us feel more hopeful.

Your Best Choice

for Antibiotic Infusion Therapy Office Infusion Center for IV Antibiotics • Healthcare provider on site • Open 7 days a week

Infectious Disease Specialists

• Inpatient/outpatient comprehensive care

More than 30,000 successful infusions.

Vaccine Clinics

• for immunocompromised • for travelers

Learn more at www.idmidwest.com

Robert G. Penn MD,

FACP, FSHEA, FIDSA

Board Certified: Infectious Diseases Marge Maack, PA-C Doug Penington, APRN Allison McLeay, APRN Stacey Shinaut, APRN Liz Jacobsen, PA-C

Infectious Diseases Associates, PC 8111 Professional Building • 8111 Dodge Street,November/December Suite 363 • Omaha, NE 68114 2012 Physicians Bulletin 11 Phone: 402.934.6504 • Fax: 402.934.6518 • www.idmidwest.com

nma message

Dale Mahlman Executive Vice President Nebraska Medical Association

Looking Forward

W

ith the 2012 election season now in

our past, it’s time to focus our attention on 2013 and the role of physicians looking ahead.

In October, the Foster Group held a presentation on health-care reform and tax insights, which included a distinguished panel of experts including Gamini Soori, M.D., and Harris Frankel, M.D., of MOMS. While the event included past and future looks at income taxes, long-term capital gains, federal estate and gift taxes, the piece of the evening that was most important to me were the comments from both physicians on the “independent physician” and the need for physicians to be “loud advocates.”

Nationally and even locally, the term “independent physician” seems to be diminishing as it relates to practice arrangements, but Dr. Soori’s message has been and continues to be the need for “independent physicians” to work together to address the challenges and opportunities presented by the Accountable Care Act and Payment System Reform. While I agree that “independent physicians” have and will continue to be an important component in the changes ahead, it’s my belief that all physicians need to support their profession and remain involved in the discussions ahead. Regardless of an employment or practice arrangement, I’d encourage all physicians to remember they are still members of one of the most respected professions and to delegate their role to an employer as their representative in these discussions doesn’t seem like the sensible thing to do.

As it relates to the “independent physician,” Dr. Frankel challenged his colleagues as well to be “loud advocates” for the profession. This continues a theme our NMA Immediate Past President Chuck Gregorius, M.D., of Lincoln has been promoting the past year. Whether it’s

12 Physicians Bulletin November/December 2012

involvement in a community or medical staff issue, a patient issue or an election issue, the role of the physician should be just like their role in the delivery of health care, actively engaged and leading the discussion.

So what does MOMS and the NMA expect for 2013? We expect there to be many opportunities for physicians to become active and loud advocates for the profession. Our 2013 legislative session would be much easier and more successful if our physician members understand the issues important to organized medicine and communicate with their state senators. It’s as easy as a phone call, email or letter. We anticipate issues including scope of practice expansion, workers’ compensation system reform, public health-related issues, and payment reform issues, including both public and private delivery systems to be areas needing our involvement. The easy part about being a “loud advocate” is you don’t have to volunteer. You can communicate your thoughts directly to your elected official when it’s convenient for you.

As a voluntary membership organization, MOMS and the NMA are constantly focusing on meeting the needs of our physician members.

Providing member benefits including access to our NMA health and dental plan with BCBS of Nebraska, medical malpractice through COPIC, financial planning services with Foster Group, our discounted travel insurance through MedJet Assist, and many other benefits in addition to our daily advocacy, education, and representing the interests of physicians, we could not do this without your continued financial support. We thank you for your past support and look forward to your continued support of your professional organizations.

NMA message

Time To@

Up Our Game

t wo successful companies, now operating as one, to offer you more products and services

omahafriendlyservices . com

s u n va l l e yo m a h a . c o m

Visit our landscape supply yard at 5 6 0 1 H a r r is on S tr ee t • Om a h a , N E 6 8 1 5 7

402.932.5704

Peace, love and litigation support.

We protect your peace of mind. And it’s why we’re the right choice for physicians. Medical liability insurance is just the beginning. We protect what matters most, with proven results. It’s a movement, and we’d love to have you join us.

Contact your independent agent or broker, or go to PeaceofMindMovement.com/PB to see what MMIC can do for you.

November/December 2012 Physicians Bulletin 13

legal update

Year-End Tax-Planning In Uncertain Times

Tom Kelley Partner in the Tax Practice Group McGrath North Mullin & Kratz, PC LLO

C

ongress appears headed toward an

epic battle over sun-setting tax rules and it looks as if the dust won’t settle until late this year or possibly next year. While many pundits believe a reasonable scenario might be for Congress to buy itself time to cobble together a comprehensive tax reform plan by extending core expired or expiring tax provisions for one more year, in today’s highly charged political environment such a reasonable solution may not prevail. This uncertainty makes year-end tax planning for 2012 an even bigger challenge than in past years. To that end, this article provides a brief background on the significant sun-setting tax rules, as well as the new 3.8 percent Medicare surtax, along with several potential income tax planning ideas for individual taxpayers to consider.

Background of Significant Sun-Setting Tax Rules and The New Medicare 3.8 Percent Surtax Changing Tax Rules: In 2010, Congress acted to extend the tax cuts passed in 2001 and 2003, including cuts to the ordinary income and capital gain rates, (commonly known in the press as the “Bush” tax cuts) through the end of 2012. So unless Congress acts, the tax rates for individuals in 2013 will revert to their prior and higher levels.

Noteworthy changes include: • Higher Tax Brackets: For 2013, the top four tax brackets will rise from 25 percent, 28 percent, 33 percent and 35 percent to 28 percent, 31 percent, 36 percent and 39.6 percent.

• Increased Tax On Capital Gains And Qualified Dividends: For 2012, most long-term capital gains are taxed at a maximum rate of 15 percent, and qualified dividend income is taxed at the same rates that apply to long-term capital gains. For 2013, unless Congress acts, most long-term capital gains will be taxed at

a maximum rate of 20 percent (18 percent for certain assets held more than five years) and dividends paid to individuals will be taxed at the same rates that apply to ordinary income.

New 3.8% Medicare Surtax: Pursuant to the health-care reform law that was signed into law by President Obama on March 23, 2010, for 2013 and beyond, a new 3.8 percent Medicare surtax applies to the lesser of: (1) a taxpayer’s net investment income, or (2) the excess of a taxpayer’s modified adjusted gross income over the following threshold amounts: $250,000 for joint filers or surviving spouses, $125,000 for a married individual filing a separate return, and $200,000 in any other case.

Tax Planning Ideas • In 2012, unreimbursed medical expenses are deductible to the extent they exceed 7.5 percent of adjusted gross income, but in 2013, for individuals under age 65, these expenses will be deductible only to the extent they exceed 10 percent of adjusted gross income. If a taxpayer is close to the 7.5 percent floor this year, the taxpayer should consider accelerating into 2012 “discretionary” medical expenses the taxpayer was planning on making in 2013.

• Losses on stock holdings may be realized while substantially preserving the taxpayer’s investment position. There are several ways this can be done. For example, a taxpayer may be able to sell an original holding, then buy back the same securities at least 31 days later. Taxpayers should consult their investment or tax advisers before executing this strategy.

• If a taxpayer is contemplating selling assets that are likely to yield large gains, the taxpayer should consider trying to make the sale before year-end, with due regard for market conditions. In 2012, long-term capital gains are taxed at a maximum rate of 15 percent, but the rate could be higher next year as noted above. And if the taxpayer’s adjusted gross income (as specially modified) exceeds certain limits, gains taken next year (along with other types of unearned income, such as dividends and interest) may be exposed to the extra 3.8 percent Medicare surtax.

• A taxpayer may own appreciated-in-value stock and want to lock in a 15 percent tax rate on the gain, but thinks the stock still has plenty of room to grow. In this situation, the taxpayer could consider selling the stock and then repurchasing it. The taxpayer would pay a maximum tax of 15 percent on long-term gain from the stock

14 Physicians Bulletin November/December 2012

that is sold. The taxpayer would also wind up with a higher basis (cost, for tax purposes) in the repurchased stock. If capital gain rates go up after 2012 and the repurchased stock is sold down the road at a profit, the total tax on the 2012 sale and the future sale could be lower than if there had been no sale in 2012 and there had just been a single sale made in the future.

This move may also reduce a taxpayer’s tax bill after 2012 if the taxpayer is subject to the extra 3.8 percent Medicare surtax on unearned income.

• Consider taking required minimum distributions (RMDs) from an IRA or 401(k) plan (or other employer-sponsored retired plan) if the taxpayer has reached age 70½. Failure to take a required withdrawal can result in a penalty equal to 50 percent of the amount of the RMD not withdrawn. If a taxpayer turns age 70½ in 2012, the taxpayer can delay the first required distribution to 2013, but if this option is chosen, the taxpayer will have to take a double distribution in 2013, the amount required for 2012 plus the amount required for 2013. A taxpayer should think twice before delaying 2012 distributions to 2013; bunching income into 2013 might push the taxpayer into a higher tax bracket or bring the taxpayer above the modified adjusted gross income level that may trigger the 3.8 percent Medicare surtax on unearned income such as dividends, interest, and capital gains. However, it could be beneficial to take both distributions in 2013 if the taxpayer will be in a substantially lower bracket in 2013, for example, because the taxpayer plans to retire late this year or early the next.

While the above list of tax planning ideas is by no means exhaustive, it should provide taxpayers with a starting place to work with their tax advisors to help develop contingency plans for both best and worst case scenarios, and then settle on a course of action once the legislative picture begins to clear.

Editor’s Note: This article should not be considered as legal, tax, business or financial advice and is designed to provide information about the subject matter covered. If legal advice or other expert assistance is required by the reader, the services of a competent professional should be sought. The following statement is required by the U.S. Treasury Department Regulations: Any U.S. tax advice contained in this communication is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing, or recommending to another party any transaction or matter addressed herein.

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

The 21st Grade

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

Zach Rosal Fourth-year Medical Student Creighton University School of Medicine

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

What we do control as physicians: our choice of a liability partner.

I selected ProAssurance because they stand behind my good medicine. In spite of the maelstrom of change, I am protected, respected, and heard.

I believe in fair treatment—and I get it.

s I finished my last shelf exam of my

third year and finally completed my 20th year of school, I began to think about everything I had been through. The stress and excitement of applying to college, being accepted to multiple schools, and shopping around for balance of value and education. Then there was the decision to go to medical school – this came with an abundance of stress. Study for the MCAT, fill out the online application, complete the secondary applications, hope for interviews, and then pray some school believed you could actually be a physician. This was followed by the elation and sense of relief upon receiving the first acceptance call.

Then came fourth year and applying for residencies. I had been told how amazing the year was. No stress, step 2 is no big deal, you will have no problem getting interviews, the match is weighted in your favor. I wouldn’t call it all lies, but it definitely isn’t the entire picture. I believe fourth year has its benefits for actually learning medicine. During the third, there is always a shelf test coming up, an attending’s evaluation to worry about, and learning how to interact with real patients on a daily basis. While it is not completely stress-free, knowing what to expect, not having to rush home and study for a test, and being able to communicate effectively fosters an ability to truly learn how to care for one’s patients in the real world.

What my previous classmates conveniently omitted was the anxiety and anticipation that comes along with applying for residency For starters, the angst and scrutiny of completing a curriculum vitae, redundant application and personal statement were undesired. You mean I have to write another statement about myself and my interest in a certain field? When will someone just accept that I have interests in a specific area of medicine? Will this be perceived as pompous or confident? Should that be a period or a semicolon there? Are they even going to look at my application if my score isn’t high enough?

Then came selecting programs; personally I had a bit of a crisis moment, what if I don’t get any interviews? Oh boy, I better apply to 10 more programs just to increase my odds. Wow, this gets expensive. Don’t they know I’m living on loans.

I have successfully secured multiple interviews, which is a huge relief in itself, but I cannot say the fear and anxiety is gone. I will begin juggling the interview trail over the next three months.

Through the fury of answering questions about myself, catching flights, and ultimately ranking programs, I am sure there will be a few more palpitations felt along the way. Here’s to all the “fourth years” as they embark on the interview trail and match day. Let’s try to enjoy what is left of our 21st and final grade.

Professional Liability Insurance & Risk Management Services ProAssurance Group is rated A (Excellent) by A.M. Best.

ProAssurance.com • 800.279.8331

November/December 2012 Physicians Bulletin 15

clinical update

Medications of Controversy: Opioids and Prescription Drug Abuse Dr. Alan M. Lembitz Chief Medical Officer COPIC Insurance Co.

M

edication issues are a high-risk

litigation area for physicians and allied health professionals. Close to 10 percent of claims against all physicians are for issues such as wrong medications, wrong dosage, drug-drug interactions, adverse reactions, lack of indications and failure to monitor. One class of medicines has recently become more available and problematic – opioids.

Since the turn of the last century, opioids have formed the backbone of pain management for medical practitioners. Liability issues have increased during the last decade along with a marked increase in addiction to various forms of these drugs.

Research on Prescription Drug Abuse The Centers for Disease Control and Prevention recently published findings¹ that showed that overdose deaths from prescription painkillers have skyrocketed during the past decade: • Prescription painkiller overdoses killed nearly 15,000 people in the United States in 2008.

This is more than three times the 4,000 people killed by these drugs in 1999.

• In 2010, about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers in the past year.

• Nearly one-half million emergency department visits in 2009 were due to people misusing or abusing prescription painkillers.

• Nonmedical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health-care costs.

Nebraska had the lowest rate of drug overdose deaths per 100,000 people in 2008 (at 5.5), while other states with the most problematic situations faced rates that were nearly five times higher.

And Nebraska was on the low end of the amount of prescription painkillers sold (at a rate of 4.2 kilograms of prescription painkillers sold per 10,000 people in 2010), while other states on the high end had a rate that was nearly three times greater².

Liability Issues with Opioids The biggest issue is the accusation of overprescribing and resultant accidental overdose. If one of your patients dies while on a drug you’ve prescribed, legal accusations may occur. Also, there have been issues around diversion and selfprescribing. The latter is a risk that can lead to loss of license and inability to practice medicine.

Informed Consent, Pain Agreement Forms, And Addiction Screening Tools Informed consent and a pain agreement are good resources that physicians can use that aid in addressing liability issues associated with prescribing opioids. Informed consent refers to the discussion and process that surrounds the use of any drug. As part of this, addiction and risk of withdrawal should be addressed.

The pain agreement refers to the specific guidelines that help when prescribing opioids.

It contains the rules of your interaction such as no lost, stolen or weekend prescriptions are acceptable; toxicology screens may be required; and follow-up appointments may be mandated.

There are several popular screening tools for addiction available such as the CAGE questionnaire (adapted to include drugs) and the Michigan Assessment-Screening Test (MAST). Finally, screening toxicology is invaluable in identifying diversion or illicit drug use that may increase the risk of opioids.

All of these help maintain a safe use of opioids and a solid relationship with your patients.

Written and signed opioid agreements can help defend against allegations of abandonment, and complaints to the state medical board for inappropriate prescribing and/or alleging inappropriate termination. Futhermore, opioid agreements can

16 Physicians Bulletin November/December 2012

assist other medical providers in coordinating care and expectations with you and your patients.

Proactive Collaboration in Nebraska Nebraska doesn’t face the severity of challenges seen in other states. However, health-care leaders are working closely with regulatory and government agencies to proactively establish open communication and generate awareness on prescription drug abuse. In October, several programs were held that brought together groups such as the Nebraska State Patrol, Nebraska Health Information Initiative (NeHII), Nebraska Department of Health and Human Services, and Creighton University to discuss how this issue impacts health care within the state and what steps can be taken to effectively address it.

With the implementation of Nebraska’s Prescription Drug Monitoring Program (PDMP), which will be overseen by NeHII, there is another resource that has the potential to help healthcare providers address the abuse of opioids.

One testimonial from NeHII’s website by an advanced practice registered nurse (who works in an emergency department setting) summarized the positive benefits of a PDMP: “Now that providers are able to access NeHII for the statewide PDMP, they have access to not only the PDMP medication fill history but patient lab, radiology, transcribed reports, allergies, immunizations and much more. Being able to access medication history has been valuable in assisting me in managing the care of patients under my care providing continuity to care regardless of where the patient is served. It will be even more valuable when even more medical facilities participate in sharing data.” ¹ http://www.cdc.gov/vitalsigns/painkilleroverdoses ² CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United States, 1999-2008.

MMWR 2011; 60: 1-6

November/December 2012 Physicians Bulletin 17

feature

Dr. Tom Tape

The Tape File Hometown: Port Jefferson, N.Y. Bachelor’s Degree: Dartmouth College in Chemistry Medical Degree: Washington University in St. Louis, Mo. Residency: University of Rochester in New York in Internal Medicine Fellowship: University of Rochester in New York in General Internal Medicine Specialty: Internal Medicine Location: Professor and Chief of the Division of General Internal Medicine at UNMC Family: Wife, Elizabeth; sons, Samuel and Benjamin Hobbies: Photography.

Why I Joined MOMS: “I wanted to be part of the Omaha medical community.”

Patient-Centered Medical Homes Take Root

T

om Tape, M.D., prefers this definition for Patient Centered

Medical Home: “It’s medical care as it should be.”

Dr. Tape, chief of general internal medicine at UNMC, said he doesn’t have to explain the concept as much as he did in 2008 when he first learned about it. “I got a lot of blank stares.

“When people heard the name, they thought we were talking of a new kind of nursing home. The first myth to dispel: We’re not talking about a physical place of care.”

When he describes the Patient Center Medical Home concept to the public, the typical response “Isn’t that the way it’s supposed to be?” Yes, Dr. Tape said, but added: “The current system is splintered into silos. Patients seeing multiple physicians. The right hand not knowing what the left hand is doing.”

Another definition (according to the National Committee for Quality Assurance): “The Patient Centered Medical Home is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family. Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.”

Funny thing, Dr. Tape said, the concept was first introduced in the 1960s as a way to improve pediatric care, and was especially targeted for treating children with chronic diseases such as cystic fibrosis. Five decades later, Patient Center Medical Home (PCMH) is starting to take root in medicine, he said.

In 2007, the concept received a boost in credibility when four organizing entities – the American Academy of Family Physi-

18 Physicians Bulletin November/December 2012

cians, the American Academy of Pediatricians, the American College of Physicians and the American Osteopathic Association – issued a set of guiding principles.

After learning about Patient Center Medical Homes at a meeting of the American College of Physicians, Dr. Tape pitched the concept to his department chair, Dr. Lynell Klassen, at UNMC. “I thought we should try it at a practice site. He (Dr. Klassen) was enthusiastic.”

For the practice site, Dr. Klassen chose UNMC’s resident teaching clinic – meaning the Midtown Clinic situated at 40th and Dodge streets. Dr. Tape said choice provided some additional challenges that went beyond creating a new kind of practice model: the ongoing introduction of new physicians in training to the clinic.

Still, Dr. Tape said, the clinic is thriving and evolving – and has recently earned the third level of certification by the National Committee for Quality Assurance, which sets PCMH standards.

Dr. Tape explained how taking a Patient Centered Medical Home approach to providing care has meant adding clinic staff: • A full-time social worker, who helps patients work through obstacles that prevent them from receiving care – for example, prescriptions they can’t afford,

in e

B2 B

e’s in

aha Maga z Om

az ag

Bu

ER

sin

•

e s s t o B u sin e

ss

M

ER

IN

N

N

s

a’

W

We appreciate your Best of B2B Vote!

ah

Commercial Construction Green Environments Disaster Recovery Industrial Medical Education

Om

access to Medicaid, when they are eligible, but never applied. “All this is very paperwork intensive for physicians. It takes a huge burden off backs of doctors and nurses.”

• A medical home nurse, who take proactive approaches with patients and what ails them. “In the old model, we waited for patients to come to us. In the medical home model, we track patients in registries according to chronic diseases they have.” For example, the clinic has a registry of patients with diabetes. The nurse engages patients in separate and specific activities, based on how well they are doing.

• A dietician, who works with patients to help them lead healthy lifestyles. For example, the dietician gives monthly cooking lessons in the teaching kitchen that is located inside the clinic. “We can tell patients they need to eat healthy, but what does that mean?”

• A behavioral specialist with experience as a marriage and family counselor.

When patients are identified as having psycho-social issues, she works with them or can refer them if their care warrants psychiatric care.

• A pharmacist who ensures that patients know how to take their prescriptions. In the old model, Dr. Tape said, patients up to 50 percent of the time weren’t following their discharging physician’s instructions.

• A home nursing team, integrated with the practice, that extends the reach of the physicians based in the clinic into the patients’ homes.

Those who do the math, Dr. Tape said, realize that adding staff may not sound like a prudent business decision. Under the current pay-forservice reimbursement system, it doesn’t, he said.

“We’re not reimbursed for keeping patients out of the hospital. We’re taking a leap of faith that the system is changing – to a value-based reimbursement system.”

Dr. Tape said a bill before Congress would force that transition in six years. Whether the bill will pass is questionable, he added.

“Under the current political climate, I’m not holding my breath. Nevertheless, it seems inevitable that the reimbursement system will change – it’s a question of how soon and how fast. In the meantime, we want to train our residents to provide the best possible patient care employing what we believe will be the health-care delivery system they will encounter in their practices.”

2 012 • W

IN

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

Boys Town Ear, Nose & Throat Institute

Helping Your Patients Feel Better Again

Boys Town Medical Campus Pacific Street Clinic 14040 Hospital Road (139th & Pacific Street)

(402) 778-6800

Our Board Certified physicians specialize in treating problems ranging from chronic ear, nose and throat illnesses to complex head and neck disorders calling

Boys Town Medical Campus Downtown Clinic

for specialized surgical care.

555 North 30th Street

(402) 498-6540

BOYS TOWN

Ear, Nose and Throat Clinic

Ear, Nose & Throat Institute

(712) 256-5272

BoysTownENT.org

320 McKenzie Avenue, Suite 202 Council Bluffs, Iowa 51503

SM

November/December 2012 Physicians Bulletin 19

feature

Serving with Purpose The Filipi File Hometown: Omaha, Neb. Bachelor’s Degree: University of NebraskaLincoln 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.”

J

eff Strohmyer, M.D., knows there are elderly people who

don’t know where to turn for assistance.

Helping them find resources is one reason he became involved with the Sarpy/Cass County Department of Health and Wellness.

“Most people cannot fathom where they can go for help,” he said.

Dr. Strohmyer serves with John Harris, M.D., on the health board.

David Filipi, M.D., serves as chairman of the Douglas County Board of Health. The three MOMS members described their experiences with government service.

The Harris File Hometown: Norman, Okla.

Bachelor’s degree: University of NebraskaLincoln in Biology Medical degree: University of Nebraska Medical Center Residency:

Dr. David Filipi Dr. Filipi had recently finished his term as president of MOMS – and was looking to stay involved. “The medical society has the privilege of appointing a member to the Douglas County Board of Health. I expressed interest and was chosen.”

The county health board must include one physician (Dr. Filipi has served the past six years and is the current president) and one dentist. All appointments are approved by the County Board of Commissioners.

Dr. Filipi said his interest grew from his involvement in the Omaha effort to get smoking banned in public buildings. “Public health is one issue that unites all physicians no matter where they’re employed. Public health touches all of our professional lives.”

He attends a two-hour meeting each month, and consults on health-related issues with county staff in between. In all, he estimates he spends four to five hours each month on Douglas County Board of Health duties.

Dr. Filipi said the health board recently made a strong recom-

20 Physicians Bulletin November/December 2012

UNMC in internal Medicine Specialty: Internal medicine Location: Alegent Creighton Clinic in Bellevue Hobbies: Exercising and chasing his children Family: Wife, Rhonda; children, Josh and Katie Why I Joined MOMS: “It’s just a way to plug into the medical community.”

feature

mendation to the Omaha School Board to survey students about at-risk behaviors – something that hadn’t been done in nearly 20 years. The school board, which previously had been leery of allowing surveys about such issues as sexual activity and drug usage, decided to change course, Dr. Filiipi said.

The survey results will be available in the coming months, and will allow the county health board, to identify trending behaviors, and then develop strategies to help students turn away from the risky ones, Dr. Filipi said. Finally, federal grants to fund those programs typically are not awarded unless survey data are a part of the application.

Dr. Filipi encouraged his peers to get involved in public health and government: “It just adds to our credibility as physicians.”

Dr. John Harris Dr. Harris has some advice for peers who are considering getting involved in public health: Do your homework. “Make sure they have time set aside to serve,” he said. “Then be aware that public health is a learning curve. It’s different from what we do.”

He decided he did – and hasn’t regretted his decision. Four years later, Dr. Harris said, he has grown as a physician and a public health advocate.

“It’s made me more aware of community needs. I’ve enjoyed the people I met. There are people out there who care a lot.”

Dr. Harris said serving on the Sarpy/Cass County Health and Wellness Board has opened his eyes about the wide range of topics that fall in the public health arena, from tracking West Nile cases to making sure community swimming pools are safe places.

“It’s a challenge,” he said, but worthwhile.”

Dr. Jeff Strohmyer Dr. Strohmyer said he had been involved in his

community (Papillion) for the past 25 years, so when Linda Ford, M.D., recruited him to succeed her on the Sarpy/Cass County Board of Health and Wellness, it was an easy yes.

The county health board could still be considered to be in its infancy – as its funding came from the Tobacco Master Settlement Agreement about a decade ago. Dr. Strohmyer joined four years ago.

Dr. Strohmyer, who also serves as county medical director, said he spends several hours a month, which includes the bi-monthly board meetings and service on several committees, serving these volunteer positions.

He said he is amazed that people – despite public awareness campaigns – still indulge in risky sexual behaviors and other unhealthy ones, including tobacco and alcohol abuse. “I see this as part of our role to let people know these behaviors are out there. People think they’re somewhere else – but they’re right here in our backyard.”

Another role the board fills is disease surveillance. He and Dr. Harris provide guidance to the county health board staff on such medical issues as tuberculosis and pertussis.

Dr. Strohmyer said he has discovered a gap exists in how society cares for its elderly. Many people aren’t doing well in their homes, and can’t afford nursing home care. “Our challenge is how can we help these people get information as to where they can turn for help.”

The Strohmyer File Hometown: Lexington, Neb. Bachelor’s Degree: University of NebraskaLincoln in Life Sciences Master’s Degree: UNL – MBA Medical Degree: University of Nebraska Medical Center Residency: Allegheny Family Physicians, Altoona, PA in Family Medicine Specialty: Family Practice Location: Papillion Family Medicine Family: Wife, Lisa; children, Natalie, Jessica, Michael and Rebekah Hobbies: Reading and Woodworking Why I Joined MOMS: “I’ve just always felt it was our duty to serve our colleagues.”

November/December 2012 Physicians Bulletin 21

feature

The Ayoub File Hometown: Hammana, Lebanon Bachelor’s Degree: Creighton University in Chemistry Medical Degree: Creighton University Medical Center Residency: CUMC in General Surgery Fellowship: Kansas University Medical Center in Kansas City, KS in plastic surgery Specialty: Plastic Surgery Location: Westfield Plastic Surgery Center Family: Wife, Jennifer Oliveto Ayoub, M.D.; sons, Tanios, Michael, Daniel and Nicholas; and daughter, Leila Why I Joined MOMS: “I believe in one voice among physicians. MOMS gives us that voice.”

It’s His Dream

T

his has cliché written all over it – but Nagi Ayoub, M.D.,

says he is living his dream.

In January, he opened his clinic – Westfield Plastic Survey Center in west Omaha – and said he has never felt more satisfied, despite the challenges that come with owning and operating a business.

Coming out of his residency in 2002, Dr. Ayoub said, he wanted to go where he was familiar: California (where he initially lived after leaving Lebanon), Kansas or Nebraska. He chose Omaha – the community where he had earned his bachelor’s and medical degrees. He was recruited by one of his attending physicians at Creighton University Medical Center, who was working at a local health-care institution.

At the time, he said, the institution’s focus was primary care. “I joined because I was eager to work. I felt joining a 140-provider practice would help me get on my feet, and get busy right away.

“That’s what happened.”

His partner started easing his way out of the practice during Dr. Ayoub’s initial years with the organization. “I got busier.

“The busier I got, the more involved I became in its multispecialty group. It was a good thing.”

He said he enjoyed the camaraderie and strength that came from being part of a large practice group. “We can achieve more, we can provide better care for patients, we can provide a multidisciplinary approach to care for our patients.”

Dr. Ayoub said his focus was helping move the organization

22 Physicians Bulletin November/December 2012

into more specialty care. He served on the its board for several years.

“I never had to worry about the business side – making overhead. Making ends meet. I came to work and was able to do what I was trained to do – take care of patients. Focus on medicine, which was very efficient.”

He also never worried that he wouldn’t have patients to see. “I knew it was always going to be there.”

Throughout his life, Dr. Ayoub said, he pursued three staples for his life: having a good marriage and family, being professionally satisfied, and achieving financial security.

Initially, Dr. Ayoub said, he had all three, but later desired more professional fulfillment. “I couldn’t steer my practice the direction I wanted because I was part of a big engine.”

Dr. Ayoub, who grew up in Lebanon and came to the United States at age 12, said the American dream for any immigrant has multiple components: • Be happily married with a family. Check.

• Attend college. Check.

• Have a professional career. Check.

“That’s the American dream for any immigrant.

FINANCIAL EXPERTISE FOR THE HEALTH CARE INDUSTRY. To speak with a dedicated specialist from our Health Care Banking Division call Ed Finan at 402-399-5028.

That was the last step for me before retirement.

(Don’t forget retirement.)”

But beginning in 2006, he started considering whether to venture on his own. He wanted to be responsible for his successes. But he took his time and did his homework. Deciding to leave was difficult. The most important step was discussing his plan with his wife, Jennifer Oliveto Ayoub, M.D., a radiologist.

Dr. Ayoub said, he spent 80 percent of his time with patients, and the remainder on administrative tasks. He knew he would spend at least 50 percent of his time growing his practice and running it while on his own.

“It’s gratifying because you’re building something. The uncertainty of the unknown, of what’s coming is very exciting and motivating.”

When colleagues ask advice about starting their own practice, Dr. Ayoub said, he is quick to set them straight. “I give them the reality of it.”

What may work for a plastic surgeon may not be practical for a primary care physician, he said. He challenges them to reassess. “The grass isn’t always greener.”

For him, it is. Dr. Ayoub said every time he walks into his office, he feels affirmed for his decision. He said he never worried that he wouldn’t be able to attract patients. The biggest challenge, he said, is the human resources component.

Managing people isn’t always easy, he said.

“Sometimes you have to be the tough guy, which isn’t always easy for me. What makes me an approachable doctor, also makes it hard when managing personnel. Somebody has to be the tough guy. It’s hard for me to do that.”

Dr. Ayoub said he has outsourced the HR and payroll components of his practice, so he can focus on marketing and patient care. Providing aesthetics services is a critical component of his clinic as it grows.

“The marketing is the biggest challenge we have. I have to figure out who buys my products and services. Then, find out the most effective way of reaching them. Once I reach them, I have to figure out how to get them to come in. When they do come in, how to convert them into being patients. Then, how to retain them. At the end of the day, we have to provide quality medical care and a comfortable, private experience.

“That’s easier said than done.”

www.anbank.com • 32 locations in Nebraska and Iowa. Call 402-457-1077 or 800-279-0007.

HEARTLAND VEIN & VASCULAR INSTITUTE

November/December 2012 Physicians Bulletin 23

Too many patients, not enough time?

Metro maha Medical Society

Consider hiring a Physician Assistant PA’s practice medicine as a licensed professional with physician supervision.

They exercise autonomy in medical decision-making and can: • take complete medical histories • perform physical examinations • order and interpret diagnostic studies • make diagnoses • order treatments • write prescriptions • assist with surgery • perform procedures such as stress electrocardiograms, sigmoldoscopic exams, lumbar punctures, suturing lacerations, and bone aspirations • apply casts and splints to fractures • provide emergency treatments for life-threatening situations

STRATEGIC PARTNERS

The Metro Omaha Medical Society Strategic Partners offer products and services are of interest to physicians. We encourage you to talk with our Strategic Partners when making valuable business decisions for yourself or your practice.

PLATINUM PARTNERS

BRONZE PARTNERS

NAPA at:

1335 H Street, Ste. 100 Lincoln, NE 68508-3784 402-476-1528 info@nebraskapa.org

Margaret Block, M.D. M. Salman Haroon, M.D.

Ralph J. Hauke, M.D. Timothy K. Huyck, M.D.

Robert M. Langdon, Jr., M.D. Kirsten M. Leu, M.D.

*Nationally Recognized in Clinical Trials and Oncology Research by the American Society of Clinical Oncology (ASCO) (402) 393-3110

(402) 334-4773

(402) 354-8124

(402) 593-3141

Alegent Creighton Health Cancer Center - Bergan

Methodist Estabrook Cancer Center

Midwest Cancer Center Legacy

Midwest Cancer Center Papillion

(402) 941-7030 Fremont and West Point

John M. Longo, M.D. Patrick J. McKenna, M.D.

Geetha Palaniappan, M.D. David A. Silverberg, M.D.

Gamini S. Soori, M.D. Yungpo Bernard Su, M.D.

Stefano R. Tarantolo, M.D. Peter M. Townley, M.D.

24 Physicians Bulletin November/December 2012

cover feature

Responding to

O

a Need neWorld Community Health Centers is a busy place – one that’s about to get notice-

ably larger and, ultimately, busier.

And that means the community health center – which provides such services as pediatrics, women’s health, family practice, dental, behavioral health and “Quick Sick” care – will be able to serve many more patients, said Joel Dougherty, chief operating officer.

Twin buildings – one situated on the northeast corner on the OneWorld site, the other on the southeast corner – are set to open in March. Each of the two mixed-use buildings will include housing for low-income seniors.

The community health center moved into the Livestock Building in 2005 and figured it had all the space it would ever need, Dougherty said.

“When we moved into the Livestock Building – with 40,000 square feet – we were positive we would never use up all the space,” he said. “We were out of space by mid-2008.

OneWorld provides care on a sliding scale to its patients. It also accepts commercial insurance, Medicaid and Medicare.

“There’s a line (for care). We turn away patients. We turn away patients every month,” he said.

“These are new people who aren’t patients of ours – yet – who call us with a medical problem.

“We have to tell people we’re sorry but we can’t take care of you. It bothers us. You work at a place like this because you want to help people.”

Donna Faber, M.D., saw OneWorld become a crowded place after joining its medical staff in 2006. The recession hit. People lost their jobs and their health insurance. The need grew and OneWorld responded by adding staff. The community health clinic began seeing patients who lived well beyond south Omaha.

Dr. Faber recalled using the clinic’s small triage room as an examination room. “I am glad we will have the capacity to take care of more patients – ones that we can’t help with our current space.

People were losing their jobs. Yet, we still had to turn people away rather than treating them.”

Story continued on page 26.

November/December 2012 Physicians Bulletin 25

feature Dr. Donna Faber

The Faber File Hometown: Clearwater, Fla. Undergraduate: Yale University in Spanish Literature Medical Degree: University of Miami Fellowship: West Suburban in Chicago in Maternal Child Health Residency: West Suburban in Chicago in Family Medicine Specialty: Family Medicine with Obstetrics Location: OneWorld Community Health Center Family: Husband, David Quimby, M.D.; daughter, Katya; and son, Alex Why I joined MOMS: “I joined because I thought it was important to get to know other physicians in the Omaha area.”

Dr. Faber said OneWorld’s expansion will provide space for the center’s expanding midwifery group and its growing prenatal patient panel.

Besides the additional space in south Omaha, OneWorld is set to open a clinic at 120th and I streets early next year. Dougherty said the demand for affordable health care isn’t restricted to one portion of Omaha.

The west Omaha clinic, which is funded by a Health Resources Services Administration grant, will include nine clinical examination rooms and three dental exam rooms (with space for two more when demand warrants the expansion).

OneWorld looked at census data, and income and insurance figures to determine where to locate its west Omaha clinic. The location provides easy access to Interstates 80 and 680 and is expected to draw patients from as far as Fremont.

“There are a lot of working-class people in west Omaha who don’t have access to health insurance,” Dougherty said. “That’s why we’re moving out there.”

Dougherty said OneWorld received a grant from the Affordable Care Act – aimed at helping community health centers reach capacity – to fund its buildings at the south Omaha location.

26 Physicians Bulletin November/December 2012

The first two floors of both buildings will include clinical space.

The north building’s first floor will house an expanded acute care clinic, a training room, a community room (for apartment residents), a lunch room, a gym (for staff and for physical and occupational therapy). OneWorld administration will occupy the second floor (with current administration space in the Livestock Building then being devoted to OneWorld’s Women, Infants & Children clinic, which now is situated near 25th and L streets).

Each of the buildings third and fourth floors will have eight housing units. Residents, who must be 55 and older and make approximately $30,000 or less, will have underground parking to keep surface parking available for OneWorld clients.

The south building will house a women’s health center, and include the prenatal (first floor) and OB/GYN (second floor) services currently provided in the Livestock Building.

“We wanted to create a warmer, calmer environment for people seeking those services,” Dougherty said.

Dr. Faber, whose specialty is family medicine and obstetrics, welcomes the additional space – especially the dedicated space for health education programs for female patients.

“OneWorld is seen as a pillar in the south Omaha community,” Dr. Faber said. “The word is out: If someone needs help, people say go to OneWorld.”

With its expansion, OneWorld will eventually add more than 100 staff members to its current staff of about 220, Dougherty said.

moms events Preparing for 2013 & Beyond

The Metro Omaha Medical Society partnered with the Nebraska Medical Association, Foster Group, and Koley Jessen to present “Preparing for 2013 & Beyond,” held Tuesday, Oct. 16 at the Omaha Marriott. The event discussion was lead by facilitator Ross Polking of Foster Group and featured a panel of experts who spoke on the personal impact of changes in health care, tax law, estate planning, and more.

Panelists included (left to right): Christy Moss – Moss Resource Consulting; Kent Kramer – Foster Group; Dr. Gamini Soori – Nebraska Cancer Specialists; Alex Wolf- Koley Jessen; Dr. Harris Frankel – UNMC; and Karen Schuler – Koley Jessen.

2. Dr. David Buck and Dr. Lori BrunnerBuck attended the session to learn more about recent changes that will impact them both personally and professionally.

3. NMA Vice-President Dale Mahlman (left) discusses the future of medicine with panelist Kent Kramer, partner at Foster Group (center) and Mark Stadtlander, president of Foster Group (right).

1.

1

2

3

Women in Medicine

The Metro Omaha Medical Society Women in Medicine hosted a meeting Tuesday, Oct. 23, at Biaggi’s.The meeting, held in partnership with the Creighton University Medical Center Women in Medicine and Science, featured Dr. Susan Johnson, from the University of Iowa, who presented tips on time management and organization.

4. In attendance were, from left, MOMS members Drs. Tina Scott-Mordhorst, Laura Wilwerding, Jane Bailey and Sushma Rai; and below from left, Drs. Vithyalakshmi Selvaraj, Priyanka Vashist, Caron Gray, Deb Reilly and Patricia Soto.

4

28 Physicians Bulletin November/December 2012

moms events

Regain the Joy of Reading Vision Helpers has modern solutions to help you.

New HD Reading Machines Lighted Magnifiers Large Print

Coming Events December 13 CPT Coding Seminar New Location! ITT Technical 1120 N 103 Plz Ste 200 (Theory 3 & 4) 8:00 AM - Noon

FREE Showroom or In Home Demo: Call 402-491-3191 11110 Fort St. |Omaha, NE | 68164 www.visionhelpers.com

January 24 MOMS Annual Meeting Omaha Marriott (Regency)

Networking Reception, Presentation of MOMS Foundation Grant Recipients and Panel discussion with representatives from OneWorld Community Health Centers, Charles Drew and HOPE Medical Outreach.

March 19 Medical/Legal Dinner Champion’s Run

Held in partnership with the Omaha Bar Association. Enjoy dinner and a presentation from Lee Simmons, Chairman of the Omaha Henry Doorly Zoo Foundation.

Dedicated to providing wellness solutions to the communities we serve in the form of state of the art treatment options, education and products.

• Lift Chairs • Portable Oxygen • Wheelchairs • Power Chairs & Scooters

• CPAP & BiPAP • Trilogy Ventilators • Ramps • Stairlifts

April 26 Medical MESS Club Joslyn Art Musuem Witherspoon Hall

877-592-2435 • 402-592-6914 (fax) www.midwestrespiratory.com

Serving Omaha/LaVista, Lincoln, Grand Island, Blair Novebmer/December 2012 Physicians Bulletin 29

moms events COMMUNITY INTERNSHIP PROGRAM

For 20 years, MOMS has bridged the gap between physicians and community leaders with its Community Internship Program. On Oct. 25, six interns, representing local media, insurance, and the Governor’s Office, had the opportunity to each shadow MOMS member physicians.

The program began with a Welcome Reception in the MOMS board room on Oct. 24, followed on by a full day of shadowing and a debriefing dinner the next day, where interns and physicians shared their experiences.

5. Attending the Welcome Reception were, left top from left to right: Dr. Alan Thorson; Dr. James Devney; intern Roseanne Shannon, KETV news director; Dr. Peter Whitted; intern Matt Matulka, policy adviser for Gov. Heineman; intern Clint Williams, Blue Cross Blue Shield senior director of Health Network Services; Dr. David Watts; Dr. Gamini Soori; Dr. Barry Fanders; Dr. Greg Nelson; intern Bob Glissman, Omaha World-Herald health beat reporter; intern Meghan McRoberts, reporter for KPTM; intern Rick Ruggles, Omaha World-Herald health beat reporter.

6. Intern Roseanne Shannon (middle) had the opportunity to meet Dr. David Watts and discuss MOHs Surgery, a procedure to remove high-risk skin cancer, before she shadowed him the following day.

7. Dr. Alan Thorson (bottom) met intern Matt Matulka, who would join him the next morning to observe colonoscopies.

But before the shadowing could begin, Matulka took Dr. Thorson up on his offer to start the day just as Dr. Thorson does, with a 5 a.m. swim before they headed to the office.

5

6

7

30 Physicians Bulletin November/December 2012

member benefits

Customed Tailored TO FIT

Your Practice

Clinical Expertise

New Benefit for MOMS’ Members:

Professional and Friendly Service Convenient Scheduling and Location 501 N 87th Street Omaha, NE 68114 (P) 402-397-7100 (F): 402-505-6949 www.omahaimaging.com

Member Pricing on Credit-Card Processing

T

he Metro Omaha Medical Society is pleased to offer our

member physicians a new member benefit through a partnership with TSYS Merchant Solutions. Members now have access to a program available exclusively to MOMS’ member physicians designed to help you save on your credit-card processing.

MOMS and TSYS Merchant Solutions have partnered to offer a program designed exclusively for MOMS’ members.

• • • •

As a MOMS member, you and your practice are eligible to receive:

Negotiated member-only rates.

Qualified service representatives available 24 hours a day.

A dedicated local account management team.

Free online reporting.

Want to lower your credit card processing expenses?

We invite you and encourage you to contact MOMS to set up a free consultation and rate comparison: Laura@omahamedical.com or 402.393.1415.

PVW

PARSONAGE VANDENACK LAW WILLIAMS LLC

LEGAL TECHNOLOGY WITH PERSONAL SERVICE

We are dedicated to legal innovation, and have taken steps to make the practice of law a more streamlined, accurate and interactive experience.

• Asset Protection Planning • Business Succession Planning • Estate Planning • Business Structure & Transactions • Retirement Plan Design & Tax Planning • Health Care Blogs, Videos, Legal Articles & Information can all be found at:

www.pvwlaw.com

CONTACT US 402.504.1300 5332 S. 138TH ST, SUITE 100 OMAHA, NE 68137-2974

November/December 2012 Physicians Bulletin 31

Member news

Kelly Caverzagie, M.D.

Dr. Caverzagie returns to UNMC, assumes new role

K

elly Caverzagie, M.D., recently assumed a new role in

the UNMC Department of Internal Medicine as associate vice-chairman for quality and physician competence.

Dr. Caverzagie, assistant professor in the Division of General Internal Medicine, is a former UNMC medical student, resident and chief resident. He returned to UNMC after serving as a clinician-educator fellow at the University of Pennsylvania and working as a senior staff physician and associate program director at Henry Ford Hospital in Detroit.

During his fellowship and subsequent career, Dr. Caverzagie developed an expertise in the assessment and evaluation of learners, with a particular focus on assessments of resident competence.

In memoriam Richard H. Engelbart, M.D. Jan. 26, 1940 – Oct. 11, 2012

32 Physicians Bulletin November/December 2012

Christina Fernandez, M.D.

Dr. Fernandez receives Continuing Medical Education Faculty Award

C

ristina Fernandez, M.D., associate professor of pediatrics, has been

selected the 2012 recipient of Creighton University’s Distinguished Continuing Medical Education (CME) Faculty Award. Dr. Fernandez has been the course director for “A New Clinical Approach to Foster Healthy Weight in Youth: Nebraska’s Model to Target and Prevent Obesity.” The course was delivered across Nebraska and later converted to 12 online continuing education offerings.

Dr. Fernandez was also instrumental in obtaining funding and collaborating with the Nebraska Department of Health and Human Services on the project. As a result of her efforts, the Nebraska Medical Association developed a tool kit that has been placed in physicians’ offices in Nebraska.

Dr. Fernandez has been a presenter at a variety of Creighton-sponsored CME activities and serves as a member of the CME Committee.

Criteria for the CME award include active involvement in CME activities, working cooperatively with the CME Division in developing CME conferences and embodying the Creighton philosophy and spirit.

Member news

Harold M. Maurer, M.D.

Dr. Maurer to lead fundraising efforts for Cancer Center Campus

H

arold M. Maurer, M.D., who as chancellor has led the UNMC to unprecedented growth,

will move to a new role with the university on June 30.

Dr. Maurer, UNMC chancellor since 1998, on July 1 will become a professor in the UNMC Department of Pediatrics and chancellor emeritus. He will devote much of his time to his new position working at the University of Nebraska Foundation, spearheading fundraising for the Cancer Center Campus, a $370 million project that will include space for cancer research and care, as well as a new multidisciplinary outpatient facility.

“I believe the time has come for me to take on a new role with UNMC. I look forward to dedicating my time completely to fund raising for the Cancer Center Campus, which will truly transform UNMC,” Dr. Maurer said. “We will continue our momentum at UNMC, and we will not change course over the next nine months. It will be business as usual.”

His achievements at UNMC include leading the merger of University Hospital and Clarkson Hospital to form the Nebraska Health System, now known as The Nebraska Medical Center, leading the institution to new heights of excellence in education, research and clinical care. He also combined more than 70 physician practice groups into one comprehensive faculty practice plan, what is now UNMC Physicians.

Upon becoming chancellor, Dr. Maurer set aggressive goals in research, repositioning UNMC from a regional center to a national center of excellence in the new century. Among others, his research achievements include: • Tripled UNMC’s external research funding, with research dollars now at more than $90 million annually.• Worked with state officials to ensure tobacco settlement funds from the state of Nebraska would support biomedical research. UNMC now receives about $7 million annually from this funding.

• Led fundraising for the Durham Research Center and Durham Research Center II. In all, more than $150 million in private support was raised to fund these facilities’ construction. Combined, the DRC and DRC II have more than 200 biomedical research laboratories.

“I would like for my legacy to be, ‘He built research at UNMC,’” Dr. Maurer said. “I’m also very proud of our many accomplishments in education, clinical care and community outreach.”

BBB recognizes Midwest Eye Care—Again

T

he Better Business Bureau presented

Midwest Eye Care with the BBB Integrity Award at the BBB’s annual Integrity Award luncheon at the La Vista Convention Center in October. Midwest Eye Care has now won this award in 2004, 2008 and 2012 – winners must wait four years before applying again for the award. Midwest Eye Care is the only medical practice or medical facility in Nebraska to win this award.

Each year the BBB Integrity Award recognizes one company in each of five categories, with the categories based on the number of employees in a company. The Integrity Award judging process evaluates a company’s ethics policy, community involvement and customer service policies. The Integrity Award does not mean that a company or its employees won’t make mistakes, but the award reflects that they are committed to fixing the mistakes that do occur.

MOMS members affiliated with Midwest Eye Care are Mark Emig, M.D., Mike Feilmeier, M.D., Jill Grennan, M.D., Michael Halsted, M.D., Courtney Hellman, M.D., Jeffery Hottman, M.D., David Ingvoldstad, M.D., Everett Madson, Jr, M.D., Martin Mizener, M.D., and Peter Whitted, M.D., J.D.

November/December 2012 Physicians Bulletin 33

CAMPUS update

Dr. Egan named endowed chair in nephrology

J

. Dan Egan, M.D., professor of medicine,

has been named the Dialysis Clinic, Inc. – J. Dan Egan, M.D., Endowed Chair in Nephrology in the School of Medicine. The chair inaugural was held at Creighton University in September.

Dr. Egan’s medical career has spanned 64 years. He joined the University’s Department of Internal Medicine in 1954, served as chief of nephrology, and currently teaches and mentors Creighton students at the Omaha Veterans Affairs Medical Center (VAMC). Dr. Egan received his medical degree from the University of Buffalo, Buffalo, N.Y. He served in the U.S. Navy and Marine Corps as well as in the U.S. Public

UNMC student enrollment increases for 8th straight year

F

Health Service. Dr. Egan founded the dialysis program at the VAMC, where he served as chief of nephrology from 1967-1999.

The endowed chair was made possible by a gift from Dialysis Clinic, Inc., a leading dialysis provider in the United States. DCI operates a network of more than 200 nonprofit dialysis centers across the country; four DCI centers in the metropolitan Omaha area serve as teaching sites for Creighton University health sciences students and the medical directors of these sites are Creighton nephrology faculty.

or the eighth straight year, UNMC

student enrollment set a record high with 3,655 students enrolled for the 2012-13 school year-an increase of .8 percent over last year’s record of 3,626.

“Our programs continue to be robust and grew modestly this year in response to the identified health-related manpower needs of Nebraska,” said Dele Davies, M.D., vice chancellor for academic affairs and dean of graduate studies.

“We continue to attract the brightest and the best students while seeking to resolve the most significant health professional needs within our rural and urban communities.

“This year, we expanded our public health offerings with new doctoral programs added in biostatistics and epidemiology. In addition, we saw a higher demand for our nursing Ph.D. programs.”

Author Tess Gerritsen featured at annual lecture event

T

ess Gerritsen, an international best-

selling author, was the featured speaker at Creighton University’s 22nd annual Women and Health Lecture held in October at the Joslyn Art Museum, Witherspoon Concert Hall.

Gerritsen is a graduate of Stanford University and the University of California, San Francisco, where she received a medical degree. She began writing fiction while on maternity leave and published her first novel, “Call After Midnight,”

Enrollment highlights include: Graduate Studies – Enrollment in doctoral and master’s programs in graduate studies increased by 3.8 percent, going from 445 students in 2011 to 462 in 2012. The number of students enrolled in doctoral programs increased 5.4 percent, going from 369 to 389.

College of Medicine – There are 132 new medical students entering their first year of medical school, bringing the total enrollment to 518, with 12 enrolled in the M.D./Ph.D. program.

The new students were selected from a total of 1,513 applicants, one of the largest numbers of applicants in the past 18 years.

College of Public Health – Enrollment in the College of Public Health this fall is 196, which includes 46 doctoral students, 100 master’s students, and 50 certificate and non-degree program students. This represents a 33 percent increase in enrollment over last fall.

School of Allied Health Professions – For the 2012-13 academic year, there are 249 new SAHP students. Total enrollment in the school’s traditional programs is 403 students, and 339 students are enrolled through distance education degree programs. There were 897 applicants this year—a 9.1 percent increase over last year.

34 Physicians Bulletin November/December 2012

in 1987. She continued to write more than 20 works and a screenplay, “Adrift,” which aired in 1993 on CBS. Her books have been published in 40 countries and have been bestsellers in the United States and abroad.

Faculty member co-authors award-winning medical book

T

he British Medical Association (BMA)

recently released its annual list of medical book awards. In the radiology category the textbook, “Diagnostic Imaging: Pediatrics,” published by Amirsys Publishing, Inc., received a highly recommended rating. Randy Richardson, M.D., assistant dean for Medical Education at Creighton University’s School of Medicine at St. Joseph’s Hospital and Medical Center in Phoenix, co-authored the book.

The awards aim to encourage and reward excellence in medical publishing. Prizes are awarded in 21 categories.

Komen grants award to train breast cancer advocates

T

he Nebraska Affiliate of Susan G. Komen

for the Cure® has awarded UNMC a $65,000 grant that will train 10 to 15 more advocates to help women get appropriate early detection, treatment and follow-up breast cancer services.

The Community Breast Health Navigator and Cancer Support Program is designed to provide support for women being evaluated for, or undergoing diagnosis and treatment for, breast cancer at any hospital or clinic. Women trained as volunteer navigators can accompany women to appointments in Douglas County before proceeding with diagnostic or treatment recommendations.

The program is looking for women dealing with breast cancer who could benefit from the free program, as well as those who wish to be volunteer navigators.

Navigators serve as a second set of ears for patients and advise them on the best approaches they have learned are needed to obtain breast care that matches best practice national guidelines.

p.402.991.7337 f.402.991.7373

www.westcenterpediatrics.com introducing:

Dr. Ann Russell

Dr. Laura Wilwerding

[will start seeing patients on Jan.15th] • Board Certified Pediatrician • Fellow of the American Academy of Pediatrics • Member of MOMS • IBCLC Certified • Fellow of Academy of Breastfeeding Medicine

• Board Certified Pediatrician • Fellow of the American Academy of Pediatrics • Member of MOMS • Breastfeeding Specialist

C O M P R E H E N S I V E P E D I AT R I C C A R E | B R E A S T F E E D I N G M E D I C I N E C A R E F O R M O T H E R S A N D I N FA N T S W I T H C O M P L I C AT E D B R E A S T F E E D I N G P R O B L E M S FRENOTOMY

The Metro Omaha Medical Society Foundation identifies and provides support to community priorities The area’s best choice for high quality and cost-effective digestive health care.

Ask for a board certified gastroenterologist to perform your colonoscopy.

where physician involvement can

8901 Indian Hills Drive • Omaha, NE 68114 17001 Lakeside Hills Plaza • Omaha, NE 68130

make a difference in

402.397.7057 or 402.504.3880 402.885.8700

www.midwestgi.com

improving the health of the Metro Omaha Community.

gr eg cu tc

ha ll Omaha restaura teur

MOMS Foundation 7906 Davenport St.

PRE MIER WEA

Nebra ska’s

LTH ADV ISOR S Database 101’s

VIN GUP TA In The Office

HAY NEEDLE

Omaha, NE 68114

WINTE R

Omaha’s Business-to-Business Magazine

2012 0 4>

CO

u.s. $3.25

PERMIT NO. 5377 DENVER,

PAID

omaha magaZine • 5921 s. 118th circLe • omaha, ne 68137

PRSRT STD U.S. POSTAGE

402-393-1415

0

74470 63856

w w w. b 2 b o m a8 .com

BB0312.indd 1

12/16/11 6:38 PM

November/December 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 November/December 2012

Apply Online: www.omahamedical.com

new member update

Michael Horn, M.D.

Sean Langenfeld, M.D.

Justin Madson, M.D.

Jeffrey Cooper, M.D.

Medical School: UNMC

Medical School: St. Louis University

Medical School: Creighton University

Medical School: UNMC

Specialty: Pathology

Specialty: Colon and Rectal Surgery

Specialty: Dermatology

Location: UnitedHealthcare

Location: UNMC Department of Surgery

Location: Midwest Dermatology Clinic, P.C.

Specialty: Emergency Medicine and Hyperbaric Medicine

Dr. Horn has been enjoying long, generally solo motorcycle rides on his mid-weight Harley cruising bike (Dyna Wideglide) for nearly 10 years.

He has ridden back from north of Seattle, back from Atlanta, and round trip to Jackson, Wyo. He usually gets a fall ride through Iowa, and two years ago flew to New Zealand for one solo lap of the south island.

Dr. Langenfeld recently returned home to Omaha after being away for 14 years. He is excited to once again be close to family and friends.

He is UNMC’S first fellowshiptrained colon and rectal surgeon, and is getting actively involved in clinical research and surgical education.

When not working, he enjoys sports, spending time with his wife and two daughters, and relaxing around an outdoor fireplace. On his return, his first order of business was to secure season tickets to Creighton basketball, which he had been forced to follow on the Internet prior to moving home.

Dr. Madson was born and raised in Omaha and, according to him, is still a Westside Warrior at heart.

He recently moved back from Oklahoma City, where he completed his residency, and is happy to be back among Husker fans.

He and his wife, who is also from Omaha, have two children who are attending the same elementary school he attended.

He enjoys recumbent bicycling, but claims to be woefully out of shape after spending so much time with his head buried in books studying obscure facts for boards.

If you Google his name, the first few hits are a cartoonist in Wisconsin, who oddly enough looks a bit like him and is roughly the same age.

NEW MEMBERS Jonathan Hart, M.D. Diagnostic Radiology

James Friedlander, M.D. Allergy and Immunology

Location: UNMC

Dr. Cooper returns to Omaha after 24 years, becoming the new director of hyperbaric medicine at the Nebraska Medical Center.

Trained by the U.S. Navy as a diving medical officer, he has been involved with medical support of military, disaster and law enforcement operations. He enjoys teaching residents, EMS providers, and martial arts students. Coming back to Omaha was all about family and friends.

Interested in becoming a MOMS Member?

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

November/December 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 November/December 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

Ruby Satpathy, M.D.

A REVOLUTIONARY HEART PROCEDURE THAT GIVES PATIENTS WITHOUT OPTIONS WHAT THEY NEED: AN OPTION.

Alegent Creighton Health Heart & Vascular Institute stands alone as the highest quality program in the Omaha-Council Bluffs metro area. And we are the only heart program in Omaha to offer TAVR, a new technology for treating aortic stenosis. For hear t patients with severe aor tic stenosis, where traditional open-hear t surgery is generally not an option, we have TAVR (Transcatheter Aor tic Valve Replacement). It’s a new, revolutionary, minimally invasive technique with major benef its – no chest wall incision, no hear t-lung machine, a shor ter procedure, with earlier ambulation and a shor ter hospital stay. It’s all par t of Alegent Creighton Health’s larger vision to be at the leading edge of cardiology by providing consistent care with ex traordinary outcomes–and then going even fur ther.

Because we, like you, want to get patients back to their lives and the things that matter most. And that’s what makes healthcare healthier. To learn more about TAVR, call Dr. Satpathy at Alegent Creighton Health Hear t & Vascular Institute at 402-398-5880. Or visit AlegentCreighton.com/Hear t

1-800-ALEGENT AlegentCreighton.com

Bergan Mercy

Creighton University Medical Center

Immanuel

Lakeside

Mercy/Council Bluffs

Midlands/Papillion

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