On Call - The Journal of Palm Beach County Medical Society (January-February 2011) by Palm Beach County Medical Society

The Journal of The Palm Beach County Medical Society

Setting the Course for 2011 Board of Directors Set Priorities

PBCMS President 2011

January - February 2011

Palm Beach County Medical Society Tenna Wiles I CEO, Palm Beach County Medical Society

hat do you want PBCMS to do for you and your patients? That is the question we have been asking our members and discussing with the 2011 PBCMS Board of Directors. Emerson said, “Do not make small plans for they do not move the soul” I am inspired that the Board of Directors has established an ambitious, focused agenda for the coming year. Underlying the targeted goals to enhance efforts to assist our members with practice management issues and move forward with a strong advocacy agenda is to improve communications with our members and the community. Building partnerships, growing membership and strengthening physician involvement will open the door for possibilities to successfully navigate the sea change facing the medical profession.

Please join us. Now is the time. The needs are great, but the possibilities are greater.

Last OnCall Issue Available online at pbcms.org

Director’s Desk

Possibilities

2011 Board of Directors James J. Byrnes, M.D.. . . . . . . . . . . President Jack Zeltzer, M.D.. . . . . . . . . . . . . . President-Elect K. Andrew Larson, M.D.. . . . . . . . . First Vice President Richard Raborn, M.D.. . . . . . . . . . Second Vice President Malcolm Dorman, M.D.. . . . . . . . . Secretary Ronald Zelnick, M.D.. . . . . . . . . . . Treasurer Lawrence Gorfine, M.D.. . . . . . . . . Immediate Past President Brandon Luskin, M.D. . . . . . . . . . . Member at Large Michael Lakow, M.D. . . . . . . . . . . . Member at Large Andrew Shapirio, M.D. . . . . . . . . . Chair, Council on Communications Brent Schillinger, M.D.. . . . . . . . . Chair, Council on Ethical & Judicial Affairs Richard Greenwald,, M.D.. . . . . . . Chair, Graduate Medical Education Daniel R. Higgins, M.D.. . . . . . . . . Chair, Health Information Technology Larry Gorfine, M.D.. . . . . . . . . . . . . Chair, Council on Legislation and Council on Medical/Legal Affairs Daniel Kapp, M.D.. . . . . . . . . . . . . . Co-Chair, Council on Legislation and Council on Medical/Legal Affairs. David Soria, M.D. . . . . . . . . . . . . . . Chair, Council on Public Health & Emergency Medicine K. Andrew Larson, M.D.. . . . . . . . . Chair, Council on Membership William Adkins, M.D.. . . . . . . . . . . Chair, Retired Physicians Section Maureen Whelihan, M.D. . . . . . . . Chair, Women Physicians Section Hatem Abou-Sayed, M.D. . . . . . . Chair, Young Physicians Section Richard Shugarman, M.D. . . . . . . Chair, Specialty Section Harish Madhav, M.D.. . . . . . . . . . . Co-Chair, Ethnic/Minority Section Roger Duncan, M.D.. . . . . . . . . . . . Co-Chair, Ethnic/Minority Section Randy Gershwin, M.D.. . . . . . . . . . Chair, Hospital Relations Mark Rubenstein, M.D.. . . . . . . . . Chair, Bylaws Stephen Babic, M.D.. . . . . . . . . . . . Chair, MEDPAC Andrew Shapiro, M.D.. . . . . . . . . . West District Representative Shawn B. Baca, M.D.. . . . . . . . . . . . South District Representative Mark Brody, M.D. . . . . . . . . . . . . . . Central District Representative Alan B. Pillersdorf, M.D. . . . . . . . . AMA/ FMA Liaison Jose F. Arrascue, M.D. . . . . . . . . . . PBCMS Services Liaison Dyani Loo. . . . . . . . . . . . . . . . . . . . . Medical Student Representative

Palm Beach County Medical Society 2011 Board of Trustees Lawrence Gorfine, M.D. Maureen Whelihan, M.D. Daniel R. Higgins, M.D. Jose F. Arrascue, M.D. Alan B. Pillersdorf, M.D. Brent M. Schillinger. M.D.

Mark Rubenstein, M.D. Jack Zeltzer, M.D. K. Andrew Larson, M.D. James J. Byrnes, M.D. Richard Raborn, M.D.

Staff: Tenna Wiles, CEO Yvonne Shapiro, Director of Communications Randy Scheid, Associate Director/Director of Resource Development Ashley Eckes, Director of Disaster Services Deanna Lessard, Director Member Services & Education Nicola Chung, Project Access Program Director Victoria McMath, Project Access Senior Program Coordinator Patsy Westall, Project Director Mindi Tingler, Administrative Assistant Raquel Agurcia, Administrative Assistant Natalie Gonzalez, Receptionist Lauren Tomé, Receptionist

OnCALL Managing Editor: Tenna Wiles Advertising Assistant: Yvonne Shapiro Subscriptions to On CALL are available for an annual rate of $50. For more information, please contact Yvonne Shapiro at (561) 433-3940. The opinions expressed in On CALL are those of the individual authors and do not necessarily reflect official policies of the Palm Beach County Medical Society, unless so stated. Advertising in On CALL does not constitute endorsement by the Palm Beach County Medical Society or its committees.

Cover photo: 2011 Palm Beach County Medical Society President, James J. Byrnes, M.D.

On CALL is owned and published (6) times per year by the Palm Beach County Medical Society, Inc. 3540 Forest Hill Blvd., West Palm Beach, FL 33406 (561) 433-3940 & (561) 276-3636. © Copyright 2011 Palm Beach County Medical Society, Inc.

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OnCall I Jan-Feb 2011

32.0%

33.0%

21.4%

8.7%

4.9%

Features I6I

President’s Page

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Board of Directors Sets Priorities for 2011

Articles I9I

The Future of Medicine Initiative

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Physician Profile on Mas G. Massoumi, M.D.

I 12 I Get Fit Palm Beach County of a “Hostile Work I 14 I Identification Environment” Clinic Regulation: I 16 I Pain A Pain for Honest Physicians

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Understanding the Affordable Care Act

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Should You Practice with An Uninsured

I 18 I Physician? I 19 I

Med Memo

Cover photo: 2011 Palm Beach County Medical Society President, James J. Byrnes, M.D.

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Medicine is a Three-Ring Circus

remember my grandparents taking us to the Ringling Bros Circus at Madison Square Garden and how difficult it was to keep track of all the action in the three rings at the same time. This reminds me of medicine today. I want to emphasize especially to our medical students that you are not a provider, not a vendor. You are a physician, caring men and women, responsible for one of the finest medical delivery systems in the world. I do not want to be an institutional employee, though the idea of a 40-hour week and a pension is appealing. And 40 hours on my current schedule would give me a three day work week! Who will take care of my patients the other four days?? An application I had to fill out asked how many years of schooling I had completed. The answer is 25 years! You can’t just pop doctors out of the Easy Bake Oven! I went to school in Italy, which has a government-run system. I did receive a great education, but docs don’t stay overtime. The hospital had eight beds per room. Your family stayed with you to assist you. You waited four weeks in the hospital to have your lung cancer excised. And Italy has good care! People got better! Have you ever been to a Caribbean hospital? My brother is a radiation oncologist in private practice. There is a big NY hospital which opened a competing clinic near him. But at 4:30 pm on a Friday afternoon, when you just found out you have cancer, they go home (no overtime permitted) while he says… “Come on over. We’ll wait for you!” We cannot afford to dumb down the system by not attracting the best students in the country to become physicians. Should they go to Wall Street instead for better pay? Can the young afford to become physicians, with the school loans they have to pay off? They definitely will have a hard time becoming a family doctor! A police sergeant or captain in the local police department makes more per hour than I do! Money is not the only issue, but the medical community has to be financially strong to be able to attract the best physicians. We expect to the see lights come on when we turn on the switch. People expect miracles when they come to our emergency departments or our offices. They expect doctors

and hospitals to be there, to be well equipped and well trained 24 hours a day, 7 days a week. The medical community isn’t permitted to close. Our youngest, and not so young, continue to serve in the emergency rooms, where care is mandated, yet not funded. We serve the community regardless of their ability to pay. Physicians have always done that. Yet it is getting harder to give free care to the truly needy when reimbursements are not keeping up with the costs of running a well equipped office or hospital. It is important that we defend the quality of medicine our physicians and hospitals provide. We have to persist in our efforts to keep quality in medicine. The government and insurance companies cannot expect to save money without changing unreasonable expectations. And we cannot easily cut back without tort reform.

President’s Report

James J. Byrnes, M.D. I President, Palm Beach County Medical Society

We cannot permit our profession to be hijacked! We have to continue to be active at the local level joining forces with the hospitals. We have to be active with organized medicine, at the state and national level the FMA and the AMA. The recent AMA controversy points out that other areas of the country are not Florida, and we need to join together to make sure our concerns are heard. We need to consider the expenses of political activity as an essential cost of running an office, not an extra unbudgeted burden. We have to work with our hospitals to ensure quality care, and that we are free from rules that don’t work, and add extra stresses to our days, distracting us from caring for patients. Too often we have rules imposed upon us by agencies or by some think tank. I am never opposed to considering ways to be a better doctor. However, I also remember hearing Mr. Richard DeVos, the founder of Amway speak at a Bethesda Foundation reception. He is the founder of AMWAY, and owner of the Orlando Magic. He said there are a few very important words in our language. For example: “I was wrong.” and “I am sorry.” When is the last time any agency has admitted that a rule that was a good idea hasn’t worked out and should be withdrawn? How many employees do our hospitals have working on new standards or guidelines that haven’t worked? Are you a better doctor because you dated and timed a note? Are you a better surgeon because of a time out? Are my notes better because I quit using time honored and world recognized abbreviations like “qAM or qPM?” Continued on page 21 I6I

Board of Directors Sets Priorities for 2011 Advocacy, communications, education and increased physician involvement were identified as the top priorities for the Palm Beach County Medical Society Board of Directors for 2011. Under the leadership of President James Byrnes M.D., the Board participated in a Planning Retreat on Saturday January 15. Significant findings from the Member Survey were presented. • 67% Strongly Agree (36.6%) or Agree (31.7%) Medicare reimbursement for primary care should be increased by at least 5% with the increase paid for by additional revenue • 56% Strongly Agree (28.7%) or Agree (27.7%) Continued challenges with Medicare reimbursement will force me to limit the number of Medicare patients in my practice • 94% Strongly Agree (62.4%) or Agree (31.7%) Medicare liability reform is necessary in order to reduce costs associated with defensive medicine • 31% Strongly Agree (18%) or Agree (13%) I am actively pursuing retirement or contemplating earlier retirement due to my dissatisfaction with the current practice environment • 86% Strongly Agree (46%) or Agree (40%) putting aside paperwork and administrative issues, I find the practice of medicine deeply satisfying • 83% Strongly Agree (41.6%) or Agree (41.6%) Paperwork and administrative issues interfere with my ability to serve patients well • 60% Agree (33%) or Strongly Agree (26.6%) PBC is facing a shortage of primary care physicians which is having an effect on patients’ ability to access medical care and maintain optimal health

Reimbursement levels are sufficient to sustain my practice.

32.0% (33)

33.0% (32)

30 21.4% (22)

• 78% Agree (44.6%) or Strongly Agree (33.7%) High medical student debt should be alleviated through tuition assistance, loan deferment and loan forgiveness for service programs • 88% Agree (52.5%) or Strongly Agree (35.6%) Reform should place an increased focus on wellness and prevention • 59% Strongly Agree (24.8%) or Agree (34.7%) Individuals should be able to enroll in a public plan that reimburses physicians and hospitals based on Medicare’s reimbursement levels • 53% Agree (38.6%) or Strongly Agree (17.8%) There should be federal funding for comparative effectiveness research (CER)

Addressing childhood obesity should be a high priority.

Strongly Agree

49.5% (47)

Agree

Neutral

Strongly Disagree Disagree

“This is a new era. The world, as physicians, is changing. Nobody else is going to experience change like the state of Florida. If you don’t get your voice out there, you’re going to be watching from the sidelines. Go get your voice out there as loud as you can.” ”Political issues are having an impact on your practices. As a member of the Medical Society, you have strength in numbers and have a powerful voice.

• There is still population growth in Palm Beach County. As economic conditions change, there will be more patients. • Baby Boomers en mass are turning 65 •You can pursue partnerships with hospitals or other practices.

• Medical education is expanding and enhancing quality of care.

13.7% (13)

10 0

An impressive panel of healthcare leaders, Bob Broadway, vice president Bethesda Health Systems, Jeff Cohen Esq, Don Mathis, The Mathis Group, and Alan Whiteman, Ph.D. provided their insights and recommendations for opportunities for the Medical Society Board Members to be effective leaders in representing physicians. The discussion helped to bring focus and clarity to the important issues facing physicians. Key messages included:

• There is also great opportunity to participate with Medicaid side.

35.8% (34)

8.7% (9) 4.9% (5)

PBC Health Leaders Share Insights

“This is a time of great opportunity for medicine in Palm Beach County.”

• 81% Agree (47.5%) or Strongly Agree (33.7%) In an advanced medical home, health outcomes are improved when patients receive coordinated care of chronic illness

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• 77% Agree (43.6%) or Strongly Agree (33.7%) Assuming the availability of low income subsidies, individuals should be responsible for purchasing health insurance

• 84% Agree (48.9%) or Strongly Agree (36.2%) Addressing childhood obesity should be a high priority

• 96% Strongly Agree (52.1%) or Agree (43.6 %) The current economic recession is having an adverse impact on my patients

1.1% (1) Disagree

Strongly Disagree

Neutral

Strongly Agree

Agree

“There is a difference between having a job/profession, and running a business. Physicians are doing the best they can with whatever resources are available—but they are primarily focusing on the profession. A business has systems in place; it has management controls;

OnCall I Jan-Feb 2011

35 30

I am actively pursuing retirement or comtemplating earlier retirement due to my 30.1% dissatisfaction with the (31) current practice enviroment. 24.3%

marketing; billing—and it requires critical mass to have all of those systems in place. Most physician practices are not “operationalized” as a business. That is the bottom line now—we need to bring business principles to the practice of medicine.”

17.5% (18)

It’s important that the Medical Society not get completely consumed by big healthcare issues. There is a huge opportunity for the Medical Society to give guidance to its members on business practices: help medical practices to improve their collections; reduce costs by purchasing services for its members and by training staff.

(25)

25 20 15

13.6% (14)

14.6% (15)

Electronic Health Records will present challenges and opportunities… with the right system.

5 0

Gov. Scott wants to focus on medicine as a business, move to centralize operations and create more efficiency. It is critical to form new partnerships and to strengthen your partnerships with hospitals and the community.

Agree

Strongly Strongly Disagree Agree

Neutral

Disagree

Educate physicians and practice administrators on new models of care delivery, utilization of physician extenders and formation of group practices

Setting Priorities for 2011 50 40

Assuming the availability of low income subsidies, individuals should be responsible for purchasing health insurance.

42.7% (44)

• Develop and implement a comprehensive public awareness campaign with targeted messages to physicians and the community.

33.0% (34)

• Continue to develop and strengthen advocacy efforts at the local, state and national levels.

• Place a high priority on continuing the retro physician payment and reinstating the hospital retro payment from the Health Care District, physician reimbursement, medical liability reform and balanced billing.

11.7% (12)

10 4.9% (5)

50 40 30

Strongly Disagree

7.8% (8)

Disagree

• Develop and implement strategies to reach out and engage young physicians, residents and medical students. Neutral

Physicians should be paid for non face-to-face services, such as online evaluations and management services, care coordination and prior authorization.

Strongly Agree

Agree

46.6% (48) 40.8% (42)

Physicians should be paid for non face-to-face services, such as online evaluations and management services, care coordination and prior authorization. 32.6% (31)

35 28.4% (27)

28.4% (27)

25 20 15

20 9.7% (10)

10 0

Armed with valuable information from PBCMS members and respected experts, the board members established the following priorities for 2011. Specific strategies and a plan of action will be developed by physician-led councils and committees.

10 5

1.0% (1) 1.9% (2) Disagree

Strongly Disagree

Neutral

Agree

Strongly Agree

8.4% (8)

2.1% (2) Strongly Disagree

Disagree Strongly Agree

Agree

Neutral

Continued on page 21 I8I

The Future of Medicine

Initiative Jose F. Arrascue, M.D.; James T. Howell, M.D. and Michael Dennis, M.D.

PBCMS Services began its roadmap to the future in 2007 – it became known as the Future of Medicine Initiative. The core question was “What can we do to improve health care in Palm Beach County?” This venture has brought together physicians, hospitals, healthcare businesses, the public health sector and community leaders to define issues, develop collaborative partnerships and build and implement models that will improve the quality of health care in our community Four specific task forces were created to develop and implement programs to address the following areas: • Increase the number of people with access to health care and healthcare insurance • Promote a culture of prevention and wellness • Improve patient safety and quality of care • Enhance and support the viability of physician practices Under the leadership of a dynamic Steering Committee chaired by Jose Arrascue M.D. and James Howell M.D. and Summit Chair, Michael Dennis M.D., the Steering Committee achieved significant accomplishments during the past year.

Future of Medicine Steering Committee Jose F. Arrascue, M.D. James T. Howell, M.D. Michael Dennis, M.D. Stephen Babic, M.D. Claude Earl Fox, M.D. Daniel Higgins, M.D. Brent M. Schillinger, M.D. James Lea, M.D.

Task Force Updates Access to Care and Cover More People Accomplishments • Project Access, a program designed to provide care for low income, uninsured residents of Palm Beach County, collaborated with other healthcare providers, including hospitals laboratories, diagnostic services and medication assistance to provide over $1.2 million in care. • Project Reach Out, an education and outreach program was launched to connect and navigate individuals with the healthcare system including language access assistance • Participated in the county-wide MAPP Community Healthcare Planning Process (Mobilizing for Action and Partnerships is a community-driven strategic planning process for improving community health) • Continued work with the Common Eligibility Task Force to identify and implement a screening tool for use by multiple agencies in the county Challenges • The high unemployment rate resulting loss of insurance coverage, uncertainty of employers about effect of healthcare reform act, and the effect of declining tax revenues on the provision of health care by public health sector • Lack of knowledge regarding “navigating” the health system

Opportunities • Maintain and enhance the Medical Society’s role as the keeper of current information about the impact of the healthcare reform bill • Expand Project Access to the extent that resources allow • Continue work on reinstating physician and hospital retro payments • Continue Reach-Out efforts Prevention and Wellness Accomplishments • Worked in partnership with community organizations to address tobacco cessation and the promotion of healthy lifestyles • Became part of the county wide ACHIEVE initiative which seeks to influence policy in both public and private institutions that encourages and supports healthy and active living • Established partnership with Get Fit Palm Beach County Challenges • Identify strategies for supporting healthy eating habits in an environment where many families are experiencing serious economic hardship • Identify ways to encourage the implementation of corporate strategies that support healthy living

Continued on page 22

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OnCall I Jan-Feb 2011

Physician Profile Mas G. Massoumi, M.D. An Innovative Hand Surgeon By Leon Fooksman

Of the dozens of prestigious awards, certificates, and diplomas hanging in his office, Dr. Mas Massoumi finds the most meaning in a plaque honoring his work as Palm Beach County Medical Society’s president from 1992 to 1993. The Iranian-born orthopedic hand surgeon is still deeply touched that his local medical colleagues elected him as their 74th president. “They understand that it doesn’t matter where I was born,” said Dr. Massoumi, who gets emotional thinking about the personal and professional friendships he has developed in the Medical Society. In his 44 years in medicine, Dr. Massoumi has earned an international reputation for his advancement to the field of hand surgery. He has worked on more than 17,000 patients, including celebrity golfers, tennis players and other athletes. He has sat on numerous national and international medical boards, and has presented and lectured on dozens of surgical topics. This fall, he was given the opportunity to speak on a topic of his choice at the Triennial Congress of the International Federation of Societies for Surgery of the Hand in Seoul, South Korea. He discussed the need for multiple, simultaneous surgical procedures of the complex upper extremity problems. Dr. Massoumi’s 14-page resume is full of significant accomplishments like this, yet the affable, tireless and innovative 70-year-old surgeon doesn’t consider his work complete. He says he wants to share his skills and contacts to help people in developing countries.

He hopes someday to create an organization called Hands Around the World, which would convert an airplane into a flying hospital and enable surgeons like him to perform operations in remote places that have limited medical resources. Complete with a pilot, nurse, therapists and anesthesiologist, the plane could conduct medical missions to provide advanced care.

In 1970, he landed a prestigious residency in orthopedics at George Washington University Medical Center and affiliated hospitals in Washington, D.C. Three years later, he received a fellowship in microsurgery and hand surgery at Thomas Jefferson University Hospital in Philadelphia, where their first child, Lila, was born.

Dr. Massoumi says his desire to help others and excel in medicine came at a young age, and he attributes his ambitions to his mother. She single-handedly raised him and his three sisters after their father died at an early age. “She forced me to go to summer school, and I didn’t like it,” Dr. Massoumi said. “But it got me motivated. From there, I was always at the head of my class.” He always knew he wanted to be a surgeon. In high school, he took apart an entire chicken’s skeleton bones and then wired it back together. Growing up in Iran, he saw poor people in rural areas dying because they didn’t have access to medical care. “No one could help them,” he said. “My goal was to become a doctor and help them.” He graduated from Tehran University Medical School in 1966 and spent the next several years working as an intern, casualty officer and orthopedic house surgeon in England. In 1969 he did his surgical residency at Buffalo University.

Mas G. Massoumi, M.D.

Continued on page 21 Leon Fooksman is a journalist who writes for the Palm Beach County Medical Society. You can reach him at leon@astorytellingcompany.com.

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OnCall I Jan-Feb 2011

Get Fit Palm Beach County What is GetFitPBC?

GetFitPBC is a social network for wellness. Because at least 50 percent of healthcare costs and issues are a result of lifestyle choices, and therefore controllable, GetFitPBC provides the 24/7 vehicle for families, organizations, employers and schools to take action on critical healthcare issues and control healthcare costs.

Who runs GetFitPBC?

It was founded as a community collaboration by the following entities which provide governance, content and initial funding: The School District of PBC, PBC Board of County Commissioners, PBC Medical Society, The Breakers, Children’s Services Council, NCCI, Palm Healthcare Foundation, PBC Tax Collector, United Way of PBC, FPL, PBC League of Cities, PBC Department of Health and the Health Care District of PBC. The PBC Education Commission, a 501(c)(3)

organization, serves as fiscal agent. Content, generated by local experts and programs and referencing many extraordinary wellness programs throughout the county, includes in-depth information on nutrition and exercise. GetFitPBC provides a single portal for community access to this content.

What does it cost?

GetFitPBC is free to all residents and businesses in PBC. The Mission is to build and sustain a healthy culture in PBC where everyone consistently eats healthy foods and exercises regularly. The social networking platform is the hub for breaking down wellness silos and engaging the community through the formation of teams and community activities. Events are designed to sustain team participation using competition, challenges, incentives, peer pressure and regular communications.

The platform provides a rich environment for participation - from a personal health assessment to participating in community challenges or creating one’s own. Companies and organizations are offered the opportunity to provide incentives and coupons for completion of physical or nutritional activity.

How is progress measured?

Team and community progress is measured through steps, fruits and vegetable servings and reduction in waist circumference. A widget on the “public” Home Page calculates and displays the results of community activities and challenges. Teams will be recruited throughout the county with an emphasis on areas with high obesity and diabetes rates. Media partners and sponsors will help to disseminate information and encourage participation.

As part of the Future of Medicine Initiative, Palm Beach County Medical Society is pleased to be a partner of Get Fit Palm Beach County. The Medical Society has been asked to convene a Medical Advisory Committee for this important initiative. If you are interested in serving on the Advisory Committee, would like information for your patients, or would like to for your practice to form a team, contact Tenna Wiles @ tennaw@pbcms.org.

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Identification of a “hostile work environment” By Kimberly A. Gilmour, Esq.

hen you hear the words ‘hostile work environment’, you generally think of ‘sexual harassment.” However, a hostile work environment may refer to any work environment where a person is being harmed because of a protected category, not just sex. For example there may be a claim of hostile work environment due to race, religion, age, national origin, sexual orientation, familial status, disability or any other protected category. In addition, there may be an allegation of a hostile work environment due to a boss who is a “bully.” With the bully manager, it is still key that the behavior is abusive as to the protected category, such as race and not just a bully to everyone. In a hostile work environment, a person is prevented from doing their job – a supervisor or co-worker is creating a workplace that prevents someone from fulfilling the duties and responsibilities they are suppose to perform. The actions of the harasser/bully whether it is behavior, language, gestures or looks must be discriminatory in nature. The actions must be more than just rudeness or boorish to create a hostile work place. Behaviors to look at from a bully are: persistent unwelcome behavior, mostly using unwarranted or invalid criticism, nit-picking, faultfinding, exclusion, isolation, being singled out and treated differently, being shouted at, humiliated and excessive monitoring. Florida courts have held that in order to establish a claim based on allegations of a hostile work environment, a plaintiff must show: (1) that he/she belongs to a protected group; (2) that he/she has been subject to unwelcome harassment; (3) that the harassment must have been based on a protected characteristic of the employee, such as [race]; (4) that the harassment was sufficiently severe or pervasive to alter the terms and conditions of employment and create a discriminatorily abusive working environment; and (5) that the employer is responsible for such environment under a theory of vicarious or of direct liability. To establish the “severe or pervasive” element, a plaintiff must show not only that he/she subjectively perceived the working environment to be abusive but also that a reasonable person would view the environment as hostile and abusive. In evaluating whether the harassment was objectively severe, we look at the totality of the circumstances and consider, among other things, “(1) the frequency

of the conduct; (2) the severity of the conduct; (3) whether the conduct is physically threatening or humiliating, or a mere offensive utterance; and (4) whether the conduct unreasonably interferes with the employee’s job performance.” (“Title VII does not prohibit profanity alone, however profane. It does not prohibit harassment alone, however severe and pervasive. Instead, Title VII prohibits discrimination, including harassment that discriminates based on a protected category” such as race.) In such a situation it is important to examine the entire work place to determine whether there is cause for alarm. It is for this reason that employers should have policies to prevent such matters and should take action to prevent and/or investigate such allegations. One fact to examine during the investigation is whether the conduct is pervasive and then the severity of the conduct. For example, is there a pattern of inappropriate behavior or is it an isolated comment or two. Further, what was said – the severity of the inappropriateness must be reviewed. The following are some important things to keep in mind: Document, document, document. When you prepare a counseling review or memo to the file or email- write is as if a judge or jury were going to read it. Likewise, do not ignore emails and respond in a professional manner. You never know who is going to read the document. Also, when you terminate employees tell them the reason. When employers do not give a reason or give several reasons and change the reason, then the employer is perceived as lying and the termination was motivated by discrimination. Follow your policies – employers need to know what the company policy is and follow the policy in a consistent even handed fashion. Failure to follow the company policy can subject the employer to liability. Also ignoring an employee is a problem – do not be an ostrich. Evaluations – prepare the evaluation based on the entire year, not just a few weeks or month. After all it is an annual review or evaluation. As the supervisor, be objective, don’t be lazy and give all 4’s (in a 1-5 scale) and then a few months later terminate the person. As an employee if you disagree with the evaluation, write something and ask

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OnCall I Jan-Feb 2011

that it be placed in your personnel file with the annual evaluation. It is a jury of your peers- the employees, not the employers. Most people who sit on a jury are employees, they are not business owners, executives or professionals. They have probably never been a supervisor or manager. Juries tend to want to help the sympathetic person not the rude jerk who

yells in the office. Bully managers do not make good witnesses and only hurt their case. Progressive Discipline- it is important not to fire an employee too soon. Was the employee warned? Was the employee given an opportunity to correct the situation? Did the manager manage or just terminate? Again managers can come across as my way or the

highway, and that can be detrimental in front of a jury. In summary, be aware of what is going on in the workplace and take action. Rude and unprofessional people should not be permitted to flourish in the workplace. A hostile work environment motivated by discriminatory behavior should not be tolerated either.

For more information on this topic or any other employment related issues please contact: Kimberly A. Gilmour, Esq. 4179 Davie Road - Suite 101 Davie FL 33314 954-584-6460 tel - 954-327-1555 fax - Gilmourlaw@aol.com

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Do you know a Hero?

Nominations now being accepted for

Heroes are people who put others before themselves. They embrace the opportunity to help others and are willing to work far beyond expectations to make a difference in the world – without seeking the spotlight. Now it’s time to shine on them! To nominate your Hero or for more info, visit www.pbcms.org or call 561-433-3940. Deadline for nominations is March 1, 2011.

Award Categories • Community Outreach • Bruce Rendina Professional Hero • Physician (Local)

Awards Ceremony

• Physician (International) • Non-Physician Healthcare Provider • Student

8th annual Heroes in Medicine Awards Luncheon May 11th, 2011 The Kravis Center, Cohen Pavilion, West Palm Beach Luncheon tickets on sale now. Call 561-433-3940. Grand Benefactor: Rendina Companies

Hearts. Hope. Healing. Heroes Salute the Heroes Among Us!

OnCall I Jan-Feb 2011

Pain Clinic Regulation: a Pain for Honest Physicians By: Linda A. Keen a counsel to The Florida Healthcare Law Firm

n an effort to control the widespread problem of “pill mills” in Florida, the Florida legislature amended laws regulating both Allopathic and Osteopathic pain management clinic practices. Those laws require, with certain exceptions, registration of pain management clinics with the Florida Department of Health. They require pain management physician completion of a pain management fellowship by 2012, subject to grandfather exceptions. They also authorize Department of Health annual inspections, unless the clinic is otherwise accredited by a Board approved accreditation agency. Lastly, they authorize the Boards to adopt rules to set standards of practice for pain management clinic physicians. The laws regulating pain management clinics were challenged in Federal court in Tallahassee on September 23, 2010 in a suit titled P.R.A. (a patient) Amy A Griswold, M.D.; Bado Pyko, D.O. and The National Pain Institute, LLC vs. State of Florida

Department of Health. The complaint alleges that providers may be unknowingly subject to registration requirements due to vagueness of the law; failure to provide notice to clinic operators of penalties for failure to register; arbitrary restrictions on pain management physicians; and arbitrary exclusion from medical practice if pain clinic registration is revoked. The plaintiffs complain of due process violations; violation of free speech rights; antitrust violations; and equal protection violations. New pain management clinic laws were effective October 1, 2010. Rules regulating osteopathic physicians became effective November 8, 2010. However, implementation of identical rules regulating allopathic physicians was temporarily tabled during the recent special legislative session. On November 24, 2010, the Florida Board of Medicine formally announced it expects to be required to review

an amended statement of regulatory costs which will determine whether the rule will need to be presented to the legislature for ratification before it becomes effective. Those identical rules dictate pain clinic practices to require very detailed documentation in medical records; random patient drug testing; adverse event reporting; unannounced annual clinic inspections; quarterly reporting to the physician’s licensing board; and a quality assurance program that is independently reviewed by a Florida licensed healthcare risk manager once every three years. Unfortunately for ethical physicians treating legitimately ill patients, many questions remain unanswered and they are getting caught up in the uncertainty. One thing is certain, however; the practice of pain management in Florida has definitely changed.

Linda A. Keen has over 20 years experience working with Florida’s health care regulating agencies and is a Florida licensed healthcare risk manager with experience developing and implementing robust risk management, quality assurance, and compliance programs. She currently is representing clients before the Board of Medicine on pain management clinic registration issues. She is available to assist your practice in meeting regulatory requirements and addressing other health care legal issues. She can be reached at (850)894-0336 or lkeen850@embarqmail.com. You also can read more about her at www.FloridaHealthcareLawFirm.com.

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Understanding the Affordable Care Act American Medical Association

he Affordable Care Act (ACA) is a comprehensive health system reform law that will increase health insurance coverage substantially for the uninsured and implement long overdue reforms to the health insurance market. While the new law represents a tremendous step forward on the path toward meaningful health system reform, it is not the last step, but rather the beginning. A number of key provisions in the law will be implemented this year, but many others will not become effective until a number of years in the future. This allows organized medicine to have maximum input into the regulatory process and to seek further legislative changes. The following is a summary of some of the major provisions in the ACA. • Increasing health insurance coverage to 32 million more Americans

• Funding state demonstration grants to study alternative medical liability reforms

• Making health insurance more affordable for families and small businesses through the creation of state health insurance exchanges and the provision of sliding-scale premium tax credits and cost- sharing subsidies

• Providing more flexibility in the Graduate Medical Education program

• Health insurance market reforms to address abuses of the health insurance industry • Preventing denials of care and coverage, including those for pre- existing conditions • Stronger patient protections

• Requiring individuals to have minimum health insurance coverage or pay a penalty • Improving Medicare prescription drug benefits by reducing the coverage gap (i.e., “doughnut hole”) • Comparative effectiveness research

• Administrative simplification, to eliminate billions of dollars of unnecessary costs and administrative burdens

Changes to the ACA already accomplished Prior to enactment several favorable changes to the legislation were made:

• Medicare bonus payments for primary care physicians and general surgeons

• Eliminating a budget neutrality adjustment for primary care and rural surgery bonuses

• Increasing Medicaid payments for primary care physicians

• Eliminating a tax on elective cosmetic surgery and medical procedures

• Increasing geographic adjustments for Medicare physician payments

• Eliminating a Medicare/Medicaid enrollment fee for physicians

• Expanding and improving coverage of preventive services in the public and private sectors

• Eliminating a five percent Medicare payment cut for “outlier” physicians

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OnCall I Jan-Feb 2011

Should You Practice With An Uninsured Physician? By: The Risk Management Experts at First Professionals Insurance Company

n some states, physicians that fail to carry malpractice insurance must post a notice to their patients that they are uninsured, or “bare”. However, such statutes do not compel that any form of notice be given to one’s colleagues. Commonly, it is not until a claim arises that a colleague’s lack of insurance is disclosed. Not until then does the impact to those who are insured become painfully apparent – often in tandem with the plaintiff’s theory of liability.

Consider the case of an oncologist who was sued for an alleged failure to diagnose cervical cancer that was missed by the patient’s gynecologist, who was uninsured. The gynecologist had referred the patient to the oncologist because of an abnormal PAP study. The oncologist examined the patient and recommended pursuit of appropriate diagnostic follow-up that was made known to, but never pursued by the gynecologist. The thrust of the plaintiff’s case, however, was made against the oncologist. Not surprisingly, the gynecologist took the position that the oncologist was at fault for failing to obtain the necessary diagnostic workup. Practicing with those who are bare can and does increase your risk of being sued. Most physicians understand the term “deep pocket” in the context of malpractice – being targeted for one’s insurance coverage instead of culpability. As illustrated in the referenced case, plaintiff attorneys often direct their case of liability to where the insurance coverage is. When a bare physician is sued, it is almost a given that they will be approached by the plaintiff’s attorney with an offer of settlement at some point during the litigation. The attorney will usually offer the bare physician an offer of settlement whereby the plaintiff will not proceed with the case against the bare physician in exchange for the bare physician’s agreement to criticize the insured codefendant physicians in deposition or at trial. Refusing to do so subjects the bare physician to aggressive action by the plaintiff attorney.

The fact of the matter is that an uninsured physician still faces the same chances of being sued as those who are insured. However, the primary issue for those physicians that are insured is one of increased risk of loss exposure. In terms of effective risk management, carefully consider the potential consequences of practicing alongside those whose claim exposure you may ultimately be forced to underwrite. For more information regarding this and other medical professional liability insurance risk management issues, please contact the risk management consultants at First Professionals Insurance Company at (800) 741-3742, ext. 3016 or send an e-mail to rm@fpic.com.

The rising number of physicians electing to forego professional liability coverage increases your likelihood of participating in healthcare delivery with an uninsured colleague. Legislation designed to enforce financial responsibility of bare practitioners is unlikely to impact the risk of being sued when practicing with a bare physician.

The information above does not establish a standard of care, nor is it a substitute for legal advice. The information and suggestions contained herein are generalized and may not apply to all practice situations. First Professionals recommends you obtain legal advice from a qualified attorney for a more specific application to your practice. This information should be used as a reference guide only.

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Med Memo

January - February 2011

FREE EHR MEMBERSHIP APPLICATION – A MEMBER BENEFIT FOR PRIORITY PRIMARY CARE PHYSICIANS (PPCP PROVIDERS) An EHR assistance program for Priority Primary Care Physicians with “meaningful use” of Health Information Technology and EHR. DON’T DELAY – SIGN UP TODAY - APPLY FOR YOUR FREE MEMBERSHIP TODAY AT www.pbcms.org Physician Resources – Education DAYS AT THE CAPITOL – MARCH 14-16 Join your PBCMS colleagues for the annual legislative visit to Tallahassee, March 14-16. During the 2011 Legislative Session, state lawmakers will make major decisions that will affect the future of medicine in Florida. This is your opportunity to meet elected officials and discuss the issues that matter most to physicians. On March 14, the FMA will host an evening, open-house reception at our new headquarters for all Days at the Capitol attendees. The FMA has reserved a block of rooms at the Hampton Inn and Suites (3388 Lonnbladh Road, Tallahassee) at a discounted rate. To reserve your room today, please call (850) 574-4900. The room block is listed under “Florida Medical Association.” For additional information contact tennaw@pbcms.org or call 561-433-3940. DOCTOR’S DAY CELEBRATION – MARCH 31ST Join PBCMS for a Doctor’s Day Celebration, March 31st at Benvenuto’s Restaurant, Boynton Beach. To RSVP on line visit www.pbcms.org (Events) or call 561-433-3940. No fee for PBCMS Members. Guest $ 75.00 Sponsorships available. OFFICE MANAGER’S INSTITUTE PROGRAMS Office Manager’s programs are held at the Airport Hilton WPB, 1:30 am – 1:00 pm. $25 Members & Staff, $35 Non-members & Staff. For additional information contact deannal@pbcms.org or call 561-433-3940. • • • •

March 2, “Handling HR with a Smile” April 6, “Hi-Tech Low-Cost Ways to Market Your Practice” May 4, “Quickbooks” June 1, “IT Security & Disaster Preparedness & Recovery”

4th PROSTATE HEALTH AND CANCER SEMINAR – Saturday, March 19 Ingall’s Memorial Prostate Seminar IV, March 19, 2011 at the FAU LLS Auditorium, Jupiter. For additional information contact David S. Most, Ph.D., Health Information Research, Inc. 561-776-6666 or dmost@enbpb.com

EDUCATIONAL OPPORTUNITIES Knock Out Stroke: Current Practice and Future Directions in Cerebrovascular Diseases • March 12 (Saturday) Biltmore Hotel, Coral Gables, Florida. 4.5 Cat. 1 Credits Spine Surgery Symposium • March 19 (Saturday) Biltmore Hotel, Coral Gables, Florida. 5 Cat. 1 Credits Pediatric Multispecialty Symposium • May 14 (Saturday) Miami Dadeland Marriott, Florida Primary Focus Symposium • June 10 – 12 (Friday-Sunday) Hawks Cay Resort, Duck Key, Florida For additional information contact juliez@baptisthealth.net or call 786-596-7710. SAVE THE DATE FOR the 8th ANNUAL HEROES IN MEDICINE AWARDS LUNCHEON – MAY 11, 2011 The 8th Annual Heroes in Medicine Awards Luncheon, The Kravis Center Cohen Pavilion. Heroes are men and women who place their needs of others above self and view personal responsibility from a global perspective. Join us as we honor these individuals and organizations who utilize their skills in the field of healthcare to provide outstanding service to meet the needs of people in local, national and global communities. Proceeds from this event benefit Project Access, providing healthcare for low income, uninsured residents of Palm Beach County. Go to www.pbcms.org or call 561-433-3940 for additional information. 2011 ALZHEIMER’S EDUCATIONAL CONFERENCE – MAY 5-6 Thursday, May 5: 8 am – 4 pm, Friday, May 6: 8 am – 2:30 pm “Life After the Diagnosis” at the Palm Beach County Convention Center, 650 Okeechobee Bld., West Palm Beach. Join thousands of caregivers, advocates and healthcare professionals as we come together to focus on the caregiver’s journey. Featuring Gail Sheehy, Author, Award Winning Journalist, Lecturer, and Advocate for Caregivers. For additional information contact Carrie Kufta, 561-683-2700 or email info@alzcare.org.

Come Unmasked and Become a New Member! Join us for our Mardi Gras Luncheon and General Membership Meeting FAT TUESDAY, MARCH 8TH - 12:00 NOON 5796 Lady Luck Road, Palm Beach Gardens I 19 I

Hosted by Barbara Egitto and “The Court” The Palm Beach County Medical Society Alliance RSVP to your host (561) 626-2572

OnCall I Jan-Feb 2011

Palm Beach County Medical Society People in Action Member Event at “The Club”

PBCMS Participates in The Maraton of the Palm Beaches

Kathy Dedo; David Coldwell; Mas G. Massoumi, M.D.; Larry Gorfine, M.D.; James DeGerrome, M.D.; Douglas D. Dedo, M.D.

John Hildreth, M.D.; Lewis Green, M.D.; Alan Pillersdorf, M.D.; Russell Anderson, M.D.

Member Event at “The Club”

PBCMS CME Program

PBCMS Medical Students

Bernd Wollschlaeger, M.D.; Robin Fiore, M.D. and Brent Schillinger, M.D.

2011 Heroes in Medicine Host Commitee Members - Members plan for upcoming Event

Greg Quattlebaum and William R. Adkins, M.D.

Remember Us in Your Will We hope you’ll consider including a gift to the Palm Beach County Medical Society Services, Inc. in your will or living trust. Called a charitable bequest, this type of gift offers these main benefits: · Simplicity. Just a few sentences in your will or trust are all that is needed. · Flexibility. Because you are not actually making a gift until after your lifetime, you can change your mind at any time. · Versatility. You can structure the bequest to leave a specific item or amount of money, make the gift contingent on certain events, or leave a percentage of your estate to us. · Tax Relief. Your estate is entitled to an estate tax charitable deduction for the gift’s full value. If you would like additional information please contact Randy Scheid at 561-433-3940 Ext. 15.

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President’ Page continued from p.4 We are considered one of the most admired professions. So why are we, as smart, well trained, well regarded physicians in this mess? Why do we train our young docs to think and then tell them they can think as long as they don’t violate the “guidelines?” We need to be heard and we need to be heard by working together. And, if others say I’m so good at what I do, why can’t I charge more than the average doctor? At a recent national hospital conference, we were told that our hospital length of stays are not out of line with world standards, and physicians are not overpaid based on our country’s GDP. So why is my salary the scapegoat to save money? And if you think “Obama care” is just a Democratic Party initiative, we were told it’s been in the works for over seven years. Watch your back…corporate America wants to save money too. When I needed spine surgery, I was very lucky to have an outstanding physician available to me and a very well equipped hospital. Can you imagine the results if the surgeon and hospital had equipment and personnel that weren’t top notch? I can raise my right arm and walk on my right leg because they were top notch! Many of us can remember the first concierge doctor……Marcus Welby. He managed to do house calls and only see a few people every day! Or how about Dr. House? He only has one patient in the hospital and is assisted by 3 residents! We need to stay involved. Our “children” are our families and the young docs who are in school today. We owe it to them to protect our profession. We need to keep our eyes on all three rings of this circus…and that means being involved.

Board of Directors Set Priorities for 2011 continued from p.8 • Develop programs and services to educate physicians on challenges and opportunities facing the medical profession. • Provide “value added” practice management resources for physicians, practice administrators and staff. • Expand opportunities to promote physician networking, social interaction and family participation. • Develop and strengthen partnerships with hospitals and community partners. • Become Involved. Please consider opportunities for becoming engaged on a Councils. Opportunities are available for the: Council on Communications Council on Legislation Council on Ethical and Judicial Affairs Council on Medical Economics

For additional information contact Tenna Wiles at tennaw@pbcms.org

Physician Profile on Mas G. Massoumi, M.D. continued from p.10 His years as a resident and fellow exposed him to some of the country’s leading doctors and mentors. Under their tutelage, the young Dr. Massoumi performed a hip replacement surgery on a fourstar military general. After that success, Dr. Massoumi developed the confidence to start his own practice and relocated to the warmer climes of Palm Beach County. He became an affiliated physician at St. Mary’s and Good Samaritan Medical Centers in West Palm Beach in 1974. He later chaired the surgery department at the former Doctor’s Hospital in Lake Worth. As he gained more experience, and there was more demand for Dr. Massoumi’s skill in hand surgery, micro-neurovascular surgery and reconstructive surgery of the upper extremity, he limited his practice to upper extremities. He became the leading doctor for the most difficult procedures. “As soon as other doctors smelled trouble and couldn’t handle it, they sent their patients to me,” Dr. Massoumi said. The leadership roles followed. He was instrumental in the creation of the Palm Beach County Healthcare District and two trauma centers: St. Mary’s and Delray Medical Centers. He was also instrumental in bringing the open heart surgery program to JFK Medical Center. The famed Dr. Michael Debakey was consulting for a new open heart surgical center but they needed a hand surgeon who was qualified to do microsurgery in case there were complications in complex procedures while drawing blood from arteries of the wrist and/or forearms that would jeopardize the circulation of the hand, and they could not have the open heart program without this kind of hand surgeon. So JFK administrators contacted Dr. Massoumi and offered him this prestigious position on the open heart team without having to take Emergency Room call, as other surgeons were required, until they were able to attract other hand surgeons who were trained to do such complex microsurgeries, if it was necessary. He worked his way up to become president of the Medical Society. He was named chairman of the Medical Advisory Council for the Rehabilitation Center for Children and Adults from 1994-1996 and since that time he has been a Member of the Board of Governors for this prestigious charitable organization. He became a member of the Oversight Committee for Doctor’s Health Plan in the Florida Medical Association/Florida Osteopathic Medical Association in 1995. In all, Dr. Massoumi has held in his career more than 30 roles as an officer or a member of committees. Still, no matter how busy his medical work became, he always made time for his family. He and his wife, Roshan, who has been a member of the Palm Beach County Medical Society’s Alliance Board of Directors, raised two children, both of whom have successful careers in their fields. Their daughter, Lila, is a psychiatrist in Michigan. Their son, Cyrus, who was born in West Palm Beach, is the co-founder and CEO of www.ZocDoc.com, which helps patients conveniently find and schedule physician and dentist appointments. Forbes Magazine named ZocDoc the best start-up company in the U.S. in April 2009. This company is currently active in New York City, Washington, D.C., Chicago, San Francisco, and Dallas; and plans to expand to the rest of the country in the future. Asked what else he wants to do in life, Dr. Massoumi says, in addition to charity work, he would like to write books about his medical stories. Dr. Massoumi says he is grateful for a career that has enabled him to help so many. “I’ve been lucky,” he said. “Helping patients is the greatest honor.”

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The Future of Medicine Initiative continued from p.9

• Identify strategies/programs for physician offices that encourage “healthy lifestyle”coaching • Ongoing struggle to educate patients and physicians on which social beliefs contribute to smoking and obesity and implement specific strategies to address these

Enhance Physician Practice Viability Accomplishments • Created the Center for Practice Innovation to assist physician practices in the development of new business models

Opportunities • Continued work with the Palm Beach County Tobacco Free Partnership to reduce smoking in the county

• Conducting a comprehensive physician census with a special focus on primary care physicians and access to Medicaid physician providers

• Develop smoking reduction strategies for work with schools and parents

• Continued to provide timely information, education and communication regarding Electronic Medical Records and how this movement will impact the private physician practice

• Create a subgroup to explore potential funding (provided for in the healthcare reform act) for employers to institute workplace wellness programs • Develop and distribute to physician’s offices a quick referral sheet that will provide websites that provide healthy living • Encourage physician and patient participation in “Get Fit Palm Beach County” Quality and Patient Safety Accomplishments • Implemented a patient centered medical home demonstration with M.D.VIP – a large concierge practice based in Palm Beach County • Implemented a fall prevention pilot program within the private physician’s practice • Established the Medical Society as a Center of Excellence for Cultural Competency • In the physician office setting, successfully piloted a cost effective solution for the use of video interpreters for deal and hard of hearing patients • Established the Medical Leadership Council, comprised of physician, hospital and community leaders to coordinate ongoing efforts to improve quality and patient safety Challenges • Limited time and resources for training physician office staff • Ongoing uncertainty about how the healthcare reform legislation might influence patient care protocols/standards Opportunities • Expand Prevention program available to physicians in the county • Potentially engage with the JFK residences pilot diabetes program • Provide educational forums for physicians on successfully proven methods for measuring quality and value • Benchmark other community efforts in quality initiatives payment reform

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• Established partnership with the South Florida Regional Extension Center Challenges • Continuation of declining physician reimbursement across many specialties • Still many unknowns regarding how the healthcare reform act will impact the private practice of medicine • Ongoing shortage of physicians in some specialties Opportunities • Continued enhancement of the On-line Physician Practice Resource Center • Continued development of the Center for Practice Innovation • Explore ventures by successful practices across the country that have found ways to survive • Encourage and support improved communication with hospitals, insurers and employers • Strengthen efforts to promote graduate medical education • Support efforts to reform professional liability laws • Expand physician census to include hospitalists, hospital employed physicians and concierge physicians

The Future of Medicine Initiative conclusion from last page

Future of Medicine Summit

The Future of Medicine, Summit IV – chaired by Michael Dennis, M.D. was held on September 23-24, 2010 at the Florida Atlantic University Boca Raton, Florida There were over 300 attendees. The Summit featured nationally recognized healthcare leaders who addressed both healthcare reform issues and strategies to address increasing the quality of care. Speakers included Howard Eisenson, M.D., Director of the Duke University Diet and Fitness Program who spoke on promoting weight loss and physical fitness and shared lessons learned from the Duke University Diet and Fitness Center; Cecil Wilson, M.D., president of the AMA Jeff Goldsmith, Ph.D., president of Health Futures Jerry Reeves, M.D., principal, Health Innovations and Phil Galewitz, Kaiser Health Network who facilitated a panel of hospital CEO’s discussing future implications of healthcare reform for the hospital community. A new component was added to the Summit this year with the creation of “expert panels” that discussed the cutting edge in both research and patient care for Alzheimer’s, Autism and Addiction. The Alzheimer’s Panel included Claes Wahlestedt, M.D., Ph.D., principle researcher at Scripps Florida, Mary Barnes, CEO of Alzheimer’s Community Care, Mark Brody, M.D., practicing neurologist and co-founder of Brain Matters and David Watson, Ph.D., C.O.O of Brain Matters.

The Autism panel consisted of Chris Kye, M.D, practicing pediatric psychiatrist, Yianolula Alexakis-Lanigan, Ph.D., clinical psychologist, Jack Scott, Ph.D., Executive Director of the CARD Center at FAU, Claes Wahlestedt, M.D., Ph.D., researcher at Scripps Florida and Dick Busto, President of the Autism Project of Palm Beach County. The Addiction Panel included Barbara Krantz, D.O., CEO of the Hanley Center, Karen Dodge, Ph.D., vice president of research, Hanley Center and Paul Kinney, Ph.D., addiction researcher at Scripps Florida. The Employer/Insurer panel included Robert Hays, Ph.D., director of Health Administration Programs at FAU, Julian Lago, Underwriter at Plastridge Agency, Becky Cherney, CEO, Florida Healthcare Coalition, Richard Bernstein, President, RSB Agency and Katherine Palmier, M.D., Chief Medical Office, SE Region, United Healthcare. In coordination with the VA Medical Center we were able to offer nine category I CME credits to physicians who attended. Plans are underway for Future of Medicine V to be held in the fall of 2011. If you are interested in volunteering or participating in the FOM Initiative contact TennaWiles @ tennawpbcms.org.

PBCMS Circle of Friends Acevedo Consulting Coding & Compliance Specialists 561-278-9328 jacevedo@acevedoconsulting.com Alpern Rosenthal Accounting & Tax Consultants 561-689-7888 tclarke@alpernfl.com Anderson Moore Construction 561-753-7400 jschumacher@amcbuild.com Avisena Revenue Cycle Management 305-446-8599 bfoster@avisena.com Broad & Cassel Attorneys at Law 305-373-9430 msegal@broadandcassel.com Danna-Gracey Medical Malpractice & Workmen’s Compensation Ins. 561-279-6906 matt@dannagracey.com FPIC Medical Malpractice Carrier 800-741-3742 hakes@fpic.com

Northwestern Mutual 561-622-4699 david.coldwell@nmfn.com 561-962-2931 david.laser@nmfn.com Professional Economic Growth Group (P.E.G.G.) 561-841-3844 sesso.peter@palmail.com Proffitt Management Solutions Business Coach 561-582-6060 nancy@proffittmanagement.com Suntrust Bank 954-765-7194 elizabeth.breslin@suntrust.com The Florida Healthcare Law Firm 561-455-7700 jcohen@floridahealthcarelawfirm.com TriNet Human Resource Services 941-741-4287 shawna.malecki@trinet.com

Gulfstream Business Bank 561-665-4212 jchen@gsbb.com

Thinsolutions Remote Control IT Management 941-741-4287 lmellgren@thinsolutions.com

Ironstone Bank 561-253-8135 laura.king@ironstone.com

VNA of Florida Home Health Agency 772-286-1844 rob.sommer@vnaflorida.org

Managed Care Advisory Group (MCAG) 800-355-0466 jgadd@mcaginc.com I 23 I

Palm Beach County Medical Society Membership Applicants Brian Feinstein, D.O. 4205 West Atlantic Ave., Delray Beach, FL 33445 Phone: (561) 498-4407 Fax: (561) 498-4480 Specialty: Dermatology Medical School: Nova Southeastern University 2002 Internship & Residency: Broward General Hospital 2003-2008 Board Certification: American Osteopathic Board of Dermatology (Dermatology & Family Practice) Hospital Affiliations: Delray Medical Center & Bethesda Memorial Hospital Earl Joseph Berman, M.D. 525 Okeechobee Blvd., 14th Floor, West Palm Beach, FL 33401 Phone: (561) 498-4407 Fax: (561) 498-4480 Specialty: Internal Medicine Medical School: Medical College of Florida 1988 Internship & Residency: Memorial Health University 1988-1991 Board Certification: American Board of Internal Medicine Hospital Affiliations: Cleveland Clinic. Physician Assistant Stasha Lynn Martella, PA

Classified Ads MEDICAL OFFICE SPACE AVAILABLE Prestigious medical office on Flagler Drive in Trump Plaza in vibrant West Palm Beach downtown area. Beautiful office space overlooking intercoastal waterway. Approximately 3100 square feet. Parking garage with valet service and self parking on premises. Shared usage with board certified plastic surgeon or full occupancy possible. Call (561) 641-1000 or email VivekReddy@msn.com. MEDICAL OFFICE SPACE AVAILABLE 1400 sq foot medical office fully equipped perfect for internist or group, centrally located off Palm Beach Lakes Blvd in West Palm Beach, available full or part time for lease or sale. Call 685-2613. MEDICAL OFFICE SPACE TO SHARE WITH OTHER PHYSICIAN Prime location in Boynton Beach. Located at Congress and Gateway. If interested call 561-733-0777

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MEDICAL OFFICE FOR IMMEDIATE OCCUPANCY 801 Meadows Road, directly opposite Boca Raton Community Hospital. 1434 Sq. Ft. newly refurbished, realistically priced for sale or rent. Call Hamilton Consultants Realty 561-289-7227 or 561-212-7200. JUPITER MEDICAL OFFICE FOR SALE OR LEASE Across the street from Jupiter Hospital, ground floor, approximately 1500 sq. ft. furnished, x-ray ready and move in ready, new tile floors and bathroom, light and bright. Call 561-747-2322.

PRSRT STD US POSTAGE

PAID WEST PALM BEACH, FL PERMIT NO. 515

3540 Forest Hill Blvd., Suite 101, West Palm Beach, FL 33406 RETURN SERVICE REQUESTED

The Future

When the government made money available to help doctors make the move to electronic health records (EHR), they entrusted just a few organizations with the funding and training to help doctors make that transition.

The Team

South Florida Regional Extension Center is the local organization that has been selected to help you transition to EHR and use it in a meaningful way to improve patient care and safety. That’s why the Palm Beach County Medical Society (PBCMS) has partnered with and supports the REC. Our highly trained specialists will help you ask the right questions to select the best EHR solution for your practice and help you reach the government standards for EHR meaningful use.

The Cost For the first 2,500 priority primary care physicians who sign up with the South Florida REC, this critical service is 100% FREE. There is no need to hire expensive consultants or search through a multitude of vendors. The South Florida REC will save you time and money in your transition to EHR. Not only that, The South Florida REC will help speed your journey toward meaningful use and the government incentives that go along with reaching that goal.

The Incentive

Practices that accept Medicaid are eligible to receive up to $63,000 in incentive money once they reach the government standards for meaningful use. Practices that accept Medicare are eligible to receive up to $44,000 in incentive money once they reach the government standards for meaningful use.

The Regional Extension Center

Because the REC is funded, trained and approved by the Office of National Coordinator, we are the recognized experts on EHR selection and implementation and the government’s standards for meaningful use.

SOUTH FLORIDA

REGIONAL EXTENSION CENTER®