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The Journal of The Palm Beach County Medical Society

November - December 2011

A Happy Hippie Holiday Gala


The Circus Isn’t Over! What an exciting year! My confidence in our Medical Society, and my faith in the abilities of our Board and our office staff under Tenna Wiles is stronger than ever. Last year I spoke about the three-ring circus of medicine, local, state and national, and then we added the 4th… the economics of medicine, and we stepped up on issues at all these levels. We are very active with the FMA…a fantastic group of dedicated doctors who work to make sure the interests of PHYSICIANS are heard at all levels. We have sent our doctors to the AMA, too, and will continue to scream and shout to see if the rest of the country will hear our concerns. Trying to get the AMA to move is like trying to do the jitter-bug with your 90year- old grandmother….you’re ready to boogy and she’s going as fast as she can…which is NOT fast at all! But, she’s still your grandmother. I am proud also that we have been able to collaborate with Broward and MiamiDade Counties as part of the South Florida Caucus. And what a fantastic Future of Medicine Summit we had last month. Doctors Arrascue and Dennis did an amazing job in leading us in this meeting. We were honored to have Dr. Carmel, President of the AMA, Dr. Wilson, Past-President of the AMA, Dr. Butler, Past-President of the FMA, along with some excellent national speakers right up there with our own local experts. NOBODY can say that the Palm Beach County Medical Society is sitting around waiting to see what Washington does! I don’t think Dr. Carmel even visits all 50 states in one year, yet he came to our Summit in Palm Beach County….and it wasn’t even winter! We worked together to find common ground with our hospitals, finding ways that help them as well as helping ourselves, and under Dr. Gorfine, we are also working with the Palm Beach County Bar to find common issues with our local attorneys. We started our own health insurance plan in cooperation with the Marion County Medical Society and Blue Cross Blue Shield, which will save my office $2,000 per month. We recognized the great job being done in Medical Education in our County. The Osteopathic Residency Programs that our own Dr. Feuer leads. The Univ. of Miami that started our first Palm Beach County based Medical School in 2004, and turned it into a four-year school, and now has Residency Training Programs as well. And we welcomed FAU as they start their new Medical School Program this year, too. Our own local doctors have proven that we have quality care in our county by our ability to teach our young future doctors! I teach with the University of Miami, and our third-year students have done better than the national average on their national exams!!! But most of all, I am proud of the quality of care we provide and the access to care. When I was first diagnosed with throat cancer in October, people asked me where I was going for treatment. Sloan Kettering? Moffitt? Mayo Clinic? Cleveland Clinic? No….I said. I’m staying in Boynton Beach. I’m staying at Bethesda, because I found I have a top notch Medical Oncologist in Dr. Niederman and a top notch Radiation Oncologist in Dr. Parsons, plus the radiation equipment at Bethesda to do the job. And, I also know that my team is not

President’s Report

JAMES J. BYRNES, MD I PRESIDENT, PALM BEACH COUNTY MEDICAL SOCIETY

the only choice in this county. I know that we have other great choices in cancer care with the hospitals and medical staffs at Boca, JFK, Jupiter and Good Sam to name a few. We, and our patients, do not need to leave our county to get world-class care. We do have world-class physicians! And our physicians have class, too. You can’t imagine the number of doctors that called me and asked how they could help me! And, money was never mentioned. No strings attached. And despite my great medical team, I know I’m going to do well, too, because I’m on the prayer list of many churches, synagogues and mosques in this county! And that relationship we have among our different ethnic and religious origins should be treasured and developed. And I found that religion does play a big role in our ethics as Physicians, our dedication to our profession. We also need to move away from the PC term “Happy Holidays,” which says nothing about why our holidays started. We need to appreciate the value of each one, and learn more about each other. We need to be able to say “Merry Christmas” and “Happy Hanukkah.” We need to understand why our fellow Physicians and patients observe Ramadan, or Yom Kippur or Rosh Hashanah or Easter. We, and especially our children, are doomed to ignorance if we lose the real meanings of our holidays, of our cultures, of our origins. We are already losing Veterans Day and Memorial Day to the stores as just another reason to have a sale. Look what has happened to “Black Friday!” I want to thank Dr. Pillersdorf for giving me the opportunity and the honor of chairing a Reference Committee at the last FMA meeting. You want to make a change? Come with us as a Delegate to the FMA meeting next summer. I fully intend to be there! Just in case you think the chemo is making me soft in the head, I am more convinced than ever that we must continue to stay involved, to join together as a medical family to address our issues, and to make sure that Washington and Tallahassee get the message, even though I know it can be a very slow process. I am also more convinced that, with rare exception, we offer quality medical care in a caring manner in Palm Beach County. But in order to give that care, our Physicians must be physically and financially healthy. I look forward to 2012 under Jack Zeltzer, MD. He’ll be a great leader for us as we continue to adapt to the changes in health care in front of us. I want to thank you for giving me the honor of being your President for 2011. Would I do it again? In a New York minute! I2I


OnCall November - December 2011

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The Future of Medicine Summit V

Articles I6I

Director’s Desk

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A Happy Hippie Holiday

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Prescription For Better Health Care

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The Future of Medicine Summit V

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How to Avoid Fraud & Embezzlement in Your Medical Practice

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Med Memo

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PBCMS Membership

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Palm Beach County Medical Society

Peace and Joy Peace, love and happiness. And please don’t forget joy. Today’s medical professionals experience stress on a daily basis, and sometimes peace, love, happiness and joy don’t make an appearance in our lives as often as they should, or as we need. This is the time of year when the air gets brisk (for South Florida, at least), noses turn red (either from the chilly weather or the flu), and the snowbirds fly south to paradise on Earth and to our high quality physicians. But this is also the time when we all need to take a step back and give thanks for the positive aspects of our lives. Here at Palm Beach County Medical Society we are thankful for so much: our physician members, our trusted leaders, our Circle of Friends, our hospital and healthcare partners, our Project Access participants, our funders, our volunteers, our patients, our many friends in the community, and for each and every one of you.

Director’s Desk

TENNA WILES I CEO, PALM BEACH COUNTY MEDICAL SOCIETY

2011 Board of Directors

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

Palm Beach County Medical Society 2011 Board of Trustees

Lawrence Gorfine, MD Maureen Whelihan, MD Daniel R. Higgins, MD Jose F. Arrascue, MD Alan B. Pillersdorf, MD Brent M. Schillinger, MD

On the cover:

2011 PBCMS and Services Board of Directors at the Hippie Holiday Gala on December 3, 2011

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

Staff: Tenna Wiles, CEO Tara Auclair Ryan, Director of Marketing and Community Relations Yvonne Shapiro, Director of Communications Ashley Eckes, Director of Disaster Services Deanna Lessard, Director Member Services & Education Nicola Chung, Project Access Program Director John James, Project Access Senior Program Coordinator Maria Turkki, Project Access Program Coordinator Mindi Tingler, Administrative Assistant Natalie Gonzalez, Receptionist Lauren Tomé, Receptionist Patricia Beele, Receptionist

OnCALL Managing Editor: Tenna Wiles Advertising Assistant: Yvonne Shapiro Subscriptions to OnCALL are available for an annual rate of $50. For more information, please contact Yvonne Shapiro at (561) 433-3940.

Last OnCall Issue

Available online at pbcms.org

The opinions expressed in OnCALL 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 OnCALL does not constitute endorsement by the Palm Beach County Medical Society or its committees. 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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A Happy Hippie Holiday By Jack Zeltzer, MD

Recently we celebrated our Annual Gala and my installation as President of the PBCMS with this theme. At first glance it seemed a bit confusing Happy Holiday seems self-evident at this time of year but what relevance does the term “Hippie” have to the Holiday Season or PBCMS? Consider this definition: A Hippie is a person who was raised under the ideological system that came out of the tumultuous 1960’s in North America and Western Europe. They are either of the flower-child / baby-boomer generation or that generations’ subsequent offspring. They possess a core belief-set revolving around the values of peace and love as being essential in an increasingly globalized society, and they are oftentimes associated with non-violent groups. They are often identified by wearing long hair, colorful clothing and sandals. They are often characterized as rejecting conventional material values and the pursuit of money for a more “communal” lifestyle. This certainly seems like a pretty heavy description of a group whose thoughts and deeds are radically different from the Mainstream. But then, flashback about 2,000 years ago, and recall another long-haired, sandalwearing group whose leader was running afoul of the Mainstream of that time by professing peace, love and kindness to their Fellow Man. Even advocating non-violence by suggesting that if struck once; to simply “turn the other cheek.” Even condemning chasing the almighty dollar, actually shekel at that time, by driving the Money Changers away. The Woodstock Festival held in 1969 was the crowning jewel of that movement. Featuring the major artists of the day, it was expected to draw 60,000 people for the three days of peace and music. To everyone’s surprise, 400,000 people showed up. It was the largest gathering of humanity ever recorded for its time. Food and housing were stressed to the brink of Chaos. Yet, just as 2000 years ago, when five loaves and five fishes sufficed for the 5,000 gathered on the mountain side then to talk of peace, love and good will towards men, everyone was fed and housed with the resources available. So perhaps the Hippies and the Holidays are two sides of the same coin. The light from a single star that illuminated the heavens 2,000 years ago to proclaim the birth of a new era, whose leaders would establish the mantra “Peace on Earth, Good will towards Men.” The reason for this holiday season was rekindled in the single flick of a switch, when the stage lights went on at Woodstock and Richie Havens and all who followed sang passionately for that cause.

Do we not render these services through Project Access and other charitable clinics, valued in the millions of dollars (who knows how many shekels), without regard to the coin the “Money Changers” would demand to broker these services? Do we not constantly strive to throw the “Money Changers” out of the Temple of Medicine? Do we not concern ourselves with the greed and bureaucracy that interposes itself between us and our appointed mission of caring and healing? Do we not try to heal THIS sick and crippled SYSTEM we call Health Care? Do we not seek a better society -- a more harmonious life for our patients and ourselves? What’s that if not peace, love, and good will towards man? So it is quite apparent that PBCMS’ “raison- d’être” – its reason for existence – is clearly linked to this holiday and the Hippies. As we move forward this year, PBCMS must carry this philosophy forward. We must take cognizance of the unacceptable rate of poverty, unemployment, and inadequate health care within our community and do something about it. At the same time we must assess ourselves and be prepared for Change. Just as a star shone 2,000 years ago to herald change, and the lights lit up the Woodstock stage, PBCMS must be a beacon of light and a generator of ideas and ENERGY to create the changes that will insure that what started over 2,000 years ago, and was reiterated in 1969 will come to fruition under our watch. It’s really not that complicated. The message is simple. Just do the right thing: peace, love, good will towards man. I am proud and humbled to be appointed the leader of a society of leaders.

Well, that’s part one. Now what is the connection between the Hippies and Palm Beach County Medical Society?

Margaret Mead said “Never believe that a few caring people can’t change the world. For, indeed, that’s all who ever have.”

Clearly it’s there. The Medical Society is woven of the same fabric started 2,000 years ago, extending to Woodstock in 1969 and up to present day.

At Woodstock, Joe Cocker sang “With a Little Help from My Friends.”

Does not the Medical Society care for the poor, tend to the sick and heal the lame? I7I

Within these two statements is our formula for success.


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Benefactors Boca Raton Regional Hospital Medical Staff Danna-Gracey Delray Medical Center Medical Staff FirstPath FPIC JFK Medical Center Medical Staff MDVIP OptaComp University of Miami Miller School of Medicine Wellington Regional Medical Center Wellington Regional Medical Center Medical Staff Table Sponsors Bethesda Memorial Hospital Medical Staff Dr. and Mrs. William Adkins Dr. James J. Byrnes Dr. and Mrs. Michael Dennis Dr. and Mrs. Larry Gorfine Dr. and Mrs. Jack Zeltzer JFK Medical Center Jupiter Medical Center Performance Data Rheumatology Associates of South Florida TD Bank Sponsors Acevedo Consulting, Inc. Alpern Rosenthal CareCloud Florida Power and Light Company Health Care District of Palm Beach County Keiser University Medical Specialists of the Palm Beaches Palm Beach Surgical Associates Shutts and Bowen

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2011 PBCMS Annual Gala Thank You to Our Sponsors

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1. Brent Schillinger MD, James J. Byrnes, MD, Alan B. Pillersdorf, MD 2. Shawn Baca, MD, Richard Greenwald, MD, Joan St Onge, MD, Michael Dennis, MD, Stephen Babic, MD 3. Malcolm Dorman, MD, Daniel Higgins, MD, Randy Gershwin, MD, William Adkins, MD, Richard Shugarman, MD 4. Tom Murpy, Lori Murphy, Cheryl LaRose, Matt Gracey 5. Mrs. Ivy and Dr. Andrew Larson 6. James J. Byrnes, MD, receives the Excellence in Medicine Award presented by Jose F. Arrascue, MD 7. Mrs. Susan and Dr. Randy Gershwin, Drs. Ileana and Bradley Feuer 8. Michelle and Jonathan Satter 9. Mrs. Kathy and Dr. Douglas Dedo, Drs. Henry and Ramsey K. Pevsner 10. Mrs. Naina and Dr. Harish Madhav, Dr. Kutty and Amie Chandran, Dr. Alan B. Pillersdorf 11. Dr. Kenneth and Gina Woliner, Mrs. Joan and Dr. Stephen Babic 12. The 1919 Society Members: Dr. J. John and Judy Goodman, Dr. Michael and Phyllis Dennis, Jose F. Arrascue, MD, Malcolm Dorman, MD 13. Dr Sarah Ferrer-Bruker, Zak Bruker, Dr Jack Groh, Dr Jamie Bosma 14. Alan B. Pillersdorf, MD and Maureen Whelihan, MD 15. Jose F. Arrascue, MD, Miguel Machado, MD, Jack Zeltzer, MD, Brent M. Schillinger, MD, James J. Byrnes, MD 16. Lila S. Chertman 17. Jack Zeltzer, MD

Circle of Friends Abacoa Insurance Group, Inc. Broad and Cassel Comerica Eppy Financial Interim Healthcare MetLife MorganStanley Proffitt Management Solutions SunTrust Bank The Florida Healthcare Law Firm Special Thanks Blue Ocean Press J & R Printing

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Do you want to get you or your company name in front of 1,300 physicians? If the answer is YES, then consider becoming a Circle of Friends member. Benefits include: • Invitations to all PBCMS sponsored events • First opportunity for event sponsorship • Access to our physician database • Listed on our PBCMS website • Ads in On Call magazine (depends on package) • Letter of endorsement from PBCMS • Company profile in Medlink, PBCMS’ weekly electronic newsletter

For more information on our Circle of Friends program, advertising or event sponsorship, call 561-433-3940.


OnCall November - December 2011

PRESCRIPTION FOR BETTER HEALTH CARE 2012 Legislative Agenda

The 2012 Florida Legislature will begin on January 10, 2012. Palm Beach County Medical Society’s Council on Legislation and Advocacy works in partnership with the Florida Medical Association to ensure that the interests of our physician members and their patients are well represented. In addition to dealing with the pressing legislative issues facing our state, this year the Florida Legislature is responsible for reapportionment of Congressional Districts. Opportunities for physician member involvement include serving as a Key Contact for legislator, serving as Doctor of the Day in Tallahassee, and participating in Palm Beach County Doctor’s Day in Tallahassee. For additional information on the issues, how to become involved and a listing of the Palm Beach County Delegation visit www.pbcms.org

The FMA’s Prescription for Better Health Care in Florida

Good for Florida’s Patients and Supported by the FMA

1) Improve Floridians’ access to health care by passing meaningful reforms to the broken medical liability system.

• Medical liability reforms that will improve Florida’s ability to attract and retain quality physicians.

2) Eliminate burdensome regulations imposed by government bureaucrats and insurance companies so that physicians can do what they do best: Take care of patients.

• Less interference and red tape from government and insurance companies so that physicians can focus on their patients and not paperwork.

3) Adopt managed care reforms that protect the economic viability of medical practices in Florida.

• Adequate physician Medicaid payment, which is essential for patient access.

4) Protect Florida’s patients and ensure high-quality health care by opposing legislation to allow non-medical doctors to independently practice medicine beyond the scope of their education and training.

• Increased funding for graduate medical education so young physicians can stay in Florida and not be exported to other states.

5) Address Florida’s physician shortage and keep the graduates of Florida’s medical schools in our state by supporting increased funding for graduate medical education. 6) Save lives and improve Floridians’ quality of life by supporting public health initiatives.

• Preventive health measures for all children and families. Harmful to Florida’s Patients and Opposed by the FMA • An out-of-control litigation system that drives up the cost of health care and limits access to care in Florida. • Government, hospital and insurance company interference in the patient-physician relationship. • Non-medical doctors practicing medicine beyond the scope of their education and training. • Fraud and abuse in the Medicare, Medicaid, and PIP programs that add unnecessary costs to the healthcare system. • Further exemptions to Florida law related to vaccines and immunization requirements. I 12 I


Palm Beach County Medical Society & MEDPAC 2012 Legislative Reception & State of Medicine Dinner Thursday, January 5, 2012 5:30 PM Registration & Networking 6:30 PM Dinner & Program Hilton Palm Beach Airport 150 Australian Avenue, West Palm Beach No charge for PBCMS Members $50 guests and non-members RSVP: 561-433-3940 or www.pbcms.org

Guest Speakers:

Senator Ellyn Setnor Bogdanoff Chair, Palm Beach County Legislative Delegation Pete Martinez Chairman of the Board, Palm Beach Medical Education Corp. Jack Zeltzer, MD President, Palm Beach County Medical Society


The Future of Medicine Summit V Shaping Our Future – Together The premise that the healthcare industry affects us all – whether we give care, get care, or pay for care – was the focus of this year’s three-day summit from October 27-29 held at the Palm Beach County Convention Center. The record 600 attendees from all areas of business in the county enjoyed national thought leaders discussing relevant issues with Palm Beach County physicians, health policy experts, hospital administrators, researchers, business executives and community representatives. Scripps Florida co-sponsored the conference and related speakers – together with local physician and community experts – discussed research breakthroughs and treatments for oncology, obesity and healthy aging. Another general session brought women from Palm Beach and Broward counties together to discuss various aspects of women’s health issues covering the mind, body and sex.

The first annual poster symposium drew 26 entries and physicians from each medical school in the county served as judges. Many congratulations to all of our 26 poster symposium applicants, and we want to especially commend the winners. In the Research category: Katherine Fyall, MS4, University of Miami Miller School of Medicine (Regional Campus student). Winners in the Clinical Vignettes category: First Place: Arjun Mohan, MBBS, MD, University of Miami Palm Beach Regional Campus Medicine Residency Program. Second Place: Megha V. Rao, MD, University of Miami Palm Beach Regional Campus Medicine Residency Program. Third Place: Omodele Awoniyi, MD, University of Miami Palm Beach Regional Campus Medicine Residency Program.

The importance of shaping the future of health care in the county by looking comprehensively at medical education, cost, quality and access was debated among several area and national experts. The premise that the future health of Palm Beach County residents will be determined by how professionals from across various industries collaborate for change provided thoughtprovoking discussion that will no doubt contribute to the Future of Medicine roadmap. Area lawyers provided legal updates valuable to physicians, and physicians heard how technology will impact the practice of medicine moving forward.

Many thanks to all of our speakers and panelists, and especially our keynote guests including Madelyn Butler, MD; Peter Carmel, MD; Sharron DiMario; Jeff Goldsmith, PhD; Alice G. Gosfield, Esq.; TR Reid; Mary Jane Saunders, PhD; Cecil Wilson, MD. There are so many to thank who helped make the Future of Medicine Summit V such a resounding success. Our Steering Committee including Jose F. Arrascue, MD, Chair; James T. Howell, MD, Co-Chair; Michael Dennis, MD, Summit Chair; Stephen Babic, MD; Cynthia Clayton, MD; Claude Earl Fox, MD; Daniel Higgins, MD; and Brent M. Schillinger, MD. The Boards of Palm Beach County Medical Society and Palm Beach County Medical Society Services. Our many sponsors: Dr. Michael Dennis, Community Partners and Friends, Exhibitors, Non-

Profit Advocates, Medical Student Sponsors and In-Kind Supporters. And many thanks to our engaged Future of Medicine Host Committee: Francisco Acosta; Alina Alonso, MD; Jose F. Arrascue, MD; Mary Barnes; Bob Broadway; Davide Carbone; Don Chester; Cynthia Clayton, MD; John D. Couris; Corinne Danielson; Michael Dennis, MD; Trish Ernst; Charles Felix; Claude Earl Fox, MD; Shawn Griffin; Rick Herman; James T. Howell, MD; Mike Jones; Christine Koehn; Trish Lowry; Stuart Markowitz, MD; Heather Siegel Miller, Esq.; Linda Quick; Brent M. Schillinger, MD; Ben Starling; Andrea Stephenson; Joan St. Onge, MD; Marge Sullivan; Marcia Teele; Patsy Westall; Maureen Whelihan, MD; and Ronald Wiewora, MD.

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Discussions Relevant to Physicians, Other Healthcare Providers, and General Public - 600 attendees

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1. Tisa James Carver, Brenda Valdez-Chinapoo, Roger Royal, Mayor Jeri Muoio, Michael J. Carmichael, MD in front of Bethesda Memorial Hospital’s DaVinci robot display 2. Richard Greenwald, MD, Dervi Ganesh, Michael Dennis, MD, Joan St. Onge, MD 3. Brent Schillinger, MD, James T. Howell, MD and Claude Earl Fox, MD, MPH 4. Bob Broadway, Karyl Gordon-Darley, Tisa James Carver, Roger L. Kirk, James A. Farrell, Esq., Terri McMunn, Roger Royal, Timothy E. Monaghan, Esq. 5. Michael Dennis, MD,


OnCall November - December 2011

It is because of all of you that we can continue to provide this valuable programming for the community.

University of Miami Miller School of Medicine

Community Leader Michael Dennis, MD Community Partner Bethesda Memorial Hospital Boca Raton Regional Hospital Medical Staff Cleveland Clinic Florida Health Care District of Palm Beach County JFK Medical Center Medical Staff South Florida Palliative Medicine Specialists, Inc.

Premier Exhibitor 1450 Inc. Abacoa Insurance Group Abaco Accounting & Payroll Services, Inc, Chase Comerica Danna-Gracey IOS Health Systems Janus Center for Psychiatric Research PNC Bank Practice Communications, LLC VITAS Palliative Care Solutions

Community Friend Delray Medical Center FirstPath Lab Florida Public Health Institute JFK Medical Center Jupiter Medical Center Palm Healthcare Foundation Shutts & Bowen

Exhibitor Alzheimer’s Community Care Arden Courts Barrett, Liner & Company Behavioral Health of the Palm Beaches Blue Cross and Blue Shield of Florida

Caregiver Services, Inc. Eppy Financial Group Fit to the Max Wellness - Solutions for Your Practice Health Care REIT – Management Services Group Lubell & Rosen Reliance Home Health Care South Florida Regional Extension Center Non-Profit Advocates Alzheimer’s Association, Southeast Florida Chapter Area Agency on Aging Children’s Services Council Diabetes Education & Research Center Florida Dept. of Health – Bureau of Vital Statistics Mental Health Association Palm Beach County Division of Senior Services Palm Beach Infectious Disease Institute Palm Beach County Library System, Main Library

Quantum House Sari Asher Center for Integrative Cancer Care The Leukemia & Lymphoma Society Medical Student Sponsors Cynthia Clayton, MD Michael Dennis, MD Daniel Higgins, MD James T. Howell, MD Jack Zeltzer, MD In Kind Suporters AMA DocMD The Alliance for Eating Disorders Awareness Scripps Florida South Florida Hospital News & Healthcare Report West Palm Beach VA Medical Center FMA WFLX Fox 29

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James J. Byrnes, MD, Mary Jane Saunders, PhD 6. Cecil Wilson, MD 7. Drs. Kathleen Minnick, Tayla Kupin, Maureen Whelihan, and Addie Dissick 8. Jose Arrascue, MD, T.R. Reid, James A. Farrell, Esq. 9. Mark L. Brody, MD, Joseph G. Ouslander, MD, Juergen Bludau, MD, Roy G. Smith, PhD 10. Tim Monahan, Esq., Judy Goodman, Esq., Jean Acevedo, James Farrell, Esq., Heather Siegel Miller, Esq., Jeff Cohen, Esq. 11. Georges Hatoum, MD, Louise Morrell, MD, Jerome Spunberg, MD, Scott Busby, PhD, Claude Earl Fox, MD, MPH 12. Michael Jones, Sharron DiMario, Jonathan Gavras, MD 13. James J. Byrnes, MD, viewing Bethesda Memorial Hospital’s DaVinci robot display

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How to Avoid Fraud & Embezzlement in Your Medical Practice By Tammy B. Clarke, CPA, MTx, Director, Healthcare Industry Services

Practitioners are always looking for ways to increase their bottom line, and this usually means earning more and spending less. Often overlooked in the search for cost-cutting measures is fraud prevention. In 2010, The Association of Certified Fraud Examiners estimated that organizations worldwide lose 5 percent of their annual revenues to fraud. A medical practice with just a few employees may well be suffering losses in excess of $10,000 every year, and this will directly impact the practice’s net income. Some doctors believe that the fraud costs are immaterial, while others insist that the expense of implementing controls outweighs the benefits. Unfortunately, industry averages prove both of these wrong. Recognizing this as a real threat is the first step in reducing your risk. A survey released by the Medical Group Management Association in November of 2010 reported that a startling 83 percent of 688 practice managers were at one point affiliated with a medical office where employee theft occurred. This survey also revealed that 18 of these types of losses involved a theft of $100,000 or more. Some types of occupational fraud include: • Skimming – Removal of cash from company prior to its entry in the accounting system; • Cash larceny – Intentional taking of company’s cash without knowledge or consent; • Asset misappropriation – Use of company assets for personal gain; • Payroll fraud – Fraudulent disbursement to fake (ghost) employees or submission of false hours; and • Expense schemes – Induce company to make fraudulent disbursements based on fraudulent documentation. Regrettably, most fraud is committed by trusted employees. Financial pressures can lead an otherwise honorable person to do dishonest things. The combination of financial need and poor internal controls can result in disastrous losses, especially if a business’ insurance does not cover the entire loss. In other words, employees commit fraud simply because they think they won’t get caught. Sometimes they start embezzling small amounts of cash that later escalates when it’s clear that no one is watching. The point is, at least one doctor in the practice should be watching and reviewing. Below are some red flags to look out for: • • • • •

Reduced cash flow even though receipts have been strong Receipts do not seem consistent with patient visits Transactions lacking proper documentation or approval Increasing accounts payable Complaints about recording of payments from the patient and/or payer

The good news is that practitioners have many ways to protect themselves and it starts with good internal controls. Specifically, it is very important that certain employee duties are segregated, even in small practices with a

limited number of staff. The following responsibilities should be separated as much as possible with at least two sets of eyes looking at every transaction: • Asset handling and disposition (the physical access to checks, cash, credit cards, inventory, etc.) • Accounting/bookkeeping (maintaining the company’s general ledgers, cash disbursement & receipt journals, inventory counting, etc.) • Authorization and approval (reviewing transactions) For example, the person who prepares the deposit should not be the same person who physically brings the money to the bank and the person at the front desk who collects the money should not reconcile the books at the end of a period. These are just a few specific areas that are very susceptible to employee theft and properly segregating these types of tasks are imperative. The following are five additional techniques that can be implemented in advance to prevent medical practice fraud: 1.) Perform background checks on all new hires. 2.) Audit the cash drawer on a daily basis. 3.) Review all bank statements, perhaps even having them mailed directly to an owner’s house. 4.) Audit payroll records on a regular basis to prevent unauthorized raises, bonuses or overtime pay. 5.) Let the employees know that someone is watching them; not in a petty or mistrusting way, but as a prudent and responsible business practice.

Alpern Rosenthal, certified public accountants and business advisors, located in West Palm Beach, offers specialized fraud prevention services, which can help detect areas of weakness in a business. Spending a little time and effort to deter and prevent fraud now can save large amounts of money and headaches in the future. For more information contact Tammy Clarke at tclarke@alpernfl.com or 561-689-7888.

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Med Memo November – December 2011 Congratulations to the 2012 PBCMS Board of Directors Jack Zeltzer, MD President K. Andrew Larson, MD President Elect, Chair, Leadership Development Council Ronald Zelnick, MD First Vice President, Chair, Council on Membership & Member Services Stephen Babic, MD Second Vice-President, Chair, Council on Legislation & Physician Advocacy Malcom Dorman, MD Secretary, Co-Chair, Council on Finance & Governance

James T. Howell, MD Treasurer, Chair, Council on Finance & Governance

Mark Brody, MD

Daniel Higgins, MD

Shawn Baca, MD

Andrew Shapiro, MD

Lawrence Gorfine, MD

James J. Byrnes, MD Past President, Leadership Development James Goldenberg, MD Roger Duncan, MD Beth Lesnikowski, MD

Richard Shugarman, MD

Hatem Abou-Sayed, MD

Brandon Luskin, MD

Michael Dennis, MD

Harish Madhav, MD

William R. Adkins, MD

PBCMS AND MEDPAC

2012 Legislative Reception & State of Medicine Dinner January 5, 2012. Hilton Palm Beach Airport, 150 Australian Avenue 5:30 pm - Registration & Networking 6:30 pm – Dinner & Program Guest Speakers: Senator Ellyn Bogdanoff; Pete Martinez, Chairman of the Board, Palm Beach Medical Education Corp.; Jack Zeltzer, MD, President Palm Beach County Medical Society; Ralph Nobo, Vice President, Florida Medical Association No charge for PBCMS Members. $50 guest and nonmembers. Register at www.pbcms.org or call 561-433-3940.

Jose F. Arrascue, MD

Richard Greenwald, MD

Karen Flannery, MD

Joan St Onge, MD

Brent Schillinger, MD

Jeffrey Bishop, DO

Kenneth Woliner, MD

David Soria, MD Jeffrey Wisnicki, MD

Mark Rubenstein, MD

Randy Gershwin, MD

Alan B. Pillersdorf, MD

Jeff Davis, DO

Maureen Whelihan, MD

EDUCATIONAL OPPORTUNITIES

January 22, 2012. Twenty-Sixth Annual Sanford H. Cole, MD Memorial OB/GYN Symposium. Miami Marriott Dadeland. February 16-18. Miami Robotics Symposium, Marriott Miami Dadeland Hotel Florida. February 23-26. Cardiovascular Disease Prevention: Tenth Annual International Comprehensive Symposium. Fountainbleau, Miami Beach, Florida. For additional information contact maidap@baptisthealth.net or call 687596-1667.

OFFICE MANAGER’S INSTITUTE SERIES

SAVE THE DATE

Topics are as follows: January 28: Health Care Reform 101 March 21: ICD-10 Coding Tips to Avoid Denials May 18: Accountability – People Do Exactly What We Let Them Do

FAU Names Dr. David J. Bjorkman Dean of the Charles E. Schmidt College of Medicine.

Delray Beach Country Club, 2200 Highland Avenue, Delray Beach The third Wednesday of each month. 11:30 am – 1 PM $25 charge for each lunch program for PBCMS members and their staff $35 charge for non-members and their staff.

Airport Hilton, West Palm Beach The first Wednesday of each month (except for January) January 11: Coding & Compliance 2012 February 1: Goggle Plus March 7: How to Handle Difficult Employment Situations April 4: Stark and Anti Kick Back Laws & Other Hot Legal Issues May 2: Managed Care Contracting – It’s More Than Just the Rate June 6: Managing Your Denials Register at www.pbcms.org

May 9, 2012. Heroes in Medicine Awards luncheon at the Kravis Center Cohen Pavilion.

Florida Atlantic University has named David J. Bjorkman, M.D., M.P.H., as the dean of the Charles E. Schmidt College of Medicine. In his new role, Bjorkman will take the lead in the development of FAU’s new medical school. Dr. Bjorkman will provide the highest quality educational experience for physicians in training; encourage and nurture collaborative and interdisciplinary relationships with other colleges and schools within FAU. I 20 I


PBCMS Membership Applicants Rashmi K. Benda, MD 701 NW 13th Street, Boca Raton, FL 33486 Phone: 561955-4111 Fax: 561-955-4894 Specialty: Radiology - Radiation Oncology Medical School: University of Miami 1994 Internship: Sinai Hospital of Detroit 1994-1995 Residency: Wayne State University 1995-1998 Board Certification: American Board of Radiology Hospital Affiliations: Delray Medical Center Viviane Conner, MD 525 Okeechobee Blvd., 14th Floor, West Palm Beach, FL 33401 Phone: 561-804-0200 Fax: 561-804-0222 Specialty: Gynecology Medical School: Boston University 1984 Internship: George Washington Hospital 1984-1985 Residency: George Washington Hospital 1985-1988 Board Certification: American Board of Obstetrics & Gynecology Hospital Affiliations: Cleveland Clinic Florida Samer Fahmy, MD 160 JFK Drive, Suite 102, Atlantis, FL 33462 Phone: 561-5481450 Fax: 561- 548-1459 Specialty: Internal Medicine Medical School: American University of the Carribean 2003 Residency: St John’s Hospital 2004-2007 Board Certification: None Hospital Affiliations: JFK Medical Center. Sam M. Faradyan, MD 525 Okeechobee Blvd, 14th Floor, West Palm Beach, FL 33401 Phone: 561-804-0200 Fax: 561-804-0222 Specialty: Pulmonary Disease Medical School: George Washington University 2002 Internship: St Elizabeth Medical Center 2002-2005 Residency: Roger Williams Medical Center 2005-2007 Fellowship: Rhode Island Hospital/Brown University 2007-2008 Board Certification: American Board of Internal Medicine- Internal Pulmonary Disease & Critical Care Medicine Hospital Affiliations: Cleveland Clinic Date of Birth: 5/18/1977. Jason J. Gorscak, MD 1717 Woolbright Road, Boynton Beach, FL 33426 Phone: 561-737-5500 Fax: 561-737-7055 Email: jgorscak78@gmail.com Specialty: Opthalmology Medical School: University of Miami 2004 Hospital Affiliations: Wellington Regional Medical Center & Bethesda Memorial Hospital Date of Birth: 2/24/1978. Ophelia J. Mall, MD 12408 Equine Lane Wellington, FL 33414 Specialty: Neonatal-Perinatal Medicine Medical School: Dow Medical College 1970 Internship: Franklin Square Hospital 1970-1971 Residency: John Hopkins University 1971-1973 Fellowship: Med Univ of SC 73-74 & Boston City Hosp 74-76 Board Certification: American Board of Pediatrics - Pediatrics & Neonatal-Perinatal Medicine Hospital Affiliations: Palms West Hospital Date of Birth: 11/28/1945. Thomas F. Mann, MD 525 Okeechobee Blvd., 14th Floor, West Palm Beach, FL 33401 Phone: 561-804-0200 Fax: 561-804-0222 Specialty: Internal Medicine Medical School: West Virginia University 1977 Internship: CAMC/ West Virginia University 1977-1978 Residency: CAMC/ West Virginia University 1978-1980 Board Certification: American Board of Internal Medicine- Internal Medicine and Hospice & Pallative Medicine Hospital Affiliations: Cleveland Clinic Florida Date of Birth: 3/12/1951. Heinz Munter (Retired) Phone: 561-208-1632 Specialty: Internal Medicine Medical School: University of Zurich 1962 Date of Birth: 8/28/1929.

Diane Scott, MD 470 Columbia Dr., Suite 102A, West Palm Beach, FL 33409 Phone: 561-640-4400 Fax: 561-640-8098 Specialty: Dermatology Medical School: George Washington University 1996 Internship: George Washington University 1996-1997 Residency: University of Alabama 1997-2000 Fellowship: Albany Medical Center 2000-2001 Board Certification: American Board of Dermatology- Dermatology & Dermatopathology Hospital Affiliations: Good Samaritan Kari Sutter, MD 525 Okeechobee Blvd, 14th Floor, West Palm Beach, FL 33401 Phone: 561-804-0200 Fax: 561-804-0222 Specialty: Rheumatology Medical School: University of Miami 2002 Internship: University of Miami / Jackson 20022003 Residency: University of Miami / Jackson 2003-2005 Fellowship: University of Texas Houston 2006-2008 Board Certification: American Board of Internal Medicine- Internal Medicine & Rheumatology Hospital Affiliations: Cleveland Clinic Florida Date of Birth: 11/15/1977. Alberto Tano, MD 5955 Ponce De Leon Blvd Coral Gables, FL 33146 Phone: 305-661-1515 Fax: 305-662-3723 Specialty: Neonatal-Perinatal Medicine Medical School: University CETEC 1982 Internship: New Rochelle Hospital 19831984 Residency: Children’s Hosp of Buffalo 1984-1987 Fellowship: Georgetown University Hospital 1987-1989 Board Certification: American Board of Pediatrics Neonatal-Perinatal Medicine Hospital Affiliations: West Boca Medical Center Date of Birth: 2/26/1961.

Physician Assistants

Cheryl Ann Leslie, PA 1500 Lee Blvd., Lehigh Acres, FL 33936 Phone: 561-283-4388 Fax: 888-740-6923. Josephine Romero, PA 1500 Lee Blvd., Lehigh Acres, FL 33936 Phone: 561-283-4388 Fax: 888-740-6923. Joyce Lynn Wagner, PA C 1500 NW 498th Street Ft. Lauderdale, FL 33309 Phone: 954-776-4456 Fax: 954-928-0196

Residents: JFK Medical Center Elizabeth Marsicano, MD Deborah Miriam Unger, Meha Venkatasubba Rao, MD

Residents: Palms West Hospital David Anderson, DO Kristen Maria Borchetta, DO Michael Borchetta, DO

Residents: Wellington Regional Medical Center Kelvin Osagie Akhigbe, DO Kanwal Kamal Akhtar, DO Swat Chalavarya, DO

Stephen Mathew Derrington, DO Marcia Ellen Hoffheimer, DO Farhan Rashid Israr, DO Adam McDaniel, DO. Melissa Rose Mora, DO Arpit Vinay Patel, DO Gregory Andrew Polar, DO William Michael Stechschulte, DO Keith Nelson Thompson, DO Alissa Tomaiolo, DO Marianna Zelenak, DO.

Medical Students

Alan Barnes Ashley Eville Sara Therese Shepard

Classified Ads OFFICE SPACE AVAILABLE Long time practicing physician would like to share office space and parking with another physician. Great location near Good Samaritan Medical Center. Contact John Schmid 561-832-3212. MEDICAL OFFICE SPACE AVAIlABLE FOR RENT Medical office Space available for rent Monday’s & Friday’s. Includes 2 exam rooms, one procedure room. Located ½ mile from Delray Medical Center. Please contact Lewis (561) 694-9493 / LBergman@wederm.com. MEDICAL OFFICE SPACE FOR LEASE OR SALE 1400 Sq. Ft. medical office, fully equipped, perfect for internist or group, centrally located off Palm Beach Lakes Blvd. in West Palm Beach. Available for full or part-time lease or sale. Call 954-547-7991. or 561685-2613.

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PAID WEST PALM BEACH, FL PERMIT NO. 515

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

Make a Difference An old man walked up a shore littered with thousands of starfish, beached and dying after a storm. A young man was picking them up and flinging them back into the ocean. “Why do you bother?” the old man scoffed. “You’re not saving enough to make a difference.” The young man picked up another starfish and sent it spinning back to the water. “Made a difference to that one,” he said. You make a difference, every day.


On Call - The Journal of Palm Beach County Medical Society (November-December 2011)