OnCall Quarter 3 - 2014

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THE OFFICIAL PUBLICATION OF THE PALM BEACH COUNTY MEDICAL SOCIETY

QUARTER THREE 2014

MEDICAL MARIJUANA: HOW DOES IT IMPACT PHYSICIANS?

ALSO IN THIS ISSUE


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President’s Report Ronald Zelnick, MD President, Palm Beach County Medical Society

This May, I attended my 30th medical school class reunion at Albany Medical College in Albany, NY. In 1984, my average yearly medical school tuition was $14,000, and room and board was $6,000, for a total average of $20,000 per year. My total medical school cost was approximately $80,000. My college tuition at George Washington University averaged $5,000 per year for a total cost of $20,000. The sum total of my college and medical school education was $100,000. Our local Florida Atlantic University medical school tuition (including room and board) is $52,000 for in-state residents, and $92,000 for out-of-state residents. Today’s entering class at Albany Medical School will pay approximately $80,000 per year for tuition and room and board. And, if that same medical student applied for loans to attend the same private university, that student would be faced with re-paying loans of approximately $600,000. In his article in The Washington Post, The outrageous cost of working in medicine, former U.S. Secretary of Health and Human Services Dr. Louis W. Sullivan notes that over the past two decades, medical school education tuition has increased by 312% in public institutions, and 165% in private medical schools. This has left graduating doctors with enormous amounts of student debt. Dr. Sullivan notes that nearly 60% of medical students come from families with incomes in the top 20% of the nation, while only 3% come from families with income in the lowest 20%. The result has been that

many would-be doctors are dissuaded from pursuing a career in medicine. According to an article in the New England Journal of Medicine, the cost of attending medical school is the numberone reason why minorities do not apply to medical school.

Medical School Debt South Florida Caucus

With a projected need for 124,000 physicians in the United States in the next 10-20 years, the PBCMS recognizes the need to encourage young physicians graduating from our state medical schools and residents training in specialties with high malpractice costs to remain in Florida. Consequently, this year, our South Florida caucus (Dade, Broward and Palm Beach County medical societies) submitted a resolution for consideration at the Florida Medical Association meeting (July 25-28, 2014), asking the FMA to support legislation to provide for loan forgiveness for practicing physicians in under-served specialties or geographic locations in Florida.

Whereas, the debt on average for young physicians is $250,000+

I am pleased to report that our resolution submitted by Dr. Steve Babic, President-Elect of the PBCMS received strong support from the FMA House of Delegates. The resolution was referred to the FMA Board of Governors.

Whereas, more than 50% of medical school graduates in Florida, leave Florida for additional training and never return to Florida to practice.

Whereas, Florida will not have enough medical doctors to care for its expanding population. Whereas, residents presently trained in neurosurgery and obstetrics and gynecology are leaving Florida because of the malpractice crisis. RESOLVED, that the FMA in conjunction with the medical schools and residency programs, petition the legislature to devise a program to provide Loan Forgiveness for physicians practicing in underserved specialties or geographic locations in Florida. Please continue to let us know your concerns. The PBCMS serves you.

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Palm Beach Illustrated is proud to support

Palm Beach County Medical Society 561.659.0210 | palmbeachillustrated.com


Contents PBCMS Staff Tenna Wiles, CEO Tennaw@pbcms.org Deanna Lessard, Director of Member Services & Education Deannal@pbcms.org Helena Edie, Finance Finance@pbcms.org Mindi Tingler, Administrative Assistant Mindit@pbcms.org Lauren Tome, Meeting and Events Coordinator Laurent@pbcms.org Nicola Chung, Project Access Program Director Nicolac@pbcms.org Melissa Nicoleau, Project Access System Coordinator Melissan@pbcms.org Sadia Peck, Senior Project Access Program Coordinator Sadiap@pbcms.org

Board of Directors Ronald Zelnick, MD President Stephen Babic, MD President-Elect James Goldenberg, MD First Vice-President Shawn Baca, MD Secretary Brandon Luskin, MD Treasurer K. Andrew Larson, MD Immediate Past President Marc Hirsh, MD Member at Large Vijay B. Harpalani, MD Member at Large

Articles

07 08 10 11 17 18

Thomas Sebastian, Project Access System Navigator Thomass@pbcms.org John James, Director of Disaster Services Johnj@pbcms.org Natalie Gonzalez, Administrative Assistant Natalieg@pbcms.org Stuart Miro, MD, Triple Aim Diabetes Initiative Stuartm@pbcms.org Sherra Sewell, Marketing and Events Sherras@pbcms.org

On Call Magazine is designed by Form G Design

H. Daniel Adams Vincent Apicella, DO Sandra Blair Michael Dennis, MD Roger Duncan, MD Brad Feuer, DO James Howell, MD Tulisa Hanflink LaRocca, MD Beth-Ann Lesnikoski, MD Alan Pillersdorf, MD Jack Zeltzer, MD

Alan Pillersdorf, MD New FMA President Power Listening: 4 Steps to Conversation Success Medical Marijuana Laws on Practice of Medicine Florida’s New “Charlotte’s Web" Medical Marijuana Law Integrating Your Electronic Systems Healthcare Change is Not Coming. Healthcare has Changed!

Features

03 22

President's Report Welcome New Members

info@formgdesign.com or www.formgdesign.com

Subscriptions to On Call are available for an annual rate of $50. For more information contact PBCMS at (561) 433-3940. The opinions expressed in On Call are those of the individual authors and do not necessarily reflect official policies of Palm Beach County Medical Society or its committees. On call is owned and published four (4) times per year by Palm Beach County Medical Society, Inc., Forest Hill Blvd., #101, West Palm Beach FL33406. (561) 433-3940 & (561) 276-3636. ©Copyright 2013 Palm Beach County Medical Society, Inc.

Board of Trustees Brent Schillinger, MD Chair Jose F. Arrascue, MD Steven Babic, MD Shawn Baca, MD Malcolm Dorman, MD James Goldenberg, MD Lawrence Gorfine, MD K. Andrew Larson, MD Alan Pillersdorf, MD Ronald Zelnick, MD Jack Zeltzer, MD

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Florida Medical Association Installs Alan B. Pillersdorf, MD, As its 138th President The Florida Medical Association installed Alan B. Pillersdorf, MD, as its 138th President on Saturday, July 26 during the 2014 FMA Annual Meeting at the Hilton Orlando Bonnet Creek. Dr. Pillersdorf, who is board certified in plastic surgery and general surgery, is President of Plastic Surgery of Palm Beach, P.A. “Dr. Pillersdorf truly believes in the power of physician unity through organized medicine,” said FMA Executive Vice President Timothy J. Stapleton. “He has a deep knowledge of the forces affecting patient care and will challenge the FMA to do even more in the coming year to help physicians practice medicine.” Dr. Pillersdorf received his medical degree from the Georgetown University School of Medicine in Washington, D.C. He completed his residency training in general surgery at Georgetown University and his plastic surgery residency at Nassau County Medical Center in New York. In addition to his FMA leadership, Dr. Pillersdorf served as President of the Palm Beach County Medical Society He currently serves as a member of the PBCMS Board of Directors, Board of Trustees and member of Palm Beach County Medical Society Services Board of Directors. He is a founding member of the 1919 Society and Project Access. Dr Pillersdorf is a recipient of the PBCMS Excellence in Medicine Award and has been recognized as a PBCMS Hero in Medicine. In addition, Dr. Pillersdorf has served as President of the Palm Beach County Society of Plastic Surgeons, President of the Florida Chapter of the American College of Surgeons and as Delegate to the American Medical Association. He succeeds W. Alan Harmon, MD, who served as the FMA’s 137th President from 2013-2014. Other FMA officers are: President-Elect Ralph J. Nobo Jr., MD; Vice President David J. Becker, MD; Secretary John N. Katopodis, MD; Treasurer Ronald F.

Dr. Pillersdorf is installed as President

Allen B. Pillersdorf, MD, FMA President

Giffler, MD; Speaker Corey L. Howard, MD; and Vice Speaker David McKalip, MD Alan Pillersdorf MD was re-elected as a Delegate to the AMA, Jose Arrasue, MD, was re-elected as an alternate delegate to the AMA. Mark Rubenstein, MD, will complete his term as an alternate delegate. Palm Beach County Medical Society was represented at the Florida Medical Association Annual Meeting by Jose Arrascue, MD; Shawn Baca, MD; Ivy Faske, MD; James Goldenberg, MD; Donald S. Grossman, MD; Marc Hirsh, MD; K. Andrew Larson, MD; Jeffrey F. Linder, MD; Harish Madhav, MD; Emanuel Newmark, MD; Norman Henry Pevsner, MD; Mark Rubenstein, MD; Richard G. Shugarman, MD; Kenneth Woliner, MD; Jack Zeltzer, MD; Maureen Whelihan, MD; Stuart Himmelstein, MD; and Jeffrey Berman, MD, led by President Ronald Zelnick and Stephen Babic, MD, who served as chair of the South Florida Caucus. Highlights of the meeting include positions on Medicaid Expansion, Medical School Debt, and Maintenance of Certification. A summary of House of Delegates actions is on www.pbcms.org

PBCMS Delegates

PBCMS physicians are well represented this year on FMA Councils and Committees Council on Medical Services and Health Care Delivery; Mark Rubenstein MD, Chair Advisory Group on Scope of Practice; Jack Zeltzer MD Committee on Accreditation and CME; Jeffry Berman MD Advisory Group Health Information Technology; James Goldenberg MD Advisory Group in Large Group Employed Physicians and Hospital Issues; Mark Rubenstein MD, Jose Arrascue MD, Peter Lamelas MD, Shawn Baca MD Committee on Government Programs; Jose Arrascue MD, Chair; Mark Hirsh MD Task Force on Future of Medicine – Jose Arrascue MD

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Power Listening: 4 Steps to Conversation Success By Nancy Proffitt

I only wish I could find an institute that teaches people how to listen. Business people need to listen at least as much as they need to talk. Too many people fail to realize that real communication goes in both directions. ~ Lee Iacocca Listening may be the most important, yet least developed, skill for personal and professional success, especially in today’s fast-paced business climate.

Good listening skills can help: • Secure a promotion or great assignment • Facilitate the right alliances • Foster sales and team alignment • Create healthy personal relationships • Find out what you don’t know • Make the right decisions • Develop innovative ideas Many people take listening skills for granted, focusing instead on how to articulate their own views more effectively. This approach is misguided. Power listening—the art of probing and challenging the information garnered from others to improve its quality and quantity—is the key to building a knowledge base that generates fresh insights. Unfortunately, business schools fail to teach power listening. Of the nearly 300 communications courses the American Management Association offers, only two deal directly with listening skills. Professionals must nonetheless write and speak more persuasively, so it’s essential to improve one’s listening capabilities. In Power Listening: Mastering the Most Critical Business Skill of All (Portfolio Hardcover, 2012), Bernard T. Ferrari 8

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suggests four steps that form a good listening foundation:

1. Show Respect. Our conversation partners often have the know-how to develop effective solutions. Part of being a good listener is helping them pinpoint critical information and see it in a new light. To harness the power of these ideas, you must fight the urge to “help” by providing immediate solutions. Learn to respect your partner’s ability to identify them. Being respectful doesn’t mean avoiding tough questions. Good listeners routinely ask key questions to uncover the information needed to make better decisions. The goal of power listening is to ensure the free and open flow of information and ideas.

2. Keep Quiet. Get out of the way of your conversations so you can hear what’s important. Don’t hog the spotlight, try to prove your own smarts or emphasize how much you care. Speak only to underscore your conversation partner’s points. Your partner should speak 80 percent of the time, with you filling the remaining 20 percent. Make your speaking time count by spending most of it asking questions, rather than having your say. This may be easier said than done, as most of us are naturally inclined to speak our minds. Still, you can’t really listen if you’re too busy talking. We’ve all spent time with lousy listeners who treat conversations as opportunities to broadcast their status or ideas. They spend more time formulating their next response than listening to the conversation.

undermines their beliefs. Good listeners seek to understand—and challenge—the assumptions that lie below the surface of every conversation. Holding onto these assumptions is the biggest roadblock to power listening. It’s admittedly hard to scrutinize preconceived notions and shake up our thinking. We must be willing to reevaluate what we know and welcome what we don’t (or can’t) know. Shift your mind-set to embrace ambiguity and uncover what each conversation partner needs from the interaction.

4. Maintain Focus. Power listening requires you to help your conversation partner isolate the problem, issue or decision at hand. Discard extraneous details or emotions that interfere with homing in on what truly matters. Create a focused, productive conversation by reducing external and internal background noise. Ask questions that highlight key issues and minimize the urge to stray from them.

3. Challenge Assumptions.

Decouple Emotions and Intellect

Too many high-caliber professionals inadvertently act like know-it-alls, remaining closed to anything that

Recognize that all conversations have intellectual and emotional components. Continued on pg 21

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PBCMS Task Force Examines Broader Medical Marijuana Law’s on Practice of Medicine By Leon Fooksman

If it passes in November, Florida Right to Medical Marijuana Initiative will enable Floridians to use medical marijuana to treat certain medical conditions when recommended by a physician. As many as 410,000 people would be expected to seek the drug in the first year for these conditions, as defined by the so-called Amendment 2 ballot question: “cancer, glaucoma, positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), hepatitis C, amyotrophic lateral sclerosis (ALS), Crohn’s disease, Parkinson’s disease, multiple sclerosis or other conditions for which a physician believes that the medical use of marijuana would likely outweigh the potential health risks for a patient.” If approved by 60 percent of voters, Amendment 2 would legalize the medical use of marijuana in the Sunshine State. The measure would expand the use of medical marijuana already approved in June through the Compassionate Medical Cannabis Act of 2014 -- nicknamed the Charlotte’s Web bill -- that allows for the use of a low-THC medical marijuana to treat conditions including epilepsy and Lou Gehrig's disease. As expected, the ballot question is a hotly contested issue, with strong opposition from Florida Sheriffs Association and Florida Medical Association, as well as many Republican leaders, including Gov. Rick Scott. Still, media polls show that 60 percent to 70 percent of voters support the measure. There are expected to be more than 1,700 registered medical marijuana treatment centers functioning in the program during the first year. Florida could generate upwards to $338 million 10

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in sales tax revenue if medical marijuana becomes law. Without question, the medical marijuana law would have significant impact on the practice of medicine. And so, Palm Beach County Medical Society (PBCMS) has made medical marijuana one of the primary topics for discussion at the Future of Medicine Summit VIII on Oct. 9-10 at the Kravis Center in West Palm Beach. A panel will go through the politics and therapeutics associated with medical marijuana. PBCMS also has set up the Medical Use of Marijuana Work Group, a task force of local physicians, a state representative, an attorney, and other professionals that is making recommendations on what the role of physicians should be in caring for patients seeking marijuana as part of their treatment.

So far, the task force has determined that many doctors want to see tight regulations on how marijuana would be delivered to patients, Dr. Schillinger said. Dr. Schillinger added that since the Amendment 2 language is vague, physicians must take a lead in determining how the medical profession will respond to the new law, which, if it gets approved on Nov. 4, will go into effect in 2015 after the Florida Department of Health sets the regulations. The PBCMS task force plans to make recommendations to the Department of Health and another blue ribbon panel reviewing the guidelines.

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“We strongly believe that physicians must be part of the process,” Dr. Schillinger said. “We’re not pro or con on this issue. We just need to be part of the process because this whole issue will fall right on our laps. As doctors, we want to be responsible in what we do on this issue.” To prevent abuse or appearance of abuse, the PBCMS task force is considering many recommendations, including the following: -- Physicians must undergo 20-30 hours of training over a period of weeks in order to recommend medical marijuana to their patients. -- Physicians must have bona fide doctorpatient relationships. There also must be a system of follow-up care between the physician and patient, if a patient is recommended medical marijuana as part of the treatment. -- There must be an extensive registration for patients seeking medical marijuana, and there must be a thorough database created to log patient information. In addition, there must be a limitation on how much medical marijuana a physician can recommend, and how many patients a physician can care for who are receiving medical marijuana. “What we want to do is avoid the situation where there’s one doctor who is known for recommending medical marijuana and he’ll have 100 people at his door every day,” Dr. Schillinger said. Once the PBCMS task force prepares its recommendations, members will share their findings with the PBCMS membership before providing the recommendations to the Department of Health and the blue ribbon panel.


Impact on Medical Community of Florida’s New “Charlotte’s Web” Medical Marijuana Law By Leon Fooksman

In June, Florida Gov. Rick Scott signed into law a medical marijuana bill that allows the use of a low-THC strain of marijuana for a limited number of medical purposes in the Sunshine State. The Compassionate Medical Cannabis Act of 2014 -- nicknamed the Charlotte’s Web bill -- is not to be confused with Amendment 2, a constitutional measure on the ballot in November in Florida that would further expand the use of medical marijuana for many more health conditions. Florida is now the 23rd state in the country to allow some form of medical marijuana. Many of the laws were drafted after Colorado legalized marijuana for a medicine that was developed there. The medical marijuana debate in Florida is often confusing for both patients and physicians. As a result, Palm Beach County Medical Society is providing the following information to explain why the Charlotte’s Web bill was passed and what it means for the medical community.

What is the new law? The Charlotte's Web bill creates a legal system for producing, dispensing and studying the drug in Florida for patients who are permanent residents of the state with cancer or seizure causing conditions. Specifically, it legalizes the use of a non-euphoric strain of marijuana to treat medical conditions including epilepsy and Lou Gehrig's disease. The decriminalization concerns a strain of marijuana that is high in cannabidiol, or CBD, but low in tetrahydrocannabinol (THC), the compound that produces a high.

What does the law mean for physicians? To prevent abuse, Florida nursery owners in operation for 30 continuous years will be allowed to grow "Charlotte's Web." The bill requires only five dispensing organizations throughout the state, requiring they hire medical directors and that staffers take training courses on the drug. It creates a "compassionate care registry" where sick patients are deemed eligible by a physician.

How many people need the drug in Florida? An estimated 125,000 children in Florida suffer from severe epilepsy. Many adults are also expected to use the drug.

How the drug can be used? Authorized patients will be allowed access to the drug through oil or vapor form, but it may not be smoked.

How does a patient qualify for the drug? To enrollment, a patient must be a resident of Florida and be evaluated by a licensed physician. If the patient is under the age of 18, a second licensed physician must evaluate and be in agreement with the first physician.

Florida physicians who are authorized to order this strain of medical marijuana can start writing recommendations in 2015 only to patients suffering from cancer or "a physical medical condition that chronically produces symptoms of seizures or severe and persistent muscle spasms." It will be sold through dispensaries licensed by Florida Department of Health. Physicians must complete an eighthour course and subsequently pass an examination offered by the Florida Medical Association or the Florida Osteopathic Medical Association. Physicians have to maintain a treatment plan that delineates dose, route of administration, planned duration, and monitoring of symptoms, tolerance and reactions. These are to be submitted and updated quarterly to the University Of Florida College Of Pharmacy for research on safety and efficacy. Leon Fooksman is a writer for Palm Beach County Medical Society who specializes in blogging and social media for medical organizations. He can be reached at leon@ digitalstoryline.com or on Twitter at @ compellingstory.

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Congratulations! It's such an honor to be recognized for excellence by your peers! Congratulations from the Palm Beach County Medical Society. And thank you Palm Beach Illustrated for your leadership and partnership.

Exceptional Physicians

Honorable Mention

Cardiovascular Disease

Anesthesiology

Mark H. Rubenstein, MD

Roger Duncan, MD

Hospice & Palliative Medicine

Cardiovascular Disease

Daniel Fortier, MD Faustino Gonzalez, MD Richard Levene, DO Infectious Disease

Larry Bush, MD Nephrology

Jack Waterman, DO Jose Arrascue, MD Neurology

Fred Boltz, MD James Goldenberg, MD Ophthalmology

Michael Patipa, MD Steven Rosenfeld, MD Physical Medicine & Rehabilitation

Mark A. Rubenstein, MD Plastic Sugery

Hatem Abou-Sayed, MD David Bogue, MD Dov Eidelman, MD David Lickstein, MD Alan Pillersdorf, MD Psychiatry

Stefan Pasternack, MD Rheumatology

Ira Pardo, MD Surgery

Joseph Colletta, MD Amy Mostafavi, MD George Mueller, MD Jack Zeltzer, MD

Steve Pollack, MD Mark Simon, MD Clinical Cardiology Electrophysiology Robert Fishel, MD Colon and Rectal Surgery Andrew Ross, MD Ronald Zelnick, MD Dermatology

Medical Oncology Elisabeth McKeen, MD Nephrology Hitesh Kapupara, MD Neurology Marc Feinberg, MD Mark Goldstein, MD Casandra Mateo, MD Obstetrics & Gynecology Melissa Friedman, MD Ophthalmology

Andrea Colton, MD

Monique Barbour, MD

Jeffrey Marcus, MD

Lee Friedman, MD

Michelle Muhart, MD

Lawrence Katzen, MD

Steven Rosenberg, MD

Mark Michels, MD

Brent Schillinger, MD Diagnostic Radiology

David Mittleman, MD Orthopaedic Surgery

Ernesto Hayn, MD Alberto Navarro, MD Jana Rasmussen, MD Richard Schwartz, MD Psychiatry Jacqueline Pevny, MD Abbey Strauss, MD Pulmonary Disease Jermey Breit, MD Michael Falkowitz, MD William Ludwig, MD Ralph Palumbo, MD Radiation Oncology Tim Williams, MD Rheumatology Shawn Baca, MD Joseph Forstot, MD

Walter Forman, MD

Clay Baynham, MD

Don Goodwin, MD

David Campbell, MD

Arul Chidambaram, MD

Joseph Kleinman, MD

Michael Cooney, MD

Daniel Higgins, MD

Eric Shapiro, MD

Mariano Ibarrola, MD

Robert Campitelli, MD

Ryan Simovitch, MD

K. Andrew Larson, MD

Jorge Inga, MD

Richard Weiner, MD

Miguel Lopez-Viego, MD

Family Medicine

Gynecology William Casale, MD Internal Medicine Robert Briskin, MD Rohit Dandiya, MD Valentina Gherghina, MD

Otolaryngology Carolyn Agresti, MD David Lehman, MD Nathan Nachlas, MD Ellis Webster, MD Pain Medicine/Anesthesiology

David Hevert, MD

Bruce Hindin, DO

Edward Jeryan, MD

Douglas Maclear, DO

Seba Krumholtz, MD Jose Carlos Lira, MD Charles Metzger, MD Richard Raborn, MD

Pediatrics Philip Colaizzo, MD Plastic Surgery Rafael Cabrera, MD Dana Goldberg, MD

Surgery

Barry Miskin, MD Jefferson R. Vaughan, MD Jonathan Wideroff, MD Surgery of Hand/Orthopaedic Surgery Roberto Acosta, MD Thoracic and Cardiac Surgery Malcolm Dorman, MD Richard Faro, MD Urology Ross Cohen, MD George Patsias, MD


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Integrating Your Electronic Systems Take these proactive steps to help ease the process. by Mary Helen Johnson, PNC Bank

Running even a small practice can be complex, and with changes to insurance and payment systems, it is only becoming more so over time. For many practices, the transition to Electronic Health Records (EHR) is both a challenge and an opportunity. The term “Electronic Health Records” often refers to a particular information system or systems that work together to create, manage, store and share information associated with a patient’s health record. The addition of managing yet another electronic system—in addition to accounting, billing, scheduling and banking—is indeed a challenge. But on the flipside, Electronic Health Records offer the opportunity to seamlessly integrate all of these systems—as long as they are compatible and communicate with one another. Here are some tips for easing the integration process.

The first step in deciding how to integrate your practice’s information technology(IT), then, is to gather together a task force of stakeholders—those who use the systems daily—to evaluate the options. Be sure to include representatives of each area that is affected: patient records, scheduling, patient billing and insurance reimbursement.

EVALUATE SOFTWARE SYSTEMS One way to facilitate interoperability among functions is to purchase a complete practice management (PM) software package. Practice-management software runs the business side of healthcare, from scheduling patients to billing to generating monthly reports. If you already have an electronic records system, a critical criterion will be making sure the PM software communicates with it as seamlessly as possible. If you’re starting from scratch, consider a singlevendor system that is fully integrated. Remember, though, that such integration often comes at the cost of flexibility.

GET INFORMED While you may work with your EHR systems on a daily basis, you likely leave management functions to other professionals, such as a practice manager, insurance coordinator or accountant.

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Healthcare Change is Not Coming. Healthcare has Changed! Why Clinical Integration is Essential for the Future of Independent Physicians By Ben Humphrey, MD, CPE, MGO Healthcare Consulting

We’re past the tipping point and are proceeding headlong into new marketdriven accountability for quality, cost and value. As these large-scale changes progress, physicians who want to thrive and be positioned for long-term success will have to embrace new ideas and approaches in their practices. A few years ago physicians in Ohio created their own physician-owned company to assist themselves with success in the changing world of healthcare. Via their company, The Medical Group of Ohio (MGO), they created a clinically integrated physician network comprised of nearly 2,100 physicians. The vast majority of these physicians are in small independent practices. Being clinically integrated means the physicians are working together, using proven physician-created protocols and measures, to demonstrably improve patient care, decrease cost, and deliver value. At the heart of medicine is the patientphysician relationship. As physicians we view this as the basis for good health and healthcare delivery. Individually we are providing excellent, yet uncoordinated care. This new approach has allowed MGO to advance a clinically integrated network of physicians and facilities by having the knowledge, tools and confidence that our patients will be receiving the best, most appropriate care possible. That care is coordinated throughout the entire continuum of care. Accordingly MGO has been able to directly and demonstrably affect health outcomes for large populations of patients while also being able to bend the cost curve which is so desperately needed and being demanded in the marketplace.

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ON CALL MAGAZINE

By their collective efforts MGO physicians have been able to invest in the resources needed to build and enable this network. The cornerstone is proprietary data collection and software that has allowed us to have access to the most complete and trusted patient data offered. MGO has effectively utilized this data to measure the performance of the individual physicians/groups and the network as a whole, rewarded performance, and continuously shared best practices enabling improvement through practice transformation. Simply, MGO has enabled physicians by providing actionable information regarding their patients in a real time fashion. MGO is a physician-owned and led organization; hence the approach is physician-driven. Physicians are not only “at the table” but are collectively creating and implementing the clinically integrated / accountable care approach.

Many ask if this type of model is applicable within their own market. The answer is yes. MGO has shared its approach with physicians throughout the country and as a result local, physicianled clinically integrated approaches are developing, While this approach involves significant change; it is absolutely necessary. As employers and/or payers demand proven value-based healthcare and with the inevitable shift from rewarding volume to rewarding value; physicians must be able to demonstrate a new standard of care to effectively remain competitive for the foreseeable future. Additional information about MGO’s clinically integrated network can be found at www.TheMGO.com and www. Health4.com. Dr. Ben Humphrey served for nearly 20 years as The Medical Group of Ohio’s CEO- from the company’s inception. He is currently working with MGO Healthcare Consulting. MGO is Ohio’s largest Independent Physician Association (IPA) and along with its hospital partner,

This approach is having great success in our market and physicians have been rewarded appropriately for their success. To deliver this clinically integrated program has necessitated MGO to collectively negotiate reimbursement rates on behalf of the entire physician network.

QUARTER THREE 2014

OhioHealth, has created a successful clinically integrated network of physicians and facilities called Health4. Health4 has network contracts with the market’s large commercial payers and Medicare advantage plans.


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Continued from pg 8 It’s important to “decouple” the two, according to Ferrari, as several emotions are guaranteed to hinder communication: 1. Impatience 2. Resentment and envy 3. Fear and feeling threatened 4. Fatigue and frustration 5. Positive emotions and overexcitement As with anger and fear, excitement can also distract you from asking the right questions and challenging underlying assumptions. “The most exciting part is that, once you get good at listening, you will be able to do it easily, almost effortlessly, without even thinking about it,” Ferrari writes. Practice his four power-listening steps to become the kind of listener others seek as a conversation partner. You’ll build valuable relationships, become more informed, make better decisions and come up with new innovative ideas.

We Have Great News! As a member of the Palm Beach County Medical Society you will receive the Exclusive PBCMS MemberCard. This robust new card is loaded with an exciting variety of member only benefits such as two-for-one meals at local restaurants & area attractions. You can use this card knowing that you are supporting your profession and your local community. As a valued member of the Medical Society, we welcome your input. If you have suggestions or comments please contact Tenna Wiles, CEO at (561) 433-3940 or tennaw@pbcms.org. We appreciate your support! B:8” T:8” S:8”

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Welcome New Members! Quarter Three 2014

Vincent Abad, MD Psychiatry, Boca Raton Rena Amro, MD Orthopedic Surgery, West Palm Beach Howard Brenker, MD Neonatal, Boca Raton Joseph Cadet, MD, Family Practice, Delray Beach Leroy Charles, MD Ob/Gyn, Greenacres Sharon Dai, MD Ob/Gyn, Loxahatchee Fernanda DeOliveira, MD Family Medicine, Boca Raton David Goldman, MD Ophthalmology, Palm Beach Gardens Jason Goldman, MD Internal Medicine, Coral Springs Arthur Handal, MD Plastic Surgery, Boca Raton Lauresha Hysa, MD Internal Medicine, Boca Raton David Kay, MD Otolaryngology, Boynton Beach Larisa Kelly, MD Dermatology, West Palm Beach Robert Kozol, MD Surgery, Atlantis Shauna Kay Kranendonk, MD Dermatology, Jupiter Stephen Livingston, MD Ob/Gyn, Jupiter Lawrence Lovitz, MD Cardiology, Atlantis Ana Raquel Mateo-Bibeau, MD Infectious Disease, Atlantis Jose Menajovsky, MD Infectious Disease, West Palm Beach Gulnaz Mirza, MD Endocrinology, Lake Worth Harvey Penziner, MD Dermatology, Boca Raton Thomas Roush, MD Orthopedic Surgery, Lake Worth Mark H. Rubenstein, MD Cardiology, Boca Raton Diego Sadler, MD Cardiology, West Palm Beach Gabriel Sandkovsky, MD Infectious Disease, Boca Raton 22

ON CALL MAGAZINE

Tommy Schechtman, MD Pediatrics, Palm Beach Gardens Caryn B. Schorr, MD Psychiatry, Boca Raton Anjani Sinha, MD Orthopedic Surgery, Wellington K. Eva Styperek-Grohmann, MD Plastic Surgery, Boynton Beach William Vinyard, MD Plastic Surgery, Palm Springs Timothy Willingham, MD Internal Medicine, West Palm Beach Mark Werner, MD Ophthalmology, Boca Raton Edward Zawadzki, DO Psychiatry, Juno Beach

Residents Oluwadamilola Akinnifesi, MD Jessica Barnes, DO Kacie Bhushan, DO Cathy Lee Ching, MD Stephanie Furlan, MD Janeiro Jose Valle Goffin, MD Nyrene Haque, MD Amy Kappes, DO Maya Khalil, MD Alexander Kushnir,MD Sagarika Koka, MD Angeli Niravel, DO Benjamin Pazin, MD Jesus Pino II, MD Fayez Sarkis, MD Kara Schmidt, DO Pallavi Shankaraiah, DO Roger Vega, MD

Danlu Wang, MD Jessica Wilbur, DO

Medical Students Kristine Almonte, Tyler Anderson, Kenan Ashouri, Dalbir Bahga, Andrew Barrett, Jordan Beau, Veronica Caballero, Kristen Capel, Emma Craig, Emily Salmon Denikos, Tim Fitzgerald, Colleen Fleshman, Jena Glavy, Kelly Glazer, Isaac Goldszer, Stephanie Gopie, Eithan Haim, Joshua Heiman, Jennifer Hewlett, Neha Hippalgaonkar, Ronnie Ibrahim, Rishabh Jethanandani, Avi Kandel, Temma Kaufman, Thomas Kershaw, Danielle Klein, Patrick Kobler, Robert Krieger, Jolie Krooks, Maria Kosyrikhina, Minh Quan Le, Ryan LaMarca, Alexandra Levy, Elaine Lin, Eric Longfellow, Anne Lopez, Syed Mahmood, Cole McCarty, Michael Migita, Christopher Mora, Shamik Patel, Courtland Polley, Trevor Reitz, David Remy, Isabelle Riley, Stephen Rohrbough, Henry Schmidt, Emily Seriderey, Lauren Shapiro, Brian Shin, Ariel Sindel, Deborah Soong, Nicholas Stagliano, Alan Stein, Alex Sullivan, William Suttan, Jordan Tannenbaum, Abhinav Totapally, Elizabeth Tranquil, Genevieve Tuveson, Trevor Kauffmann, Lena Vaynberg, Alexander Webb, Erica Michelle Weber, Kaitlyn Weinert-Stein,Michele Saragoza, Katherine Wojcicki

CLASSIFIEDS AAAASF certified OR and recovery room space available to sublet 2-3 days/ week. Reasonable rates. Located in east Boca Raton, next to Boca Community Hospital. Excellent for Plastic Surgeon, Facial Plastic Surgeon, Oculoplastic Surgeon, Pain Management, Orthopedic Surgeon or General Surgeon. Please call 561-416-1272.

QUARTER THREE 2014

2300 sq. ft. free-standing, single story medical building, located one block from Good Samaritan Hospital. Perfect for primary or satellite office. On-site parking. 7 treatment rooms. Contact 561-248-6131.


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