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Stress Less ac r b m E


ge n a h C

Take Time Off Balance Work and Personal Life

Avoid a Negative Mindset

Physician Wellness

Foster Your Curiosity

Breath Regulate Your Emotional and Physical Health

Take Pride in Being a Doctor


Stephen Babic, MD President, Palm Beach County Medical Society

According to a recent survey, 56% of female physicians and 53% of male physicians are dissatisfied with the practice of medicine. A survey this year also showed that 46% of physicians responded that they suffered from burnout. Both physician dissatisfaction and burnout have increased nationally in the last three years. Why? And what can be done? I contend that doctors for the most part remain satisfied seeing patients, talking with them about their illnesses, prescribing appropriate treatments, and guiding their health management. However, it is the ever-increasing administrative and bureaucratic roadblocks that interfere with and hamper the doctor-patient relationship that create the problem of physician dissatisfaction. I would like to review with you some of those roadblocks and what can be done to remedy the situation. First, there are burgeoning rules, regulations, and laws imposed by insurance companies and Medicare. These entities continue to require unending, unwieldy, and cumbersome documentation. Indeed, excessive bureaucratic tasks were the most common cause given for physician burnout in both 2013 and 2015. The net effect is to increase the amount of physician time required to perform such tasks, which proportionately reduces the time for physician-patient interaction. All too often, the rules and regulations result in either the denial of payments for services or a significant delay in payment. Tests like MRI scans, CAT scans, and nuclear cardiac stress tests are frequently denied,

making the physician question who is actually responsible for the care of their patient. Once the appropriate diagnosis is made, then another battle ensues to obtain the best drug or therapy for that patient and their particular condition.

practice and realize that a 0.5% increase in income is woefully inadequate. Because of this, many family physicians and internists are now suffering financial difficulties maintaining their private practice.

We at Palm Beach County Medical Society and the Florida Medical Association are constantly working to reduce burdensome restrictions and support legislation that will make it easier for you to practice.

The internist of today has multiple choices in order to continue to practice. Being a one-man or two-man private practice may no longer be a viable economic option. Each year more internists are electing to become concierge physicians, hospital employees, or join Accountable Care Organizations. This trend in medical practice with more doctors electing to become concierge physicians results in a decrease in the number of patients in their practices from over 2,000 per year to 400-500 per year. This reduction in the number of patients seen will create a significant manpower shortage in the future. Many communities are already seeing this in action- too few non-concierge physicians to handle the number of patients who are unable to afford concierge fees and must change physicians.

Second is the frustration many of you are having using and paying for electronic medical records. As the various vendors consolidate and create improved software and voice recognition, the use of electronic medical records should become more efficient and easier to manage. In the meantime, we have to educate our legislators that penalties for “meaningful use� are inappropriate at this time and place an unfair and onerous burden on physicians, especially those in small practice settings. Third is the problem of reasonable financial incentives for physician services. Medicare has not given physicians a real raise in fees since 1992. The passage of the recent SGR legislation only ensures that doctors will not get a 20% decrease in payment. The 0.5% increase in payments starting this summer does not come close to matching the national annual cost of living increases that physicians face personally and in the management of their office economics. All physicians in private practice are painfully aware of the yearly increases in the overhead of managing their office

One possible solution for this problem is to pass a balanced billing amendment for Medicare patients. If this were allowed, doctors would be allowed to bill those patients an additional fee to keep up with the costs of running a medical practice and therefore permit physicians to keep their medical practices financially solvent without having to change to a concierge model of care. Continued on Page 26




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Contents PBCMS Staff

Board of Directors

Tenna Wiles, CEO

Stephen Babic, MD President James Goldenberg, MD President-Elect Shawn Baca, MD First Vice-President Brandon Luskin, MD Secretary Marc Hirsh, MD Treasurer Ronald Zelnick, MD Immediate Past President Roger Duncan, MD Member at Large Deanna Lessard, Director of Member Services & Education Helena Wiley, Finance Mindi Tingler, Administrative Assistant Lauren Tome, Meeting and Events Coordinator Lauren Stoops, Project Access Program Director Graciela Gordillo, Project Access System Coordinator


06 09 10 13 17

Melissa Nicoleau, Project Access System Coordinator

Larry Bush, MD Michael Dennis, MD James Howell, MD Tulisa LaRocca, MD Beth-Ann Lesnikoski, MD K. Andrew Larson, MD Alan Pillersdorf, MD Samathi Raja, MD Brent Schillinger, MD Robert Tome, MD John Vara, MD Frederick Williams, MD Jack Zeltzer, MD Matthew Uhde, DO Resident Amanda Barnes Medical Student

On Call Magazine is designed by Form G Design

Board of Trustees or

Jack Zeltzer, MD Chair Jose F. Arrascue, MD Stephen Babic, MD Shawn Baca, MD Malcolm Dorman, MD James Goldenberg, MD K. Andrew Larson, MD Alan Pillersdorf, MD Ronald Zelnick, MD Mark Rubenstein, MD Brandon Luskin, MD Clara Yvette Acero, Project Access System Navigator John James, Director of Disaster Services Stuart Miro, MD, Triple Aim Diabetes Initiative Sherra Sewell, Marketing and Promotions Demi deGioia, Communications Coordinator Patricia Beeler, Administrative Assistant Gwendolyn Marrero, Administrative Assistance

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.

21 23 25 26

Heroes in Medicine Ten Tips to Cope with Stress and Avoid Burnout Physician Burnout The Stress Switch Palm Beach County Medical Society Services Annual Report Physicians and Finance Telemedicine as a Growing Practice Model 7 Ways to be More Productive Concierge, ACOs and IPAs Beware of Vicarious Liability for Your Doctors


03 29 30

President's Report Med Memo Welcome New Members




This year's Heroes in Medicine Awards luncheon carried all the glam of Hollywood with a tropical Florida air at the Kravis Center, Cohen Pavilion in West Palm Beach. But what was most impressive was the noble contributions being made in our community and beyond by the 2015 slate of Heroes. While Heroes of the Year were announced in each category, all who were recognized inspired a crowd of more than 400 guests.

Back Row Left to Right; John Vara, MD; Cyrus Massoumi; Commissioner Carol A. Roberts; Ivy Faske, MD; Davide Carbone; Andrea Palestro, DO; Michael D. Black, MD; Duyen Le; Grace Cenat; Suzanne Boyd; Ronald Z. Surowitz, DO; Front Row Left to Right; James T. Howell, MD; Marsha J. Fishbane, MD; Catherine Lowe, MD; Jean Acevedo; Julia Belkowitz, MD; K ayla Abramowitz; Michelle O'Boyle, RN; Quinn Hayes

Honorary hosts were Dr. and Mrs. Alan Pillersdorf, and presenting benefactor was Rendina Healthcare Real Estate. Suzanne Boyd of CBS News 12 emceed the event, which beneďŹ ts Project Access. Special thanks goes to all the sponsors and host committee. For more information, visit events/heroes-in-medicine.

Michael F. Gervasi, DO; Tara Auclair Ryan; Ronald J. Wiewora, MD

Michael F. Gervasi, DO; Patti Patrick; Jeff Davis, DO; Mas G. Massoumi, MD

Amy Pepper; Margaret Rietman; John Vara, MD

Alisa Cohen; Richard G. Cohen, MD

Larry M. Bush, MD; Michael D. Black, MD; Malcolm Dorman, MD;

James N. Goldenberg, MD; Cyrus Massoumi; Lara Goodwin

Alan Barth Pillersdorf, MD; Davide Carbone; Richard Rendina

2015 Heroes of The Year

James Howell, MD Dick Van Eldik, MD Distinguished Service Award

Paul Niloff, MD Lifetime Achievement

Healthcare District of Palm Beach County Making a Difference Award

Ivy Faske, MD James Byrnes, MD Humanitarian Award

David Carbone Bruce Redina Professional

Michelle O'Boyle, RN Provider Non-Physician

Cyrus Edward Massoumi Healthcare Innovator

John Vara, MD Healthcare Educator

Michael Black, MD Physician

Caridad Center Community Outreach

Andrea Palestro, DO Student

Rodeania Peart Student

Grand Benefactor Redina Healthcare Real Estate Provider Non-Physician Duyen Le Jane Miller Lynne Palma, DNP Physician Marsha Fishbane, MD William Kaye, MD Catherine Lowe, MD Marion Webster, MD

2015 Heroes in Medicine Healthcare Innovator Michael Miller Sara Uhrig, ORT/L CHT Healthcare Educator Rose Ann Roche, RN Julie Servoss, MD Community Outreach Kayla Cares 4 Kids, Inc Ronald Surowitz, DO

Honorary Hosts Dr. and Mrs. Alan Pillersdorf Bruce Rendina Professional Jean Acevedo Julia Belkowitz, MD Quinn Hayes Student Nerea Anya Grace Cenat Janie Sanchez

Thank You to Our Supporters Rendina Healthcare Real Estate Alzheimer’s Community Care Trustbridge Medical Specialists of the Palm Beaches Healthcare Reit HCA Palm Beach Hospitals

Health Care District Palm Beach County Cleveland Clinic Tenet Florida Physician Services University of Miami Miller School of Medicine Batman Medical Group, P.A. Co-Chairs Greg Quattlebaum and Christine Brooks

Morgan Stanley West Boca Medical Center Dignity Memorial Channel 12 News Palm Beach Illustrated South Florida Hospital News Legends 100.3 FM

Palm Beach Illustrated is proud to support

Palm Beach County Medical Society 561.659.0210 |

Ten Tips to Cope with Stress and Avoid Burnout B y Stefan A Pasternack, M.D. DLFAPA

Studies document the stresses that every physician faces in every aspect of their careers. Stefan A. Pasternack, MD Physicians today are practicing in a changing health care environment they never could have predicted much less be prepared for according to one expert. The risks of “ physician burnout “ have increased. Physicians complain bitterly about the lack of time to spend with patients, lack of incentives for high quality care, the time wasted with electronic health records, battles with insurance companies, the pressure to see more and more patients each day and uncertainties about Obama Care. Physicians feel trapped in a web of financial pressures. Medicare and Medicaid audits, challenges of complex cases, and continuing threats of malpractice lawsuits. Doctors worry about the costs to comply with more government regulations while their practice financial margins shrink. Physicians are opting out of solo or small group practice to take jobs in accountable care organizations ( ACOs) or HMOs. Yet even there the freedom to provide patient care as they deem appropriate is hampered by “evidence based medicine” which may overlook the need of an “individual patient.” Physicians still have great responsibility but decreasing control over practice life. This disparity is a root cause of burnout. So what is burnout? Burnout is a specific professional stress syndrome manifested by emotional exhaustion and demoralization, cynicism, loss of a sense of purpose and of clinical effectiveness, and withdrawal from professional relationships, social isolation.

Certain personality factors may predispose physicians to burnout. The very traits of compulsivity and attention to detail which are needed to succeed and habits of overwork from years of demanding study set doctors up for overwork. Physicians are prone to feel they have not done enough for their patients, to feel guilty if the best result isn’t achieved, are prone to second guessing their decisions and often neglect their own emotional or physical needs to the point of emotional exhaustion and lack of pleasure in life. Female physicians are even more susceptible to burnout as they have seem to have more difficulty than men in setting limits on patients Signs of burnout include impaired work, headaches, back aches, insomnia, fatigue, loss of concentration, irritability, marital difficulties, anxiety and depression, and too often abuse of alcohol or substance abuse. A burned out doctor no longer believes in what he does. If you are in a situation where you have high responsibility with lack of control over schedules and workload you are vulnerable to feeling unfairly treated, becoming angry, resentful and losing faith in your profession. You can easily slip into an irreversible downward spiral which, in worst circumstances, can result in severe depression and a physician suicide. In spite of all the stresses and strain the modern doctor must face and master, you can avoid burnout if you follow these Ten Tips :

1. Embrace change- don’t fight it, but seek to implement the best changes. One day the electronic health record will really work!

2. Take time off from work: make sure you plan your vacations first so you guarantee yourself and your family adequate time for fun and renewal.

3. Pay attention to your own emotional and physical health. Exercise regularly; follow a healthy diet; engage in sports and hobbies. Have an annual physical exam and rely on your own physician. Feeling depressed or anxious? Seek professional help sooner rather than later

4. Observe religious or spiritual activity which adds meaning to life.

5. Take credit for your work: accentuate the positive; eliminate the negative. At the end of the day focus on what you have done well, not mainly on things that went wrong. Avoid a negative mindset.

6. Enrich your marriage or partnership with enough time for unhurried conversation and shared activities. Foster your sex life. A good relationshp is your best refuge at the end of the day.

7. Avoid denial-identify and deal with all personal and professional problems promptly. For example, denying symptoms of ill health leads to a more serious ailment later. Promptly address any practice problems to avoid complications later.

8. Make lifetime learning a pleasurable pursuit. Foster your curiosity and be excited about new developments. There are many fascinating developments in modern medicine. Take pride in being part of a profession that offers more new and better treatments than ever. Continued on Page 26




Physician Burnout: How to Avoid This Serious Problem By Leon Fooksman

Brett Hutton, MD

Perhaps it’s not surprising: Faced with long hours, exhausting bureaucratic duties, and unrelenting pressures from patients and insurance companies, a growing number of physicians are experiencing burnout and stress.

Wade Van Sice, MD Untreated, burnout can lead to empathy, exhaustion, and a low sense of personal accomplishment, studies show.

Even more concerning, dissatisfied physicians are far more likely to make medical errors and are less able to communicate effectively with patients and co-workers, according to Modern Healthcare. These physicians also are at a higher risk for substance abuse, lying, cheating and even suicide. And many are more likely to leave the profession for good. It’s becoming a serious problem: • Nearly one in two U.S physicians has reported at least one symptom of burnout, with many of these physicians working in the fields of critical care, emergency medicine, family medicine, internal medicine, and HIV/infectious diseases. (2012 Mayo Clinic survey and other studies) • In 2014, 46 percent of all physicians responded that they had experienced symptoms of burnout -- an increase from slightly under 40 percent of respondents in 2013. (Medscape Physician Lifestyle Report)



The reasons for burnout in medicine vary, but studies have found that physicians experiencing stress tended to be less confident about their health, haven’t volunteerec much, struggled to save money, and have never married or are living alone. The burnout problem comes at a time when physician care is in high demand – and doctors are needed most. As the U.S. population grows and ages, the number of physicians needed to care for them is only going to increase. If burnout leads more physicians to reduce or close their practice, patient access to medical care will diminish significantly, just as millions of newly uninsured people are entering the healthcare system. There is good news, though. Despite the increase in burnout rates and the harmful problems that go with it, more physicians, particularly younger ones, are fighting back by taking on leadership roles in doctor groups, hospitals, and medical associations. Others are rediscovering what got them into medicine in the first place: the importance of being compassionate and serving their patients, and the idea that medicine is not a job or career but rather a calling. Palm Beach County Medical Society asked two local physicians to explain how they find the delicate “balance” between their professional work and their personal lives. They shared their insights, experiences and strategies on avoiding the emotional, mental and physical exhaustion characteristic of burnout. The first physician is Dr. Brett Hutton, a rheumatologist in Delray Beach. The second physician is Dr. Wade Van Sice, who specializes in orthopedics and sports medicine in Jupiter.


How do you think we can keep physicians from burning out on their jobs? Dr. Hutton: We need to help physicians understand the importance of balance. Physicians should be encouraged to balance their careers with personal aspects of their lives (ie. friends, family, hobbies, other interests, etc.). This could be accomplished by offering classes at the hospital or even state board level. Physicians must be allowed to completely remove themselves from their duties for periods of time. Too often physicians feel that they are always "on call." This can lead to burnout. Burnout can be minimized with mandatory call sharing, vacation time, and restricted work hours for physicians on staff at hospitals. Similar duty restrictions currently exist for physicians during their residency programs. Dr. Van Sice: I believe physician burnout occurs not because of the demands of patient care, but because of the increasing difficulty to deliver the care that we have dedicated our lives to provide. Physicians go into medicine to care for others. This is what we enjoy; this is what keeps us going. In recent years, there has been a transition from physicians leading treatments, to corporate regulation of patient treatments, access, and a drastic increase in the administrative burdens on the healthcare system as a whole. A patient's relationship is with their caregiver -- physician, nurse, or therapist alike. As a medical professional, it is disheartening to see the field of medicine being diminished to templates over individuals. I believe the best way to prevent burnout is to put care back into the hands of those who care.

What do you do to stay in good health and prevent yourself from burning out? Dr. Hutton: I try and implement a healthy lifestyle. There are certain things I try and do on a daily basis. At the end of each work day, I engage in exercise whether it be the gym, running or playing sports outdoors (in my case tennis). Exercise works as an incredible stress reliever and allows me time to "disconnect" from work. I’ve also found a healthy diet to be extremely helpful. It provides me with a better energy level. Adequate rest is equally as important. Sufficient nightly restorative sleep allows me to work hard the following day. All of these help me to enhance my mood and provide me with the energy I need to prevent burnout. Dr. Van Sice: I believe balance is instrumental to maintaining good health. I aim to take time everyday to do physical activity, whether it is a gym workout, sand volleyball game, surf sesh, bike ride, or a walk around the block. Physical activity allows me to clear my mind and recharge. I find it is also imperative to remember: once we leave the office or the operating room, we are mothers, fathers, husbands, wives, and members of the community and to put as much effort into being these people as we do as being professionals. For me balance is the key. Leon Fooksman is a writer for On Call who specializes in helping medical practices with social media, blogging, and content marketing. He can be reached at leon@ or on Twitter at @compellingstory






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The Stress Switch: The importance of conscious breathing. By Kirk Slobody

What might the following scenarios have in common? You are stuck in traffic on the way to a meeting. You are Janine Tiede & concentrating Kirk Slobody on a challenging task. You are dealing with a difficult patient. You have to deal with an unpleasant or heated family situation. I would bet in each situation your breathing was very shallow or you were holding breath.

Recent research shows that stress is a major issue for many employees.

51% 50% 46% 90% 50% 40%

Of employees say they have “high levels of stress with extreme fatigue/feeling out of control.”4 Of employees Miss one to two days of work per year due to stress. 4 Surveyed say they come to work one to four days a year when they are too stressed to be effective. 4 Of all visits to primary care physicians are for stress-related complaints. 1 More is spent on Healthcare for workers who report high levels of stress. 2 Of job turnover is due to stress. 3

Job stress costs US industry $200 to $300 billion annually in absenteeism, diminished productivity, employee turnover, accidents, and medical, legal and insurance fees.1 1. American Institute for Stress 2. Journal of Occupational and Environmental Medicine 3. American Institute of Stress 4. Stress reduction clinic University of Mass Medical Center

Suddenly you feel overloaded, burdened to the point of affecting the way you feel, your outlook, your performance, and how you behave towards others. The stress meter has pegged the red line! Time magazine’s June 6, 1983 cover story called stress “The Epidemic of the Eighties.” In that survey 55 percent said they felt under great stress on a weekly basis. A 1996 Prevention magazine survey reported almost 75 percent were under great stress. A 2011 American Psychological Association Stress in America study reported that 94 percent of adults believe that stress can contribute to the development of major illnesses, such as heart disease, depression and obesity. Today’s stress has become chronic: job demands, the ever present phones, horns honking and the nature of our connected lives effects sleep, contributes to anxiety, causes headaches, bad skin, depression, fatigue, digestive issues, poor eating habits, weight gain and more. So what do you do to handle one of the situations above? Grab a drink? Pop a pill? Have a smoke?

Although these habits are common place and frighteningly acceptable there are much healthier, sustainable actions that are extremely simple for managing stress, and for this article I’ll focus on conscious breathing. The first thing to remember is that stress can be your ally. It is your body’s natural internal response to a perceived or real threat to your wellbeing. Short term stress is useful in a “flight or fight situation” like slamming on your breaks so you don’t hit the car in front you, or getting out of a building that is on fire. Secondly, stress is not floating out there waiting to pounce: the traffic is not stressful, your response to it is. Your children calling you with an issue is not stressful, your response is. The emotional patient is not stressful; it’s your response that can be.

reduces anxiety and relaxes the body, and reduces stress while improving the conditions caused by stress. When you feel anxiety, tension, shortness in temper, or shallow breathing, one very effective technique is to utilize Breath Control or Extension. In yoga this is called Pranayama. It is about becoming aware, withdrawing your senses from the irritant, and concentrating on a universal, primal necessity: breathing fully. It really is that simple and powerful. When you tune into your breath you tune in directly to your current situation. It is a gauge of efficiency. The breath warms and cools you, it helps you become grounded and centered. The breath directly affects your state of mind, anxiety levels, blood pressure, fatigue, and on, and on, and on.

The Exercise: It is actually amazing how effective and easy it is to learn to incorporate conscious breathing into our day. The benefits are numerous: it increases energy, mental alertness and clarity, improves concentration and mental functions, stimulates the release of endorphins,

• Find a place to sit quietly either in a chair with your feet flat on the ground, on the ground with your legs crossed, or lying on your back with your feet flat on the floor. Continued on Page 25




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Annual Report

"Making a Difference in Healthcare"



$10.5 Million Donated Care


Triple Aim

9,000 Patients


Making a Difference Access



2,500 Volunteers

June 2015



From the President Palm Beach County Medical Society Services began in 2000 as the charitable arm of the Palm Beach County Medical Society. Physician leaders recognized the significance of expanding its role in supporting medical education and improving individual and community health. By launching innovative programs and working in partnership with medical, business, and community leaders, PBCMS Services has become widely recognized as a leader in improving the health of residents in the region. This past year has demonstrated our commitment to excellence. Working closely with community partners, we expanded our efforts to provide access to care for the uninsured through Project Access by educating and offering personal navigation advice for those in need of health coverage. Recognizing the major complications posed by Type II diabetes, our physicians created a successful pilot program resulting in improved outcomes and, in addition, partnered with the Department of Health to address the obesity crisis. Our nationally recognized Health Emergency Response Coalition (HERC) and Medical Reserve Corp rose to the challenge of preparing our community for disasters and emerging health threats such as Ebola and Chikungunya. Demonstrating our strong commitment to innovation in medicine and securing the best health environment for our community, we hosted the annual Future of Medicine Summit which assembled nationally known speakers to address issues of concern for both medical professionals and the public. Looking ahead, there are several key objectives on our agenda. Among them is a concerted effort to establish an endowment structure that will guarantee the sustainability of existing programs benefiting the public and providing the opportunity to initiate others if needed. This includes upgrading the office facility to meet the needs of our growing programs and the patients we serve. We need to augment the high quality and attractiveness of our events such as Heroes in Medicine, the Future of Medicine Summit, and the Gala by expanding our message of service throughout the community. And we must work diligently and persuasively to recruit more physicians and community partners into the Services network who can devote their time and resources to the incredibly unique programs of Palm Beach County Medical Society Services. With your help, our mission will reach new heights of success for the people of our region. It is a privilege to be a part of this endeavor and to work with colleagues, business and community leaders, and an incredible staff. Thank you.

Board of Directors Michael T.B. Dennis, MD President Ivy Faske, MD Vice President Don Chester Treasurer Matt Gracey Secretary Douglas D. Dedo, MD Immediate Past President Jean Acevedo William Adkins, MD Alina Alonso, MD Jose F. Arrascue, MD Brenda Atkins Yolette Bonnet Tammy B. Clarke Cynthia Clayton, MD Patti Corbett Judith B. Goodman, Esq. Robert Hill Stuart B. Himmelstein, MD James T. Howell, MD Roderick King, MD Leslie Mills, DO Alan B. Pillersdorf, MD Greg Quattlebaum Brent M. Schillinger, MD Heather Siegel Miller, Esq. James Sugarman Maureen Whelihan, MD Marisa Vinas Jack Zeltzer, MD

Michael T.B. Dennis, MD Palm Beach County Medical Society Services President

“Never doubt a small group of thoughtful committed people can change the world, indeed it is the only thing that ever has.� - Margaret Mead

Project Access “Project Access continues to grow and serve those in need of medical care in Palm Beach County. Our participating providers list is expanding and draws new, enthusiastic participants. While our need for surgery centers remains, we appreciate all of the partnerships and their commitment to the patients in project access”. - Maureen Whelihan, MD

2,500 physicians and healthcare providers have contributed over $10.5 million dollars in charitable care to over 9,000 individuals.

Pictured Above: Ivy Faske, MD; Hitesh Kapupara, MD

Disaster Services "Emergency prepardness involves a community wide effort. By failing to prepare, you are preparing to fail." - Ashley Lee Chair, HERC Delray Medical Center

1,383 volunteers donate their time and expertise through the Medical Reserve Corps to promote healthy living and prepare for and respond to emergencies. The Health Emergency Response Coalition has been nationally recognized as a model program by National Association County Health Association Pictured Above: HERC Ebola Exercise

Future of Medicine “Each of us has an important role to play in shaping the future of health care. By working together we can transform health care to meet the needs of our residents”. – Jose Arrascue, MD Chair, Future of Medicine

The Future of Medicine Initiative has brought together healthcare and community leaders to define issues, establish partnerships and explore and implement opportunities to improve the quality of health care in our community. Pictured Above: Jose Arrascue, MD

Heroes in Medicine “Heroes are people who see a need and respond.” - Greg Quattlebaum Chair, 2015 Heroes in Medicine

The 12th Annual Heroes in Medicine Award luncheon recognized outstanding individuals, organizations and community leaders who have made a significant contribution to healthcare and have demonstrated a commitment to community service. Pictured Left to Right: Alan Pillersdorf, MD; Bruce Rendina

Donors Making a Difference Palm Beach County Medical Society Services is dedicated to "Making a Difference in Healthcare" in Palm Beach County. The programs and services provide an opportunity for individuals, physicians and our community partners who share medicine’s goals to improve health care and make a substantial difference in our quality of life.

Pictured Left to Right: Douglas Dedo, MD; Kathy Dedo; Roger Duncan, MD; Lisa Quarrie-Duncan

Community Partners

1919 Society

Hippocrates Society

Admirals Cove Cares Charitable Foundation B4BC “Two Wheels One Cause” The Ernst & Gertrude Ticho Charitable Foundation Florida Department of Health Health Care District of Palm Beach County Health Council of Southeast Florida Jarden Consumer Solutions Community Fund, Inc. JFK Medical Center National Association of County and City Health Officials (NACCHO) Michael T.B. Dennis, MD Palm Healthcare Foundation Quantum Foundation United Way of Palm Beach County Urban Areas Security Initiative (UASI)

Jose F. Arrascue, MD Jeffrey Berman, MD Michael T.B. Dennis, MD Malcolm Dorman, MD J. John Goodman, MD & Judy Goodman, Esq. Howard Allen Green, MD Beth-Ann Lesnikoski, MD Alan B. Pillersdorf, MD Brent M. Schillinger, MD Ida Sebastain, MD Robert Tome, MD Ronald S. Zelnick,MD

Bethesda Health Boca Raton Regional Hospital Delray Medical Center JFK Medical Center Jupiter Medical Center Wellington Regional Medical Center

Benefactors Anonymous Michael T.B Dennis, MD Rendina Healthcare Real Estate Trustbridge Health

Financial Statement Income



Fund Related . . . . . . . . . . . . . . . . . . Grants & Contributions . . . . . . . . . . Donations/Operating . . . . . . . . . . . Total Income . . . . . . . . . . . . . . . . . . .

$206,963.79 $683,313.14 $45,156.95 $935,433.88

Operations . . . . . . . . . . . . . . . . . . . . Fund Related . . . . . . . . . . . . . . . . . . Direct Program Costs . . . . . . . . . . . Total Expenses . . . . . . . . . . . . . . . . .

$156,274.55 $124,361.60 $662,816.77 $933,452.92

Palm Beach County Medical Society Services is a 501c3 charitable organization which relies on the generosity of our donors. Please visit us at to learn more about our programs. If you would like to learn how you can support our mission, please contact us at 561-433-3940 or

Our hospital and physician tenants reported a


More than

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Pictured Right Nolan Bohan Age 7

Your Vision. Our Passion. 661 University Blvd. I Suite 200 I Jupiter, FL 33458

Physicians and Finance: What no one ever told you in med school By Jeffrey J. Rockefeller, MBA, CFP

From the moment you finished your training and entered private practice, you were thrust into the world of business. Remember that with few exceptions, medicine is a for-profit system and that put you, at that instant, squarely in this world. For many, this was unwittingly and unknowingly. For those of you in solo practice you were propelled directly up to the position of CEO, without a hint of training and maybe not even knowing what a CEO is or does. The only good news was you didn’t have to spend a minute in the mailroom to get there.

Accounts Receivable I have often said it seems easier to get patients better than it is to get paid to get patients better. Anyone remember even a mention of this in school? The physician does not have to be reminded of the shear complexity of the AR with the volume of procedure codes and insurance plans. Combine that with a less – than – willing third party payer and you have a mind numbing challenge. One for only a competent CEO. Give yourself another pat on the back for learning to survive.

So take a minute and congratulate yourself for surviving and still keeping your eye on the ball – helping others. Keep good advisors close to you and let them help you. Any good CEO would.

Debt Business doesn’t degrade medicine; it’s the reality of how you get paid. A financially well run practice can be satisfying and stabilizing. It just requires some basic knowledge of finance and reaching out to competent, trusted advisors who can assist. More on that later.

Medicine and Business Do Mix One statement we often hear is “Well, doctors are terrible at business.” In my opinion nothing could be further from the truth. Actually the financial challenge you have in medicine is considered by some business experts to be nearly insurmountable. Let me explain. One important tool to evaluate the health of a business is to look at the relationship of income to expenses. The least desirable situation would be when income goes down at the same time expenses go up. Look in any financial text book and the author will tell you to sell any business in this condition or would certainly advise you not to buy it. In truth, this scenario is often a reality in private medical practice and has been for some time. Yet you the “the – terrible – at – business” physician has found ways to survive and, for many, prosper. Pat yourself on the back! This is an incredibly difficult task in the business world.

Additionally something else you may not have been taught in school but learned along the way -sometimes the hard way – was accumulating debt. Some physicians know instinctively to proceed with caution with any business debt even if it is presented as acceptable. Unfortunately this is often not the majority. Then the stark reality comes when you realize (but were told otherwise) that you will not pay this debt back “before you know it.” If I could pick one business course to be taught in med school, it would be debt management. Finally, let’s touch on financial planning.

Jeffrey J. Rockefeller, MBA, CFP® Jupiter Office: (561) 575-6363

Jeffrey J. Rockefeller is a registered representative of and offers securities through Kovack Securities, Inc. Member FINRA/SPIC 6451 N. Federal Highway, Ste. 1201, Ft. Lauderdale, FL. 33308 (954) 782-4771. Investment Advisory Services are offer through Kovack Advisors, Inc. Rockefeller & Associates is not affiliated with Kovack Securities, Inc. or Kovack Advisors, Inc. The information contained in this report or information provided does not purport to be a complete description of the securities, markets, or developments referred to in this material. The information has been obtained from sources considered reliable, but we do not guarantee that the

Financial Planning

foregoing material is accurate or complete. Expressions of

While many physicians have been told that financial planning means investing, it is actually just one part of the planning process. On the subject of investments, as a general rule don’t try to manage your retirement savings without a trusted professional’s help unless you have a real and true understanding of the subject. One thing is for sure, you need a plan. In addition to retirement planning, all the important aspects from asset protection to estate planning need to be addressed with a qualified financial planner. As a physician you actually need three advisors: an accountant, a financial planner and an attorney.

opinion are as of this date and are subject to change without notice. This information is not intended as a solicitation of an offer to buy or sell any security referred herein. Past performance may not be indicative of future result. No buy or sell orders may be given using the email, please call the above number to contact your Advisor. Jeffrey J. Rockefeller is registered with and securities are offered through Kovack Securities, Inc. Member FINRA/SIPC. 6451 N. Federal Hwy. Ste 1201, Ft. Lauderdale, FL 33308 (954) 782-4771. Investment Advisory services are offered through Kovack Advisors. Rockefeller & Associates is not affiliated with Kovack Securities, Inc./Kovack Advisors, Inc.




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Telemedicine as a Growing Practice Model By Til Jolly, MD

Healthcare in the United States is often compromised by fragmentation in its delivery, limited patient access due to a shortage of primary care doctors, long wait times (even for patients who have appointments), and spiraling costs. As a result, innovative approaches to delivering healthcare are becoming increasingly important in America’s continued pursuit of improved outcomes and reduced cost of care. Healthcare delivery models such as telemedicine aim to address the long wait times and high administrative costs associated with traditional care and offer important insights for improving the healthcare process. By definition, telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Although telemedicine is rapidly expanding, it is a concept that has existed for more than half a century. At its basic level, telemedicine is a physician talking on the phone to a patient or another physician. Today, the term telemedicine includes remote physician consultations through channels such as texting, video, e-mail, and other wireless tools. Ultimately, the goal is to connect a physician with a patient to provide a diagnosis and recommend treatment options. The U.S. population is getting older and more patients are dealing with chronic conditions. The result is an increasing demand for care. Unfortunately, communities across the country are simultaneously experiencing physician shortages. The Association of American Medical Colleges estimates that the U.S. will face a shortage of more than 130,600 physicians by 2025. The use of telemedicine has the potential to provide some relief from this shortage, which is expected to be equally distributed among

primary care and medical specialties such as general surgery, cardiology, and oncology. Telemedicine can be a cost-effective way to monitor patients, promote better health habits, and provide patients with access to healthcare professionals beyond the walls of their local hospitals and health practices. Telemedicine can help with urgent requests to see a physician as well as more routine followup appointments and visits specifically for prescription refills. Although telemedicine has a lot to offer America’s health system, physicians must carefully consider when to incorporate it into the continuum of care. According to The Doctors Company, the nation’s largest physician-owned medical malpractice insurer, the following are some potential risks providers should be aware of:

Telemedicine can pose challenges for the traditional physician-patient relationship. Office visits allow time for conversations that build relationships and have a positive impact on care. Personal relationships matter in healthcare, and patients need engaged care providers to become engaged themselves. Done properly, telemedicine provides connection, communication, and continuity that can enhance patient care and the physician-patient relationship. Consider developing strategies to ensure patients understand how telemedicine improves their medical care.

A physician cannot perform the onsite portions of a physical exam. Not having a physician on site to perform a physical examination can mean inaccuracies from patient self-reporting and missing additional findings that may only be caught in person. These risks

should be communicated to the patient and documented very clearly in the medical record. In some settings, local onsite support personnel can be part of a complete telemedicine program. The literature increasingly supports inclusion of telemedicine in many practice settings.

Telemedicine is very dependent on technology. It relies on equipment like examination cameras, remote monitoring devices, and surgical robots. If the equipment is inoperable, patient safety and health are at risk. Faulty technology or equipment may cause a physician to act on inaccurate information or prevent the physician from facilitating adequate or continuous care. Continued on Page 25




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Financial Planning for Medical Professionals

â&#x20AC;&#x153;Money isnâ&#x20AC;&#x2122;t everything, but not enough isâ&#x20AC;? 



        Jeffrey J Rockefeller, MBA, CFPÂŽ 


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Proud to be an Endorsed Partner of the PBCMS 

1025 West Indiantown Road, Suite 101, Jupiter, FL 33458 Office: (561) 575-6363 Fax: (561) 575-6386 Cell: (561) 818-8512 EMAIL:


Jeffrey J. Rockefeller is a registered representative of and offers securities through Kovack Securities, Inc. Member FINRA/SPIC 6451 N. Federal Highway, Ste. 1201, Ft. Lauderdale, FL. 33308 (954) 782-4771. Investment Advisory Services are offer through Kovack Advisors, Inc. Rockefeller & Associates is not affiliated with Kovack Securities, Inc. or Kovack Advisors, Inc. The information contained in this report or information provided does not purport to be a complete description of the securities, markets, or developments referred to in this material. The information has been obtained from sources considered reliable, but we do not guarantee that the foregoing material is accurate or complete. Expressions of opinion are as of this date and are subject to change without notice. This information is not intended as a solicitation of an offer to buy or sell any security referred herein. Past performance may not be indicative of future result. No buy or sell orders may be given using the email, please call the above number to contact your Advisor. Jeffrey J. Rockefeller is registered with and securities are offered through Kovack Securities, Inc. Member FINRA/SIPC. 6451 N. Federal Hwy. Ste 1201, Ft. Lauderdale, FL 33308 (954) 782-4771. Investment Advisory services are offered through Kovack Advisors. Rockefeller & Associates is not affiliated with Kovack Securities, Inc./Kovack Advisors, Inc.

Continued from Page 13 • Close your eyes and begin to breathe slowly in and out. Extend your exhales longer than your inhales. • Start observing your body at checkpoints: the legs and hips, the chest and shoulders, and the neck and head. Breathe in and focus on one area’s tension, and as you exhale consciously let the area relax and become heavy. Stay at that area for two to three breaths then mentally move on to the next area and repeat. After all three areas have been completed take a few more breaths and allow the whole body to ‘fall’ on exhales. The whole exercise takes about two minutes. Two minutes out of your day to release and reset "the pressure valve." This type of "smoke break" should be encouraged. The payback is priceless. To learn more visit

Continued from Page 23

Be aware of privacy, security, and patient confidentiality. It’s important to remain HIPAA-compliant. Physicians interested in integrating telemedicine into their practices should ensure patient data files are encrypted to prevent a data breach or cyberattack, clearly define proper protocol for webcams and web-based portals, and ensure there is a mechanism in place to protect the privacy of individuals— including staff members, other patients, or patients’ families—who do not want to be videotaped if sessions are being recorded. Managing the social aspects of telemedicine can be challenging, but telemedicine has the potential to support a stressed delivery system by increasing patient access to care, improving outcomes, and reducing healthcare costs.

7 Ways to be More Productive: These 7 tips can help your practice run more efficiently. Time: There’s never enough of it. You already spend hours and energy, both mental and physical, taking care of your patients, and that makes it challenging to be asked to attend to additional concerns. That’s why it’s important to make sure that time-consuming office tasks are dealt with as efficiently as possible, giving you the maximum possible work time to attend to patients. Try the following tips to help increase efficiency.

1. Have staff perform any tasks that do not absolutely require your input. Administrative tasks should be performed by office staff. Consider whether some procedures can be performed by physician assistants. Saving your time and attention for when it is absolutely necessary will allow you to use that time best.

2. Make sure instructions to staff are clear and easily accessible, so questions are easy to answer, and a standard for how tasks should be performed is readily available.

3. Educate your patients in how your practice works so they can go to the appropriate person for their needs, whether there’s a scheduling question to be answered or a billing issue to be addressed. Patient education can dramatically improve your practice’s efficiency.

your mindset to suit different types of tasks.

6. Schedule patient appointments appropriately. Take into account the amount of time necessary for an appointment, and also allow some open slots for possible emergencies. That way, you will be better able to avoid running late, which means you can also avoid resulting inefficiencies of lateness, such as patient complaints, rescheduled appointments, and patients assuming you are running late and then being late themselves.

7. Keep exam room assignments consistent. Any time spent reorienting yourself in an unfamiliar exam room or finding where a patient is waiting is time wasted. Have your staff assign patients to rooms in a consistent and predictable pattern, and be sure that any necessary materials and supplies are there. Doing your job to the best of your abilities is a time- and energy-consuming process. Make it easier on yourself by taking steps to make your practice more efficient. The MGMA and PBCMS Practice Management Resource Center have excellent tools to help you implement the above recommendations. PNC Healthcare Business Banking

Health Care Delivery System Reform. The Commonwealth Fund. Accessed September 5, 2014. What is Telemedicine? American Telemedicine Association. Accessed September 5, 2014. Physician Shortages to Worsen Without Increases

4. Group together your essential nonpatient tasks, like practice decisions and signing documents, so you can take care of them all at once.

in Residency Training. Association of American Medical Colleges. Accessed September 4, 2014. Contributed by The Doctors Company

At PNC, we understand healthcare professionals have unique needs, and generic financial services aren’t always the right solution. As your PNC Healthcare Business Banker, I can offer you extensive cash flow solutions and targeted banking tools and resources to help you effectively manage the business

5. Schedule similar types of patient appointments together to minimize time spent recalibrating or changing

side of your practice, finance your plans for future growth and enable your journey toward your personal financial goals. To learn more, please feel free to contact me at (561) 803-9238, or e-mail:




Concierge, ACOs and IPAs Beware of Vicarious Liability for Your Doctors By Tom Murphy

On February 10, 2015, a Palm Beach County jury returned a verdict of $8.5 million against MDVIP, the largest concierge medical practice in the country. This is believed to be the first medicalmalpractice verdict against MDVIP and the first against any concierge physicianmanagement company. The verdict confirmed that the jury found MDVIP to be negligent for the actions of one of its physicians who had been sued for misdiagnosing a patient’s leg pain. Eventually, the patient required an amputation of the leg. In addition, the jury determined that MDVIP had falsely advertised their exceptional physicians and patient care. The physician settled

the case with the patient prior to the trial. The company plans to appeal the verdict. This should be a wakeup call to all concierge medical practices, as well as accountable-care organizations and independent physician associations regarding the potential for vicarious liability associated with the care provided by their member physicians or medical providers. Until this verdict, most of these forms of medical-management companies believed that this type of liability did not exist since the physicians are not employees and are contracted to pay a per-patient fee for management services and marketing.

Over the past couple of years, concierge, ACO, and IPA companies have been busy trying to build their businesses while at the same time attempting to comply with all of the newly implemented regulations associated with ACA, HIPAA, and ICD-10. We have found that liability and riskmanagement issues have not been a priority. Given this recent verdict, these items should become a priority and the leaders of similar physician companies should immediately revisit their current professional-liability policies with a medical-professional-liability-insurance specialist. Tom Murphy is a medical malpractice insurance and workers’ compensation specialist with Danna-Gracey. He can be reached at or (800) 966-2120 or

Continued from Page 3 Fourth is the fact that many doctors feel they are underappreciated. The public has come to expect unreasonable results. On a daily basis we cure patients of deadly diseases and are able to alleviate pain and suffering in many, but not all, patients. We clearly have prolonged patients’ lives. Yet, these facts are underreported in the media, and only the most horrific medical mishaps are presented to the public on televisions and in the print media. Such unbalanced coverage serves to erode the doctorpatient trust relationship that has been the foundation of medical care for millennia. Unfortunately, we have allowed politicians and insurance companies to devalue our services and our profession. As physicians, we are often considered to be just one of many types of health care providers, and our patients are frequently referred to as clients. The proud and noble profession of medicine has been both denigrated and minimalized. Yet we remain the prime movers for all the improvements in 26


health care delivery in the United States. Hospitals may win awards for patient care, but we, the physicians are the ones who truly earn those awards. If you read of the commendations our hospitals receive, you will notice that they quickly thank their physician staff. We feel part of the problem is our public relations. We need to get the physician perspective of our healthcare systems, along with its weaknesses and strengths, out to the community. We must regain the trust and admiration of our patients. To this end, we are in the process of hiring a public relations firm to increase our visibility and more accurately present the physician point of view. Finally, recognizing the magnitude of the problem of physician dissatisfaction and burnout, the American Medical Association is spending $10 million dollars to identify areas of physician dissatisfaction and combat the “regulatory tsunami” that often frustrates and impedes patient care.


We look forward to working with all of you to improve physician satisfaction, reduce burnout, and restore the practice of medicine to a scientific, rather than a bureaucratic endeavor.

Continued from Page 9 9. Reassess the balance between your work and your personal life to ensure a healthy balance and seek family feedback and avoid the dangers of compulsive overwork and unhealthy ambition. Reassess this every 5-6 years

10. Stick to your Hippocratic ideals and sense of higher purpose in life, while also adjusting for the realities of modern practice. Follow these tips and you can take back control over your life. Stefan A. Pasternack, M.D. DLFAPA Affiliate Professor, Charles E. Schmidt College of Medicine at FAU and Teaching Analyst s Florida Psychoanalytic Institute

It was the first note I ever got in crayon. “Thank you for making my daddy feel better.” I keep it on my desk, where I pore over patient records and cash flow statements. Because even if the medical field seems to be changing by the day, the reasons I practice never do.

Morgan Stanley is proud to sponsor Palm Beach County Medical Society

SunTrust Medical Specialty Group provides the dedicated team and tailored solutions to help with your financial needs.

Patricia Corbett CFP® Vice President Financial Advisor 595 SOUTH FEDERAL HIGHWAY Boca Raton, FL 33432 +1 561 393-1535

Contact SunTrust Private Wealth Management Medical Specialty Group: Ashlea Ayer – Client Advisor or 954.765.7380

Ashlea Ayer is a registered representative of SunTrust Investment Services. Investment and Insurance Products: • Are not FDIC or any other Government Agency Insured • Are not Bank Guaranteed • May Lose Value SunTrust Private Wealth Management is a marketing name used by SunTrust Banks, Inc. and the following affliliates: Banking and trust products and services, including investment advisory products and services, are provided by SunTrust Bank. Securities, insurance (including annuities) and other investment products and services are offered by SunTrust Investment Services, Inc., an SEC registered investment adviser and broker- dealer, member FINRA, SIPC, and a licensed insurance agency. SunTrust Bank, Member FDIC. ©2015 SunTrust Banks, Inc. SunTrust and How can we help you shine? are federally registered service marks of SunTrust Banks, Inc.

© 2012 Morgan Stanley Smith Barney LLC. Member SIPC.

NY CS 7181509 SUP012 10/12 GP10-01281P-N06/10

EĂŶĐLJWƌŽĸƩ is an award-winning business growth expert, author and ĨŽƌŵĞƌ&ŽƌƚƵŶĞϱϬϬĐŽŵƉĂŶLJĞdžĞĐƵƟǀĞ͘

Upcoming symposiums State of Science Symposium: Critical Care Best Practices (Sixth Annual)

Primary Care Focus Symposium (14th Annual)

Saturday, June 6 Baptist Hospital Auditorium (6.25 CME/6 CE)

Friday-Sunday, July 24-26 Ritz Carlton, Naples (13 CME/CE)

Beneath the Surface: In-depth Focus on Wound Care and Critical Limb Ischemia Symposium (10th Annual)

Foot and Ankle Symposium (Third Annual) Friday, September 18 The Ritz-Carlton Coconut Grove, Miami (4 CME/CE)

Saturday, September 19 The Ritz-Carlton Coconut Grove, Miami (6.5 CME/CE)

More CME opportunities at

Connect with us BaptistCME

Med Memo Quarter Two 2015

Samaritan Hospital, as well as Radiologistin-Chief at both St. Mary’s Hospital and Bethesda Memorial Hospital until his retirement. Contributed by Malcolm S. Van de Water, MD

SAVE THE DATE May 28, 2015 5:30 – 7:30pm

PBCMS Ladies Night Out Norcross Patio 5023 S. Dixie Highway, West Palm Beach, FL 33405 More info:

Larry Bush, MD; James Goldenberg, MD; Robert Tome, MD; Stephen Babic, MD; James Howell, MD

July 31 – August 2, 2015

FMA Annual Meeting Disney’s Yacht & Beach Club Resort More info: August 9 – 16, 2015

PBCMS - FMA Alaska Cruise More info:

FMA 2015 Annual Meeting July 31 – August 2, 2015 at Disney’s Yacht & Beach Club Resort Live CME, including state-mandated courses. Registration is now open; the FMA room block rate for single/double occupancy is $189. For more information visit http://www.

Palm Beach County Medical Society – FMA Alaskan Cruise 7-Night Alaskan Cruise Conference, Round-trip Seattle, Washington onboard Holland America’s ms Amsterdam. Cruise rates start at $764 per person based on double occupancy, plus taxes and fees. Registration fees: Members $495, NonMembers $695. CME Credits: 12 Contact Hours: 12. For more information visit www.

Thank you for “Making a Difference” during the Great Give 2015 This year Palm Beach County Medical Society Services raised $6,000 during the Great Give 2015! Thank you to everyone

who contributed during the event, we couldn’t have done it without you.

2015 Harold Strasser Scholarship winner Congratulations to James Parson of Seminole Ridge High School. James has maintained leadership roles by serving in the Student Government Association, and participating in multiple varsity sports throughout his high school career. He also helps others within his community by volunteering in the Special Olympics, mentoring elementary age students and participating in many community service projects. James plans on obtaining a Master’s degree in Criminal Justice from the University of Central Florida to fulfill his goal of becoming a Federal Bureau of Investigation agent.

You’re invited to shop for a cause! Join PBCMS at Norcross Patio & Gifts to shop their newest summer boutique fashions and accessories. 15% of all purchases will benefit Project Access. Cocktails and appetizers will be provided. $15.00 donation at registration. For more information contact Lauren Tome at or 561-433-3940

Moment in History: Dr. Frederick K. Herpel (1893- 1981) served as Palm Beach County Medical Society’s president in 1929. Known as a “pioneer of radiology in Florida”, Dr. Herpel was Chief of Staff in 1946 at Good

Alan Pillersdorf, MD; Shawn Baca, MD; Stephen Babic, MD, PBCMS physicians spend the day at the capital Tallahassee, FL

Preston Graef; Renata Graef; Lorin Graef, MD; Jonathan Graef Doctor’s Day Celebration South Florida Science Center & Aquarium, West Palm Beach, FL

Stephen Babic, MD PBCMS House Call Speaking Event St. Andrews Country Club, Boca Raton, FL




Welcome New Members! Quarter Two 2015 Michael D. Black, MD Pediatric Cardiology/General Surgery West Palm Beach Joseph Etienne, MD Infectious Disease, Wellington

Cheryl Counsell, MD Ob/Gyn, Boynton Beach

Kenneth Homer, MD Internal Medicine, Fort Lauderdale

Michael Galin, DO Otolaryngology, Wellington

Oneka Marriott, DO Pediatrics now Administrative, Fort Lauderdale

Mignon Metcalf, MD Internal Medicine, West Palm Beach

Wade Van Sice, MD Orthopaedic Surgery, Jupiter Martin Schnier, DO Faculty/ Administrative, Belle Glade

Bernardo Obeso, MD Administrative Medicine (FAU Residency Program), Boca Raton

Laura Balda, MD Family Medicine, West Palm Beach

Brian Wagstaff, MD Family Medicine , West Palm Beach


Malayandi Rajamanickam, MD Jupiter


Helen Martin, PA South University - Program Director for Physician Assistant Program

6DIH3DVVDJHWR6XSHULRU3UDFWLFH +LJKOLJKWLQJ/HJDO(WKLFDO 5LVN0DQDJHPHQW%HVW3UDFWLFHVIRU )ORULGD/LFHQVHG3K\VLFLDQV 7-Night Alaskan Cruise Conference, Round-trip Seattle, Washington Onboard Holland Americaâ&#x20AC;&#x2122;s ms Amsterdam â&#x20AC;&#x153;Supported by a generous contribution from The Doctors Company.â&#x20AC;?

August 9-16, 2015 sĹ?Ć?Ć&#x161;Ç Ä&#x17E;Ä?Ć?Ĺ?Ć&#x161;Ä&#x17E;Ć&#x161;Ĺ˝Ç&#x20AC;Ä&#x17E;Ĺ?Ç Ć&#x152;Ä&#x201A;Ć&#x161;Ä&#x17E;Ć?Í&#x2014;Ç Ç Ç Í&#x2DC;ŽŜĆ&#x161;Ĺ?ŜƾĹ?ĹśĹ?Ä&#x161;ĆľÄ?Ä&#x201A;Ć&#x161;Ĺ?ŽŜÍ&#x2DC;ĹśÄ&#x17E;Ć&#x161; Registration Fees: Members: $495 Non-Members: $695 12 DĆ&#x152;Ä&#x17E;Ä&#x161;Ĺ?Ć&#x161;Ć?Contact Hours: 12

Î&#x17D; Taxes and fees $464.67 per person ; Prices are per person based on double occupancy and subject to change. All specials offered by the cruise line are reviewed at the time of booking and if applicable will be extended to you. Continuing Education / University at Sea ÂŽ For reservations please 1-800-422-0711 or 727-526-1571 www.ContinuingEducation.NET



patients safe and keep claims low, we all win. The Doctors Company is strong, with 76,000 members and $4.5 billion in assets. This strength allows us to defend, protect, and reward the practice of good medicine like no other.






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

Important Conversations on Healthcare September 1 7 t h - 18th, 2015

The Palm Beach County Convention Center, West Palm Beach For registration or supporter opportunities, visit or call 561-433-3940.

Making a Difference in Healthcare.

2015 OnCall Quater 2  
2015 OnCall Quater 2