QUARTER 3 2018
THE OFFICIAL PUBLICATION OF THE PALM BEACH COUNTY MEDICAL SOCIETY
Talented Docs Page 14
Mostly Doctors Band
Dan Higgins MD, Jack Zeltzer MD, John Fernandez MD and Kevin Beckley
Work to Live or Live to Work?
Integrate “Life” Back Into Career
Retired Physicians Making a Diﬀerence
Brandon Luskin, MD
President Palm Beach County Medical Society
Work to Live or Live to Work?
s we move through the summer and soon will face the fall in South Florida, I am becoming more and more aware of the growing population of our county. I remember 20 years ago how slow the summer could get, and how invariably some much needed rest was seemingly built into the system after a long and stressful snowbird season. Over the last two decades, the differential between the work stress of winter vs an eventual slowdown of summer has significantly diminished. With this in mind, it is now even more important that we physicians must learn to find time to replenish ourselves all along the way. The issues of physician burnout have most recently come to the forefront as a significant problem in health care. Like most of the problems that we physicians face, nobody will solve this for us, and we can only look to ourselves for solutions. The concept of work-life balance is not one that bodes well with many of us. When considering this issue, we must first ask ourselves do we want to “work to live or live to work?” This can at times be difficult to answer. With so many responsibilities already laying on our shoulders, we do at times feel like we live to work, because so many people from our patients, to our own family members deeply rely on us. We handle immense responsibilities and make it look easy to others, and in doing so, seem to invite even more obligations than we want to manage. Attention to the concept of work-life balance is likely the best way of preventing and treating physician burnout. I would like to share some key points that I have recently read in Forbes magazine in an article by award-winning journalist Deborah Jin Lee. She highlights six tips for better work-life balance, which are applicable to all careers, not just Medicine. I share them with you. First, let go of perfectionism. If ever there was a profession that would seem to demand total full-time perfection it is Medicine. In reality we can strive for perfection but must learn to accept that there frequently is no such thing. Set high
standards for yourself but don’t expect to always be able to deliver perfection. Learn to let it go. Her second tip is to “unplug”. Although technology has made many areas of our lives easier, telecommunications have seemed to make us too available. It is just not realistic that we should be consistently accessible. Taking greater control of your availability leads to a greater sense of control of your life. Don’t forget about exercise or meditation. We make time for so many things, but when we get busy with too much to handle, it is often these areas that are the first to go. Exercise is an effective stress reducer. If time really gets limited, some deep breathing exercises during a commute or drive home can accomplish wonders. Limit time-wasting activities and people. Decide who and what are most important to you, and then set firm boundaries, keeping those people and activities that don’t help you achieve your goals to a minimum. It may be a chatty colleague who holds you hostage in the halls of the hospital or running to a facility you don’t go to often. Learn to politely excuse yourself from those situations that don’t work toward your best interest. Never be afraid to change the structure of your life. Lee recommends that we take a bird’s-eye view of our lives and ask ourselves: what changes could make our lives easier? Find out what you can do to let go in ways that help you and benefit other people. For example, many internists no longer make hospital visits on their patients, and have allocated this to the hospitalists. Although this may be disappointing to some patients, it has enabled many physicians to be better doctors overall by preventing burnout. Lastly, she recommends starting small, and building from there. Rome wasn’t built in a day. It is more likely that a series of small changes will succeed than an attempt at a big change that may be unrealistic. The goal is to be happier with ourselves and with what we do. So, receive this advice in good faith, and I wish you all the best of luck in your personal journey with work-life balance. OnCall • Q3 2018
BOARD OF DIRECTORS Brandon Luskin, MD
Marc Hirsh, MD
Larry Bush, MD
Shawn Baca, MD
Stephen Babic, MD Andrew Berkman, MD Berna Buyukozturk, Medical Student Dawn Davanzo, MD Kleper de Almeida, MD Michael Dennis, MD James Goldenberg, MD Henry Haire, MD James Heron, MD Hitesh Kapupara, MD
Milad Khoury, MD Krishna Kishor, MD Ekaterina Kostioukhina, MD Claudia Mason, MD Stefan Pasternack, MD Leslie Perla, MD Alan Pillersdorf, MD Ronald Zelnick, MD Jack Zeltzer, MD
First Vice President
D E PA R T M E N TS
3 6 7
President's Report Med Memo Welcome New Members
BOARD OF TRUSTEES Jose Arrascue, MD Stephen Babic, MD Shawn Baca, MD Larry Bush, MD
James Goldenberg, MD Maureen Whelihan, MD Marc Hirsh, MD Ronald Zelnick, MD Brandon Luskin, MD Jack Zeltzer, MD Alan Pillersdorf, MD
BOARD OF DIRECTORS Michael Dennis, MD Don Chester President
Ivy Faske, MD
Jean Acevedo William Adkins, MD Elaine Alvarez Jose F. Arrascue, MD Brenda Atkins Steven Borzak, MD Tish Carlo Ljubica “Jibby” Ciric
Patti Corbett Mollie Shulan, MD Bobbi Horwich Kelly Skidmore Andrew Larson, MD Patricia Thomas Gary Lesser Maureen Whelihan, MD Roshan Massoumi Paul Wieseneck Stuart Miro, MD Jack Zeltzer, MD Alan B. Pillersdorf, MD Tenna Wiles, CEO Brent M. Schillinger, MD
PBCMS STAFF DIRECTORY Tenna Wiles Mindi Tingler
Project Access Director
Member Services & Physician Wellness Director
Membership Development & Events Director
FE AT U R E S
Subscriptions to OnCall are available for an annual rate of $50. For more information contact PBCMS at (561) 433-3940. The opinions expressed in OnCall are those of the individual authors and do not necessarily reﬂect official policies of Palm Beach County Medical Society or its committees. OnCall is owned and published four (4) times per year by Palm Beach County Medical Society, Inc., 3540 Forest Hill Blvd., #101, West Palm Beach, FL 33406. (561) 433-3940. ©Copyright 2018 Palm Beach County Medical Society, Inc. OnCall Magazine is designed by MillerDesignPros, email us at email@example.com or visit us on the web at www.millerdesignpros.com
Heroes in Medicine Event May 19
Standing Ovation for Talented Docs
Retired Physicians Making a Difference
The Rising Risks of Sexual Harassment Allegations
Cultural Competence Introduction
Is it Time for Your Medical Practice to Have a Quick Check-Up?
Care Coordination Services Director
Public Health & Disaster Services Director
A Proven Cure for Burnout
Page 18 OnCall • Q3 2018
Physician Leadership Academy of SF Graduates Second Class
Mark Your Calendar September 26
Women in Medicine
Benvenuto’s, Boynton Beach October 26-28
Physician Well Being Cruise Port of Palm Beach November 17
Annual Starﬁsh Gala
Kravis Center, Cohen Pavilion, West Palm Beach February 7-8, 2019
Future of Medicine
Remember to VOTE!
Elections are August 28! Every election cycle, MEDPAC works to identify and support candidates who have a proven record of standing with medicine and supporting our patients and our profession. The MEDPAC Board of Directors conducted candidate interviews and supports the following candidates: State Legislature District 81 Tina Scott Polsky (D) District 85 Rick Roth (R) District 86 Matt Willhite (D) District 87 David Silvers (D) District 88 Al Jacquet (D) District 89 Matt Spritz (R) District 90 Joe Casello (D) District 91 Emily Slosberg (D) District 30 Bobby Powell (D)
(L to r) Seated row: Gazelle Aram, MD; Barbara Montford, MD; Martha Rodriguez, MD; Tarannum Kahn, MD; Anjali Bhasin, DO; Jennifer Capezzuti, DO. Standing; Jim Sugarman, PLA Facilitator; Ralph Nobo, MD; Cynthia Peterson, CEO-BCMA; Manual Torres, MD; Shady Salib, MD; Ramon Cuevas-Trisan, MD; William Slomka, MD; Rafael Torres, MD; Claude Jones, DO; Bharat Gupta, MD; Brandon Luskin, MD, President-PBCMS, Zubin Panthaki, MD; Abby Berens, MD, BCMA Board Representative; David Coradin, MD; Rudy Moise, DO; James Goldenberg, MD, PLA-Advisory Council Chair, Tenna Wiles, CEO-PBCMS; Patricia Handler, EVP-DCMA; Eduardo Martinez, MD-DCMA Board Representative; Ronald Giﬄer, MD (Not pictured: Graduates William Gans, MD and Jorge Marcos, MD)
The Physician Leadership Academy of South Florida (PLA), under the auspices of the Palm Beach County Medical Society and held in collaboration with the Broward County Medical Association and Dade County Medical Association held its 2018 graduation May 21. Eighteen physicians from the three counties graduated from the PLA. Along with guests of family members, colleagues and friends were Ralph Nobo, MD and Ronald Giﬄer, MD. Palm Beach County graduates are Ramon Cuevas-Trisan, MD, William Slomka, MD and William Gans, MD. The PLA is funded by The Physicians Foundation and has been endorsed by the Florida Medical Association, which provided CMEs to all attendees.
Starﬁsh Gala Set For November 17
Circuit Court Judges Group 13 Scott Kerner Group 18 Marybel Reinoso Coleman Group 25 Michael McAuliﬀe County Court Judge Group 4 Gabe Ermine County Commissioners District 2 Gregg Weiss (D) District 4 Robert Weinroth (D)
PBCMS membership payments can be paid online. If you have not logged in before, call 561-433-3940 for easy instructions. Do you have a colleague who is not a PBCMS member yet? Now is the time to JOIN! If they join by August 3, their office manager will be entered into a drawing.
Q3 2018 • OnCall
The Annual Starﬁsh Gala and Festival of Trees & Lights is set for November 17 at Kravis Center. For tickets, information on sponsorships, and applications for the Festival of Trees and Lights (shown above) call 561-433-3940.
Six Obtain CHW Certiﬁcation
Six Community Health Workers obtained CHW Certification through the Florida Certification Board. All individuals received training through the CHW Care Coordination Training program held through the PBCMSS Institute for Learning. (L to r) Gonzalina C. Perez CCHW, Marco Meneses CCHW, Lydia Mercedes Rodriguez CCHW, Michaelle Schutt Anne CCHW, Olga L. Sierra CCHW, and Carmen Maria Castillo CCHW (Missing from photo: Betzy Raga CCHW). All participants attended the training for professional development through their employers, which includes Health Care District of Palm Beach County, Healthy Mothers and Healthy Babies Coalition of Palm Beach County, and Vita Nova. All trainees provide health and resource navigation to patients for chronic health conditions, prenatal care, and mental health diagnosis.
Opioid Healthcare Response Task Force Meeting
Welcome New Members! A. Geni Abraham, MD Gazelle Aram, MD Kale Geetanjali, MD Ricardo Leano, MD Jill Rodila, MD Residents Stephannie Gopie, MD Spencer Greaves, MD Michael Morejon, MD
(L to r) Belma Andric, MD; Courtney Rowling, MD; Robert Moran, MD; Greg McNeil and John Hulick at the meeting.
In May, PBCMS and HERC conducted an Opioid Healthcare Response meeting where the taskforce shared its Opioid Response Plan with health care community leaders. The plan’s overarching goal is to reduce opioid deaths in Palm Beach County by one-third using a comprehensive approach that recognizes addiction as a medical illness and is accomplished by an evidence-based strategy that addresses Prevention, Rescue, Treatment and Recovery. Contact John James — JohnJ@pbcms.org for additional information.
Seeking Physicians Who Want to Build and Enhance Their Leadership Capabilities
The Physician Leadership Academy (PLA) of SFL is seeking physicians who have an interest in building their leadership knowledge and skills. Over the past two years the PLA of SFL has graduated 36 South Florida physicians from Palm Beach, Dade and Broward Counties. Contact Karen Harwood at KarenH@pbcms.org or 561-433-3940 x122 for additional information.
Nominate a Woman Physician by August 20 September is Woman in Medicine Month and PBCMS will honor a woman physician who has offered her time, wisdom and support to advancing women with careers in medicine. Take a moment to nominate a professional colleague or teacher who has supported you during your professional journey and has provided important mentorship or inspiration. Consider nominating a physician for our Female Physician of the Year! Deadline for nominations is August 20, 2018. Visit www.pbcms.org for more information.
Residents — FAU H. Daniel Adams, MD Jamin Kweki Addae, MD Sharmin Akher, MD Adrian Artiles, MD Priya Bansal, MD Kendra D. Batey, MD Katharine L. Burton, MD Alexander Mark Busko, MD Eric Chacko, MD Franco J. Chevalier, MD Oladipo Cole, MD Gopika Dasari, MD David Del Sol, MD Asia Filatov, MD Wayne Fluss, MD Jordy Godinez, MD Zachariah Hatoum, MD
Fawzi M. Hindi, MD Anneka Hutton, MD Kendall Rae Johnson, MD Navneet Kaur, MD Jared Kelly, MD Andrew Kirsner, MD Danielle Klein, MD Shane Lince, MD Daud Lodin, MD Adam Mann, MD Amanda Marsh, MD Zuheir Mirza, MD Shaheen Mizyed, MD Mayur Patel, MD Sanja Hotic Patino, MD Minh Quan, MD Fred N. Qafiti, MD Steven Shanab, MD Nisha Sharma, MD Pamraj Sharma, MD Anabelle Taveras, MD David L. Waldbury, MD Slee La Yi, MD Medical Students University of Miami Elizabeth Akinsoji Jonathan Amodio Kelly Brennan
Victoria Brennan Corinne Bullock Anise Crane Allison Ferris Kelsey Franklin Carolina Gonzalez Alexandra Hernandez Alexandra Heyes Michael Hu Taylor James Jennifer Koh Vaishnavi Krishnan Dalia Kuakuer Jared Lee Nicole Lin Daniel Lopez Hannah McMurry Vanessa Nascimento Harris Onugha Faradia Pierre Kayla Polcari Maxwell Presser Andrew Stine-Rowe Camille Scott Juliet Silberstein Jennifer Tibangin Darren C. Tsang Felicia Yan Catherine Zaw
Docs in the Community Larry Bush, MD, a member of the PBCMS Board of Directors, presented on Vaccines to a group of 150 guests at the Valencia Cove Men’s Club, Boynton Beach. Dr. Bush is an infectious disease specialist in Atlantis, Florida and is affiliated with multiple hospitals, including JFK Medical Center and JFK Medical Center North Campus.
Congratulations to the Graduating Class of the Spring 2018 CHW Care Coordination Training Program. Participating community partners include Medical Specialists of the Palm Beaches, Health Care District of Palm Beach, Healthy Mothers Healthy Babies Coalition of the Palm Beaches, and Clinics Can Help. The next training session will be held this fall. For more information contact Karen Harwood, firstname.lastname@example.org or 561-433-3940, ext. 122. OnCall • Q3 2018
A Proven Cure for Burnout
Physicians Share How They Integrate “Life” Back Into Their Careers
By Leon Fooksman The couple also paints and is known among artists in Teypical physician duties include patient visits, administrative duties, charting, teaching, meetings, and com- questa and Key West — Dr. Rowe for oil, acrylic, and landmunity activities. Now add on mobile technology, and scape scenes, and Dr. Sykes for pop art and animal portraits (she also illustrated a children’s book). work time can easily creep into life time. Dr. Rowe adds, “There are so many things going on in the That’s evident by most physicians reporting that they work 40 to 60 hours a week — and close to 20 percent of physicians health care industry today that create stress for all of us. So it’s important to do other things. report that they work 61 to 80 hours “Experts point to You have to get away and have a week, according to an American fun and escape it all. It’s got to be Medical Association study. the importance something active — watching TV It’s no wonder physician burnout or sports isn’t enough. All of this and dissatisfaction rates are at an of...sleep, nutrition, will stave off Alzheimer’s Disease.” all-time high in the United States. exercise, hobbies, In fact, the levels of burnout among Daily Exercise physicians are substantially higher spiritual pursuits, That’s Fun, Too than in the general population. and interactions.” On any given weekend, you’ll Not surprising, satisfaction with fi nd Maureen Whelihan, MD, trollwork-life balance also is on the deLeon Fooksman, Staﬀ Writer, OnCall ing for dolphin, mahi, tuna and cline. And perhaps that’s the most troubling part of being a physician today: lacking work-life other fish (as well as photographing) off the Boynton Inlet. If balance can lead to further burnout, lower quality patient care, fish are caught, her job is to drive the boat and clean the fish stress on relationships at home, and poor physician health, rather than clean the boat! “I am better with a knife (scalpel) studies show. Many experts point to the importance of finding than a scrub brush,” she jokes. Dr. Whelihan adds, “If the seas are too rough, we (she and time outside of medical work for wellness like sleep, nutrition, exercise, hobbies, spiritual pursuits, and interactions with fam- Chuck) like to get out on our motorcycles. I learned how to ride when I was 50. We have matching 2016 HD Heritage Clasily and friends. Thankfully, some physicians have incorporated “life” back sics. We make time for travel which always includes hiking, into their careers, finding unique ways to unwind from daily zip-lining or other forms of exercise to keep us in our daily routine. We rarely miss a day of exercise, ever.” stress, and keep the threat of burnout at bay. She says she has become much better at finding time for The Palm Beach County Medical Society asked local physicians to explain how they spend their time after work, and fun in her life. “I have learned that the work will always be what activities help them cope with demands of the medical there and will eventually get done. Returning to the work profession. We found physicians enjoying many conventional and unconventional hobbies — such as riding motorcycles on lazy weekend afternoons, ﬂying planes to South American countries, playing in rock bands, singing to audiences, and painting animal portraits. Here are their stories.
Music Is the Best Therapy
Thomas Rowe, MD, and his wife, Robin Sykes, MD, have enjoyed playing music for 15 years. Dr. Rowe loves coming home from work as a surgeon and playing his bass guitar to the music of the Beatles and Rolling Stones, and Dr. Sykes, also a surgeon, plays the ﬂute and keyboards. “Music is the best therapy,” Dr. Rowe says.
Q3 2018 • OnCall
Dr. Robin Sykes and her husband Dr. Thomas Rowe share a love of music and art which helps them achieve a work-life balance.
Dr. Maureen Whelihan and Chuck never fail to exercise and have fun almost every day. Here they are ﬁshing, zip-lining and biking.
of sleep. “2009 was the first year in my adult life that I had an opportunity for uninterrupted sleep on an ongoing basis. I celebrated with a new mattress, the most opulent bed linens I could afford, and made my bedroom as comfortable as possible. One thing was not allowed — a TV,” she explains. Dr. Mason says weekends are made for family. Most of Up, Up and Away Graham Whitfield, MD, took up ﬂying years ago. With a her family lives in New York City, so she takes the “grandcommercial pilot’s license, he has a plane (an 8-seater cabin ma express” from Palm Beach International Airport to visclass twin) that has taken him to the islands of the Caribbean, it her mother, son, grandson, and daughter-in-law about as well as to Venezuela, Mexico, and Belize and other parts once a month. “This affords me a happy getaway, reconnects me with my loved ones, and is a distraction from my daily of South America. “Pilots lead exciting lives,” he says. “The reason that I enjoy work,” she says. being a pilot is that it gives me balance in my life.” Born in England, Dr. Whitfield holds dual citizenship. “We have a Do a Little Bit of Everything Geetanjali (Kelkar) Kale, MD is an endocrinologist and a saying in England: ‘All work and no play makes Jack a dull boy!’ When I am ﬂying the airplane, I feel as if I am on va- proud mother. She says, “Before I had kids, I lived and breathed medicine. cation. It takes very focused attention to ﬂy a plane, so I My journey to motherhood has been rocky to say the least. My am not thinking about any twin daughters were born 14 weeks early, while I was still in matters relating to my med- fellowship and ended up spending four months in NICU. That ical practice.” Dr. Whitfield, changed what medicine meant to me completely. If I didn’t an orthopedic surgeon, also have the support of my husband, my family and wonderful reduces stress by dancing and and kind strangers I met along the way, I would not be able singing. He was a big hit at the to be a proud mother of two, beautiful four-year-old girls, recent Docs Got Talent show as well as a part-time endocrinologist, a fierce patient safety with his karaoke performance advocate, an avid reader, amateur chef, and a world traveler.” Dr. Kale says she’s always looking forward to new experiof “I Will Survive.” ences and adventures. “I try to do a little bit of everything so Give the Gift of Sleep I do not get tired of doing the same thing every day.” Since retiring from obstetrics and now practicing Make Every Moment Count Dr. Graham Whitﬁeld gynecology, Claudia Mason, An orthopedic surgeon, Mirylsa Colón-Martínez, MD, at Docs Got Talent. MD, has given herself the gift spends a lot of her free time with her family, practicing yoga,
week feeling refreshed leads to more productivity in the end. No burnout here. I actually LOVE what I do for a profession (she is a gynecologist) but certainly enjoy my time having fun with my man when I can,” she says.
OnCall • Q3 2018
The audience loved Dr. Mirylsa ColónMartínez’ “Misty”at Docs Got Talent.
boating, and singing. And can she sing. As a participant in the recent Docs Got Talent, her jazzy rendition of “Misty” was a show-stopper. She says she creates balance in her life by choosing happiness over success. “At this point in my career, I believe I don’t have to prove anything to anyone else. My priority is my happiness and my family. Learning when to say “no” has been a challenge, but rewarding beyond words. I opened my own practice so I have full control of the way I practice, my work hours, the hospitals I cover, etc. I make the effort to make every moment count, at work, as well as with my family. I focus on quality rather than quantity.”
“Whether it is a month away or a year away, so much of the enjoyment of travel is anticipating, researching, and planning. We try to plan at least one special family trip a year,” says Dr. Nachlas. He adds, “It is very easy to get so preoccupied with the growing practice that you lose sight of what is truly important. Traveling and travel photography have been not only fun hobbies, but a way to engage the family and spend special time with them. The more exotic and challenging travel (India, Bhutan, Greenland, etc.) I do with one of my four children at a time. That gives me extra opportunity for that irreplaceable one-on-one interaction.”
Jamming to Escape
For Jack Zeltzer, MD, his escape from doing surgery is finding simple pleasures such as “just puttering around the house doing yard work and small repairs… I spend a couple of hours on the weekend messing up things I am trying to fix.” Once a week, though, he attends a “jam night” at one of the local clubs and gets to sit in and drum with local musicians. (Dr. Zeltzer, the drummer for the Mostly Doctors Band, graces the cover of OnCall with his bandmates.) He says, “The things I do are great stress relievers and very enjoyable for me. It is fun to be part of a group (even for a Focus on Family, Work and Travel When taking a break from his busy facial plastic and recon- short time) playing good music with great musicians. What structive surgery practice, Nathan E. Nachlas, MD, focuses on is really nice is the camaraderie and tolerance they have for my amateur status. And most importantly, nobody sues you if three things: family, work, and travel. He says, “Traveling the world, experiencing other cultures, you miss a beat!” and documenting these adventures through photography have been a constant for the past three decades of practice…We Leon Fooksman is a writer for OnCall. He can be reached at: leon@digitalstoryline. com or @compellingstory on Twitter. always have a trip planned.
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There are many ways you could be wasting money on your malpractice insurance Did you know that most doctors unknowingly waste money on malpractice insurance, which is one of the largest expenses in a medical practice each year? Some of the most common ways doctors continually spend too much include:
#6. Not working with the right agent or broker Find an independent agent specializing in malpractice insurance placement for your type of practice setting (solo, group, hospital, surgical center, etc.) and one who has an educational approach versus a sales orientation. Your agent should be strong enough within the malpractice insurance marketplace to fully and competently negotiate the best rates for you with the top insurers in your state. With such a large expense and such costly mistakes possible, you deserve the best available assistance.
Isnâ€™t it time you called Matt Gracey, the med mal insurance expert? Delray Beach â€¢ Jacksonville â€¢ Miami â€¢ Orlando â€¢ Panama City â€¢ Pensacola Matt@dannagracey.com â€¢ 800.966.2120 â€¢ www.dannagracey.com
;OL7)*4:>VYRLYZÂ»*VTW0UZ\YHUJL 7YVNYHT/HZH5L^5HTLHUKHU,UOHUJLK+P]PKLUK All current and new Palm Beach County Medical Society members are eligible for an enhanced dividend of \W[V . 7)*4:TLTILYZOH]LYLJLP]LKV]LYTPSSPVUHUKJV\U[PUN :PUJL[OLYH[LZMVY^VYRLYZÂ»JVTWLUZH[PVUPUZ\YHUJLHYLZL[I`[OLZ[H[LWYPJLZHYL[OLZHTLUVTH[[LY^OLYL`V\ ZLJ\YLJV]LYHNL)\[UV^`V\HYLLSPNPISLMVY[OPZLUOHUJLK KP]PKLUK^OPJOLMMLJ[P]LS`YLK\JLZ[OL[Y\LJVZ[ VMJV]LYHNL6[OLYWYVNYHTZTH`VMMLYZPTPSHYKP]PKLUKZVUHUPUKP]PK\HSIHZPZI\[V\YWYVNYHTPZIHZLKVU[OLNYV\WÂ»Z L_WLYPLUJLHUKUV[[OLPUKP]PK\HSÂ»ZL_WLYPLUJL;OPZWYV]PKLZHIL[[LYJOHUJL[VUV[VUS`YLJLP]L[OLKP]PKLUKI\[[V YLJLP]LHOPNOLYKP]PKLUK (T;Y\Z[5VY[O(TLYPJHMVYTLYS`*VTW6W[PVUZOHZILLUH[Y\LWHY[ULY[V[OL7HST)LHJO*V\U[`4LKPJHS:VJPL[`MVYTHU` `LHYZHUKUV^^P[O[OLYLZV\YJLZVM(T;Y\Z[YH[LKÂ¸(Â¹,_JLSSLU[I`(4)LZ[^LHYLHISL[VWYV]PKL[OPZL_JS\ZP]L LUOHUJLKKP]PKLUKWYVNYHT[OH[PZSPRLUVV[OLYMVY-SVYPKHWO`ZPJPHUZHUKTLKPJHSWYHJ[PJLZ;VKH[L[OLZLWYVNYHTZOH]L YL[\YULKHKP]PKLUKMVYZ[YHPNO[`LHYZ^P[OV]LYTPSSPVUV]LY[OLWHZ[Ã„]L`LHYZ[V-SVYPKHTLKPJHSHZZVJPH[PVUZÂ»TLTILYZ! TPSSPVUVM[OH[^LU[[V7)*4:TLTILYZ -VYTVYLKL[HPSZHUK[VLUYVSSPU[OPZILULÃ„JPHSWYVNYHTWSLHZL JVU[HJ[;VT4\YWO`VM+HUUH.YHJL`H[ VY [VT'KHUUHNYHJL`JVT
Heroes in Medicine Set For May 19
Annual Luncheon Honors Health Care Heroes
ohn Dalton, CEO and President of OptimumRTS, is the chair of the Heroes in Medicine Luncheon set for May 19, 2019 at the Kravis Center, Cohen Pavilion, West Palm Beach. He will be assisted by co-chairs Gregory Cotes, MHA, Administrative Director, Support Services, St. Mary’s Medical Center; and Judith Dunn, Manager of Healthcare Partnerships at CareerSource Palm Beach County, as well as a number of dedicated volunteers. Dalton believes that helping others ultimately results in personal and professional fulfillment, and he is thrilled and honored to head up the 2019 Heroes in Medicine event, especially as it will be held during the year-long Centennial Celebration of the Palm Beach County Medical Society. Rendina Healthcare Real Estate is a trusted national leader in healthcare real estate, providing comprehensive solutions to our clients and giving back to the communities we serve. We assist hospitals and health systems in fulfilling growth and physician recruitment strategies by offering creative solutions for a variety of healthcare real estate initiatives. Services in our full-service platform include the design, development, acquisition, leasing and management of healthcare real estate. For more than 30 years we have been an integrated real estate partner to healthcare providers and have developed more than 7.75 million square feet of real estate throughout the country, including more than 3.5 million square feet in Palm Beach County, Florida. Trust is a principle our clients value when selecting a development partner. As such, we have completed 114 of 115 facilities on time and within budget, resulting in 85 percent of our business being repeat business. We have also partnered with five of the nation’s 10 largest health systems on transactions that have amounted to nearly $2 billion in financing — without ever defaulting on a loan. Headquartered in Jupiter, Florida, with offices in five additional states, Rendina has the scale, experience, and unmatched insight to turn our healthcare clients’ vision into a reality. www.rendina.com, 866-630-5055
Q3 2018 • OnCall
Gregory Cotes (l) and John Dalton look forward to the 16th Annual Heroes in Medicine set for May 19, 2018, at the Kravis Center.
Thanks to the Sponsors
It’s important to note that success cannot be achieved without continued support from generous sponsors. For the 2018 Heroes in Medicine, PBCMS&S recognizes and thanks the following sponsors: Rendina Healthcare Real Estate, Acevedo Consulting, and Trustbridge. Palm Beach County Medical Society Services encourages supporters to learn more about these three sponsors on this page. For additional information, contact Katherine Zuber, Palm Beach County Medical Society, 561-433-3940, email Heroes@PBCMS.org or go to www.pbcms.org. Acevedo Consulting, located in Delray Beach, is your trusted firm for compliance and HIPAA programs, chart audits and coding questions and education, Medicare/ Medicaid enrollment, assistance with payer audits, CMS Quality Payment Programs, pre- and post-acquisition due diligence and support programs. Our team, which is Certified in Health Care Compliance and holds numerous coding certifications, has been assisting physicians and other health care organizations in making sense of the complex regulatory and payment rules for almost 20 years. Visit our website for more information, www.AcevedoConsultingInc.com, or call 561-278-9328.
From hospice care to spiritual and emotional support, Trustbridge provides compassionate, professional health care for families facing any stage of life-limiting illness. Since 1978, our expert staff has cared for nearly 200,000 patients. As a non-profit, 501(c) (3) organization, we care for all who want and qualify for our services. We offer the physical, emotional and spiritual care that brings comfort and dignity to those with terminal illness and their loved ones. For families who need emotional support, we offer grief support services including individual and group counseling. www.trustbridge.com.
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O v g a n i t d i o n n for a t S Jazz pianist and vocalist Jerold Kramer, DO.
Comedian extraordinaire Dan Greenstein, DDS.
Q3 2018 • OnCall
Talented Docs Harpist Jill Rodila, MD
he Palm Beach County Medical Society’s mission is to unite physicians to serve the common interest of the profession and to connect with others to improve the community’s health. An important and serious purpose for sure but that doesn’t mean they can’t have fun, too. In today’s all-important quest to show how physicians can integrate their serious, sometimes life-and-death work with stress-reducing and fun experiences, the PBCMS presented Docs Got Talent charity dinner and show on June 1 at Atlantis Country Club. Several talented physicians and dentists traded in their stethoscopes for guitars and more to entertain their supporters and to raise funds for the programs of the Palm Beach County Medical Society Services including Project Access, Care Coordination, Disaster Management and more. The performers delivered a fun-filled night of amazing entertainment. Mistress of Ceremonies Leslie Gray Streeter, an award-winning journalist for The Palm Beach Post and an entertainer/ By Susan Fell singer in her own right, introduced the acts and performers including Jack Zeltzer, MD, the chair of the Docs Got Talent committee, and the drummer in the rockin’ Mostly Doctors Band along with Dan Higgins, MD; John Fernandez, MD; and Kevin Beckley. Also, comedian extraordinaire Dan Greenstein, DDS; karaoke star Graham Whitfield, MD, Jazz pianist and vocalist Jerold Kramer, DO; harpist Jill Rodila, MD; Billie Holiday-like Jazz singer Miryisa Colon Martinez, MD; Broadway-style songstress Robin I. Shecter, DO and heartrending vocalist Rosmy Jimmy, MD, performed to rave reviews. An art exhibit/reception showcased local physicians talents and was followed by the dinner and show. For more information, contact Deanna at the Palm Beach County Medical Society, 561-433-3940 or email@example.com.
The outstanding performers of the Docs Got Talent Show.
Dr . and Mrs. Michael Dennis arrive at Docs Got Talent.
Jack Zeltzer, MD, the chair of the Docs Got Talent committee, and the drummer in the rockinâ€™ Mostly Doctors Band.
The Mostly Doctors Band, CEO Tenna Wiles (3rd from right) and Sharon Beckley.
Mrs. and Dr. Samuel Kaufman presented his new book Delivering Justice at the event.
Mistress of Ceremonies Leslie Gray Streeter (left) and Shelli Lockhart.
OnCall â€˘ Q3 2018
Retired Physicians Making a Diﬀerence
Drs. David and Mollie Shulan Win at Work-Life Balance By Susan Fell
rs. David and Mollie Shulan are active “refired” physicians who enjoy volunteering and networking in their community and with other members of the Palm Beach County Medical Society. We shine the spotlight on them in this issue of OnCall as exceptional examples of how to successfully succeed at work-life integration all the way from medical school to the coveted retirement years. Mollie Shulan, MD, and her husband David Shulan, MD, reside in Boynton Beach. They relocated from Albany, New York, after gratifying careers in medicine. Dr. Mollie Shulan had a geriatric medical practice and was Chief of Geriatrics
at the Albany Stratton VA Medical Center, while Dr. David Shulan practiced medicine in Allergy/Immunology for nearly 30 years in Albany and the Capital District of New York. Dr. Shulan, who received her undergraduate training at the University of Toledo, Toledo, Ohio, and received her MD from Ohio State College of Medicine, Columbus, Ohio, entered the field of medicine because she was fascinated with the sciences and new developments that would help people as well as the progressive technology in the field, all of which focused on improving diagnosis and the potential of enhancing the quality of life. She says that geriatrics appealed to her because “there was
not a lot known about the field and older adults were treated like middle-aged adults with no distinction.” She recognized that there was a great deal “to investigate, gain in knowledge and apply. The older population was increasing in numbers and the potential for expanding into areas of research, education and patient care was phenomenal.” Dr. David Shulan completed his undergraduate and Masters work at Northwestern and worked in a tumor Immunology lab at Northwestern for three years before going to medical school. He, like his wife, wanted to become a physician “to help people and apply knowledge of science and medicine to practical use.”
Managing a Two-Physician Family
Now as they are retired in sunny, warm South Florida, they look back on how they successfully managed careers as a two-physician family by multitasking and sharing responsibilities. Dr. Shulan explains, “David was in private practice, and I worked for the VA that had more regular hours with more ﬂexibility. We made sure that our two children were in beforeand after-school programs. Shopping and cooking were done over the weekends, and we always made time to watch the kids play hockey, baseball, etc.” The physicians stay abreast of their specialties by reading journals and attending regional and national meetings. Dr. David is on some national organization committees and is an abstract reviewer for the American Academy of Allergy and Asthma and Immunology Annual Meeting. Dr. Mollie was involved in the PBCMS Conversation Project; gives CME lectures on topics of Delirium and Dementia
Dr. David and Dr. Mollie Shulan.
for Florida Scientific Sessions; reviewed scientific posters at the Future of Medicine conferences, among other projects. A pickleball enthusiast, Dr. Mollie is keen on promoting health by encouraging older adults to be active walkers. And as members of the Citizen’s Patrol she says, “David and I are the eyes and ears for the Sheriff ’s Dept. walking miles each day to promote safety and security for our community.” The Shulans look forward to continue learning about the field of medicine and meeting many of their peers at future events of the Retired Physicians group. For more information contact PBCMS, Deanna Lessard 561-433-3940, ext.105 or email her at firstname.lastname@example.org.
The Rising Risks of Sexual Harassment Allegations
Do You Have a Zero-Tolerance Policy? By Richard Cahill, JD
successful and highly-respected pediatrician with an unblemished record over decades of practice learns of a HIPAA breach by a member of his clerical staff. After an investigation reveals the employee is a repeat offender, she is terminated. Imagine the physician’s reaction when the employee’s attorney not only initiates a wrongful termination suit, but also alleges retaliation, claiming the employee rebuffed sexual advances from the doctor. To gain additional leverage, the former employee’s attorney submits a complaint of sexual harassment with the medical board and has the plaintiff fi le a criminal complaint for sexual battery. The attorney also sends a letter to the medical executive committee of the principal hospital where the doctor admits patients, resulting in a peer review
Q3 2018 • OnCall
investigation. Finally, the former employee blankets social media with an aggressive smear campaign. This example demonstrates that health care providers are not immune from the growing number of reported incidents of alleged sexual harassment in the workplace. Accusers may be employees, patients, third-party vendors or visitors. Individuals alleged to have acted inappropriately may include co-workers, both supervisors and subordinates, professional staff — and even patients.
Repercussions of Harassment Claims
Shortly after complaints are filed, costly and potentially embarrassing investigations are often conducted by law enforcement, human resources departments, and administrative agencies. Depending on the nature and scope of the
findings, serious adverse consequences and often irreparable harm to a person’s reputation may follow, including: • Criminal prosecution • Civil litigation with the potential for substantial damages • Licensing board actions that may impose limitations on an individual’s continued privilege to pursue his or her profession
Adopt and Enforce Zero Tolerance
Given the risks, heightened awareness, and increased scrutiny, health care practitioners and facilities are strongly encouraged to develop and consistently enforce a zero-tolerance policy. Protocols must be written, periodically reviewed, and updated as necessary, detailing: • The types of conduct that will not be tolerated, regardless of the identity of the alleged perpetrator • A clear methodology for reporting claimed instances of wrongdoing • The process to be followed in investigating complaints, and rules that should be observed to help insure that confidentiality and due process are appropriately protected • Documentation to be completed and maintained • The range of sanctions, up to and including termination, for both employees and patients, should the allegations ultimately be determined to be true Staff should receive proper training as part of the on-boarding process of each new employee and on a regular basis thereafter. Offices should develop and retain attendance sign-in sheets of such training in the regular course of business to demonstrate, in the event of a subsequent problem, the good faith and due diligence as continuing efforts of the clinic, provider or facility to comply with federal and state requirements. It is recommended that health care facilities, clinics and other professional offices institute a process of publishing their zero-tolerance policy towards harassment. This can be achieved in employee on-boarding documentation, professional employment contracts, conditions of treatment or admission, third-party vendor agreements, website notices, and even office signage.
derstand the potential financial risks of claims involving allegations of sexual harassment or misconduct. They should then confer with their insurance agent or broker to determine proactively what coverages might be available in their respective states to protect the provider in the event of such a claim. Policy language and state regulatory requirements often vary from jurisdiction to jurisdiction. Most practitioners carry professional liability coverage in the event of a claim
“It is recommended that health care facilities, clinics and other professional offices institute a process of publishing their zero-tolerance policy towards harassment.” Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
for medical malpractice. Not uncommonly, however, medical professional liability policies specifically exclude coverage for acts of sexual misconduct committed by a physician against a patient. Depending upon the professional liability carrier, the physician may be provided with a courtesy defense covering the costs of legal fees and expenses, but no payment for any indemnity incurred in the event of an adverse jury verdict. It’s also prudent to consult with insurance brokers and agents about the availability of Employment Practices Liability Insurance (EPLI). EPLI may provide coverage for certain types of workplace harassment, which may include sexual misconduct involving the policy holder and an employee. And finally, claims of inappropriate sexual behavior against a physician or other licensed health care practitioner may result in administrative proceedings by a state medical board, or the privileges committee of a hospital or other facility regulated by The Joint Commission. EndorseBe Sure You’re Covered ments are widely available as part of medical professional Health care providers are also strongly encouraged to liability policies to pay legal defense costs in the event of consult with their personal or corporate attorney to un- an investigation or subsequent disciplinary hearing.
Delegates Represent PBCMS at FMA
Seated l-r: Henry Pevsner MD, Stephen Babic MD, Brandon Luskin MD, and Alan Pillersdorf MD. Standing: Juan Galvez MD, Jack Zeltzer MD, Marc Hirsh MD, James Howell MD, Dawn Davanzo MD, Anthony Dardano MD, Jean Malecki, MD, Richard Shugarman MD, William Slomka MD, and James Goldenberg MD. OnCall • Q3 2018 19
An Introduction for Skeptical Health Care Providers
By Gail Price-Wise, MS
have led training workshops in cultural competence and diversity for thousands of health care providers. Many assert that they are not biased or that their biases do not interfere with patient care or outcomes. With all due respect, I think many of these people are deluding themselves. Everyone experiences automatic thoughts and feelings about others based on race, ethnicity, accent, religion, sexual orientation, age, socio-economic level, physical presentation (clothing, body type, tattoos, etc.) and other factors. Unless one is an award-winning actor, patients sense when their providers don’t like or respect them and recognize when the provider is making assumptions about them based on their demographic category. For example, one study found that White doctors spend more time speaking with White
“It is important for providers to acknowledge and manage their biases regarding diﬀerent groups of people.”
of traditional herbal remedies, which may result in adverse interactions with prescribed medicine. For this reason, it is important for providers to acknowledge and manage their biases regarding different groups of people. They should be honest with themselves about their biases and proactively learn about the positive qualities of individuals within the group, who do not fit negative stereotypes. This can help providers to behave in a more positive manner with their patients. A good patient-provider rapport may not correlate with race and ethnicity. For example, Latin Americans are of European, Native, African, Asian, and “other” descent. There is racism and classism throughout Latin America, and tension between some countries. This affects how Hispanic patients experience their encounters with Hispanic physicians. Similarly, there are inter-ethnic tensions and military conﬂicts throughout much of the world that affect how immigrants feel about each other. People from the same region may or may not be comfortable with one another.
Creating a Good Patient Relationship
Encouraging studies have shown that providers who use patient-centered communication can create a good relationship with the patients, regardless of race and ethnicity. Patient-centered communication is characterized by physiGail Price-Wise, MS, President, Florida Center for Cultural cian open-ended communication and relationship building. Competence Inc., email@example.com This kind of interaction can be learned. One test of this skill patients than Black patients, and their speech is slower with is to ask the patient whether this statement is true: “When a more positive emotional tone. This is not the overt racism I don’t understand what my providers say, I ask questions.” of slavery or segregation. It’s much more subtle. It has to do This question can be answered on a Likert scale and the data with whether people perceive themselves to be personally sorted by self-determined race and ethnicity. Another resimilar to one another and simply whether they like each vealing statement is simply, “My provider likes and respects other. Not surprisingly, patients are able to accurately per- me.” I believe some of the skeptics in my trainings would be ceive whether their providers like them, which can impact surprised by how strongly their patients agree or disagree with these statements. patient satisfaction and adherence. Patients who mistrust their providers may fail to give a Gail Price-Wise is the president of the Florida Center for complete and accurate medical history and often decline to Cultural Competence, Inc. and a former president of the Harask questions when they don’t understand or agree with the vard T.H. Chan School of Public Health alumni council. treatment plan. This results in a lost opportunity to jointly Editor’s Note: All endnotes for this article are availdevelop a treatment plan that the patient understands and is motivated to follow. Further, patients may hide their use able by request.
Q3 2018 • OnCall
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Is it Time for Your Medical Practice to Have a Quick Check-Up?
By Lou J. Fuoco, CPA re you a physician in need of a prescription for financial health and wellness? Here’s our Rx to protect and enhance your bottom line so you can spend more time practicing medicine and taking care of patients: 1. Hire Better. This will save you money in the long run as having to replace staff is expensive in many ways and bad employees can cost you patients. You wear a lot of hats in your practice, but remember that patients spend a great deal of time in front of your employees so make sure they are technically skilled, compassionate and personable. The more your staff can do, the less time you have to devote to tedious tasks, and you might just help your stress level as well as your financial statement. 2. Don’t Be Afraid of Change. When your practice stagnates so does your bottom line. Embrace technology that streamlines daily tasks, billing, processes, patient intake and records, etc. In the end it saves time, and makes com- 5. Toot Your Own Horn. You can grow your practice by pliance and collections easier. On another note, be aware figuring out what is special about your brand or medical of technology trends that are changing the status quo such niche and then marketing that. If you are not ready for a as telehealth and telemedicine — there may be financial Facebook page, at the very least make sure all your onopportunities there and ways to better serve patients! line profiles are accurate, and your website is visible and accessible. Join the local medical society or professional “Join the local medical organization and network with other doctors or large employers in your area who can refer patients to you. society or professional 6. Avoid Burnout. You are the practice leader as well as the healer. You can’t do either well when you are seriorganization and network ously fatigued. Remember exhaustion is mental, physical with other doctors or large and emotional. Know your limits, when to slow down and when to ask for help. Communicate, build a team, employers in your area who re-evaluate scheduling and workload, delegate where poscan refer patients to you.” sible, and accept your limitations. Whether you are an internist, specialist, or surgeon, perLou J. Fuoco, CPA haps it’s time to consider an accounting ally in the health care 3. Look Beyond Reimbursement. What insurers and oth- industry with single or multiple physician practice expertise. er payors, including the government, are willing to re- In addition to tax and accounting services, Fuoco Group’s new imburse is not controlled by physicians. We have seen financial dialogue includes a 360-degree business advisory how $$$ for quality vs procedure has shifted the financial program. All designed to take the burden off you and your landscape. Focus instead on internal costs that you can physician partners because worrying about costs, reimbursecontrol. Focus instead on proper coding and compliance ments, margins, operations and finances shouldn’t be keeping to avoid penalties. you awake at night! 4. Better Billing. Train staff to increase time for revenue-producing activities, code and bill accordingly. Lou J. Fuoco, CPA Reward staff for opportunities seized to streamline activ- Fuoco Group Managing Partner LFuoco@fuoco.com, 561-209-1101 ities and avoid waste and duplication.
Q3 2018 • OnCall
PRSRT STD US POSTAGE
PAID WEST PALM BEACH, FL PERMIT NO.515
3540 Forest Hill Blvd. Suite 101 West Palm Beach, FL 33406 RETURN SERVICE REQUESTED
Starfish Gala You are cordially invited to the
Saturday, November 17, 2018 Kravis Center, Cohen Pavilion West Palm Beach, Florida
2018 Annual Gala and Installation
Presented by Palm Beach County Medical Society & Services
6:30 p.m. Reception Holiday Hall of Trees and Lights Silent Auction 7:30 p.m. Dinner, Program and Entertainment
Join us in gratitude as we honor our president Brandon Luskin, MD and welcome incoming president Marc Hirsh, MD
Elegant Evening Attire RSVP by November 13, 2018
Future of Medicine Summit XII February 7-8, 2019 Kravis Center, The Cohen Pavilion West Palm Beach, Florida
www.pbcms.org | 561-433-3940