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OnCall

QUARTER ONE 2019

THE OFFICIAL PUBLICATION OF THE PALM BEACH COUNTY MEDICAL SOCIETY

Revisiting Key Moments in PBCMS History Page 13

Future of Medicine Summit XII Page 12

Marc J. Hirsh, MD

President Palm Beach County Medical Society


President’s Report

Marc J. Hirsh, MD

President Palm Beach County Medical Society

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A Tradition of Care For 100 Years

ay “happy birthday!” Your county medical society is100-years-old this year! Like any organization, we only continue to exist if our mission continues to be relevant. We, as physicians, are here to advocate for each other and support each other, starting at the local level. Please make 2019 a year in which you take advantage of our programs, a year in which you let us know how we can support you professionally, and a year in which you volunteer your time and expertise to help the “house of medicine” here in Palm Beach County. We are stronger together.

Engage and Support

We have a vast array of programs, including physician wellness, practice support, legislative advocacy, physician leadership training, physician social and networking functions, and community service opportunities. In addition, PBCMS supports medical students, residents, women physicians and retired physicians. Depending on your specialty and your practice setting, you will face different challenges this year. We at the medical society recognize this. We have something to offer both the independent practitioners and the employed physicians; we are here to engage and support both the outpatient-based specialists and the hospital-based specialists.

Physician Wellness and Leadership Academy

All physicians deal with professional and personal stress, and many are affected by burnout. We offer a Physician Wellness Program https://www.pbcms.org/physician-wellness-program to help deal with the issues of physician stress and burnout. Part of dealing with burnout is bringing back the joy and engagement in medicine, and we also run a very successful Physician Leadership Academy that trains the physician leaders of tomorrow https://www.pbcms.org/physician-leadership-academy. We recognize that beyond our mission of physician support and advocacy, we have a moral and ethical obligation to community service as well. Please read about Project Access,

which is a coordinated system of volunteer physician care that helps low-income uninsured residents of Palm Beach County https://projectaccesspbc.org. Join the several hundred physicians in our community who have provided care through this program.

A Strong Voice

While we all have large state and national organizations that support us (and that we pay dues to), the first link that connects us to these larger organizations is our county medical society. We, the Palm Beach County Medical Society, are here to address strictly local issues that are unique to our area; we are also here to give us a strong, unified voice when it does come to working with the state and national. For example, an appeal to the Florida Medical Association for assistance with an issue comes across louder if it comes from the PBCMS representing 1,600 members, than if it comes from any of us as an individual. Bring us your problems and let us work with you to solve them!

Celebrate Our Birthday

There will be a series of events and special 100-year celebrations this year, and we developed a new logo for your medical society in honor of this milestone. Enjoy the history of the Palm Beach Medical Society in this issue beginning on page 13 where we revisit key moments of history from 1919-1944. Every quarter of OnCall will highlight 25 years of PBCMS history. The longevity and vibrancy of our medical society owes itself to your involvement, and to your dedication to your colleagues and your patients. We are stronger together. OnCall • Q1 2019 

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Iggy Chester says… Support Project Access

FINANCIAL PLANNING FOR TODAY'S HOSPITALIST

Medicine Protection Investment Wealth Creation Retirement


Contents

BOARD OF DIRECTORS Marc J. Hirsh, MD President

Larry Bush, MD

Claudia Mason, MD

Roger Duncan, MD

Dawn Davanzo, MD

Stephen Babic, MD Shawn Baca, MD Andrew Berkman, MD David Coradin, MD Kleper de Almeida, MD Michael Dennis, MD Henry Haire, MD James Heron, MD

Allison Kohn Ekaterina Kostioukhina, MD Brandon Luskin, MD Leslie Perla, MD Alan Pillersdorf, MD Martha Rodriguez, MD Jack Zeltzer, MD

President-Elect

Secretary

Vice-President

Treasurer

BOARD OF TRUSTEES Jose F. Arrascue, MD Shawn Baca, MD Larry Bush, MD Roger Duncan, MD

James Goldenberg, MD Marc J. Hirsh, MD Brandon Luskin, MD Claudia Mason, MD

Alan Pillersdorf, MD Brent Schillinger, MD Jack Zeltzer, MD

D E PA R T M E N TS

3 President's Report 6 Med Memo 7 Welcome New Members FE AT U RE S

Page 13

9 Your Voice Matters Terms– 11 Hidden Hidden Headaches

BOARD OF DIRECTORS Michael Dennis, MD Don Chester President

Treasurer

Ivy Faske, MD

Matt Gracey

Vice President

Jean Acevedo William Adkins, MD Elaine Alvarez Jose F. Arrascue, MD Brenda Atkins Steven Borzak, MD Tish Carlo Ljubica “Jibby” Ciric

Secretary

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

of Medicine 12 Future Summit XII The History of Medicine in Palm Beach County

The first physician in the Palm Beach County area, Dr. Richard Potter.

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Survey: Patients Still Top Concern

Survey results indicate patients still top concern of physicians.

PBCMS STAFF DIRECTORY Tenna Wiles Mindi Tingler Operations Director

Deanna Lessard

CEO

Lauren Stoops

Project Access Director

Karen Harwood

Member Services & Physician Wellness Director

Director of Resources & Education

Katherine Zuber

Public Health & Disaster Services Director

Membership Development & Events Director

22 Annual Starfish Gala

John James

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 2019 Palm Beach County Medical Society, Inc. OnCall journal is designed by MillerDesignPros, email us at m.miller@millerdesignpros.com or visit us on the web at www.millerdesignpros.com; and edited by Susan W. Fell.

Dr. Marc J. Hirsh, 2019 PBCMS President, presents Dr. Brandon Luskin (l) with the Leadership Award in recognition for outstanding service.

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Med Memo Women’s Physician Social

Save the Date

Doctors’ Day Centennial Celebration Celebrating our Past

(L to r )Catherine Lowe, MD; Katherine Brazzale, MD; and Melanie Bone, MD at the Womens’ Physician Social.

PBCMS held a Women’s Physician Social on Thursday, January 17, 2019. PBCMS thanks Dr. Martha Rodriguez for hosting the event at her office.

Weekly Caduceus Meetings

Caduceus hosts weekly meetings on Wednesday evenings at 7:00 pm at Crossroads (Lake Ida Rd & Congress Avenue). Physicians and all healthcare providers are welcome to attend. The program is based on AA 12 step program. If you have questions please call Deanna Lessard at PBCMS (561) 433-3940 ext. 105.

Saturday, March 30, 2019 Historical Society of Palm Beach County 300 N Dixie Hwy, West Palm Beach, FL 33401 4 pm – 7 pm Historical Exhibits, Special Presentations, Family Activities and Delicious Food Complimentary for PBCMS Members and their families RSVP Required online at www.pbms.org or call Amanda Krudis 561-433-3940 x105

Centennial Donations

Please join us in congratulating the Fall 2018 graduates of the CHW Care Coordination Training Program. If you are interested in hiring a trained care coordinator, or would like to learn more about the program, please contact Karen Harwood at 561-433-3940 ext 122.

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Roy J. Cacciaguida, MD

Paul Niloff, MD

Ida Sebastian, MD

Henry Haire, MD

Neil Ozer, MD

Robin Shecter, DO

Kurt Hasenhuttl, MD

Gerald Robinson, MD

Yrma Mirta Signo, MD

Stuart Himmelstein, MD

Steven Rosenberg, MD

Jerome Spunberg, MD

Jean Malecki, MD, MPH

David Schwartzfarb, MD

Donna Ann Zeide, MD


PALM BEACH COUNTY MEDICAL SOCIETY New Members

PBCMS welcomes all new members including the entire FAU faculty and all the physicians at Medical Specialists of the Palm Beaches. Peter Bendetson, MD Jonathan Kamerlink, MD

Sowmya Kishor, MD Aaron L. Klein, DO

Joel B. Kornberg, MD, JD

Medical Students Alexander Besser Ruben Cendan

Mahtab Forouzandeh Sameer Gupta

Daniella Lamour

New MSPB Members Daniel Amaez, MD Geni Abraham, MD Gregory Aslanian, MD Robin Braver, MD Edward Cane, MD Alexander Chernobelsky, MD Peter Cowen, MD William Davis, MD Jan Dobrowolski, MD Britney Epstein, DO Norman Erenrich, MD Brian Galbut, MD Meri Gare, MD

Maria Eden Giammaria, MD Joshua Gottsegen, MD Elizabeth Gunther, DO Christopher Hawk, MD Marty Jacob, MD Andrew Krasner, MD Stephen Krasner, MD Michael Lakow, MD Ladan Lamea, MD Robert Levin, MD Elizabeth Mohr, MD Joseph Ojea, MD Anderson Penuela, MD

New FAU Faculty Members Scott M. Alter, MD Stuart L. Markowitz, MD Peter A. Averkiou, MD Lisa Martinez, MD William Benda, MD Minda Neimark, MD Bruce M. Brenner, MD Joseph G. Ouslander, MD Leonard Berkowitz, MD Parvathi Perumareddi, DO Jennifer Caceres, MD Bernardo J. Reyes Fernandez, MD Stephanie Chrisphonte, MD Gary J. Rose, MD Lisa M. Clayton, DO Karishma A. Samtani, MD Ellen S. Eisenberg, MD Michelle S. Finkelstein, DO Rainald Schmidt-Kastner, MD Michelle P. Schwartz, MD James Galvin, MD Mandi Sehgal, MD Stuart J. Goldman, MD Dawn H. Sherling, MD Elizabeth C. Gundersen, MD Richard D. Shih, MD Daniel S. Gutman, MD Roger P. Smith, MD Charles H. Hennekens, MD Randi A. Sperling, DO Peter J. Holland, MD Darin p Trelka, MD Allison M. Holley, MD Suzanne B. Weiner, MD Patrick G. Hughes, DO Dayna M. Weinert, MD Mario Jacomino, MD Debra Weiss, DO Daniel Kantor, MD Touqir Zahra, MD Mitchell Karl, MD Morton H. Levitt, MD

Walter Pinedo, MD Andrew Raxenberg, DO Mark Rothenberg, MD Peter Schwartz, MD Pavel Sergeyev, MD Marc Shiman, MD Michael Shiman, MD David Speizman, DO Neda VandenBosch, MD Nagavardhan Vasuki, MD Robert von Sohsten, MD Fred Tow, MD Nathan Watson, DO


PBCMS/HERC Opioid CME Educational Program for Physicians

The Health Care Connection Luncheon “Where’s the Money?” was presented by Nancy Brown on Wednesday, November 14, 2018 at Atlantis Country Club. (L to r) Brian Foster, Nancy Brown and John Dalton are pictured at the luncheon.

(L to r) PBCMS CEO Tenna Wiles, DCA for Health’s Lynne Marlette, and Lauren Stoops, Director of Project Access, at the Congratulations DCA for Health, the charitable, nonprofit arm of Diagnostic Centers of America. DCA for Health presented Project Access with a $25,000 donation to provide medical care through the Project Access Patient Care Fund. DCA for Health’s mission is “To focus our energies building healthier lives in South Florida, particularly those in need.” This extraordinary contribution will help provide hundreds of Project Access patients with the critical medical care they so desperately need. Wiles said, “Thank you DCA for Health for the huge impact you are making here in Palm Beach County.”

2019 Heroes in Medicine Host Committee at a recent meeting.

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Kimberly A. Gilmour, PA, a local attorney who specializes in Employee Law, shared some very important information with area practice administrators at the PBCMS luncheon on December 12th at the West Palm Beach Marriott.

Jean Acevedo of Acevedo Consulting updated area practice administrators on billing and coding at the PBCMS January Health Care Connection luncheon at Atlantis Country Club.

Special thanks to Grandview Gardens Bed & Breakfast, West Palm Beach, for hosting the Palm Beach County Medical Society and Services Board Holiday Party on December 5, 2018.

(L to r) John Hulick, Patrick McNamara, Mark Rubenstein, MD; and Beckey Walker at the HERC Opioid Task Force program.

(L to r) Also at the Gregory School of Pharmacy at Palm Beach Atlantic University program were (l to r) Robert Moran, MD: Dave Aronberg, Palm Beach County State Attorney; Abby Strauss, MD; and Brent Shellenberger, MD.

Steven Rosenberg, MD, West Palm Beach dermatologist, was elected Chair of the Florida Board of Medicine during the December meeting of the Board in Orlando.

Palm Beach County Medical Society/HERC Opioid Task Force presented an Opioid CME Educational Program for Physicians on December 1, 2018 at the Gregory School of Pharmacy at Palm Beach Atlantic University. Thank you to Mark Rubenstein, MD; Dave Aronberg, State Attorney for Palm Beach County, and all the presenters: Belma Andric, MD; William Benda, MD; Dawn Davanzo, MD; John Hulick, Patrick McNamara, Robert Moran, MD; Houston Park, Scott Philip Rice, MD; Janet Robishaw, PhD; Abbey Strauss, MD; Adam Shestack, MD; Abbey Strauss, MD; Becky Walker and Frank P. Whiting.


Legislative

Meet Our Physician LegislativeTeam

Your Voice Matters

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How to Participate and Make a Difference

By Tenna Wiles he many challenges facing the medical profession and our patients can only be resolved through the coordinated efforts of organized medicine. Palm Beach County Medical Society (PBCMS) is committed to championing physician rights, being the political voice of physicians and building a stronger, more unified health care community in Palm Beach County. Through Palm Beach County Medical Society, the 1,600 members can advocate together on medical issues at the local state and federal levels. There are numerous opportunities for members to be involved in legislative and policy issues. The Council on Advocacy and Legislation reviews and makes recommendations to the Board of Directors on proposed legislation, rules and regulations. Wiles Developing positive relations with our elected officials, policymakers and community partners is a top priority. We also participate in Palm Beach County Days and send physician representatives to Tallahassee during the Legislative Session. Our physicians meet with key lawmakers to ensure our voices are heard. PBCMS physicians also are asked to provide expert testimony to the Legislature Each year, PBCMS sends approximately 22 delegates to the Florida Medical Association House of Delegates. Our delegates meet to develop resolutions to be considered by the South Florida Caucus, which represents Palm Beach, Broward and Dade Counties, and presented to the FMA House of Delegates. A similar process occurs at the AMA level. PBCMS is represented by two physicians. MEDPAC, our political action committee, supports pro-medicine candidates at the state level. The 2019 Legislative Session begins on March 5. We invite you to become engaged. You can stay informed on legislative issues through our weekly updates and Legislative Alerts. See page 10 for a complete listing of all elected officials. Please contact me at tennaw@pbcms,org or 561 433-3940 if you are interested in participating in Palm Beach County Days or serving as a delegate. Tenna Wiles is the CEO of the Palm Beach County Medical Society and the Palm

Andrew Berkman, MD Chair Council on Advocacy & Legislation

Steve Babic, MD Chair MEDPAC

FMA Board of Governors

Alan Pillersdorf, MD

James Goldenberg, MD

Mark Rubenstein, MD

Ankush Bansal, MD

FMA PAC

Marc J. Hirsh, MD

Beach County Medical Society Services.

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ELECTED OFFICIALS UNITED STATES SENATE Marco Rubio 4580 PGA Blvd., Suite 201 Palm Beach Gardens, FL 33418 Phone: 561-775-3360

Rick Scott

B3 Russell Senate Office Building Washington, DC 20510 Phone: 202-224-5274

U.S. HOUSE OF REPRESENTATIVES Ted Deutch, District 22 7900 Glades Road, #250 Boca Raton, FL 33434 Phone: 561-470-5540

Alcee L. Hastings, District 20

Town of Mangonia Park Municipal Center 1755 East Tiffany Drive Mangonia Park, FL 33407 Phone: 561-676-7911

Lois Frankel, District 21

Brian Mast District 18

2500 N. Military Trail, Suite 490 Boca Raton, FL 33431 Phone: 561-998-9045

420 U.S. Highway One, Suite 19, North Palm Beach, FL 33408 Phone: 561-530-7778

FLORIDA STATE OFFICIALS Ron DeSantis

Governor, State of Florida 850-488-7146 www.flgov.com

STATE SENATE www.flsenate.gov Lori Berman, District 31

Bobby Powell, District 30

561-292-6014 berman.lori.web@flsenate. gov

561-650-6880 powell.bobby.web@flsenate.gov

Gayle Harrell, District 25

Kevin J. Rader, District 29

772-221-4019 harrell.gayle.web@flsenate. gov

443-8170 rader.kevin.web@flsenate.gov

FLORIDA HOUSE OF REPRESENTATIVES www.myfloridahouse.gov Mike Caruso, District 89

Rep. MaryLynn Magar, District 82

Rep. David Silvers, District 87

Joe Casello, District 90

Tina Polsky, District 81

Emily Slosberg, District 91

561-4750-2396 mike.caruso@ myfloridahouse.gov

772-545-3481 marilynn.magar@myfloridahouse.gov

561-357-4824 david.silvers@myfloridahouse.gov

561-292-6015 joe.casello@ myfloridahouse.gov

561-470-2086 tina.polsky@myfloridahouse.gov

561-496-5940 emily.slosberg@myfloridahouse.gov

Rep. Al Jacquet, District 88

Rep. Rick Roth, District 85

Rep. Matt Willhite, District 86

561-650-6846 al.jacquet@myfloridahouse.gov

561-625-5176 rick.roth@myfloridahouse.gov

561-791-4071 matt.willhite@myfloridahouse.gov

PALM BEACH COUNTY COMMISSIONERS www.pbcgov.com Hal Valeche, District 1 561-355-2201 hvaleche@pbcgov.org

Gregg Weiss, District 2

561-355-2202 gweiss@pbcgov.org

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Dave Kerner, District 3 561-355-2203 dkerner@pbcgov.org

Robert Weinroth, District 4 561-355-2204 rweinroth@pbcgov.org

Mary Lou Berger, District 5 561-355-2205 mberger@pbcgov.com

Melissa McKinlay, District 6 561-355-2206 mmckinlay@pbcgov.org

Mack Bernard, Mayor, District 7

561-355-2207 mbernard@pbcgov.org


Legal Issues

Hidden Terms–Hidden Headaches Don’t Always Take Physician Employment Contracts at Face Value

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By David Davidson, Esq. ver the past few years, it seems like physician em- So despite the short contract, it also contained whatever was ployment agreements are getting shorter and short- found in those “incorporated” documents. er. While I applaud all efforts towards efficiency and economy, you should not always take those Hard Copies or Online? documents at face value. For example, I recently reviewed a Interestingly, my client was not provided with copies of any one page employment contract for a client. That single page of the referenced documents. Instead, the prospective employbasically said, “We are hiring you as our er provided a link to access the materials online. When we employee for a term of one year, with an pulled up the documents, we discovered that the Bylaws were annual salary of $$$.” 30 pages long. The Rules & Regulations were 20 pages, and the HR policies were 50 pages. So our simple one-page contract Ask Essential Questions suddenly totaled over 100 pages. And in those materials, we At first glance, the simplicity of that discovered some unexpected provisions regarding renewals, document might seem refreshing. That’s termination and daily operations of the practice. We could especially true if you’re worried about how then approach the prospective employer with a request to spemuch time it’s going to take for your lawyer cifically address those areas in the body of the contract, notto get through it! My client’s second glance withstanding the provisions of the incorporated documents. Davidson revealed a multitude of unanswered (and The practice of “incorporation by reference” is not new. essential) questions. There was no mention of expected duties, It is not inappropriate, unethical, or illegal (as long as the schedules, standards, renewals, terminations, insurance, ben- provisions incorporated are inherently legal). But it is a shortefits, vacation time, sick leave, CME, etc. However, when we hand way to include a lot of material in an otherwise short reviewed the contract together, we discovered that although document. So when you see outside documents incorporated those points were not even referenced on that single page, they in an agreement, remember the Latin, Caveat Medicus – Let were still legally, “in there.” the Doctor Beware!

What Are Incorporated Documents?

Towards the end of the document, there was a somewhat innocuous statement that generally read, “The parties agree that the terms of Employee’s employment shall be governed by Employer’s Bylaws, Rules & Regulations, and HR Policies for Physicians which are incorporated herein by reference.”

David Davidson, Esq. is Florida Board Certified as a specialist in Health Law with nearly 30 years of concentrated experience assisting health care professionals and businesses. His practice at the Florida Healthcare Law Firm immerses him in numerous health care transactions and has helped him develop a unique understanding of the provider’s perspective. For more information, email dave@ floridahealthcarelawfirm.com or call 561-455-7700.

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The Future of Medicine Summit XII

Patrice A. Harris, MD, AMA President-Elect, is flanked by (l to r) Ronald F. Giffler, MD, FMA President-Elect; Alan Pillersdorf, MD; Marc J. Hirsh, MD,PBCMS President; and Corey Howard, MD, FMA President.

Jose Arrascue, MD, and Keynote Speaker Pedro J. Greer Jr., MD.

(L) Chair Michael T.B. Dennis, MD, and Jose Arrascue, MD, founder of the Summit.

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Patrice A. Harris, MD, AMA President-Elect, gave a compelling presentation at the Summit.

he 12th Annual Future of Medicine Summit of the Palm Beach County Medical Society showcased the impact medicine has had in the last 100 years and launched (L to r) David Kenigsberg, MD, President of Broward County Medical Association Dr. James Goldenberg, the Excellence in Marc J. Hirsh, MD; Alan Pillersdorf, MD, and the Centennial Year of and Dr Daniel Lichstein, MD. Medicine Awardee,with his wife and mother. Larry Bush, MD, PBCMS President-Elect Celebrations for the society, which will mark their 100th Anniversary in September 2019. The two-day event, February 7-8 at the Kravis Center, Cohen Pavilion, West Palm Beach, focused on varied areas of health care innovation and advancement. The annual event featured highly respected national speakers and experts such as Patrice Harris, MD, president-elect of the American Medical Association, chair of the AMA’s Opioid Task Force; Corey Howard, MD, president of the Florida Medical Association and Presidential Medal of Freedom Honoree Pedro J. Greer Jr., MD, a tireless advocate for those without health care. Known as Joe, Dr. Greer’s keynote speech inspired and motivated the hundreds of attendees to consider how social justice fits into their medical or health care career. The Future of Medicine initiative, founded in Palm Beach County by Jose Arrascue, MD, in 2007, began with the goal to present health care as a joint physician-community effort with an aim of improving access to care with quality, safety and improved physician practice viability. Chaired by Tulisa La Rocca, MD (2nd from r) and Gauri Agarwal, Michael T.B. Dennis, MD, the prestigious summit explored the innovations MD (far right) present Poster Symposium Awards. and advancements in medicine; the new reality of health care delivery; the social responsibilities in health care, and focus on the society’s responsibilities to the community. Dr. James Goldenberg received the Palm Beach County Medical Society Excellence in Medicine Award, the society’s highest honor.

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Feature

The History of Medicine in Palm Beach County Revisiting Key Moments From 1919-1944 By Leon Fooksman Physicians have led the way in transforming the healthcare system in Palm Beach County — from the age of house calls to an era of sophisticated, specialized care. Through it all, Palm Beach County Medical Society has served as the inspiration, guidance and support for physicians. In 2019, the Medical Society is celebrating our centennial year in helping physicians pave the way for improving the quality of life for the masses and putting our community on the map for groundbreaking medical research and outstanding care. As part of our special year, we are revisiting the key moments in the history of medicine in Palm Beach County and our organization’s role in it — as told in the Fooksman book, A Tradition of Caring, A History of Medicine in Palm Beach County, by Leon Fooksman (Legacy Publishing Company, 2013). Let’s start with our first 25 years of history from 1919-1944.

Medical Society Forms in 1919

With Drs. Van Landingham and Cason away during that meeting, the members elected Dr. C.M. Merrill as president, H.C. Hood as vice president, and Dr. T.D. Gunter as secretary and treasurer. They set annual charter dues at $5. They also set a fee schedule for medical services: West Palm Beach calls were $2 and out of town calls were $3; night calls, from 11 pm-6 am, were $4; obstetrical calls were $30; urine examinations were $2; anesthesia was $5-25; and gonorrhea and syphilis first treatment was $5. During the first year, the members of the Medical Society met regularly in different homes and offices to enjoy each other’s company, discuss cases, exchange ideas about patients, and prepare papers on their findings. Some of the first papers included “Intestinal Parasites” by Dr. Conkling; “Early Application of Forceps in Labor” by Dr. John Robert Cason; and “Fibroid Tumors” by Dr. Peek.

Palm Beach County Adopts Public Health Measures

Cooled by the hot ocean breezes, a group of local physicians gathered in the office of Dr. L.A. Peek in West Palm Beach on the afternoon of September 20, 1919. The first meeting of Palm Beach County Medical Society had a long agenda. Based on the minutes recorded in shorthand, those present were Drs. Merrill, Hand, Peek, Cooley, Gerlach, Miller, Gunter, Van Epp, Crow, and Conkling. Their first order of business was electing officers, appointing a committee to prepare a constitution and bylaws, and setting a fee schedule for county physicians. Dr. Richard Buckley Potter, the first physician in the area.

Dr. William E. Van Landingham was behind much of the early public health movement in Palm Beach County. Serving as a charter member of the Medical Society, Dr. Van Landingham became the group’s secretary and later president in 1924. He went on to serve as the first administrator of Good Samaritan Hospital. His public health work in Palm Beach County started when he was appointed city physician in 1919 and city health officer in 1926. In 1945, Dr. Van Landingham added the duties of county physician, director of the welfare department, and director of the county home and hospital until he resigned in 1960. During those years, Dr. Van Landingham had conOnCall • Q1 2019 13


Left: According to the Historical Society of Palm Beach County, T. Leroy Jefferson, MD, was the first black physician in West Palm Beach. He was nicknamed the “bicycle doctor” because he was seen cycling around town, elegant and upright with his black medical bag. He took care of patients for most of his life.

thousands of people. After 50 years of service, he recorded a message that is often still invoked today in reminding physicians about the way healthcare is supposed to work: “Little does the doctor of today realize how fortunate he is to walk into a complete workshop furnished him in modGraduation photos of Drs. Anna and Roy Darrow, her husband. She was ern hospitals, with miracle drugs to aid him. Consultants in the second woman to be licensed as a physician in the State of Florida. every line of practice, and laboratories to assist in diagnosis, She practiced medicine and ran a pharmacy in Okeechobee and rather than his having to depend on clinical knowledge or charged $1 for an office call and $1 a mile for traveling to a patient. judgment. Unless a doctor has been fortunate enough to have siderable responsibilities. He was charged with overseeing had a glimpse of country practice before moving into an urban the laboratories that checked the milk supply from all di- area, it must be admitted that he really has lost some of the aries serving West Palm Beach. He ran water samples, and experiences that were commonplace to the doctor of yesterdid blood and urine work for the issuance of health cards year and he is also deprived of that nostalgic feeling that we to domestic workers and food handlers. He visited nursing now enjoy for having lived in that age of hardship, sharing homes, supervised foster homes, treated indigent patients at with each family the joy of a new born baby’s cry, the sadness a clinic in West Palm Beach, and oversaw welfare workers and tears of the loss of a loved one, and the wishful thinking who dispersed county funds for food, clothing and other of what we might have accomplished had we not been born expenses. In addition, Dr. Van Landingham worked with thirty years too soon.” school nurses in the clinics of West Palm Beach and in the Glades area and he was the registrar of vital statistics for the Hard Times During Great Depression Florida Board of Health. As the Great Depression set in during the 1930s, and Dr. Van Landingham is credited with changing many most people lost everything from the land boom that went county health codes that raised the standards of health for bust, physicians continued moving to Palm Beach County.

Left: A plaque commemorating the burial site of the victims of the Hurricane of 1928. Top: In the 1920s, this is a view of102 Clematis Street looking west from City Park. Photographs on this page Courtesy Historical Society of Palm Beach County

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Bottom left: Trucks loaded with coffins after the 1928 hurricane in the Belle Glade area. Left: Early treatment and operating rooms at Pine Ridge Hospital in West Palm Beach which was the only hospital for blacks in five South Florida counties. It closed in the 1950s. Top left: Pine Ridge Hospital around the 1920s; Top: Good Samaritan Hospital and staff, 1924. Photographs Courtesy Historical Society of Palm Beach County

Dr. V. Marklin Johnson arrived in 1931, as the county still cleaned up from a devastating hurricane of 1928, which killed thousands of farmers and migrant workers along Lake Okeechobee. A graduate of Tulane University and a native of Key West, his background in tropical medicine gave him an advantage for practicing in Florida. In a 1989 article in On Call, Dr. Johnson, who went on to become Palm Beach County’s first pathologist, recalled the hardships of providing medical care during those times. “Banks failed. There was no money and businesses were in terrible shape. People were still rebuilding from the hurricane. Good Samaritan was the only hospital, other than Pine Ridge, between Fort Lauderdale and Stuart, so my practice covered quite a large area geographically. Without major highways, traveling was time consuming and exhausting. “In those days, we didn’t have antibiotics like we have today. When I arrived here I saw a lot of diseases I saw in New Orleans. I treated mostly cases of tularemia, amoebiasis, malaria and ‘dengue fever.’ I always felt my knowledge of tropical medicine helped me a great deal.”

Saint Mary’s Becomes A Hospital

In 1939, as Saint Mary’s expanded from a convalescent home to a hospital, the Sisters of St. Francis were credited with running the facility, but it was the philanthropists who raised the money and donated their time to building the center into a reputable institution. Together, they recognized that another hospital in Palm Beach County was needed more than a nursing home as the population continued growing. Here’s how the Palm Beach Post-Times described in 1952 the expansion of the facility: “The white colonial building was completed in November 1939. The first floor housed the general and administrative rooms and offices. Mrs. Edward T. Stotesbury furnished the recreation room while Mrs. Byron D. Miller gave the chinaware, silver and glassware in the kitchen. The second and third floors were comprised of sites and rooms with private or connecting OnCall • Q1 2019 15


World War II Years

As the 1940s rolled in, and America was at war again, the demands grew for physicians. More than 60,000 doctors served in the U.S. Armed Forces during World War Two. For doctors who stayed behind at home, most worked long hours and went days, even months, without time off to keep up with their communities’ healthcare needs. By 1942, the military training facilities in Florida became heavily overcrowded. So the military began taking over many hotel facilities, including some of the nation’s best-known resorts. Among them was The Breakers in Palm Beach, which was established as the Ream General Hospital to treat the expected high number of wounded soldiers from the allied invasion of North Africa. The Palm Beach Biltmore Hotel also was converted into a U.S. Naval Special Hospital in 1945 until the war ended, taking in 1,400 soldiers recovering from rheumatic fever or arthritis St. Mary’s Hospital, now known as St. Mary’s Medical Center, in the late brought on by exposure. 1930s. Photograph courtesy Historical Society of Palm Beach County Following the war, there was a rapid decline in the numbaths. Interior decorating was done by Mrs. Henry Harding ber of physicians choosing general practice as a career. More and Miss Margaret Maddock. The corner suite was furnished doctors were seeking medical specialties like surgery, ophby the West Palm Beach Women’s Club. An Italian primitive thalmology, otolaryngology, and internal medicine. They on the landing between the first and second floors was given by were drawn to the demographic, economic, and cultural Mrs. Henry Ittleson; the automatic elevator was a gift of Mrs. trends that fueled demand for specialty services, including Elisha Hubbard Dyer. population shifts from rural to urban areas, which had increased access to specialists. An American Medical News article explained the enormous opportunities that opened for physicians after the war, esp ecially t hos e s eeking specialization: “The life of a small-town generalist didn’t look quite as attractive to many military veterans, and the doctors who had stayed at home were weary of 80-hour workweeks and saw other attractions in specialty and group practice arrangements. That trend, coupled with the explosive growth in scientific knowledge, served as the launching pad for the A view of Downtown West Palm Beach — Clematis Street specialty-oriented practice of 1930s-1940s. Photograph Courtesy Historical Society of medicine that exists today.” Palm Beach County

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Q1 2019 • OnCall

1.

Be among the first to congratulate PBCMS on their 100-year Centennial in the first quarter issue of OnCall. Reserve space NOW!! for this Special Centennial Section that will cover the first 25 years of PBCMS history from 1919-1943. The Future of Medicine Summit XII will kick off the official celebration February 7-8, 2019 at the Kravis Center.

2.

The second quarter issue will cover the history of the PBCMS from 1943-1969. The noteworthy Heroes in Medicine Luncheon will be presented on May 19, 2019 at the Kravis Center.

3.

The third quarter issue will explore the years from 1969-1984 — a period of extraordinary growth and development.

4.

The fourth quarter issue will be devoted to the years from 1984 to the present day, and The Centennial Gala will be held in November, 2019.

Contact: Mindi Tingler • 561-433-3940, ext. 107 • mindit@pbcms.org


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Patient Care

Survey: Doctors Conflicted but Patients Still Top Concern Results Give Some Reason for Optimism

P

By Bill Fleming hysicians are concerned about the quality of care they advanced practice providers such as nurse practitioners and provide to patients — that is, after all, the reason they physician assistants will likely fill the gap. And while practice chose the profession. But physicians today report being consolidation appears to have slowed, evolving technologies so disappointed with the present state of medical prac- and reimbursement models are viewed as encumbrances to tice, that 7 out of 10 say they cannot recommend the profession the most important reason doctors practice medicine: carto their children or other family members. ing for patients. That’s the message from the 2018 Future Here are some of the most relevant findings: of Healthcare survey, featuring respons• 54 percent believe current electronic health record (EHR) es and comments from more than 3,400 technology is having a negative impact on the physician/ physicians nationwide. Conducted by patient relationship. The Doctors Company, the nation’s larg• 62 percent say they don’t plan to change practice models est physician-owned medical malpractice within the next five years. insurer, the survey reveals a complicated • 54 percent contemplate retirement within five years due picture about the attitudes of physicians to changes in health care. towards the state of health care. And physicians were clear in their comments. “If I had to Fleming start today, I would choose another field of endeavor,” said What Does it All Mean? one. Another opined, “We love what we do, but…we need to The survey results indicate that in the future, health care will restore the dignity back to the physician-patient relationship.” likely be much different than what providers and patients are While many say they are disheartened with medicine, it accustomed to today. The number of physicians may contin- gives us hope that the unique passion physicians possess for ue to decrease, with fewer entering the profession and many patient care remains. As one California surgeon noted: “There practicing physicians retiring in the next five years. Patients is no other life I would choose, regardless of compensation may no longer see a physician for non-critical conditions, as or regulation.”

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Despite the cautionary notes these results strike for the future, they still give some reason for optimism. Younger doctors shared a more positive perspective of EHRs. Moreover, after a period of relative flux in practice models, doctors now anticipate that their practice settings will stabilize over the next five years. The vast majority say they will not change practice models in the near future. This structural solidification may give patients more reassurance and predictability when it comes to their health care experiences. What can be done to reverse some of the disenchantment? Based on the responses to this survey, we need to think long-term. Physician disenchantment may ultimately change the face of health care as we know it. As it stands today, by 2020 we will already reach a tipping point, with more primary care physicians retiring than graduating from primary care residencies across the US. From this alone, we can predict a reshaping of services, with physician assistants and nurse practitioners composing more of the family practice workforce. The medical profession is emerging from a period of uncertainty. The use of EHRs is finally becoming familiar, if not popular. And though new business structures and pricing methods might not be second nature, the challenges are at least better understood. To help advance the practice of good medicine, surveys like the Future of Healthcare are instructive and vital. Doctors deserve a loud voice in the health care debate, so that quality care and the doctor-patient relationship are the cornerstone of every decision. Bill Fleming is Chief Operating Officer of The Doctors Company.

The 2019 Renewal is Here! The BCBS INSURANCE TRUST FUND received an excellent, 8% RENEWAL. New HMO options have also been added to enhance the oering, with prices below current levels! Palm Beach Medical Society offers an exclusive, association type health insurance opportunity to physician practices in Palm Beach County. The plans provide affordable health insurance to member EMPLOYER-physicians, their fulltime employees, and their families. It offers comprehensive plans, and a range of benefit levels. The Trust Plans are a Co-Op/Association type plan, where the members merge assets together to create a larger group. The Trust Plans have both traditional plans and High Deductible Health Plans (HDHP) that utilize Health Savings Account (HSA). Most plans are BCBS Blue Options Network plans (Their all-encompassing National/International network). Two new HMO plans have become available, to enhance the overall offering. If you are interested in receiving a proposal for your group, please reach out to Barry Levi or Jeremy Cohen, at 561-353-1234.


2018 Annual Starfish Gala

Dr. and Mrs. Marc Hirsh.

T

Master of Ceremonies Dr. Maureen Whelihan and Matt Gracy.

Dr. Brandon Luskin presents the gavel to Dr. Marc Hirsh.

Palm Beach County Past Presidents pose at the annual Gala.

he 2018 Starfish Gala, presented by Palm Beach County Medical Society Services, was held at the Kravis Center’s Cohen Pavilion in November. The gala honored the 2018 Palm Beach County Medical Society President Brandon Luskin, MD, and introduced Marc Hirsh, MD, the 2019 PBCMS President, who is leading the organization during the 100-year Centennial of the Palm Beach County Medical Society. Michael Dennis, MD, of Palm Beach, the president of Palm Beach County Medical Society Services, highlighted how the event’s proceeds benefit PBCMS Services programs including Project Access, a physician-led system of volunteer care for low-income residents; Disaster Services, such as HERC, which develops health care emergency preparedness, and MRC, which organizes and utilizes volunteers to respond to disasters; Medical Education supports medical students, future physicians, health care leaders; Care Coordination programs; and the Physician Wellness Program.

Bobbi Horwich (l) and Anne Gannon.

Dr. and Mrs. William Slomka.

Holiday Trees Light Up the Gala

The gala showcases the annual Festival of Holiday Trees & Lights — a unique and visually exciting array of 4-foot lighted trees decorated by guests and volunteers for the silent auction. This year’s first-place winner is Bobbi Horwich of Palm Beach. The Starfish Gala raised more than $100,000 this year.

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Q1 2019 • OnCall

Dr. and Mrs. Andrew Berkman

Dr. Jill Rodila entertains guests.


Tenet Florida Physician Services proudly supports the

The Palm Beach County Medical Society. Tenet Florida Physician Services is committed to the health of our community with over 240 providers across multiple specialties offering a broad continuum of care. Our mission is to improve the lives of every person who walks through our doors.

TFPSdocs.com


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Palm Beach County Medical Society and Services

2019 Calendar of Events

February 7-8

State of Medicine Dinner/ Future of Medicine Summit February 13

HCC — Protecting Your Practice from Cyber Criminals – WPB Marriot

16th Annual Heroes in Medicine Awards Luncheon presented by

Palm Beach County Medical Society Services Friday May 17, 2019 The Cohen Pavilion at the Kravis Center Proceeds from the event benefit Project Access, which provides resources and health care for low income, uninsured residents of Palm Beach County as well as other valued programs of PBCMS Services

For more information on sponsorship opportunities, event advertising and ticket sales, go to

www.pbcms.org or call 561-433-3940

February 18

President’s Day – Office Closed

March 5-6

Palm Beach County Legislative Days in Tallahassee March 13

HCC — Engaging Patients Through Social Media and Other Tips to grow your Practice – Atlantis CC March 20

Services Annual Dinner March 30

Doctor’s Day PBC Historical Society May 17

Heroes in Medicine – Kravis Center September 21

100th Year Birthday/ Docs Got Talent November 16

Centennial Celebration

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