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Roger Duncan, MD

Palm Beach County Medical Society President

Serving those who provide care.

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President’s Message Roger Duncan, MD Vice Chief of Anesthesiology, Palms West Hospital

Riding Out the Hurricanes Survival in the times of great change Just as 2020 has brought us a record number of named storms, social unrest and economic instability, it has also brought cataclysmic challenges to the delivery of healthcare. The COVID-19 pandemic has stretched the healthcare system to its limits with close to 400,000 deaths, hospitals overrun with patients and the community clamoring for the administration of vaccines in a calm and well-executed manner. But the community is depending on us to step up and lead them through this crisis, and our years of training, fortitude and resilience have prepared us for this moment. Those years of training with many nights of on-call coverage during residency with dozens and dozens of patients has prepared us to lead the charge on this front just as we did 100 years ago with the Spanish Flu. But make no mistake, these extraordinary times call for new thinking and new responses. I am honored to serve as the 102nd President of the Palm Beach County Medical Society and do not take lightly the magnitude of the challenges we face during my administration. I am writing to layout my vision for surviving these storms and hope that each and everyone of you will join me because achieving and maintaining the viability of MEDICINE in Palm Beach County for the next 100 years and beyond is OUR responsibility. I have a three point plan to success.

COVID-19 RESPONSE: My first goal is to ensure that healthcare providers have access to the vaccine and proper and adequate personal protective equipment (PPE), as well as, educate the community about the benefits of being vaccinated. The COVID-19 pandemic has hit our medical families especially hard and as such, we will continue to build on the new COVID-19 Resource Center, which provides practice management resources and guidance related to all aspects of a physician practice and local and national educational resources for physicians and health care professionals. Through it all, our profession has been a beacon for true and accurate medical and scientific information and medical practice maintenance and

recovery. We have fought for appropriate testing for our patients and communities and we will continue to work with state and local agencies.

ADVOCACY One message that we hope will resonate with all physicians in Palm President, Roger Duncan, MD Beach County is that we ALL need to either get more involved with, or better financially support, legislative advocacy on the local, state, and national levels if we want our practices to survive in Palm Beach County. All physicians should be aligned in preventing further erosion of the scope of practice, physician reimbursement and physician directed care. It requires all of our efforts and financial support to continue to communicate what studies have shown, which is, that physician-directed care is the most costeffective and provides the highest quality of care.

INCREASING ENGAGEMENT My third goal is to have increased membership and engagement with the medical society. There are still some who see very little, if any, benefit with becoming a member of the medical society and I hope to convince them otherwise. In order to achieve this goal we need to engage our younger physicians by embracing technology, expanding mentorship, demonstrating the value of bonding together to protect our profession and recognizing their desire for work life balance. Another way that we intend to achieve this goal is through the formation of a new committee which will focus on inclusion and cultural competence. The goal of this new committee will be to value and seek out new voices and faces of medical care in our community and to reduce barriers to care from bias. Finally, I will be establishing a subcommittee whose focus will be to build bridges/inroads with employed physicians, megagroup physicians and hospital-based physicians and to convince them of the value proposition of joining up with and jointly advocating for the practice of medicine. In these times, I am extremely proud to be a doctor and a part of a group of professionals who have risen to the call to steer the ship through this Category 5 Hurricane just as we did 100 years ago. I look forward to serving with each one of you over the next year and I look forward in advance to your support.

OnCall • Q1 2021




Roger Duncan, MD President Claudia Mason, MD                                       Dawn Davanzo, MD President-Elect Vice-President Martha Rodriguez, MD Andrew Berkman, MD Secretary Treasurer Larry Bush, MD Immediate Past President      

Ayesha Abid Jose Arrascue, MD                                           Stephen Babic, MD                                         Shawn B. Baca, MD Colette Brown-Graham, MD Ramon L. Cuevas-Trisan, MD Kleper de Almeida, MD Micheal Dennis, MD James Goldenberg, MD Gregg Goldin, MD Faustino Gonzalez, MD Henry M. Haire, MD Brandon Luskin, MD Marc J. Hirsh, MD Larry Bush, MD Alan Pillersdorf, MD

James Heron, MD Marc Hirsh, MD Krishna Kishor, MD Ekaterina Kostioukhina, MD Catherine Lowe, MD Harish Madhav, MD Alan B. Pillersdorf, MD David Shulan, MD Ali Syed, MD Charles Szuchan Justin Williams, DO Jack Zelter, MD

BOARD OF TRUSTEES Mark Rubenstein, MD Jack Zeltzer, MD Jose F. Arrascue, MD Chair Roger Duncan, MD

Claudia Mason, MD Dawn Davanzo, MD Martha Rodriguez, MD

BOARD OF DIRECTORS Ivy Faske, MD President Matt Gracey Vice President

Stuart Miro, MD Secretary Don Chester Treasurer

Michael T.B. Dennis, MD President Emeritus Jean Acevedo Elaine Alvarez Jose F. Arrascue, MD Brenda Atkins Steven Borzak, MD Bob Broadway Madelyn Christopher

Ljubica “Jibby” Ciric Patti Corbett Bobbi Horwich Barbara James Andrew Larson, MD Gary Lesser, Esq Roshan Massoumi Alan B. Pillersdorf, MD

Brent M. Schillinger, MD Mollie Shulan, MD Ben Starling III Patricia Thomas Maureen Whelihan, MD Paul Wieseneck Jack Zeltzer, MD


President’s Report


Chief Executive Officer of

Mindi Tingler Director of Communications Katherine Zuber Membership Development & Events Director

Karen Harwood Director of Community Programs

John James Public Health & Disaster Services Director

Mindy Gonzalez Director of Finance & Administration

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 and edited by Mad 4 Marketing. Visit us on the web at mad4marketing.com 954.485.5448


Q4 2020 • OnCall


Welcome New Members


Palm Beach County Medical Society


Telemedicine Applications


2021 Board of Directors

Kelly Skidmore

CEO Palm Beach County Medical Society

Put Your Practice at Risk of Cyberattack Tom Murphy


Palm Beach County Medical Society Installation Gala & Heroes in Medicine Celebration


AS We honor our PreSident larrY BuSh, Md and WelCoMe inCoMing PreSident roger dunCan, Md

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Congratulations to Our 2020 Heroes in Medicine

to the


PalM BeaCh CountY MediCal SoCietY ServiCeS

www.pbcms.org • 561-433-3940


Congratulations to Our


Palm Beach County Medical Society Installation Gala & Heroes in Medicine Celebration


2020 Heroes in Medicine Finalists AS We honor our PreSident larrY BuSh, Md and WelCoMe inCoMing PreSident roger dunCan, Md


C o r d i a l lY i n v i t e d

to the


Palm Beach County Medical Society Installation Gala & Heroes in Medicine Celebration

AS Well aS our 2020 heroeS in MediCine


C o r d i a l lY i n v i t e d

Palm Beach County Medical Society Installation Gala & Heroes in Medicine Celebration

6:30 P.M. Pre-Event Celebration & Silent Auction 7:00 P.M. Program & Entertainment

RSVP BY NOVEMBER 20, 2020 www.pbcms.org • 561-433-3940



AS Well aS our 2020 heroeS in MediCine


First Virtual Gala Celebrated Heroes 6:30 P.M. Pre-Event Celebration & Silent Auction 7:00 P.M. Program & Entertainment


PalM BeaCh CountY MediCal SoCietY ServiCeS

www.pbcms.org • 561-433-3940

RSVP BY NOVEMBER 20, 2020 www.pbcms.org • 561-433-3940

Raised Nearly $45,000 for Those in Need

Contributions benefit Palm Beach County Medical Society Services, Inc., a not for profit tax exempt organization.




Kelly Skidmore CEO Deanna Lessard Member Services & Physician Wellness Director

Roger Duncan, MD

Roger Duncan, MD inducted as 102nd President




Strategies for Successful


Roger Duncan, MD President

Patient Safety in the Medical Office

Implementation of Mandatory Vaccine Policy for your Workforce

2021 Circle of Friends

Karen Davila

Florida Healthcare Law Firm

Circle of Friends 2021

New Members PALM BEACH COUNTY MEDICAL SOCIETY Charles O. Alakija, MD (part-time) Emergency Medicine Paldeep S. Atwal, MD Medical Genetics and Genomics - Clinical Genetics and Genomics & Medical Biochemical Genetics Jeffrey Collins Emergency Medicine David Dillon, MD Rheumatology


Joseph Goldberg, MD Internal Medicine

Leonard Benedict, MD

Seneca Harberger, MD Family Medicine

Lawrence H. Brickman, MD

Stuart H. Isaacson, MD Neurology Jerisa Johnson, DO Emergency Medicine Alexis Katz, DO Rheumatology

Dolores Arnold, MD Jerome E. Bernstein, MD Susan B. Giesecke, MD Joseph Goldberg, MD Murray R. Gordon, MD Marilyn Kassirer, MD Mario Ludmer, MD Fredric W. Pullen V, MD Gary V. Prim, MD

Linda Kiley, MD Patricia A. Randall, MD Medicine Obstetrics and Gynecology Irving P. Ratner, MD

FINANCIAL Craig Forleiter, MD Protection Joseph H Richman, MD Cosmetic, Plastic & Amit Rastogi, MD Investment PLANNING FOR Reconstructive Surgery Jeanne A. Rodman, MD CEO Jupiter Medical Center Wealth Creation Irwin M. Suna, MD TODAY'S Teresita Fox, MD Rosalie Tassone, MD Retirement Pediatrics Anesthesiology (Pediatric) Col. Jose R. Thomas-Richards, DO HOSPITALIST Norman Wiesenthal, MD For membership information contact Deanna Lessard at deannal@pbcms.org or 561-433-3940 x105.




Chief Executive Officer of Palm Beach County Medical Society By Kelly Skidmore


CEO, Palm Beach County Medical Society

What an extraordinary time in world history for health care professionals. The task at hand has indeed been daunting and the need overwhelming, yet our physicians continue to rise to the occasion every day to deliver services, treatment, and care during the most extensive public health emergency of our lifetime. It is truly an honor for me to be named as chief executive officer (CEO) of the Palm Beach County Medical Society (PBCMS) as it enters its 102nd year of service to doctors, patients, and the community at large. PBCMS is an exemplary organization of dedicated individuals whose mission is to safeguard the delivery of and access to quality healthcare. It is a noble pursuit toward a common purpose, with physician leaders at the forefront of protecting patients, advocating for improved public policy, communicating vital information, and providing care wherever and whenever it is needed. It seems as though nothing before has had quite the power to so rapidly influence and impact nearly every aspect of everyday life the way COVID-19 has. From lockdowns and quarantines, to determining essential worker status, to remote working and learning, to the explosion of delivery services, to the wearing of masks, enhanced hygiene, and physical distancing, to the rapid inclusion of new jargon, like PPE, N95, and positivity rates, not to mention Zoom, into the American lexicon. Technology advancements have occurred at astonishing speed and many are likely to remain permanent. At the PBCMS, we are prepared to embrace efficiencies, streamline processes, and create a culture of transparency and accountability for our members and those we serve. Throughout this pandemic, physicians have remained the reliable source of not just providing immediate life-saving care, but being trusted agents of pro-action, innovation, adaptation, information, and communication, all vital elements to helping us to contain the virus and protect ourselves and


Q1 2021  •  OnCall

Kelly Skidmore

one another. The PBCMS has a storied legacy of its 19 founding physicians, who also dealt with the conditions of a deadly pandemic, and while many patients tragically lost their life then as now, many more were saved. And, as we slowly begin the process of vaccine distribution and mass inoculation, we know our physicians will once again stand on the front line of delivering this important community protection. I believe 2021 will present PBCMS many new and exciting opportunities to continue to improve the delivery and quality of care to patients throughout the County. Through the many essential programs offered through PBCMS Services, like Project Access, Care Coordination Training, the Opioid Task Force, Disaster Services, the Physician Leadership Academy, and more on the horizon, we will lead the community into the next decade of transformational initiatives that advance the healthcare profession, increase access to care, and continue to improve outcomes. Thank you for allowing me to be a part of this amazing organization. I look forward to working with each and everyone toward achieving our collective goals. All the best, Kelly Skidmore, CEO

For more information contact Kelly Skidmore by email kellys@pbcms.org or call 561-433-3940.

Since the rates for workers’ compensation insurance are set by the state, the cost will be the same no matter where you secure coverage. But now, all current and new PBCMS members are eligible for up to a 30% maximum dividend on their premium. AmTrust North America, a true partner to the PBCMS and Danna-Gracey for many years, and now, with the resources of AmTrust – rated “A” (Excellent) by A.M. Best – we are able to provide this exclusive enhanced dividend program like no other for Florida physicians and medical practices. To date, the program has given back over $10 million in dividends to our society members insured through this program. For more details and to enroll in this beneficial program, please contact Tom Murphy at Danna-Gracey in Delray Beach, 800-966-2120 or tom@dannagracey.com.

When I looked out over the water, my soul stirred. I realized that Palm Beach was more to me than a luxurious haven. It’s where I want to be, because when you live like this, you want to stay a lit tle longer

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T: 561 617 9334 All photographs, renderings, and illustrations are for artistic representation purposes only. Oral representations cannot be relied upon as correctly stating the representations of the developer. For correct representations, reference should be made to the documents required by section 718.503, Florida statutes, to be furnished by a developer to a buyer or lessee. This offering is made only by the offering documents for the condominium and no statement should be relied upon if not made in the offering documents. This is not an offer to sell, or solicitation of offers to buy, the condominium units in states where such offer or solicitation cannot be made. Prices, plans and specifications are subject to change without notice, E. & O. E.

OnCall • Q1 2021


Telemedicine Applications Put Your Practice at Risk of a Cyberattack The current COVID-19 pandemic has accelerated the use of telemedicine. It has forced the sudden adoption of telemedicine by many medical practices and healthcare systems, accompanied by government and payer emergency measures that have helped to make telemedicine care easier. Most of these emergency measures will sunset, and while most physicians and patients will welcome the return to safe in-person visits, the dramatic increase in virtual care is here to stay. The use of telemedicine apps, along with the large number of people working remotely, has created the potential for the acceleration of cyber security breaches. These security breaches are not just limited to the medical practice and can impact your patients as well. It is widely known that medical records, or personal health information (PHI), is the most-sought-after information for cyber criminals due to the amount of money this information can fetch on the Dark Web. The current COVID-19 pandemic has made obtaining this information easier for cyber criminals due to the large volume of people that have started using telemedicine apps in a period of a few months. The most-common forms of these cyber attacks seeking PHI are currently ransomware and cyber extortion. Cyber criminals are getting very proficient at tricking people into falling for phishing scams that allow them into your system to collect information or lock down your system until a “ransom” is paid. Another cyber-attack method is when the criminal pretends to be someone in your organization or with whom you regularly do business and tricks an unsuspecting individual into wiring funds, believing that the criminal is a legitimate business partner. This is a fraudulent transfer of funds. A single data breach can have costly, long-term implications that can severely impact your medical practice and create a business interruption that can


Q1 2021 • OnCall

Tom Murphy be difficult to overcome. The good news is that unlike most insurance policies, a good cyber policy will protect you for the business-interruption exposure. In addition to this very-important coverage, you are also protected for ransomware, cyber extortion, breach notification costs, data recreation, regulatory fines and penalties, credit monitoring, fraudulent transfer of funds, public relations, and much more.

For more information about workers’ compensation and medical malpractice insurance, contact Tom Murphy at (561) 276-3553 or (800) 966-2120 or Murphy@dannagracey.com

MAKE AN IMPACT Joining the Project Access Volunteer Network (PAVN) means supporting a healthier Palm Beach County.

This group of volunteers enable patients to receive care through our collaboration with safety-net clinics and specialty providers.

As a physician volunteer with Project Access, you receive: • Sovereign Immunity for services provided through the Florida Department of Health’s Volunteer Health Care Provider Program. •Up to five CME credits, every two years. • Complete discretion in the number of patients treated – the number of donated services is up to you! • The opportunity to be part of a seamless experience for the you and the patients because all care and services are managed through the Direct Care program. • The satisfaction of knowing your participation in Project Access helps reduce inappropriate ER admissions.

Contact Angelica Cervantes at angelac@pbcms.org for more information.

2021 Board of Directors Executive Committee

Roger Duncan, MD President

Claudia Mason, MD President-Elect

Dawn Davanzo, MD First Vice-President

Martha Rodriguez, MD Secretary

Andrew Berkman, MD Treasurer

Larry Bush, MD Immediate Past President

Ayesha Abid

Jose Arrascue, MD

Stephen Babic, MD

Shawn Baca, MD

Colette Brown-Graham, MD

Ramon L. Cuevas-Trisan, MD

Kleper de Almeida, MD

Michael T.B. Dennis, MD

James Goldberg, MD

Gregg Goldin, MD

Faustino Gonzalez, MD

Henry M. Haire, MD

James Heron, MD

Marc Hirsh, MD

Krishna Kishor, MD

Ekaterina Kostioukhina, MD

Catherine Lowe, MD

Harish Madhav, MD

Alan Pillersdorf, MD

David Shulan, MD

Ali Syed, MD

Charles Szuchan

Justin Williams, DO

Jack Zeltzer, MD

OnCall  •  Q1 2021 


Barry Levi or Jeremy Cohen, at 561-353-1234.

Thank you

to FoundCare’s Healthcare Heroes

We are a ‘Community Hero’ because of you!

Congratulations Dr. Roger L. Duncan, III

102nd President of the Palm Beach County Medical Society

We Salute You! (561) 432-5849 2330 S. Congress Avenue, Palm Springs, FL 33406 | www.foundcare.org


T. Leroy Jefferson Medical Society www.tljmedicalsociety.org 561.318.0814


At Florida Power & Light Company we are working together with the communities we serve to make Florida an even better place to raise a family and do business.


2020 HEROES IN MEDICINE The Palm Beach County Medical Society (PBCMS) Services celebrated the recipients of the 17th Annual Heroes in Medicine awards. Honorees were recognized at the Society’s annual gala on December 5, 2020. Net proceeds from this event will support PBCMS Services programs, including COVID-19 Response, Project Access, Disaster Services, Opioid Task Force and Care Coordination. Heroes in Medicine awards spotlight those Individuals and organizations in Palm Beach County that provide outstanding service to meet the needs of people in local, national and/or global communities. Nominees complete a rigorous review process, including inperson interviews selected by community leaders and volunteers. Heroes in Medicine is made possible by the generous support of Rendina Healthcare Real Estate.

2020 HEROES IN MEDICINE ARE: 2020 Physician Hero award, goes to Nuclear Medicine Specialist Norman Pevsner, MD. He was nominated because of his litany of scientific, patient care and philanthropic contributions. For example, he developed the first Cardiac Stress SPECT scanning test in South Florida and serves as an instructor and lecturer as part of his belief that “being good doctors is the key to better health care and self fulfilment.” Among his many industry association and community roles include being elected as a Fellow to the American College of Radiology, donating computer libraries to medical students at Nova Southeastern


Q1 2021  •  OnCall

University, and serving as a long-time board member of Physicians Resource Network. Dr. Pevsner has been driven to make a difference in health care for the citizens of Florida and the nation. Bruce Rendina Professional Hero: Patrick McNamara, CEO, Palm Beach Health Foundation, receives this award as a professional who is not a direct provider of patient care but uses his abilities to improve the health of the community. He has built vital partnerships, strengthened relationships with system partners and created innovative approaches of solving complex health problems. Recently, he worked with the Southeast Florida Behavioral Health Network to help unify the countywide system of care for the addicted. Community Organization Hero: FoundCare, Inc. Originally an AIDS support program, this organization today operates as a comprehensive community health center to help meet the unmet health care needs of Palm Beach County residents, giving every patient the same high-quality standard of care regardless of insurance coverage. “We will always do our best to provide the resources they need to take charge of their health; because everyone deserves the right to be healthy,” states FoundCare.

Health Care Educator Hero: Miguel LopezViego, Jr., MD, Baptist Health Physician Group. A Cuban immigrant, this hero arrived in Miami at age 2 and has since built a reputation as one of South Florida’s top general and vascular surgeons. Starting as the chief editor of a trauma handbook during his residency in Dallas, he has remained committed to the education of medical students and residents. The patience and enthusiasm with which he has led medical students has inspired countless students to pursue careers in general and vascular surgery. Health Care Innovation Hero: Kathy Schilling, MD, Lynn Women’s Health & Wellness Institute. As Medical Director and Radiologist, Dr. Schilling has innovated a new care pathway for the over 65,000 women who seek breast-imaging services at any one of our breast centers. Through this new approach, we will be able to identify those women who are at a higher risk for developing the top diseases that kill women. She sees the possibility, forges ahead with passion and conviction, and takes the necessary steps out of the ordinary and into the extraordinary. Health Care Provider Hero: Brittany Reidy, RN, Medical Team Director, Bahamas Relief Cruise. Within a few days after Hurricane Dorian, this critical care and trauma intensive care nurse set up and ran an impromptu triage care area to care for evacuees. The experience inspired her to take 14 additional humanitarian trips to Grand Bahama and Abaco. She also organized a prosthetic clinic for Bahamian storm survivors who either lost their prosthetics or had never had artificial limbs.

Humanitarian Award: Nancy Brinker, The Promise Fund. Nancy Brinker spent four decades growing the Susan G. Komen Foundation and changing forever the awareness of breast cancer in memory of her sister, who died at age 36 from the disease. More recently, she helped to start The Promise Fund whose mission is to reduce and prevent the progression of breast and cervical cancer, especially among the underserved, in Palm Beach County. Lifetime Achievement Award: Gordon Johnson, MD, Anatomic & Clinical Pathology. Now retired, this dedicated pathologist has redefined what it means to give back. He mentors young people in an effort to bring more diversity into the medical field. He tutors high school students, sponsors food pantry activities and helps underserved children participate in sports. Dr. Johnson is committed to making a difference where possible. He is a strong advocate for youth and medically underserved individuals. Leadership Award: Tulisa LaRocca, MD, University of Miami Miller School of Medicine/JFK Medical Center. The best test of effectiveness in a teacher or educator is to actually see the light in the student or resident. When you were in the room with Dr. LaRocca, the whole room glowed. Her passion was contagious, inspiring and sincere. Dr. Tulisa LaRocca passed away at her home in Boynton Beach, Florida on October 13, 2020, after battling breast cancer. Born on January 21, 1976 in Castro Valley, California. She is survived by her parents, Naftula and Isabel Hanflink, and her husband of 10 years, Nicholas LaRocca. OnCall  •  Q1 2021 




University of Miami/JFK Internal Medicine Residency Program

Christine E. Lynn College of Nursing – FAU









Shenandoah Medical Care Center

College of Nursing – FSU

Edward Via College of Osteopathic Medicine — Auburn

Bethesda Health — Baptist Health South Florida

Foundcare, Inc.

Florida Medical Association

Charles E. Schmidt College of Medicine – FAU

FirstLantic Healthcare

THANK YOU SPONSORS CIRCLE OF FRIENDS Amtrust Danna-Gracey The Doctors Company

SPONSORS Rendina Healthcare Real Estate Eugene & Nancy Beard Palm Health Foundation Florida Power & Light Company Christine E. Lynn Triple O Research Institute Acevedo Consulting MMR Healthcare Dr. Roger Duncan and Mrs. Lisa Quarrie-Duncan Florida Blue Gold Square Consulting Rheumatology Associates of South Florida T. Leroy Jefferson Medical Society Triple O Medical Services Clarence D. Williams Robert and Michelle Adkins Margaret Donnelley


Q1 2021  •  OnCall

University of Miami Miller School of Medicine Dr. Mas Massoumi and Mrs. Roshan Massoumi Dr. Jack Zeltzer and Mrs. Marcy Zeltzer Steven Borzak, MD Center for Modern Medicine Fantastic Wellness Center Fidelity Investments Bobbi Horwich & Judge Jamie Goodman Nancy Hogan Gordon Johnson, MD Ivy Faske, MD Claudia Mason, MD The Hirsh Center Palm Beach ACO Ellis Webster, MD


Judy Dunn, John Dalton, Gregory Cotes Elaine Alvarez Jose F. Arrascue, MD Shawn Baca, MD Larry Bush, MD Sally Chester Darcy Davis Rodney Dunetz Trish Ernst Patricia Forde Mark Goldstein, PhD Carol Hakemian Kathleen Hillman Mario Jacomino, MD Beth Johnston Christina MacEachern

Claudia Mason, MD Brandy Monteleone Robert Moreland Emanuel Newmark, MD Owen O’Neill Robin Parson Claudia Rodney Sharon Rose Marnique Sparago Sarah Steele Stephanie Stiepleman David Summers Paula Triana Raymond Zelhof, PharmD


2020 GALA & HEROES IN MEDICINE First Virtual Gala Celebrated Heroes and Raised Nearly $45,000 for Those in Need Roger Duncan, MD, inducted as 102nd President Celebrating the health care heroes among us was particularly heartfelt as this year’s first-ever virtual gala honored the Heroes in Medicine, inducted a new president and welcomed a new CEO. Brent Schillinger, MD and Maureen Whelihan, MD served as masters of ceremony for the event. “Although COVID-19 has made a global impact on our world, the Medical Society has worked extra hard to be a support and resource for you -- our members -- as well as the community at large. Our commitment to the health and safety of our community has never been stronger,” said outgoing CEO Tenna Wiles. “Another reason tonight is extra special is that we once again get to celebrate the heroes among us.” The gala committee, with support from sponsors and attendees, was able to clear after expenses nearly $45,000 to support Palm Beach Medical Society Services and such programs as Project Access, Future of Medicine, Disaster Services, Opioid Task Force, My Health Access, Physician Wellness and Care Coordination. “As we honor the extraordinary men and women health care stars, let’s also remember those less fortunate who desperately depend on Services programs,” stressed Dr. Whelihan. Drs. Schillinger and Whelihan thanked the volunteers and sponsors who made the Heroes in Medicine Awards possible before kicking off the presentations. “The 17-year Heroes in Medicine Awards tradition recognizes the outstanding accomplishments of individuals and groups who strive to improve the quality of health care in Palm Beach County,” said Dr. Schillinger. OnCall  •  Q1 2021 


PBCMS President Larry Bush, MD, presented the highest honor, the Excellence in Medicine Award, to Alina Alonso, MD of the Florida Department of Health in Palm Beach County, who was also recognized as the “COVID-19 Hero” because of her extraordinary leadership in managing the crisis in the local community. Following the award presentations, Dr. Bush passed the gavel to 2021 PBCMS President Roger Duncan, MD. The leadership baton also was handed over to the new CEO of the Society, Kelly Skidmore.

“I am most grateful for the opportunity of serving as CEO of PBCMS and Services for the past 22 1/2 years,” said Wiles. “It is my honor to introduce the new CEO, who am confident will lead the Society and Services to achieve great success.” “I am grateful for Tenna’s steady hand over the years and I look forward to following in her footsteps - despite the big shoes I have to fill,” responded Skidmore. “I’m ready to tackle the challenges that lie ahead and humbled to be part of this incredible team that is committed to advocating on behalf of physicians and their patients to improve health care in our community.”


Q1 2021  •  OnCall

GALA HOST COMMITTEE: Jose Arrascue, MD Colette Brown-Graham, MD Larry Bush, MD F. Malcolm Cunningham, Jr. Dawn Davanzo, MD Earnest Ellison, Jr. Ivy Faske, MD James Goldenberg, MD Al Green Gordon Johnson, MD Catherine Lowe, MD Patrick McNamara

Olayemi Osiyemi, MD Alan Pillersdorf, MD Martha Rodriguez, MD Brent Schillinger, MD Darrell Searcy Grasford Smith, Jr. Tricia Thompkins Hansel Tookes, II Ellis Webster, MD Maureen Whelihan, MD Clarence Williams

Dr. James and Mrs. Dianne Goldenberg Thank

Dr. Larry Bush & Congratulate Dr. Roger Duncan Sponsored by Gold Square Consulting Healthcare Specialists 561-309-6790

COVID-19 and Patient Safety in the Medical Office Debbie Kane Hill, MBA, RN, Senior Patient Safety Risk Manager As the pandemic hits its third nationwide surge, families are gathering for the holidays, and practices are preparing for a potential increase in cases. Medical offices in states that were not strongly affected by the first and second waves of the virus may now be facing an influx of COVID-19 patients. Therefore, medical offices must remain very attentive to the widespread outbreak of COVID-19, continuing to proactively take steps to safely manage patients while protecting clinical staff.

Here are tips and resources for this season of the pandemic: • Documentation: Maintain administrative records of how you have adapted to the evolving crisis including the challenges you faced. For details, see Keep a COVID-19 Diary: Document Now in Case of Future Lawsuits.

Now in Case of Future Lawsuits. • Legislation and Guidance: Reference the CDC, your state medical board, professional societies, and federal, state, and local authorities daily for public health guidance and new legislation, as this continues to be a fluid situation. • Screening Criteria: Follow the CDC’s patient assessment protocol for early disease detection for patients presenting to your practice. Patients should be screened using these guidelines: Overview of Testing for SARS-CoV-2 (COVID-19). Essential visitors to your facility should also be assessed for symptoms

of coronavirus and contact exposure and redirected to remain outside if suspect. • Accepting Patients: Do not turn patients away simply because a patient calls with acute respiratory symptoms. Refusing assessment/care may lead to concerns of patient abandonment. • Designated Triage Location: Check with your local public health authorities for locations designated to triage suspected patients, so exposure is limited in general medical offices. • Telehealth Triage: Licensed staff should be trained in triage protocol to determine which patients can be managed safely at home. See Healthcare Facilities: Managing Operations During the COVID-19 Pandemic. The CDC provides Phone Advice Line Tools, while The Doctors Company offers resources on telemedicine in our COVID-19 Telehealth Resource Center. • Patient Testing:  When there is a reasonable presumption that a patient may have been exposed to COVID-19, contact the local or state health department to coordinate testing using available community resources. See the CDC’s Testing for COVID-19, the COVID-19 Testing Overview, and the Clinician Call Center. • Elective Services: Check with regional governmental and health authorities on the provision of nonessential and elective healthcare visits and group-related activities. Many states continue or have reinstated restrictions on the provision of nonurgent, elective surgeries and procedures (See ACOS: COVID-19: Executive Orders by State on Dental, Medical, and Surgical Procedures). • Patient Precautions: Educational resources, including posters for use in the medical office, are available from the WHO and for healthcare workers from the CDC (Contact Precautions, Droplet Precautions, and Airborne Precautions). Reference the CDC’s Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic and Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) for patient management guidance. • Provider/Staff Precautions: Follow Standard Precautions and Transmission-Based Precautions, including gloves, gowns, protective eyewear, and NIOSH-certified N95 respirators that have been OnCall  •  Q1 2021 


properly fit-tested. If there is a shortage of N95 respirators in your facility, access current CDC respirator recommendations and review Optimizing Personal Protective Equipment (PPE) Supplies. • Limit Exposure: Limit staff exposure to suspected patients, with the exam room door kept closed. Ideally, the designated exam room should be at the back of the office, far away from other staff and patients. • Surface Disinfection: Once the patient exits the room, conduct surface disinfection while staff continues to wear PPE. For general guidance, see Clinical Questions about COVID-19: Questions and Answers. • Patient Education: Provide up-to-date, factual information on the virus to suspected COVID-19 positive patients and their close contacts. • Provider/Staff Exposure: Screen healthcare personnel daily for symptoms/contacts relevant to COVID-19. Any unprotected occupational exposure by staff members should be assessed and monitored. See Interim U.S. Guidance for Risk Assessment and


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Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19. Should providers and/or staff test positive within your facility, conduct and document a risk assessment identifying contacts, type of interaction, and PPE in use, then contact local health authorities for additional instruction. The CDC provides guidance here under the section “Infection Control,” as does the American Dental Association: What to Do if Someone on Your Staff Tests Positive for COVID-19. The health department may assist with patient notification if determined to be necessary. For return-to-work guidance, review the Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 Infection (Interim Guidance). • Staff Training: Provide and document additional staff training as protocols change. Maintain training records in administrative files. The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.


Karen Davila

Florida Healthcare Law Firm

Florida Healthcare Law Firm

Can an employer require employees to be vaccinated against influenza? And, a COVID-19 vaccine likely will be approved in the not-todistant future. What about that vaccine when it becomes available? These are questions with which many organizations are grappling today. With the confluence of what is expected to be a very active influenza season and the ongoing and unprecedented COVID-19 pandemic, employers are contemplating how best to protect their workforce and clients/customers/patients. One of the most effective ways to achieve this is a mandatory vaccine policy, but is that right for your organization? Mandatory vaccination programs are not new. Depending on your business, a mandatory vaccine policy may be the industry norm. What factors should you consider? What processes would you need to develop to address exceptions?

CAN YOUR BUSINESS MANDATE VACCINATIONS? In general the answer is yes. Although federal and state laws may vary, such programs are permissible provided any mandatory vaccination policy incorporates processes to address the required exceptions: medical accommodations under the Americans with Disabilities Act (ADA); and religious accommodations under Title VII of the Civil Rights Act of 1964 (Title VII).

WHAT IF AN EMPLOYEE REFUSES TO BE VACCINATED? Accommodations under the ADA An employee refusing vaccination because of a disability must provide medical documentation of the existence of that disability. Mere sensitivity to vaccines may not be sufficient to constitute a covered disability. Courts have taken opposing positions on this so it is important to confer

with your legal counsel if faced with nuanced questions concerning whether a disability requiring accommodation exists. Once the existence of a covered disability is established, the employer must either provide an accommodation or demonstrate through “special circumstances” that an undue hardship exists in allowing any such accommodation. If accommodations can be made without undue hardship, the employer must provide such accommodations. In the context of vaccines, options for accommodations may include requiring the employee to wear face coverings at all times while on the business premises (and additional PPE, as warranted) or use of alternative vaccine formulations that do not contain the ingredients associated with employee’s medical condition (e.g. egg or swine byproducts).

ACCOMMODATIONS UNDER TITLE VII Although similar accommodations may be provided under Title VII, the threshold for an employee to be eligible for such accommodations is higher. An employee seeking a religious accommodation must prove that s/he has a “sincerely held religious belief.” Because an employee’s right to express his/her religion in the work place is not without limits, any expression of that religion that disrupts or negatively impact operations may be restricted. The employer is entitled to make a limited inquiry into the facts and circumstances of the employee’s claim that the belief or practice at issue is religious, sincerely held, and gives rise to the need for accommodation. The employer is not required to provide a religious accommodation that results in more than a de minimis burden, whether economic or non-economic. In at least one reported case in a health care setting, a court found that a religious accommodation and exemption from the mandatory flu vaccine would pose an undue OnCall  •  Q1 2021 


hardship (more than a de minimis burden) by putting the health of vulnerable patients at risk. The initial analysis of any request for a religious accommodation must focus on whether a person’s objection to the vaccination is actually religious. Ethical or personal objections generally do not meet that threshold. Anti-vaxxers may have a difficult time convincing an employer that their personal beliefs on vaccinations rise to the level of religious beliefs. Nonetheless, employers must tread carefully in this space as some courts broadly construe religious beliefs to include any belief held so sincerely by an employee as to take on a role in their life similar to traditional religious beliefs. In many cases, religious accommodations are sought for sincerely held religious beliefs concerning the ingredients in the vaccine itself. Such religious beliefs may prohibit the consumption of one or more of the ingredients in the vaccine formulation, such as products that, if consumed, would violate kosher or halal rules. A particularly challenging question arises when an employee requests accommodation for a sincerely held religious belief where that belief is based on false information. One such example is the opposition to the influenza vaccine because the employee believes it contains or was formulated using fetal cells. While some vaccines (e.g. rubella, measles, chickenpox and smallpox) may use fetal cells in the development of the vaccine, none of the currently approved formulations of the influenza vaccine do. And, although some of the COVID-19 vaccine formulations currently in development and testing are being manufactured using fetal cells, no vaccine has yet been approved, so for the moment, decisions on this issue can be deferred. A falsely held belief that the influenza vaccine contains fetal cells likely is not sufficient to require the employer to grant an accommodation. The ability to demonstrate the vaccine’s ingredients is important in challenging certain requests for accommodations. And, if alternative formulations are available, the employer should consider those, thereby reducing exceptions and improving compliance with the mandatory vaccine policy. Regardless, caution should be exercised whenever considering denying an accommodation for a person’s religious beliefs.


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DOES YOUR BUSINESS NEED A MANDATORY VACCINE POLICY? Given the above, does a mandatory vaccine policy make sense for your organization? This may depend on several factors, including the following: • Are your employees in direct contact with clients/ customers/patients? • Is that contact prolonged and in indoor spaces where air circulation may be limited? • If one or more of your employees become ill, does that jeopardize continuity of your business? If you answer “YES” to one or more of these questions, you may want to consider implementing a mandatory flu vaccine.

MANAGING ACCOMMODATIONS In order to effectively implement a mandatory vaccination policy, you must develop both the policy and the process to manage exceptions (i.e. requests for accommodations). The process generally involves the submission of an employerdeveloped form along with any additional supporting documentation. The accommodations process should include review of information submitted by the employee in support of the accommodation, request for additional information as and when appropriate, an interactive process between the employer and employee in evaluating any potential accommodation, and ultimately a determination if the requested accommodation poses an undue burden that is more than de minimis on the employer. As you prepare for review of any exceptions, assure you have mechanisms in place to address the following: • Understand and assess the essential functions of the job performed by the employee. • Analyze various options for accommodations in the context of employee’s specific job and essential functions. • Review accommodations offered to other employees in similar instances. • Analyze undue hardship to the employer and safety risks of any exception. • When necessary for clarity or understanding, engage in interactive dialogue with employee.

• Document and communicate your decision to the employee. For accommodations based on the ADA, this process is fairly straight forward and welldeveloped in the business world. In the case of a mandatory vaccine policy, the accommodation is often the requirement to wear a face covering (or other PPE) or use of a different formulation of the vaccine. Bottom line, if the employer receives documentation from a treating health care provider that the employee has a medical condition that contraindicates vaccination, an accommodation is generally offered. On the other hand, if an accommodation is sought based on Title VII, the employee bears the burden of proof to establish that s/he has a sincerely held religious belief in opposition to the vaccine. Understanding the nature of the belief, weighing the risks/benefits of any accommodation that might be granted, and engaging in an interactive dialogue with the employee are critical steps before any decision to deny an accommodation.

SUMMARY While mandatory vaccination programs are becoming more commonplace, particularly in industries with direct and prolonged contact with clients/customers/patients (especially in the health care industry), these programs must be implemented with the recognition that it will be necessary to manage the almost certain requests for accommodations that will immediately follow. And, when managing particularly challenging requests for accommodations, it is advisable to involve legal counsel early in that review.

Financial Solutions for Medical Practices With our long-term commitment to business in our local markets, we understand the complexities involved in running a medical practice. Your local banker will engage a team of specialists to customize a package of financial solutions to fit the evolving needs of your practice.

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Karen L. Davila is an attorney with the Florida Healthcare Law Firm and specializes in risk management, compliance and audit support for a multitude of healthcare businesses. She has served as general counsel for both hospitals and health systems in addition to time with Walmart, Inc., advising on complex regulatory matters. She can be reached via email via Karen@FloridaHealthcareLawFirm.com or by calling (561) 455-7700.

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Circle of Friends 2021

First Citizens Bank: Stable, Safe and Sound. In uncertain times, working with a strong, stable bank can make all the difference. Since 1898, First Citizens has helped families and businesses prosper by keeping an eye on their long-term success. Contact Claudia Rodney, Claudia.Rodney@firstcitizens.com, 561-544-1902.

Optimum RTS is a full-service medical employment agency that works tirelessly to find top notch employees for your office. Our services can assist you to fill all positions from front desk through Physician. Contact John Dalton jdalton@optimumrts.com, 954-336-4086.

NAI/Merin Hunter Codman is one of South Florida’s leading commercial real estate firms and the largest firm in Palm Beach County, Florida with over three decades of experience advising clients on strategic acquisitions and dispositions and providing landlord representation, tenant representation, property management and construction management services. The firm has expertise in all commercial property sectors including office, retail, industrial, multifamily, hotels and land. Contact Lesley Sheinberg, Medical Space Specialist, lsheinberg@mhcreal.com, 561-254-7810.

Visiting Angels is an awardwinning, private duty, Home Health Agency with strict pandemic safety protocols in place so that our caregivers can provide services for your patients recovering from accident, illness, surgery, or those with Alzheimer’s. Contact owner Irv Seldin at 561-328-7611 or iseldin@visitingangels.com. The Keiser University Spine Care Clinic – A Chiropractic Healthcare Facility is now open at 2081 Vista Parkway, West Palm Beach, FL 33411. Please call to schedule an appointment at 561-273-0099, kuspinecare.com.  Keiser University is a Level VI, regionally accredited university by the Southern Association of Colleges and Schools Commission on Colleges to award certificates and degrees at the associate, baccalaureate, masters, specialist, and doctoral levels. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097 or call 404-679-4500 for questions about the accreditation of Keiser University.


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“Fuoco Group, Palm Beach Post’s “Best” Accountant winner, has innovative financial solutions for the challenges you face now and postpandemic. For customized business and financial advisory services as well as tax, accounting, PPP forgiveness and audit, contact Paul Wieseneck CPA at 561-209-1102 or pwieseneck@fuoco.com. The Florida Healthcare Law Firm is the first and only boutique full service law firm. Clients who work with the Florida Healthcare Law Firm are protected by deep healthcare industry experience and fully served by attorneys aligned with their success. The team here doesn’t dabble in healthcare law, we specialize in full spectrum representation of healthcare providers and nearly every type of healthcare business. Contact Autumn Piccolo apiccolo@floridahealthcarelawfirm.com, 561-455-7700 floridahealthcarelawfirm.com. Think Big Health Care Solutions. Practice Medicine Happy. Think Big offers full-service practice management and consulting solutions including contracting, credentialing, financial review, workflow optimization, revenue cycle and billing, audits, compliance, OSHA and HIPAA, outsourced HR - payroll/benefit oversight, athena implementation and optimization, group formation, turn-key practice start-up and complete outsourced MSO services to manage your entire group or practice. Cheryl Anders, cheryl.anders@thinkbighcs.com, 561-758-3360, www.thinkBighcs.com.

Med Mal: It is no longer just a matter of a few signs hinting at a hardening market. Indisputable evidence is now at the forefront. Rates are rising, discounts are being withdrawn. Weaker malpractice insurance carriers are being placed into receivership or merging in the face of withering profits. Shockingly high awards are being made by juries in Florida, which leads to higher insurance rates even with the financially strong insurers. At Danna-Gracey, we understand the complex landscape of insurance coverage for medical professionals. An independent agency with a statewide team of specialists, we are dedicated solely to insurance-coverage placement for Florida’s doctors and healthcare providers. Our personalized client attention and command of the insurance marketplace enable us to effectively negotiate competitive rates – even with the top carriers. Contact Matt Gracey for a free, no-obligation assessment of your current medical malpractice coverage at 800-966-2120 or matt@dannagracey.com. Workers’ Comp Insurance: Since the rates for workers’ compensation insurance are set by the state, the cost will be the same no matter where you secure coverage. But now, all current and new PBCMS members are eligible for up to a 30% maximum dividend on their premium. AmTrust North America, a true partner to the PBCMS and Danna-Gracey for many years, and now, with the resources of AmTrust – rated “A” (Excellent) by A.M. Best – we are able to provide this exclusive enhanced dividend program like no other for Florida physicians and medical practices.  To date, the program has given back over $8 million in dividends to our society members insured through this program. For more details and to enroll in this beneficial program, please contact Tom Murphy at DannaGracey in Delray Beach, 800-966-2120 or tom@dannagracey.com.

Cyber Insurance: Your cyber liability risks are growing so rapidly that many predict they are now greater than your malpractice risk. Did you know that the healthcare industry now suffers 51 percent of all data breaches and that the average cost of dealing with a breach was $2.4 million in the last two years? Even more scary, the majority of cyber issues occur in practices with less than 100 employees. If a doctor uses e-mail, has networked PCs, a website, or stores private patient information on their computer systems or in paper files, then they need cyber insurance. Cyber Insurance was created as a result of the expansion of liabilities against companies for breach of private information, and insurance for digital assets. You may have firewalls, virus protection, anti-spam systems, and prudent procedures to protect passwords and prevent employees from downloading dangerous material, but these measures are not foolproof. For more details, please contact Tom Murphy at Danna-Gracey in Delray Beach, 800-966-2120 or tom@ dannagracey.com.

As an established insurance brokerage company dating back to 1993, Levi & Associates can offer the comprehensive coverage which businesses expect, coupled with a personalized approach families and employees so desperately seek. Regardless of your needs, we can develop a solution tailored to your individual circumstances. Our teams work in unison to offer you customized services designed to provide solutions for your personal and business financial needs. Levi & Associates Insurance, Jeremy Cohen.jeremy@leviinsurance.com.  The SunTrust Medical Specialty Group works exclusively with medical practices, physicians and their families. Our teams include dedicated Medical Relationship Managers, Medical Client Advisors and Medical Client Advisor Associates who understands the financial issues and implications of ongoing changes in the healthcare industry as well as the ongoing demands on your time. By partnering with us, you will have access to a customized, comprehensive set of financial products and services delivered with an incredible depth of expertise. Contact Javier Dadan, CRPC® Javier.Dadan@SunTrust.com or call 561-515-1952.

INFECTIOS DISEASE HIV & HEPATITIS MANAGEMENT CONCIERGE SERVICES WOUND CARE TRAVEL CLINIC IMMAGRATION PHYSICALS 2580 Metro cente Blvd, suit 4, West Palm Beach, FL 33407 Cell: (561) 855-7871 Email: contact@tripleoresearch.com


Research consists of but not limited to: Covid-19 (Prevention & Vaccine) Human Immunodeficiency Virus (HIV) Hepatitis B Hepatitis C Influenza Diabetic Foot Infection New Antibiotic Regimens 2580 Metro cente Blvd, suit 4, West Palm Beach, FL 33407 Cell: (561) 855-7871 Email: contact@tripleoresearch.com


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PAID WEST PALM BEACH, FL PERMIT NO.515 3540 Forest Hill Blvd. Suite 101 West Palm Beach, FL 33406 RETURN SERVICE REQUESTED

Cheers to

100 Years!

Celebrating a Century of Medical Excellence








roudly honoring people throughout

Palm Beach County who use their skills and resources to provide outstanding services. Proceeds from the event benefit Project

Access, providing health care for low income,

uninsured residents of Palm Beach County and other services of the Medical Society.

THURSDAY MAY 20, 2021 6:00PM

NOMINATE YOUR HERO TODAY AT PBCMS.ORG Nominations must be received by Friday March 12th at noon.


PBCMS.org or Call 561-433-3940

Profile for Palm Beach County Medical Society & Services

2021 OnCall Q1