Summer 2021 PIERCE COUNTY MEDICAL SOCIETY
BULLET N Serving Our Members and Community Since 1888
Inside this Edition
• President’s Message • Executive Director Report
• TPCHD Update • PC Project Access Update
Visit us at www.pcmswa.org
Table of Contents
PIERCE COUNTY MEDICAL SOCIETY
BULLET N Serving Our Members and Community Since 1888
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Audentes Fortuna Juvat (“Fortune Favors the Bold”)
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Preserving Our History
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Medicare Increases Payment for Cognitive Care
8 Ability to Bill for PPE CPT Code 99072 Extended 9
TPCHD: When Storms Become Tsunamis
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PC Project Access Update
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In Memoriam
PCMS Officers/Trustees
Ann Goetcheus Gehl, MD, President Dina C. Titova, MD, PhD, President-Elect A. Alex Mohit, MD, PhD, Past President C. Blake Perry, MD, Vice President Courtney M. Kennel, DO, Secretary/Tresurer Julian S. Arroyo, MD H. Matt Davis, MD Irene Grias, DO Christine L. Hammer, MD Nicholas Rajacich, MD Camille P. Samujh, DO, MPH
PCMS Foundation
Charles Weatherby, MD, President Lawrence A. Larson, DO, Vice President Mark S. Grubb, MD Mary Eversole, Secretary
Staff
Executive Director: Mary Eversole Membership Coordinator: Tanya McClain
The Bulletin
is published quarterly by PCMS. Contact Tanya McClain regarding deadlines for submitting articles and advertisements: tanya@pcmswa.org or 253-572-3667.
The Bulletin
is dedicated to the art, science and delivery of medicine and the betterment of the health and medical welfare of the community. The opinions herein are those of the individual contributors and do not necessarily reflect the official position of PCMS. Acceptance of advertising in no way constitutes professional approval or endorsement of products or services advertised. The Bulletin reserves the right to reject any advertising.
Managing Editor: Mary Eversole Advertising Information: 253-572-3667; tanya@pcmswa.org
Cover photo: “Summer daisies in grassy meadow” by Zela www.rgbstock.com
223 Tacoma Avenue South, Tacoma, WA 98402 Phone (253) 572-3667 Fax (253) 572-2470 Email pcms@pcmswa.org
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PIERCE COUNTY MEDICAL SOCIETY
President’s Page
Audentes Fortuna Juvat (“Fortune Favors the Bold”) Ann Goetcheus Gehl, MD When I became President several months ago, it was announced that a major medical society in the northwest region was shuttering. That gave us pause and raised the question: what about PCMS’ future? The Board of Trustees took a hard look at the financial health of PCMS. Part of that process was looking at our resources, including the PCMS building. A Bit of History The building was purchased by Membership Benefits Inc. (former for-profit entity at PCMS) in 1990. It was a wise investment decision at the time. Like the changes with employed physicians over the years, the Society, and the needs of its members have changed. Unfortunately, the cost of maintaining the building and deferred maintenance has surpassed our return on investment. The Process After market analysis, and following robust and thoughtful discussion, the Board unanimously voted to sell the building. It was clear to leadership that our finite resources should be reinvested in support of our mission and members. Next Steps While the balance sheet has not changed, we are developing an investment strategy to ensure the perpetuation of PCMS. Over the next few months, the Trustees will be discussing investment strategy and expanded programs and services for our members. We welcome member input on expanded programs and services. Our Future Our society was formed a year before statehood in 1888. One hundred and thirty-three years later, I know for sure that our future is bright. It is a future that grows a strong connected membership, establishes Pierce County as a sought-after residency location, supports patient care, and protects the public health.
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In Memoria m
THANKS FOR ATTENDING THE 2021 RESIDENTS' PICNIC
Save the date for next year! Residents' picnic August 18, 2022 date subject to change | location to be announced 4
PIERCE COUNTY MEDICAL SOCIETY
Executive Director Report
Preserving Our History Mary Eversole
When you move, experts recommend starting the process eight weeks in advance. This allows you to cope with the stress of moving and reduces the chances of feeling overwhelmed. In our case, it’s a major change from occupying nearly 7,500 square feet for over thirty years, with tenants, to an 890 square foot office with just two staff. The professionals say you must get organized. It involves a lot of moving pieces—new office lease, finding reliable movers, decluttering, donations, helping tenants’ transition, address changes, cancelling service contracts, and more. Facilitating a move such as ours is like watching the Antiques Road Show on PBS—part adventure, part history lesson and part treasure hunt. In the creepy storage room in the basement of our building, the annals of PCMS began to emerge. And what to do with these possessions was the bigger question. Fortuitously, we were introduced to a local historian who advised us well. Happily, some PCMS members took advantage of our hybrid Estate Sale and now have medical treasures to relish. We were able to donate an extensive collection to the Washington State Historical Society adding to our archives already there. More finds uncovered recently are signed photos of the Mayo brothers, donated to the Society by past president J.R. Yocum, MD, we estimate a hundred years ago. There is a great story about Dr. Yocum, but that will wait for another day to tell. Moving is never effortless. While that is certainly true, our history is notable and we are excited to see what emerges through this adventure with trusted stewards.
Bulletin Submissions If you have a clinical best practice to share with your colleagues, a success story about individual physicians or PAs or a health system, or news about health care innovation taking place in Pierce County that you would like considered for inclusion in an upcoming edition of the PCMS Bulletin, please send your submission to Mary Eversole at mary@pcmswa.org.
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PIERCE COUNTY MEDICAL SOCIETY
Medicare increases payment for cognitive care
Alzheimer’s dementia affects one in nine people aged 65 and older and kills more than breast and prostate cancers combined. The Centers for Medicare & Medicaid Services has taken steps to address this public health crisis by increasing payment for and expanding access to cognitive assessment and care plan services. Effective Jan. 1, 2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of primary care services in the Medicare Shared Savings Program, and permanently covered these services via telehealth. Four Things to Know About the Cognitive Assessment & Care Plan Services: • If your patient shows signs of cognitive impairment at an Annual Wellness Visit (AWV) or other routine visit, you may perform a more detailed cognitive assessment and develop a care plan. • The Cognitive Assessment & Care Plan Services (CPT code 99483) typically start with a 50-minute face-to-face visit that includes a detailed history and patient exam, resulting in a written care plan. • If you report evaluation and management (E/M) services, you can offer this service, including: physicians (MD and DO), nurse practitioners, clinical nurse specialists, and physician assistants. • Use CPT code 99483 to bill for this service. Part B coinsurance and deductible apply. You may bill this code separately from the AWV. For More Information Additional details on Medicare coverage requirements and billing standards are available at cms.gov/cognitive. For more information on assessing cognitive impairment, please refer to the Alzheimer’s and Dementia Resources for Professionals webpage. SUMMER 2021
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Ability to bill PPE CPT code 99072 extended until Oct. 18, 2021 The Department of Health and Human Services Secretary Xavier Becerra has renewed the federal public health emergency for COVID-19. This allows providers to continue to bill CPT code 99072 until at least Oct. 18, 2021. Senate Bill 5169 requires commercial insurance carriers to reimburse for PPE costs for the duration of the federal public health emergency. Physicians or health care providers treating patients with state-regulated commercial health plans that have incurred costs for PPE are able to bill the newly created CPT code 99072 and be reimbursed $6.57 per patient encounter.
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PIERCE COUNTY MEDICAL SOCIETY
The Health Status of Pierce County
When storms become tsunamis: Delta requires more and stronger protection against COVID-19 Imagine you’re walking in the pouring rain. Good news: You grabbed an umbrella! You might catch a few drops of water, but you’re almost completely dry. But, a strong wind blows in. Your jacket is getting wet, and you still have a long walk ahead. What now? For the last year and a half, COVID-19 was that storm. Last winter, vaccines gave us an umbrella. But now, the wind is whipping in with the Delta variant. You’re not going to get soaked, but you’re more likely to get wet and you need some extra protection. Our data shows we’re experiencing the longest and strongest case increase we’ve seen since the beginning of the pandemic. Cases and hospitalizations are rising in Pierce County and across the country, driven by the highly contagious variant. What we know right now is the vast majority of cases in Washington from Feb. 1, 2021-July 31, 2021 happened to unvaccinated people. During that time, people who weren’t fully vaccinated made up: • 95.5% of confirmed cases. • 95.4% of COVID-19 hospitalizations. • 94.4% of COVID-19 deaths. We expect those numbers to change as the Delta variant becomes more prevalent and more people get vaccinated. Vaccines are extremely effective at preventing serious illness, hospitalization, and death. Vaccination is still the best protection. How do we stay dry now? If you’ve lived in the Pacific Northwest for long, you know we’re famous for not using umbrellas. But you should make sure you and the people you care about take advantage of vaccines. They offer by far the best protection against COVID-19. Just like an umbrella doesn’t keep you 100% dry, the vaccine is not 100% effective. That’s because they offer protection, not total immunity. In the case of COVID-19, they offer a LOT of protection.
Nigel Turner The Delta variant is related to some reduction in vaccine effectiveness, especially if people are only partially vaccinated. Evidence shows the vaccine is still very effective against severe disease and death if you’re fully vaccinated. Breakthrough cases, where fully vaccinated people contract COVID-19, are more common with Delta. Since it spreads much faster, we are seeing more breakthrough cases. They’re still rare. We saw cases drop dramatically between April and early July. But as the variant brings more cases, the number of breakthrough cases, hospitalizations, and deaths among the vaccinated goes up, too. A changing storm requires new safeguards. In the same way you might add a raincoat when the wind kicks up, you’re now seeing new steps to add protection in light of the Delta variant. Efforts to increase to protection. That’s why you’re seeing more work to protect your family. Gov. Inslee announced a series of vaccine requirements for healthcare, school and state workers. The three major healthcare systems in Pierce County mandated vaccines for their staff. Our Director of Health, Dr. Anthony L-T Chen, recently joined other local Directors of Health in issuing a mask recommendation and followed up with directive for Pierce County. And on Aug. 18, Gov. Inslee announced an indoor mask mandate. Beginning Monday, Aug. 23, everyone—regardless of vaccination status— is required to wear masks in indoor settings. While we all breathed a sigh of relief when case rates and hospitalizations dropped so dramatically and the state reopened, things have changed. Once again, we should go back to the basics to stop the spread: • • • • •
If you haven’t already, get vaccinated. Wear a mask when appropriate. Wash your hands often. Get tested for COVID-19 if you have symptoms. Stay home if you’re sick.
You can also subscribe to Your Reliable Source blog updates for the latest information. SUMMER 2021
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NEEDS YOU!
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DONATED CARE PROGRAM
Join 700 of Your Peers Seeking Volunteer Primary & Specialty Providers Providers specify how many referrals they accept yearly
253.336.4812 vanessa@pcprojectaccess.org
Providers receive additional malpractice protections under the Good Samaritan Act High Demand Practice Areas Needed Today!
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Vascular Surgeon | Anesthesiology Otorhinolaryngology | Primary Care | CRheumatology P I E R C E CPlastic O U N T Y MSurgery EDICAL SO IETY
PCPA proudly maintains a 1% patient no show rate!
Pierce County Project Access
Vanessa Kitt, PCPA Executive Director
Project Access thanks YOU for your compassion and dedication! We know the last year has been more than difficult for healthcare professionals, but we want to make sure you know how valued you are, and how much of a difference you are making in the lives of our patients. Because of you, hundreds of uninsured patients are getting the care they desperately need every year.
We are humbled by the commitment expressed by all of you, not only to Project Access, but to every one of our neighbors that needs healthcare. Thank you for your refreshing empathy, for your steadfast vision of serving all, and for your courageous leadership through uncertain challenges.
Often in the midst of a health crisis, we receive countless letters Your example gives hope and motivation as we steward our from our patients who express their deepest gratitude for the patients every day. care they receive from your hands. Your service reminds us that we’re all connected, that we’re all From literal life-saving treatments to continual preventative equal and deserving of care. care, you are not only helping others but also reducing costs that burden health systems and taxpayers. The world is a better place because of you and your passion for helping others live a better life. Your participation in our Donated Care program has served over 4,000 Pierce County residents since 2009. We are honored to partner with you to create a healthier Pierce County and more compassionate world. The Pierce County Medical Society continues to be a key leader and partner for providing care to those without health Thank you! insurance.
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"The proper aim of giving is to put the recipients in a state where they no longer need our gifts." –C. S. Lewis
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PIERCE COUNTY MEDICAL SOCIETY
In Memoriam
James Foss, MD 1948 - 2021
James Michael Foss, M.D. passed away on July 13, 2021. He was born October 4,1948 in Pt.Townsend, WA. to the Rev. William J. Foss and Mrs. Marion M. Dix Foss. Jim graduated from Stadium High School, The University of Washington, and The University of Washington Medical School. He completed his internship and Family Practice Residency at Madigan Army Medical Center. Jim opened his Family Practice office in Parkland and remained there for over 30 years.
He is survived by his wife Sue Ellen, son Tory (Giovanna), daughter Marida Davis (Chris), and grandchildren Sawyer and Finley Foss; Nolan, Millie, Erik and Kelsey Davis; brother Stephen(Rosalia), sister Linda Davelaar(Brian); and seven nieces and nephews. Services will be at Lake City Community Church Sunday August 1, 2021 at 2:30. Reprinted from The News Tribune, Jul. 25, 2021
David Sparling, MD 1925 - 2021
David Sparling, M.D. Born in 1925, son of Rev. Clyde V. Sparling and Laura Strickland Sparling, David Sparling was raised in northern New York State. Following graduation from Colgate University and Albany Medical College and additional training in New Orleans and Louisville, he completed pediatric residency at Johns Hopkins Hospital, Baltimore. For eight years he was the U.S. Public Health Service pediatrician at Mt. Edgecumb (Sitka, Alaska), from whence he traveled widely on consultation tours throughout Alaska. He was for a time the only pediatrician in the then Territory. While in Sitka he married Florence Bouzas. Dr. Sparling’s pediatric practice in Tacoma (1960 – 1997), in association with Doctors Nelson, Coyner, Cain, Clabots, Takahashi, Tan, Weissinger, Samujh, and Schoenike and outstanding nurses and staff was a constant source of joy and included hundreds of children from throughout Pierce County and a number of their children. He was a University of Washington Clinical Associate Professor of Pediatrics, a member of the Pierce County Medical Society and Washington State Medical Association, Fellow of the American Academy of Pediatrics, past chairman of its Committee on Standards of Child Health Care, past president of the Washington State Society of Pediatrics and the professional staffs of Mary Bridge Children’s Hospital and St. Clare (Lakewood) Hospital, Director of the Mary Bridge-Chelyabinsk Affiliation (1993-2002), a member of the Tacoma-Pierce County Board of Health (1994 – 1999), and a board member of a number of local service and arts organizations, including Tacoma Philharmonic, Steilacoom Historical Society and Kiwanis.
Award, the Tacoma-Pierce County Health Department’s Distinguished Service Award and the City of Tacoma’s City of Destiny Award. He was an elder, choir member and frequent volunteer at UP Presbyterian Church and current member of Little Church on the Prairie, Lakewood. As a resident of Steilacoom, he found many volunteer opportunities and friends. David Sparling was a dedicated family man, reading aloud and playing games with his children and spending many days camping, skiing, hiking and vacationing with them in a cabin near Mt. Rainier. His wife Florence died in 1990 after a prolonged illness. He was subsequently blessed with a second marriage to Barbara Lehmann which brought joys of retirement, gardening and travel. He was predeceased by step-daughter Cynthia LaPrelle and survived by his wife, children John Sparling, Helen Sparling, brother-in-law Thomas Maresh (Carolyn), stepdaughters Jennifer Schilz (Ronald) and Amy Adkisson (Robert), 7 grandchildren, Nolan, Anders and Luke Schilz; Russell Phil, Morgan LaPrelle,and Ryan and Cynthia Alexandria Adkisson and 4 great grandchildren. A family graveside service was recently held. Memorials may be made Little Church on the Prairie (Lakewood) or Mary Bridge Children’s Hospital. Reprinted from The News Tribune, Feb. 28, 2021
He received the Pierce County Medical Society’s Community Service
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Pierce County Medical Society has been supporting Pierce County physicians and patients over 130 years. PCMS represents the interests of local physicians and physician assistants from all specialties and practice types at all stages of their careers.
www.pcmswa.org