50 Volume 53
H
4 Number 2
O O S I E
D O
R
Summer 2014
Published by The Indiana Association of Osteopathic Physicians and Surgeons, Inc.
Greetings. I hope this letter finds you well. My name is Adrian Carter, D.O., and I am an osteopathic family physician who practices in Fort Branch, IN for Deaconess Clinic. I also have the privilege of practicing medicine in the emergency room at Good Samaritan Hospital in Vincennes, IN. Many Adrian L. Carter, D.O. people and great IOA President opportunities have helped me on my journey as a physician for which I am grateful. My goal as president for the next year and a half is to represent you well at the Indiana Osteopathic Association (IOA) and the American Osteopathic Association. I also want to work with the Indiana State Medical Association (ISMA) to strengthen the “House of Medicine” in our state because we share the same interests and policies. First, many of you know that we are working in an environment of frequent change. The last few years have been defined by possibly more change than what has occurred in the last 20 years. Some change has improved efficiency in our practices and positively impacted patient care. Other change has increased costs for our practices and our patients with negative outcomes being noticed. My hope is that the IOA leadership will be given an opportunity to confront some of these less favorable changes that don’t seem to be improving care or saving money. Medicine has become more political than at any other time in recent history. Our patients are not interested in politics, but instead in how well they are cared for in the settings in which their healthcare is rendered. Next, the IOA will be updating technology to better support our members. In the coming years, we will be increasing opportunities for low cost and high yield continuing medical education. We also will be exploring creation of an application (an App) that can be placed on your hand held device to improve (continued on page 15)
PRESIDENT’S MESSAGE
ANNUAL CONVENTION
During the president’s luncheon at the annual convention on May 3, 2014, Mark S. Cantieri, D.O., brought greetings from the American Osteopathic Association (AOA) and an update on AOA activities. He also swore in new officers. Stephanie M. Overmars, D.O., of Indianapolis, also was honored. She was named Outstanding Young D.O. of the Year for 2014, an honor which is reserved for physicians who have been in practice less than ten years and who have made significant contributions to the IOA and their communities. See pages 4 and 5 for highlights from other annual convention activities.
IN THIS THIS ISSUE IN ISSUE Member Concerns……………………………………..…3 117th Annual Convention…..………………………...….4 WMD Update……………….…………..………….….....6 Tips From Our Consultant……………..………………..7 Indiana Academy of Osteopathy Annual Seminar…….14 AIOA News……………….……………………….…….15 Dean’s Update…………………………………………..16 Motyka Dannin Foundation……………………………18 Coming Events………………………………………….19 Practice Opportunities………………………………….20
Summer 2014 Winter 2014
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IN MEMORIAM
EDITOR TIPS HAT TO
The IOA has learned that Cecil P. Deckard, D.O., of Winchester, died on February 22, 2014. Life member of the AIOA, Ruth Motyka, of Crown Point, and widow of Daniel J. Motyka, D.O., died on April 10, 2014. Ruth worked alongside her late husband at his private medical practice for many years. She is survived by her children Laurie Heyl (Daniel Swift), Kenneth (Laura) Heyl, Danette (Mark) Janickovic, Kristi (Kevin) Gescheideler, Christopher (Missy) Motyka, Daniel Motyka, Jr., grandchildren and greatgrandchildren. Life member of the IOA, Bill G. Odell, D.O., of Freelandville, died on May 17, 2014. Dr. Odell graduated from A. T. Still University Kirksville College of Osteopathic Medicine (ATSUKCOM) in 1953. He joined the IOA in 1954 and practiced family medicine in Freelandville until his retirement. Survivors include his wife, Patsie, daughters, Debbie Telligman and Sherri Koers, grandchildren and great-grandchildren. Life Member of the IOA, Harold T. Sparks, D.O., of Evansville, died on June 2, 2014. He was preceded in death by his wife of 61 years, Eloise. While a college student at Eastern Illinois University, Eloise saw a portrait of her future husband in an Army fancy cap, which his dad had put on the hall bulletin board. She started writing Harold and they were married on January 25, 1947. When Harold was discharged from the Army, they moved to Kirksville, MO, where she taught high school business until he graduated from ATSUKCOM in May of 1953. In July of 1953, they adopted two sisters, Sharon, 3, and Ruth, 2. A move to Cleveland, OH, was next for Dr. Sparks’ one year internship. They then moved to Evansville, where Dr. Sparks was in medical practice for 45 years. He is survived by daughter, Sharon Sparks and her children, John Wingo, Joe and Tracy Wingo, Dennis Wingo Jr., and his son, Jordan; daughter, Ruth and Ron Orman and children, Mikki and Wayne Fortner and their son, Carter. Memorial contributions may be made to the Motyka Dannin Foundation.
Marian University College of Osteopathic Medicine faculty members, Lisa R. Chun, D.O., Assistant Professor in Osteopathic Manipulative Medicine (OMM), and Michael L. Kuchera, D.O., Chair of OMM, who have been inducted into the National Academy of Osteopathic Medical Educators (NAOME). This is a five year term where they will function as leaders and mentors for academic scholarship and excellence within the osteopathic medical education community. John J. Wernert, M.D., husband of Erin Wernert, Executive Director, who has been recruited by Governor Michael R. Pence to serve as Indiana’s new Secretary of Family and Social Services Administration (FSSA), beginning in late July. Dr. Wernert will be the first physician to take on this position, which is an exciting new direction for the state. FSSA has jurisdiction over aging, disability and rehabilitation, family, Medicaid, and mental health and addiction services.
MEMBER CONCERNS REMEMBER IN PRAYER Thurman V. Alvey, III, D.O., of Indianapolis, on the death of his father, Thurman V. Alvey, II, on April 12.
NEW LIFE MEMBERS HONORED Congratulations to Evan H. Geissler, D.O.,of Hammond, and Jerry M. Hancock, D.O., of Seymour, on their achievement of life membership in the IOA. These physicians were honored during the president’s luncheon at the 117th Annual Convention.
MARIAN UNIVERSITY GALA The Marian University Gala is set for Friday, October 17, 2014, at the downtown JW Marriott. This is a great opportunity to learn more about Marian University as well as meet several of the students and faculty at the Marian University College of Osteopathic Medicine (MUCOM). For those who have attended the Gala in the past, you can attest to a night of excellent company, fine dining, and support for—and pride in—Marian University and the MUCOM. It would be great to have a tremendous show of support from the Indiana D.O.s as we celebrate the state’s only osteopathic medical school. For more details on the Gala and/or to make a reservation, please contact John Finke by telephone at (317) 955-6202 or send an e-mail message to jfinke@marian.edu.
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117TH ANNUAL CONVENTION The following exhibitors, grantors, and in kind supporters made possible the excellent continuing medical education (CME) program offered during the annual convention. The CME Committee and the Board of Trustees of the Indiana Osteopathic Association (IOA) urges all members to let representatives of these companies know that you appreciate their support. EXHIBITORS AbbVie Alere Toxicology American Clinical Solutions Amgen Apothetech Rx Astellas Boston Heart Diagnostics Bristol-Myers Squibb Center for Diagnostic Imaging Community Health Network Eli Lilly Genova Diagnostics Indiana Professional Licensing Agency Marian University College of Osteopathic Medicine Med Express Merck MMIC Group Novo Nordisk Pfizer Point of Care Ultrasound ProAssurance Purdue Pharma Reckitt Benckiser Salix Sanofi-Aventis SouthernCare United Allergy Services Vivus
GRANTORS American Osteopathic Association Creative Educational Concepts Deaconess Health System Osteopathic Medical Foundation of Michiana IN KIND SUPPORTERS American Osteopathic Association American Society for Asset Protection Indiana State Department of Health Johnson Memorial Hospital Marian University College of Osteopathic Medicine Newby Consulting VEI/Indianapolis Medical Management
Mark Cantieri, D.O., AOA trustee, (left) swears in incoming president, Adrian Carter, D.O.
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SPECIAL RECOGNITION OF INDUSTRY SUPPORTER The IOA has recognized one company for outstanding support of the 117th Annual Convention. This company played a significant role in making this year’s program a success. This company is: Creative Educational Concepts The CME Committee and the Board of Trustees of the IOA recommend that you express special thanks to this company. Creative Educational Concepts’ help, along with that of other grantors, in kind supporters, and exhibitors allows our association to offer excellent CME programs yet keep the cost to you as practicing physicians as low as possible.
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Adrian Carter, D.O., incoming president, (left) presents outgoing president, Angela Wagner, D.O., with a plaque.
Angela Wagner, D.O., outgoing president, (left) presents incoming president, Adrian Carter, D.O., with a proclamation from Kansas City University of Medicine and Biosciences College of Osteopathic Medicine.
Stephanie Overmars, D.O., recipient of the Outstanding Young D.O. of the Year award addresses audience. Angela Wagner, D.O., outgoing president, is in background.
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WMD UPDATE
By: Colonel Charles A. Holt, D.O. Al-salam alaykum. It is good to be back in the States after 6 months in Kuwait with the Army. Shlunak and shlunich. Every summer is the Annual Indiana Emergency Support Function-8 Conference, held in Indy. I highly recommend it to anyone involved with EM (emergency management), whether in private practice/in a hospital or with government agencies--no matter where you live in the U.S. Some pearls from the 2013 event: 1. In order to get funding for EM training, it is best to get elected and appointed officials involved--they hold the purse strings. 2. Lessons learned from the 10/29/2012 Hurricane Sandy flooding of Bellvue Hospital, NYC: a. What is the plan for care of hospitalized prisoners/how to provide interpreters/living quarters for staff who decide to stay to help (family concerns and inability to return to a flooded city are big decision pinch points for staff) including cots & scrubs & showers & parking & laundry & water & food & security? b. What will happen if the generators fail or run out of fuel (remember the bucket brigade up 10 stories to keep the diesel generators going?)? c. What will happen if the hospital stays open, yet is cut off from all help--like with Bellvue--is it worth the risk to all involved--what are the critical factors which will force the decision? d. How can you enforce diversion once you have declared an emergency, yet the ambulances and walk-ins keep coming? e. Can your hospital afford to relocate all utilities to the second floor of your facility? If rebuilding a hospital have you put this in the design (multiple basement and 1st floor floodings every year knock out hospitals)? f. Do you have pre-designated teams who can adequately bag all ventilator patients 24/7 in very frequent rotating shifts? Their lives are now literally in your hands! g. Do you have head lamps and walkie-talkies with multiple batteries at every bedside for you and the patients and everyone is trained on their use? h. Do you have paper EMR substitutes for a week? i. Do you know how to do group texting to all staff members' cell phones? j. Does every employee know how and train quarterly on the use of backboards/skids/stairwell evacuation in total darkness but for head lamps? This is reality, not just something to get you past JACHO for the year! k. Are you prepared to ship all ICU/ventilator/isolation/psychiatry patients ASAP and prioritize all other patients? l. Are you, right now, ready to emergency credential outside providers and have the same packets available for your providers helping at other facilities? m. Do you already have plans for a freestanding ER, separate from your isolated/closed hospital, where you can conduct out-patient 'business as usual' until you can reopen? n. Can you remodel or plan to build a
facility that has separate elevators, that have no parts lower than the second floor, to prevent flooding disabling them? 3. Lessons learned from mass fatality plane crashes: a. Bring in experienced/trained staff from the git go. b. Equipment includes reefers/PPE/breakaway vests labeled, as largely as possible, with your name/agency, archaeological grids/staking equipment/tape measures/ziplock bags of all sizes (#1 item!). c. Prepare the responders that they will need lots of mental resiliency to deal with the endless personal effects such as family photos and have robust mental health staff for the workers. d. Never use a public place, such as a school gym, for a temporary morgue--use a warehouse--otherwise the gym will always be associated with shocking death and dismemberment. e. All should be aware of how one IDs a body/body part: DNA/tattoos/dental and surgical implants/finger prints/personal effects--usually facial recognition is not possible. 4. Lessons learned from an IN EMS Strike Team that deployed to Super Storm Sandy: a. Never drive individual vehicles--hire professional trucking companies which saves an incredible amount of money on gas and vehicle wear and allows the responders to sleep on the way there. b. You must bring a fuel truck capable of serving the transport trucks--as the team got closer to the East Coast, the empty gas stations became the norm--they almost didn't make it there and were totally exhausted! c. Bring your OWN radios with which you are familiar and re-chargers/batteries--the team could NOT communicate with any other EMS teams onsite! d. Ship your OWN container with expendable medical supplies. e. Expect bureaucracy and paperwork to be your worst challenge. e. Know that school buses are, by far, the best way to transport large numbers of victims.
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TIPS FROM OUR CONSULTANT By: Joy Newby, LPN, CPC, PCS Newby Consulting
CONFUSED ABOUT MEDICARE PREVENTATIVE VISITS? SO ARE YOUR PATIENTS! Congress legislated coverage for two preventive visits for Medicare beneficiaries: • •
Initial Preventive Physical Examination (IPPE), also referred to as the Welcome to Medicare Visit Annual Wellness Visit (AWV) Initial Subsequent
Even though these services have been covered for several years, physicians continue to have questions about who is eligible for a Medicare covered visit, what services are included in the visit, who can perform the visit, etc. Given all the questions surrounding these visits, we were asked to provide information about each visit Medicare Part B Eligibility While Medicare Part A is typically premium-free to anyone eligible for social security or railroad retirement benefits, or would be eligible for such benefits if the worker's quarters of coverage (QC) from government employment were regular social security QCs, Medicare Part B is voluntary and a beneficiary may refuse enrollment because the beneficiary is required to pay a premium for the coverage. Depending on the beneficiary’s circumstances, e.g., continues active employment and is covered under the employer’s group health insurance, a beneficiary may choose to delay enrollment in Medicare. The effective dates for Parts A and B are noted on the beneficiary’s Medicare card. This information is also included on CMS Secure Net Access Portal (C-SNAP), the Wisconsin Physician Services (WPS) eligibility, patient information, and claims data.
Coverage for the IPPE and AWV All new Medicare beneficiaries who are within the first 12 months of their first Medicare Part B coverage period may receive an IPPE. Thus, if a beneficiary’s effective entitlement date is September 1, 2013 enrolled in Medicare in October 2013, the Welcome Visit must be performed no later than August 31, 2014. This is a one-time benefit. Medicare covers an AWV for beneficiaries who:
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are not in the first 12 months of their first Part B coverage period and have not received an IPPE or AWV within the past 12 months
At least 11 months have passed following the month in which the IPPE or the last AWV was performed and billed to Medicare. Medicare pays for only one initial AWV per beneficiary per lifetime, and pays for one subsequent AWV per year thereafter. Members can access C-SNAP to confirm the date when the patient is eligible for their next AWV. The IPPE is meant to be an introduction to Medicare and covered benefits. The intent of both visits is to help Medicare beneficiaries stay well. Physicians should focus on health promotion and disease prevention and detection. Deductible and Coinsurance/Copayment Medicare waives both the coinsurance/copayment and the Medicare Part B deductible for the IPPE and AWV. Thus, there is no out-of-pocket expense for these services. Who May Perform the Preventive Visit? IPPE Either a physician (a doctor of medicine or osteopathy) or a qualified non-physician practitioner (a physician assistant, nurse practitioner, or certified clinical nurse specialist) must furnish the IPPE. The provider performing the IPPE must be shown as the billing provider on the claim (Item 24j or its electronic equivalent). Services performed by a qualified non-physician practitioner cannot be billed by the supervising/collaborative physician because Medicare’s “Incident To” rules do not apply. AWV Health professional can perform the IPPE. For purposes of the AWV, this term includes: • • •
a physician (a doctor of medicine or osteopathy), a qualified non-physician practitioner (a physician assistant, nurse practitioner, or certified clinical nurse specialist), or a medical professional (including a health educator, registered dietitian, nutrition professional, or other licensed practitioner), or a team of such medical professionals who are working under the direct supervision of a physician, must furnish the AWV. (Physician must be physically present in the office, but is not required to have a face-to-face encounter unless the physician is practicing in a Rural Health Clinic.)
Coding Requirements CMS does not require a specific diagnosis code for the IPPE or the AWV. You may choose any appropriate diagnosis code, e.g., V70.0 routine general medical examination at a health care facility. The IPPE is reported using HCPCS code: •
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment
The AWV is reporting using one of the following HCPCS codes:
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G0438 Annual wellness visit; includes a personalized prevention plan of service (PPPS), initial visit G0439 Annual wellness visit, includes a personalized prevention plan of service (PPPS), subsequent visit
Coverage of the Initial vs. Subsequent Annual Wellness Visit is based on whether the patient has previously received a Medicare covered AWV. It is NOT based on whether the patient has previously received a covered AWV from the individual physician or by the same group practice. Components for IPPE and AWV While similar, there are some differences in the required components for the IPPE, Initial AWV, and Subsequent AWV. We believe using a consistent template combining the components for each of these services into one document will make it much easier to perform and document the required services. We have underlined the requirements specific to the AWV in the event you choose to have more than one template. AWV requires a Health Risk Assessment (HRA) that at a minimum must include the following elements (updated at each AWV): • • • • •
Collects self-reported information the beneficiary knows; You or the beneficiary can administer the health risk assessment before, or as part of, the AWV encounter; Takes into account the communication needs of underserved populations, persons with limited English proficiency, and persons with health literacy needs, and is appropriately tailored to their needs; Takes no more than 20 minutes to complete; and At a minimum, addresses the following topics: Demographic data; Self-assessment of health status; Psychosocial risks; Behavioral risks; Activities of Daily Living (ADLs) including but not limited to: dressing, bathing, and walking; and Instrumental ADLs including but not limited to: shopping, housekeeping, and handling finances.
For more information about HRAs, CMS instructs providers http://www.cdc.gov/policy/ohsc/HRA/FrameworkForHRA.pdf The AAFP has an excellent Health Risk Assessment http://www.aafp.org/fpm/2012/0300/fpm20120300p11-rt1.pdf 1.
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Review of the beneficiary’s medical and social history a. At a minimum, collect the following: Past medical/surgical history (experiences with illnesses, hospital stays, operations, allergies, injuries, and treatments) – (Updated at each AWV); Current medications and supplements (including calcium and vitamins) – (Updated at each AWV); Family history (review of medical events in the beneficiary’s family, including diseases that may be hereditary or place the beneficiary at risk) – Medical events in the beneficiary’s parents and any siblings and children, including diseases that may be hereditary or place the beneficiary at increased risks – (Updated at each AWV) History of alcohol, tobacco, and illicit drug use; Diet; and Physical activities.
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2.
Review of the beneficiary’s potential risk factors for depression and other mood disorders a. Use any appropriate screening instrument for beneficiaries without a current diagnosis of depression recognized by national professional medical organizations to obtain current or past experiences with depression or other mood disorders.
3.
Review of the beneficiary’s functional ability and level of safety a. Use any appropriate screening questions or standardized questionnaires recognized by national professional medical organizations to review, at a minimum, the following areas: Hearing impairment; Activities of daily living; Falls risk; and Home safety. b.
4.
AWV - Use direct observation of the beneficiary or any appropriate screening questions or a screening questionnaire
Physical examination a. Although the title of the IPPE includes “physical examination,” only the following examination is required for an IPPE height, weight, and blood pressure visual acuity screen measurement of body mass index (or waist circumference, if appropriate) other factors (routine measurements) deemed appropriate based on the beneficiary’s medical and social history and current clinical standards b.
Detection of any cognitive impairment that the beneficiary may have Assess the beneficiary’s cognitive function by direct observation, with due consideration of information obtained by way of patient reports and concerns raised by family members, friends, caretakers, or others.
Even in 2014, Medicare does not cover “routine physical examinations.” When an age appropriate comprehensive preventive physical examination is performed in addition to the IPPE/AWV, it may be separately reported using the appropriate CPT from the Preventive Medicine Section, e.g., 99385-99387 or 99395-99397. The fee for this examination should reflect the additional preventive work not included in the IPPE/AWV. The beneficiary is financially responsible for the charges related to the additional examination. WPS provides the following clarification: In choosing the pricing for the yearly physical exam, you must remove any elements that are included in the IPPE/AWV. The provider would submit the IPPE/AWV in full with reduced pricing on the yearly physical exam. This would reduce the patient's liability. 5.
End-of-life planning, upon agreement of the beneficiary a. End-of-life planning is verbal or written information provided to the beneficiary about: The beneficiary’s ability to prepare an advance directive in the case that an injury or illness causes the beneficiary to be unable to make health care decisions; and Whether or not you are willing to follow the beneficiary’s wishes as expressed in the advance directive. b.
Establishment of a list of current providers and suppliers
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Include current providers and suppliers that are regularly involved in providing medical care to the beneficiary
6.
Education, counseling, and referral based on the previous five components a. Based on the results of the review and evaluation services provided in the previous five components, provide education, counseling, and referral as appropriate.
7.
Education, counseling, and referral for other preventive services a. Includes a brief written plan, such as a checklist, to be given to the beneficiary for obtaining: A screening electrocardiogram (EKG/ECG), as appropriate Only covered when ordered as part of an IPPE. All other screening ECGs are not covered by Medicare.
Medicare-covered preventive services. The beneficiary appropriate screenings and other preventive services that Medicare covers.
Other Medicare Part B Preventive Services As applicable, the following preventive services should be ordered during the IPPE/AWV and included on the Patient’s Personalized Prevention Plan Services (PPPS) which is provided to the patient during/following the visit.
Abdominal Aortic Aneurysm (AAA) Bone Mass Measurements Cardiovascular Disease Screening Blood Tests Colorectal Cancer Screening Counseling to Prevent Tobacco Use for Asymptomatic Patients Diabetes Screening Tests Diabetes Self-Management Training (DSMT) Glaucoma Screening Human Immunodeficiency Virus (HIV) Screening Influenza, Pneumococcal, and Hepatitis B Vaccinations and their Administration Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD), also referred to as a CVD risk reduction visit IBT for Obesity Medical Nutrition Therapy (MNT) Prostate Cancer Screening Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse Screening for Depression in Adults Screening Mammography Screening Pap Tests and Pelvic Examination Sexually Transmitted Infections (STIs) Screening and High Intensity Behavioral Counseling (HIBC) to Prevent STIs
CMS has a Quick Reference Guide for Preventive Services on its website at http://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/downloads/MPS_Quic kReferenceChart_1.pdf This summary document includes the following information
Service HCPCS/CPT codes ICD-9 codes Who is covered Coverage frequency What the beneficiary Pays
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Establishment of a written screening schedule for the beneficiary, such as a checklist for the next 5 to 10 years as appropriate – (Updated at each AWV)
Base written screening schedule on
Age-appropriate preventive services Medicare Covers Recommendations from the United States Preventive Services Task Force (USPSTF) and the Advisory Committee on Immunization Practices (ACIP The beneficiary’s health status and screening history
8.
Establishment of a list of risk factors and conditions for which the primary, secondary, or tertiary interventions are recommended or underway for the beneficiary a. Include the following Any mental health conditions or any such risk factors or conditions identified as a result of previous and current preventive visits A list of treatment options and their associated risks and benefits
9.
Furnishing of personalized health advice to the beneficiary and a referral, as appropriate, to health education or preventive counseling services a. Includes referrals to programs aimed at Community-based lifestyle interventions to reduce health risks and promote selfmanagement and wellness Fall prevention Nutrition Physical activity Tobacco-use cessation Weight loss The AAFP has an excellent combined template posted on the AAFP website at http://www.aafp.org/fpm/2011/0100/fpm20110100p22-rt3.pdf Since the USPSTF recommends the screening, this template needs to be updated to remove the requirement that the Screening AAA Ultrasound be ordered in conjunction with an IPPE. Due to the Affordable Care Act, the Centers for Medicare and Medicaid Services eliminated the requirement that the test had to be ordered during an IPPE. According to the Medicare Final Rule published in the December 10, 2013 Federal Register, effective January 1, 2014, a screening AAA ultrasound is now covered once in the patient’s lifetime when the following requirements are met
has not been previously furnished AAA screening under the Medicare program has a family history of AAA a man age 65 to 75 who has smoked at least 100 cigarettes in his lifetime
Can a Problem-Oriented Evaluation and Management Service be Performed on the Same Day as an IPPE or AWV? Medicare may pay for a significant, separately identifiable, medically necessary evaluation and management (E/M) billed with CPT codes 99201 – 99215) provided in conjunction with an IPPE or AWV as long as the visit is “medically necessary to treat the beneficiary’s illness or injury or to improve the functioning of a malformed body member.” Modifier -25 must be appended to the problem-oriented E/M code. WPS provides the following clarification: When billing for an E/M and the IPPE/AWV on the same day, the provider must remove those portions of the E/M that are included in the IPPE/AWV. You cannot include any duplicative services in the coding of the E/M. Once that process is complete, you would then look to see if the E/M met the Modifier 25 guidelines for a significant, separately identifiable service. If the E/M is a great amount of additional work over and above what would be performed in the IPPE/AWV, then you may append modifier 25 to the E/M procedure code. If it is not, then bill the IPPE/AWV only. Given this clarification, due to the Past, Family, and Social history required by the IPPE/AWV, it would be difficult to meet the E/M coding requirements for a level of care greater than 99202 for a new patient.
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SMARTPHONE APPS: A GROWING TREND IN MEDICINE By: Jenice M. Deming, J.D.; ProAssurance Service Center Director
A smartphone isn’t just a phone; it’s a miniature computer. We surf the web, email, play games, and use smartphones and other wireless devices as tools for work. This explosive growth in use has been aided by mobile applications (“apps”). Today physicians can monitor a patient’s vital signs, download patient schedules, access medical records, dictate office notes, and consult with other physicians without entering a clinical setting. One of the first medical apps in use was Epocrates, providing clinical information on thousands of prescription and over-the-counter drugs.1 In addition to reference apps like Epocrates, physicians are using specialty-specific, federal government, and semi-interactive apps (e.g., to review and monitor ECG histories). Greater Access, New Risks As with any new medical device, there are risks to consider. Mobile devices “are considered one of the most vulnerable areas for [privacy] breaches.”2 This is in part due to security assessments that failed to address the use of mobile devices.3 The Health Information Technology for Economic and Clinical Health (HITECH) Act requires notification whenever a breach of unsecured protected health information (PHI) occurs.4 Additionally, the Department of Health and Human Services requires security of PHI on storage devices (hard drives), transmission media (cyberspace), and portable electronic media (e.g., smartphones).5 Reference guides, such as Epocrates, should not be a HIPAA risk. However, apps that transmit PHI could be intercepted by hackers or corrupted by a virus. Regardless of whether a physician’s mobile device is used to access, transmit, or store PHI, consider all HIPAA and HITECH requirements. HIPAA requires data security and proper destruction, and retention of PHI, when appropriate. What Can You Do? • • • • • •
Review potential wireless apps to ensure security of PHI at all levels; Limit the type of app that can be used based upon the individual app’s level of security; Use encryption software that makes data unusable by intercepting parties; Develop a security policy addressing mobile devices and the types of apps that can be used, along with the appropriate use and destruction of PHI data; Develop an eDiscovery policy for retaining PHI in the event of litigation; seek assistance from your attorney or your medical professional liability carrier’s risk management staff; and Work closely with IT personnel to address all security issues.
1 Glenn, B. “Physicians’ top 5 most-used medical apps for smartphones and tablets.” June 13, 2013, http://medicaleconomics.modernmedicine.com/medical-economics/news/physicians-top-5-most-used-medical-appssmartphones-and-tablets (accessed August 27, 2013). 2 Dolan, P. “Large settlement for data breach sends message to lock up laptops and smartphones.” American Medical News, September 28, 2012, http://www.amednews.com/article/20120928/business/309289995/8/ (accessed August 27, 2013). 3, 4, 5 “Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules Under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act; Other Modifications to the HIPAA Rules,” 78 Fed. Reg. 5568 (25 January 2013). This article is not intended to provide legal advice, and no attempt is made to suggest more or less appropriate medical conduct. Copyright © 2014 ProAssurance Corporation.
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INDIANA ACADEMY OF OSTEOPATHY ANNUAL SEMINAR CO-SPONSORED BY THE INDIANA OSTEOPATHIC ASSOCIATION “A Sutural Approach to Osteopathy in the Cranial Field” Charles A. Beck, Jr., D.O., FAAO, president, Table Training will be an integral part of the announced that the Indiana Academy of Osteopathy seminar. Ample time will be provided for questions and (IAO) will hold its Annual Seminar, August 1 - 3, 2014, answers throughout the seminar. This is intended to be at the Marian University College of Osteopathic as practical and useful to physicians as possible. Medicine (MUCOM) in Indianapolis. The Indiana Book your room early! The Holiday Inn’s Osteopathic Association (IOA), co-sponsor, has address is One South Capitol Avenue, Indianapolis, IN requested that the AOA Council on Continuing Medical 46204. Make your reservation via the internet at Education approve this program for 20 hours of AOA https://resweb.passkey.com/go/osas or call (800) 233category 1-A CME credit. Approval is currently 1234. Room rates are $149.00 per night single or pending. double occupancy, $174 per night triple occupancy, and Edward G. Stiles, D.O., FAAO, will be the $199 per night quadruple occupancy until July 10, course director. Dr. Stiles is a graduate of A. T. Still 2014. Be sure to mention the IAO Annual Seminar to University Kirksville College of Osteopathic Medicine. receive these rates. Make your reservation now even if He is board certified in osteopathic manipulative you’re not certain you will need a room. If you decide medicine. Dr. Stiles is a fellow of the American to cancel your reservation, please contact the IAO first. Academy of Osteopathy, and teaches at the University of The MUCOM is just 10 minutes driving from Pikeville Kentucky College of Osteopathic Medicine the Hyatt. It is in the Michael A. Evans Center for (UPKYCOM). Health Sciences, 3200 Cold Spring Road, Indianapolis, A brochure may be downloaded on the IOA’s IN 46222. website at www.inosteo.org, by clicking on Download This seminar will be facilitated in the Brochure under Coming Events, Other Meetings, MUCOM’s OMM lab, which is located in room number Indiana Academy of Osteopathy Annual Seminar under 9 on the lower level or basement of the building. the Resources tab. --------------------------------------------------------------------------------------------------------------------------------------------------IAO ANNUAL SEMINAR AUGUST 1 - 3, 2014 REGISTRATION FORM __________________________________________________________________________________________________ Name (indicate first and last for name badges) Degree AOA Member Number __________________________________________________________________________________________________ City State Zip Code Mailing Address (indicate G office G residence) __________________________________________________________________________________________________ Medical College Year of Graduation Telephone Number (indicate G office G residence G cell) __________________________________________________________________________________________________ E-Mail Address Specialty REGISTRATION FEES (circle appropriate fee) Before 7/4/14 After 7/4/14 Non Member $750 $800 Member (IAO) $650 $700 Fellows/Residents/Interns $375 $375 Students $100 $100 No more than four (4) fellows/residents/interns and four (4) students may register for this seminar. Check (made payable to IAO) enclosed. Visa Mastercard Discover American Express _____________________________________________________________________________________ Card Number Expiration Date CVV Number Authorized Signature CANCELLATIONS & REFUNDS: The IAO must receive notice of cancellations by July 4, 2014, to grant full refunds. If originally paid by credit card, cancellations are subject to a 5% service fee. All cancellations received after July 4 are subject to a 15% service fee. After July 25, 2014, all cancellations are subject to a 25% service fee. MAIL REGISTRATION FORM WITH PAYMENT TO: IAO, 3200 Cold Spring Road, Michael A. Evans Center for Health Sciences, Suite 107, Indianapolis, IN 46222 QUESTIONS? Call (317) 926-3009. SPECIAL NEEDS? Contact the IAO before July 4, 2014, if possible.
Summer 2014
PRESIDENT’S MESSAGE
Adrian L. Carter, D.O. IOA President
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AIOA NEWS
(continued from page 1)
communication within our organization. This has the potential to encourage future generations of D.O.s to be more involved as well as become a spring board to a more effective organization. Third and most importantly, I am asking for you to be more involved in the IOA by considering a position on one of our organization’s committees. I encourage you to consider this opportunity as we continue to develop future leaders in our organization. Your participation will not require a huge time commitment, but it will keep you more involved in the IOA. I would like to add that our organization was started in 1899, and it has had leadership from many D.O.s across our state. This is a perfect time in the history of our organization for you to share your time and talents. Lastly, I would like to encourage you to continue to support the Marian University College of Osteopathic Medicine (MUCOM) and our osteopathic medical students. This school is unique in that our organization and its members were instrumental in making this school a reality. We are thankful for academic and business leaders such as MUCOM Dean Paul Evans, D.O., Marian University President Dan Elsner, founder of AIT Laboratories Michael Evans, and many others for their guidance, vision and generosity. Thank you to those of you who have contributed and continue to contribute to osteopathic medicine in Indiana as you are helping the future health of Indiana’s citizens. If you have not already, please consider donating your time and/or treasure to this worthy cause so that our medical students can have an excellent educational experience. We want to be involved in training the best and brightest physicians in Indiana. I am grateful to the IOA Board of Trustees for their help and guidance as I move forward in my position as president. Please continue to encourage Erin and Debbie as they make the wheels of our organization turn. I ask you for your prayers and support for IOA board members, officers and myself as we work to represent you well. God bless you and thank you.
HOOSIER D.O.
I am honored to continue serving as president of the Advocates to the IOA (AIOA). Advocates activities at the recent annual convention were great as usual. I always enjoy spending time with the spouses/guests. Thank you to everyone who helped with preparations for our silent auction during the President’s Luncheon on Saturday afternoon. Between the silent auction and the raffle, the Advocates were able to raise over $6,000. The money raised will go to the Motyka Dannin Foundation to fund forgivable loans to Indiana students in osteopathic medical school. I again would like to invite all spouses and others who choose to support and promote the osteopathic profession to join the AIOA. As I’ve mentioned many times I’m certain you will have a good time and make some new friends. More importantly, with more members we can be of even greater service. Please contact Debbie Coyle at the IOA office to receive an application, or download an application at www.inosteo.org by clicking on Advocates to the IOA under the Related Organizations tab.
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Summer 2014
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DEAN’S UPDATE
By: Paul Evans, D.O., FAAFP, FACOFP Vice President and Dean Marian University College of Osteopathic Medicine Our inaugural class has finished its first year. Remember neuro-anatomy, cardiovascular physiology and heart sounds simulation? They did that, but at a higher level than we ever did. D.O. students actually take heart sound quizzes on their iPads in the first year! Things are very different than when we were students--it is much better! We asked for a lot from them and they delivered. If you are a mentor, send a message of encouragement to your students. The word is out about the high quality of our new school. This year we had 3,789 applicants for our 162 seats, a 13% increase. This represents 23 applicants for each seat. We completed over 600 planned interviews and our D.O. Class of 2018 is full. The quality of applicants has improved in both GPA and MCAT scores from last year and we continue to rate above the national average. Of note, our community physicians have been invaluable in interviews and on our admissions committee in assisting Marian to select its next class. Kudos to Drs. Gaston Dana, Paul Frascella, Michael Parker, David Williams, and Angela Wagner for their commitment to selecting the next generation of osteopathic physicians in our state. The MUCOM students are joining the community as advocates for health and wellness education. They taught 2nd graders about germs and hand washing to prevent illness. They put on a wellness 5k run and health screenings at the WTHR Health & Fitness Expo event on April 26 and 27 at the Indiana State Fair Grounds. This activity included demonstrations of OMT to the community. The MUCOM’s television ads were on Channel 13 giving the College of Osteopathic Medicine and School of Nursing great exposure! This is a wonderful way to re-introduce osteopathic medicine to the public. The MUCOM students also are getting active in health care advocacy in state associations and in student groups working to improve the health in our city. MUCOM’s clinical education network continues to grow. Potential teaching beds for our hospital partners now exceed 10,000. We have over 60 hospitals formally affiliated across the state, with St. Vincent Health, Community Health Network, and Suburban Health as our primary clinical teaching sites in metro Indianapolis. Our clerkship network appears to be forming nicely, allowing for quality educational experiences for our students when they start their third year rotations in 2015. We now have had many local physicians give lectures and run case-based group discussions at the college with strong student enthusiasm for their contributions. It is a great way for osteopathic physicians to give back to the profession which helped us to become successful physicians. We have first year students forming
differential diagnoses in the case review sessions. With your continuing help and support, we hope to build a strong foundation from which to provide exceptional osteopathic medical education experiences and expand the presence of our new medical school in Indiana in the years to come.
APRIL 13 – 19 PROCLAIMED OSTEOPATHIC MEDICINE WEEK IN INDIANA Governor Michael R. Pence proclaimed April 13 – 19, 2014, as National Osteopathic Medicine (NOM) Week in Indiana. He joined Governors and Mayors across the United States in recognizing osteopathic medicine’s role in providing quality care to Americans. On Wednesday, April 16, the IOA’s Class of 2017 Student Committee hosted a specialty meet and greet at Marian University in the Michael A. Evans Center for Health Sciences where the IOA office and the MUCOM are located. Students were able to meet specialists in areas of their interests, ask questions and begin to really think about where they belong. The event was a huge success. Everyone had a great time. Ideas for future events already are being discussed. NOM Week brings the osteopathic medical profession together to focus on one common goal-increasing awareness of osteopathic medicine and doctors of osteopathic medicine (D.O.s) in our communities.
Summer 2014
IOA ELECTS NEW OFFICERS AND TRUSTEES At the Annual Meeting of Members, May 2, 2014, Adrian L. Carter, D.O., of Evansville, was elected president. Mark S. Cantieri, D.O., of Mishawaka, was elected first vice president. Gaston Dana, D.O., of Franklin, was elected second vice president. Terry A. Iwasko, D.O., of Indianapolis, was elected secretary. Patrick J. Woodman, D.O., of Indianapolis, was elected treasurer. Serving new three year terms as trustees are Brian H. Black, D.O., of Greencastle, and Rachel A. Shockley, D.O., of Indianapolis. Dr. Carter succeeds Angela B. Wagner, D.O., of Indianapolis. Dr. Wagner remains on the Board of Trustees as immediate past president. Chris A. Lowery, D.O., of Indianapolis, will fill an unexpired term as a trustee. Thurman V. Alvey, III, D.O., of Indianapolis, Dr. Cantieri, and Dr. Wagner will serve new three year terms as delegates to the American Osteopathic Association (AOA) House of Delegates. Max E. Helman, D.O., of Mishawaka, will serve a new three year term as an alternate delegate. Dr. Carter will serve a new one year term as an alternate delegate.
ADVOCATES OFFICERS During the Advocates’ annual business meeting, Mike Coyle, of Cumberland, was elected president, for 2014 – 2015. Others elected were Gloria Krejsa, of Lowell, vice president; Rebecca Brink, of Princeton, recording secretary; David Riesbeck, of Granger, treasurer; and Sharon Helman, of Granger, corresponding secretary.
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DR. CARTER APPOINTS 2014 – 2015 COMMITTEES Awards Committee Bruce Brink, Jr., D.O. Paul Evans, D.O. Ben Huang, D.O. By-Laws and Manual of Procedures Committee Susan Moore Riesbeck, D.O., Chair Christopher Braden, D.O. Mark Cantieri, D.O. David Coil, D.O. Paul Evans, D.O. Angela Wagner, D.O. Continuing Medical Education Committee Bruce Brink, Jr., D.O., Chair, Annual Winter Update Gaston Dana, D.O., Chair, Annual Convention Charles Beck, D.O. Brian Black D.O. David Coil, D.O. Stephanie Overmars, D.O. Lisa Richter, D.O. Rachel Shockley, D.O. Patrick Woodman, D.O. Finance/Investment Committee Mark Cantieri, D.O. Adrian Carter, D.O. Gaston Dana, D.O. Terry Iwasko, D.O. Angela Wagner, D.O. Patrick Woodman, D.O. Fundraising and Development Committee Brian Black, D.O., Chair Thurman Alvey, D.O. Chris Lowery, D.O. Ben Huang, D.O. Angela Wagner, D.O. Legislative Committee Rachel Shockley, D.O.,Chair Mark Cantieri, D.O. Lisa Chun, D.O. Stephanie Overmars, D.O. Michelle Snyder, D.O. Patrick Woodman, D.O. Membership Committee Angela Wagner, D.O., Chair Mary Burden, D.O. David Coil, D.O. Dan Galloway, D.O. Terry Iwasko, D.O. David Koronkiewicz, D.O. Medical Economics Committee Terry Iwasko, D.O., Chair Thurman Alvey, D.O. Peer Review Committee David Koronkiewicz, D.O., Chair Brian Black, D.O. Mark Cantieri, D.O. Max Helman, D.O. Public Health/Hospitals Committee Ben Huang, D.O., Chair Thurman Alvey, D.O. Public Relations/Publications Committee Mary Burden, D.O., Chair Lisa Chun, D.O. Paul Evans, D.O. Errin Weisman, D.O. Students, Interns, and Residents Committee Errin Weisman, D.O., Chair Stephanie Overmars, D.O. Angela Wagner, D.O.
Summer 2014
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REMEMBER THE
MOTYKA DANNIN FOUNDATION
MOTYKA DANNIN FOUNDATION CONTRIBUTORS Advocates to the IOA Bruce C. Brink, Sr., D.O. (in memory of Bill G. Odell, D.O.)
As you make your charitable giving plans, think about how you can help Indiana students in colleges of osteopathic medicine. Ask your tax advisor how you can reduce your taxes while giving to the Motyka Dannin Foundation.
ESTATE PLANNING , TOO We also remind you, when you write or revise your will, to remember the Motyka Dannin Foundation. After you have provided for your loved ones, church, alma mater, and favorite charities, perform one last generous act for the future of your profession. Telephone: 317/926-3009 or 800/942-0501 Motyka Dannin Osteopathic Educational Foundation a 501(c)(3) charitable organization
MOTYKA DANNIN FOUNDATION LOAN RECIPIENTS Three loans totaling $ 3,000 were awarded to osteopathic medical students by the Motyka Dannin Osteopathic Educational Foundation, Inc. (Motyhka Dannin Foundation) at its February 9, 2014, meeting. The recipients of the 2013 – 2014 forgivable loans are Cory J. Banashak, a first year student at Marian University College of Osteopathic Medicine, Maria G. Ficker, a second year student at Midwestern University Chicago College of Osteopathic Medicine (MWUCCOM), and Jarod R. Walerstein, a first year student at Lincoln Memorial University DeBusk College of Osteopathic Medicine. Mr. Banashak is from Greensburg. Ms. Ficker is from Crown Point. Mr. Walerstein is from Carmel. Recipients of other awards are Hasan Mukhtar, a first year student at West Virginia School of Osteopathic Medicine; Steven J. Rice, a first year student at MWUCCOM, Andrew S. Rumble, a second year student at MWUCCOM. Mr. Mukhtar is from Plainfield. Mr. Rice is from Fort Wayne. Mr. Rumble is from Greenwood.
Christine and Dan C. Galloway, D.O. (in memory of Ruth Motyka) Gloria Krejsa (in memory of Ruth Motyka) IOA (in memory of Cecil Deckard, D.O., P. J. MacGregor, D.O., George E. Midla, D.O., Bill G. Odell, D.O., Joanna E. Reusser, D.O., and Harold T. Sparks, D.O.) Hertha Miley (in memory of James M. Miley, D.O. and Ruth Motyka) On behalf of the future osteopathic physicians who will be helped by your generosity, thank you for your gifts to the Motyka Dannin Osteopathic Educational Foundation, Inc. (Motyka Dannin Foundation). For additional information regarding the Motyka Dannin Foundation, contact Erin Wernert, Executive Director, at the IOA office. Contributions can be sent to the Motyka Dannin Foundation, 3200 Cold Spring Road, Michael A. Evans Center for Health Sciences, Suite 107, Indianapolis, IN 46222.
SCIENCE FAIR AWARDS The IOA again sponsored the Hoosier Science and Engineering Fair, Indiana’s science fair. This year two prices in the category of human health, biology, or life sciences were awarded. First prize, and a check for $100, was won by Mckayla Paige Tucker, Boone Grove High School, Valparaiso, IN. The project title was “What is the Best Environment for Tooth Cavity Formation?” Second prize, and a check for $50, was won by Kimber Ann Schnarr, grade 6, Jasper Middle School, Jasper, IN. The project title was “What is the True Stress on the Knee?”
Summer 2014
COMING EVENTS... Annual Seminar: “A Sutural Approach to Osteopathy in the Cranial Field” August 1 – 3, 2014 25 hours category 1-A credit anticipated, pending approval by AOA CCME Marian University College of Osteopathic Medicine, Indianapolis, IN Sponsor: Indiana Academy of Osteopathy Contact: IAO, (317) 926-3009 or www.inosteo.org The Cranial Base September 19 – 21, 2014 Renaissance Suites O’Hare, Chicago, IL Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com AOA Convention October 25 – 29, 2014 Washington State Convention Center, Seattle, WA Sponsor: American Osteopathic Association Contact: AOA, (312) 202-8014 or www.osteopathic.org The Midline Course November 7 – 9, 2014 Doubletree Hotel San Francisco Airport, San Francisco, CA Sponsor: The Cranial Academy Contact: The Cranial Academy, (317) 581-0411 or www.cranialacademy.com Preconference OMT Workshop: “Muscle Energy for the Lower Half of the Body” December 4, 2014 8 hours category 1-A credit anticipated, pending approval by AOA CCME Hyatt Regency, Downtown Indianapolis, IN Sponsor: Indiana Academy of Osteopathy Contact: IAO, (317) 926-3009 or www.inosteo.org
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33rd Annual Winter Update December 5 - 7, 2014 25 hours category 1-A credit anticipated, pending approval by AOA CCME Hyatt Regency, Downtown Indianapolis, IN Sponsor: Indiana Osteopathic Association Contact: IOA, (317) 926-3009 or www.inosteo.org
MARK YOUR CALENDARS
NOW AND PLAN TO ATTEND THE IOA 33RD ANNUAL WINTER UPDATE DECEMBER 5 - 7, 2014 HYATT REGENCY DOWNTOWN INDIANAPOLIS, IN
Is Hyperbaric Oxygen Therapy Right for Your Patient? Nearly six million people in America are affected by chronic wounds. Every year more than one million people with diabetes will develop foot ulcers; 20% to 30% of these cases will eventually require amputation. These hard-to-heal wounds should be treated aggressively and with the most effective techniques and equipment. Specialists at the Community Westview Advanced Wound Center work with you as the referring physician to determine the best care plan, and we keep you updated on progress. We provide each patient with dedicated, specialized attention. Our Hyperbaric Oxygen Therapy (HBOT) is one of several advanced treatments offered by the center that can accelerate the wound healing process. Examples of wounds we care for include: arterial ulcers, complex softtissue wounds, diabetic wounds, infected wounds, non-healing surgical wounds, pressure ulcers, traumatic wounds, vasculitic ulcers, venous statis ulcers, and any other wound not showing signs of improvement in 30 days.
www.communitywestview.org
For a referral, consultation, or for more information, call our center at (317) 682-2032. We are located at 3520 N. Guion Rd., Suite 100, Indianapolis, IN 46222.
Summer 2014
HOOSIER D.O.
HOOSIER
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PRACTICE OPPORTUNITIES AVAILABLE IN INDIANA IOA Serves as an Informal Clearinghouse for physicians seeking practice locations.
2014 - 2015 OFFICERS Adrian L. Carter, D.O. President Mark S. Cantieri, D.O. First Vice President Gaston Dana, D.O. Second Vice President Terry A. Iwasko, D.O. Secretary Patrick J. Woodman, D.O. Treasurer Angela B. Wagner, D.O. Immediate Past President TRUSTEES Brian H. Black, D.O. Mary Burden, D.O. Steven J. DeLee, D.O. Chris A. Lowery, D.O. Stephanie M. Overmars, D.O. Rachel A. Shockley, D.O. DISTRICT VICE PRESIDENTS Brian H. Black, D.O., District I Vacant, District II Vacant, District III Vacant, District IV Bruce C. Brink, Jr., D.O., District V Dan C. Galloway, D.O., District VI A.O.A. DELEGATES Thurman V. Alvey, III, D.O. Mark S. Cantieri, D.O. David L. Coil, D.O. Dan C. Galloway, D.O. David C. Koronkiewicz, D.O. Susan M. Moore Riesbeck, D.O. Angela B. Wagner, D.O. A.O.A. ALTERNATE DELEGATES Adrian L. Carter, D.O. Max E. Helman, D.O. Ben D. Huang, D.O. The Hoosier D.O. is published four times per year in the Winter, Spring, Summer, and Fall by the Indiana Association of Osteopathic Physicians and Surgeons, Inc. dba Indiana Osteopathic Association. Editor: Deborah E. Coyle, CPS IOA Staff: Erin L. Wernert, Executive Director Deborah E. Coyle, Manager of CME Programs and Office Manager The IOA Office is located at: 3200 Cold Spring Road Evans Center, Suite 107 Indianapolis, IN 46222 (317)926-3009 www.inosteo.org
FREELANDVILLE INDIANA. The small rural community of Freelandville misses its retired physician and is hoping a new one will come to town. If interested in a solo practice, contact Erin Wernert or Debbie Coyle, IOA, at (317) 926-3009. INDIANAPOLIS INDIANA. Community Physician Network is seeking osteopathic family medicine physicians for an exciting opportunity to join Community Westview Hospital’s Family Medicine Residency faculty. Ideal candidates will be team-oriented, highly accountable, have a strong interest in teaching, and be board certified in family medicine by the American Board of Osteopathic Family Medicine. Candidates with experience in education are highly preferred. Highlights of this full-time opportunity include: • Focus on educating and advising Family Medicine residents in an AOA accredited, 3-year residency program • Part-time clinical practice • Inpatient training at sites throughout Community Health Network, including Community Westview, Indiana’s only osteopathic hospital • Ability to practice preventive care and personal, hands-on treatment utilizing therapies such as OMT and acupuncture • Shared call schedule • Patient-centered Medical Home practice model • Implementing an Electronic Medical Record (EPIC) • Potential appointment with the new Marian University College of Osteopathic Medicine • Market competitive salary and excellent benefits package For more information regarding this opportunity, as well as other opportunities in family medicine, visit www.ecommunity.com/physicianrecruitment or contact Jason Houston, Senior Network Physician Recruiter, at (317) 621-1999 or send an e-mail message to docjobs@ecommunity.com. INDIANAPOLIS PHYSICIAN AVAILABLE FOR FAMILY PRACTICE, OCCUPATIONAL MEDICINE, OR URGENT CARE. Certified in family practice in 1999. For additional information, contact Erin Wernert or Debbie Coyle, IOA, at (317) 926-3009. NORTHERN INDIANA. Mishawaka Osteopathic Clinic has an immediate opening for a physician to come into the practice. We have a well-established and large patient base. Our experienced, loyal, and well-trained staff attracts many new patients. Currently, we have one full time and one part time D.O., an R.N., multiple medical assistants, fully staffed front office and medical records. Our Clinic has 11 exam rooms, including an office surgery/procedure room, PAP room, conference/lunch room and a large comfortable waiting room. We are a fast paced and patient friendly practice caring for families since 1969. Come join our team of patient care professionals who feel that “our patients matter.” For more information, please contact Mary Behrle, RN Staff Coordinator at (574) 323-3812 or e-mail inquiries along with your CV to mocnurse@yahoo.com. PREMIER INDIANAPOLIS AREA FAMILY MEDICINE OPPORTUNITES AVAILABLE. Our practices are growing, and you can be busy right away. You’ll enjoy a collaborative environment with administration and your fellow physicians. Experience the benefits of practicing in a small town environment without sacrificing any big city amenities. Our hospitals offer: supportive cultures, competitive salaries, comprehensive benefits, rapidly growing communities, full and part time options, skilled support staff at each practice and accessible specialty and sub-specialty medicine. Hospital owners: Hancock Regional Hospital, Hendricks Regional Health, Henry County Hospital, Johnson Memorial Hospital, Major Hospital, Riverview Health and Witham Health Services. Contact Suburban Health Organization, (317) 295-5279 or send an e-mail message to laurenc@suburbanhealth.com. SOUTHERN INDIANA. Brink’s Family Practice in Princeton has an immediate opening for a physician to come into the practice. The practice has a well-established patient base with experienced, well-trained staff and an in-house lab. The practice is located in a growing community that still possesses small town friendliness and has access to large city amenities. For more information, please e-mail inquiries along with your CV to c.hurtbfp@mw.twcbc.com or contact Erin Wernert or Debbie Coyle, IOA, at or (317) 926-3009.