SCMS BULLETIN - May 2020

The

Bulletin Saginaw County Medical Society

May 2020 | Volume 78 | No 8

Peaceful Low Tide Sunset in Bar Harbor, Maine www.SaginawCountyMS.com

Cancer Care Center Support Groups

Covenant Regional

Revised February 2020

SUPPORT GROUPS ARE PROVIDED AS A FREE SERVICE TO OUR COMMUNITY

All Cancer Survivors and Caregivers Survivors with Oral, Head and Neck Cancer and Caregivers

Coping with Cancer When: 1st & 3rd Tuesday of each month

Support for Those with Treatment-Related Swallowing Difficulties (including Lung and Upper-Gastrointestinal Cancers) S.P.O.H.N.C. – Saginaw Chapter When: 2nd Tuesday of each month Time: 2:00-3:30 pm Women’s Cancer Support When: 2nd Tuesday of each month

Female Cancer Survivors

Time: 12:00 Noon-1:30 pm

Time: 6:00-7:30 pm

Young Women’s Cancer Support (suggested age 45 and under) When: 4th Tuesday of each month Time: 6:00-7:30 pm

Pulmonary Patients and Caregivers

Better Breathers Pulmonary Support When: 2nd & 4th Wednesday of each month Time: 2:00-3:00 pm

Grieving Spouses in the First Year of Loss

Spousal Loss – Introduction (six-week series) When: Select Thursdays by pre-registration only Time: 10:15-11:30 am

Quitting or Have Quit Smokers

Support for those who are quitting or have quit smoking When: 2nd Wednesday of each month Time: 6:00-7:00 pm Location for all support groups: Covenant Cancer Care Center 5400 Mackinaw, Saginaw, Michigan Third Floor Conference Room A For more information, please call: Gerry Bishop, LMSW, M. Div – 989.583.5267 Alison VanNorman, LMSW, OSW-C – 989.583.5268

©2020 Bus. Dev. (AQ/RF) Rev. 2/20 13076

The

Bulletin Saginaw County Medical Society

2019-2020 OFFICERS AND DIRECTORS President Mildred J. Willy MD President-Elect Anthony M. Zacharek MD Past President Julia M. Walter MD Secretary Caroline G.M. Scott MD Treasurer Miriam T. Schteingart MD Board of Directors Jorge M. Plasencia MD Tiffany K. Kim MD Mark G. Greenwell MD Harvey K. Yee MD Elizabeth A. Paulus MD Furhut R. Janssen DO Bulletin Editor Louis L. Constan, MD Retiree Representative Rustico B. Ortiz, MD Resident Representatives Mary J. McKuen, MD Anushka N. Magal MD MSMS Delegates Elvira M. Dawis MD Julia M. Walter MD Mildred J. Willy MD Anthony M. Zacharek MD Jorge M. Plasencia MD Christopher J. Allen MD Miriam T. Schteingart MD MSMS Alternate Delegates Caroline G.M. Scott MD

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Joseph P. Contino MD Kristine K. Spence DO Karensa L. Franklin MD Scott E. Cheney MD Michael W. Warren MD Peer Review Ethics Committee Waheed Akbar, MD, Chair Caroline G.M. Scott, MD James R. Hines, MD MSMS Region 7 Director Thomas J. Veverka, MD Executive Director Joan M. Cramer Administrative Assistant Keri Benkert

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COVID-19 Telehealth Program Connected Care Pilot Program

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MENTAL HEALTH RESOURCES SENATE BILL 899 – Immunity Regarding Medical Liability Contact Your Lawmakers!

COVID-19 CMS Advocacy Talking Points Contact Your Lawmakers!

Update from SCHD Phase 2 Guidance Know Your Rights As An Employed Physician

CQ Technology Focus Telemedicine Revolution

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President’s Letter – Guest Writer

Cancellation of SCMS Meetings and Events

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Physician Support Line

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May and June Birthdays

From the Editor CMU College of Medicine CMU Health Fulfill Your Board of Medicine Requirements on Your Time

20 MSMS

• Dr. Khaldun Addresses Temporary Restrictions

• CME Credit for COVID-19 Extended • FREE COVID-19 On-Demand Webinars

• Tele-Town Hall for Physicians on COVID-19 • ABIM Increases Flexibility to Maintain Certification • Financial Assistance for Physician Medical Practices

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Ascension St. Mary’s

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Covenant HealthCare

In Memory – Rustico B. Ortiz, MD

Advertiser Index Caduceus Meeting Key Providers Calendar of Events COVID-19 Resources

The Bulletin can be viewed online at www.SaginawCountyMS.com under the Bulletin tab.

ON THE COVER: LOW TIDE SUNSET IN BAR HARBOR, MAINE - AUGUST 2019

Mohammad Yahya Khan MD Steven J. Vance MD

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REGISTER NOW! THRIVE Welcomes the Surgeon General | Virtual Webcast Tuesday, May 26 from 2-4 p.m.

Waheed Akbar MD Virginia R. Dedicatoria MD

MSMS Launches Website to Get PPE for Physician Practices

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COVID-19 RESOURCES AND INFORMATION AVAILABLE AT www.SaginawCountyMS.com

EDITOR Louis L. Constan, MD EXECUTIVE DIRECTOR Joan M. Cramer DESIGNER Lori Krygier

PUBLISHER Saginaw County Medical Society 350 St. Andrews Rd., Suite 242, Saginaw, Michigan 48638-5988. Hours: Tuesday, Wednesday, Thursday 8:30 AM - 3:30 PM. Web: SaginawCountyMS.com Telephone: (989) 790-3590. Fax: (989) 790-3640 E-Mail: jmcramer@sbcglobal.net

All statements or comments in the Bulletin are those of the writers, and not necessarily the opinion of the Saginaw County Medical Society. Contributions are welcome. We publish committee reports, letters to the editor, Alliance reports, public health activities of the members, and some personal items (birthdays, weddings, graduations and like events).

The Editor determines which are accepted. Advertisements are accepted as space is available at our going rates. Members may advertise office information, professional services, skills, and procedures, also at our going rates. We do not accept advertisements from nonmembers, or non-Saginaw hospitals.

The Bulletin is mailed free of charge to SCMS members as part of their membership.

Complimentary copies are sent to various other parties. Others may subscribe at the rate of $50 per year.

The Bulletin | May 2020 3

PRESIDENT’S LETTER - Guest Writer Julie Novak, MSMS CEO

Opinion: Michigan Physicians Face Financial Crisis The following article was written by Julie Novak, MSMS CEO, and published in The Detroit News on Wednesday, April 22, 2020.

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OVID-19 has changed everything. Seemingly overnight our world was shaken and tipped upside down, and now we’re all doing our best to pick up the pieces, make some sense of the mess, and carry forward as best we can.

Michigan’s health care community has undoubtedly risen to the challenge in that regard. Every day - and at the risk of their own lives physicians, nurses and other health care providers across the state are doing everything they can to see and treat patients in need of care during these extraordinary times.

Nothing about that is surprising though. Simply put, physicians are called to serve. They pursue medicine because they want to provide care to those in need, and right now, people are suffering. Understaffed, overworked and under protected in the fight against COVID-19, they act to provide treatment and care to those who need it most.

The burdens they can’t bear are the financial ones this pandemic is

creating, and without assistance, the ill effects they may create will paralyze our health care system for years to come - long after the COVID-19 pandemic has gone.

Patient volume has fallen dramatically for practices throughout Michigan. Between government mandates and safety precautions canceling elective procedures and nonessential office visits, as well as, fear preventing those truly in need of care from seeking it out, business-as-usual has nearly ground to a halt for the majority of physician practices. Many physicians have seen patient volume fall as much as 40 percent, while others have observed far steeper declines.

But what hasn’t ceased are the financial obligations these clinicians are facing. Practices still need to make their rent, pay their staff, retain critical software and tech support, be available to see patients with emergent needs. The list goes on. One Michigan practice has seen its patient load drop 98 percent, yet they still face a $10,000 bill to maintain their electronic health records system. Another has $75,000

worth of critical vaccines sitting idly in the refrigerator with no young children to immunize against things like pertussis, meningitis and even measles - critical vaccines that need to be delivered and aren’t, yet the distributor still needs to be paid.

Moreover, hundreds of physicians are receiving their professional liability insurance premium renewals - in some cases at an alarming 35 percent increase. Presented with these kinds of stark figures, it’s clear something must give.

Without a lifeline, these practices will start having to make hard choices. Some will be forced to dramatically cut their staffs, and some will just shutter their doors entirely, jeopardizing patients’ access to the kind of timely quality care they need and deserve.

As Congress considers another COVID-19 relief package, it’s critical they continue to provide assistance to health care providers who desperately need it right now. Michigan’s elected officials also have the opportunity to lead by example in extending continued on page 5

One Michigan practice has seen its patient load drop 98 percent, yet they still face a $10,000 bill to maintain their electronic health records system.

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The Bulletin | May 2020

COVID-19 Resources and Information Available at www.SaginawCountyMS.com In an attempt to keep members informed, the SCMS website, www.SaginawCountyMS.com is updated on a regular basis. The home page is filled with COVID-19 resources from and on the following topics: continued from page 4

additional support to Michigan’s struggling health care providers. As the state considers how to allocate federal stimulus dollars, they can help protect patient access to care by preserving the viability of physician practices as part of Michigan’s essential health care system. The fact is, Michigan’s physicians need help from Washington, D.C. and Lansing to weather this storm, and one day soon - when stay-home orders are lifted, and life gradually returns to some semblance of normal - we’ll need them again, too. Let’s do what they’ve always done for us - provide support when it’s needed most.

Saginaw County Health Department Michigan State Medical Society (including FREE COVID on-demand webinars) CMU College of Medicine OCME Telemedicine Financial Resources American Medical Association Michigan Department of Health & Human Services Centers for Medicare & Medicaid Services Mental Health Resources Centers for Disease Control American College of Emergency Physicians Personal Protection Equipment

CANCELLATION OF SCMS MEETINGS AND EVENTS Due to COVID-19, the SCMS has cancelled the following meetings and events for 2020: • May Annual Membership Meeting • Foundation Golf Outing scheduled for June • September Membership Meeting • October Membership Meeting – status to be determined

Entries are tagged with date of posting.

Some entries are listed under multiple categories depending on source and type of information (e.g., financial, PPE, etc.)

Joan M. Cramer Executive Director jmcramer@sbcglobal.net Cell (989) 284-8884

The April Membership Meeting program, "Physician Compassion Fatigue” to be presented by Molly E. GabrielChampine, PhD, LP, Director of Behavioral Science, Family Medicine Residency at McLaren Bay, will be rescheduled in 2021.

The 16th Annual Health Fair postponed in March will not be rescheduled in 2020. We do not feel it is in the best interests of the public who attend (many of whom have multiple medical conditions), our vendors, members and staff to bring together a large group of people since it is believed there will be waves of COVID later this year.

Board meetings for the immediate future will be held virtually.

The Bulletin | May 2020 5

FROM THE EDITOR

Credit Due

By Louis L. Constan, MD

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s we reflect on the progress of our careers in medicine, and on the progress of the Medical Profession as a whole, it is wholly appropriate from time to time that we give due appreciation to those physicians who have gone above and beyond the call of duty. Those individuals who have had an outside influence on what we do. Think of the giants of American medicine: Osler, the great diagnostician; the Mayo brothers, who carried surgery into the modern era; Salk, the brilliant virologist who conquered Polio; and DeBakey, the daring heart transplant surgeon. Now think of the physicians who inspired you personally - your residency directors perhaps, some mentor along the way, perhaps an old family doctor who inspired you to go into medicine way back when you were a child.

Now I’d like to suggest you consider a doctor whom you may never have heard of, Jerome M. Adams, MD. Dr. Adams had a Horatio Alger beginning, his father a farmer, but he had high ambitions, great intelligence and dogged determination.

He secured critical scholarships to college and medical school, then took a residency in Anesthesiology in Indiana. So far, a fairly routine career. For most of us, it was time to settle into a prescribed career, get a job, pay off debts, buy a house. But for Dr. Adams, a man with infectious energy, enthusiasm, even charisma according to some who know him, he was just getting started.

Sure, he worked as an anesthesiologist, but then he also obtained a Master’s in Public Health at UC Berkeley, secured leadership positions with the Indiana State Medical Society, the Indiana Society of Anesthesiologists and the AMA. Here was a man determined to make a difference. As it happened, an opening came about for the Indiana Health Commissioner, and Dr. Adams, who had never before been a political animal, was determined to take a very public role in life while being fiercely determined to serve the public health using only proven science.

Thus, when Indiana experienced an epidemic of contaminated-needlecaused HIV and Hepatitis C, he pushed for and got money from the state legislature for a needle exchange program. Yes, even in deeply conservative (both politically and culturally) Indiana, he managed to convince the skeptics to go with the science and fund the right program to get the job done. Among his other initiatives, in a state with shamefully high infant mortality rate, was a state-funded comprehensive “Labor of Love” initiative, with a hotline that women can call for help at all stages of pre-pregnancy or pregnancy. Michigan, and especially Saginaw County, could use such a program.

At this point, let me back up and say I can easily point to at least a dozen Saginaw County Medical Society physicians who have made commitments

to our profession and to the public health, at least as deep and long-lasting as those of Dr. Adams. They serve selflessly and often with no recognition.

At some point, you give them a word of thanks. I wish I could name them all here, but sadly, do not have the time or space. Our task is to discuss Dr. Adams, and so we shall.

In 2017, despite his lack of political credentials, and the baggage of his controversial use of evidence-based approaches to public health problems, Dr. Adams’ talents and abilities were so respected on the state and national level that he was appointed and confirmed as the 20th United States Surgeon General. This made him instantly the most notable physician in the country, and his “Surgeon General’s” report was eagerly anticipated in government and medical circles. What disease, what public health issue would he focus on?

Previous Surgeon Generals, as described in the March issue of The Bulletin, had focused on tobacco, sex education, drug use, minority health, etc. What would Dr. Adams focus on?

Well, in his three years as Surgeon General, Dr. Adams has not issued a formal report, but he has focused, with laser precision, on a serious problem in America, as is well known to those who follow his speeches, seminars and daily tweets to numerous followers. continued on page 7

He argued that addiction is a medical, not a moral, problem and needs scientifically proven prevention and treatment efforts on a national scale.

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The Bulletin | May 2020

continued from page 6

Dr. Adams believes, and this is ironic given recent events, that you cannot have a healthy America without having a prosperous America; but that the converse is also true…you cannot have a prosperous America without having a healthy America.

And we have found that out…in spades. We can have NO prosperity, at all, without good health.

Actually, such thoughts have long been central to the efforts of our own THRIVE community which has been working diligently on bringing together the healthcare community with the business community to improve the economic and physical vitality of our region, and which has secured a promise from the very same Jerome M. Adams MD, Surgeon General of the United States, to visit with us on Tuesday, May 26.

Circumstances unfortunately necessitate the visit, as is so much these days, be ‘virtual,’ but you will nonetheless want to take the time to see what he has to say about our efforts.

Further information about the event can be found in the THRIVE article on pages 8-9 in this issue of The Bulletin.

MSMS Launches Website to Get PPE for Physician Practices MSMS, in partnership with Foresight Group, recently announced the launch of a new website, http://MSMS.org/PPESupplies, to get personal protective equipment and other supplies for Michigan's physician practices. The website will allow physicians and their practices to purchase essential medical supplies, including respirators, face shields, goggles and gowns.

Once the practice identifies their need and quantity, information is shared with Foresight Group, who will then identify the best rate and delivery times available, confirm need with the practice, collect payment information, and place the order, which will then ship directly to the practice.

If there are specific supplies needed, please notify MSMS@MSMS.org so those supplies may be added as an option.

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The Bulletin | May 2020 7

Stronger, Together.

By THRIVE Staff

W

e are stronger together. This has never been more evident as the Great Lakes Bay Region came together to respond and assist with collecting and securing Personal Protective Equipment (PPE) for those essential workers battling the COVID-19 pandemic. One hundred thousand pairs of gloves, hundreds of gallons of hand sanitizer, goggles and disinfectant wipes from classrooms, and hundreds of hands creating homemade masks are just a few of the items donated and created by the Great Lakes Bay Region in the past six weeks.

In early March, when we stood at the beginning stages of the COVID-19 pandemic entering the United States, we realized the weeks that followed would determine how we as a region survive - and eventually emerge - from this unprecedented time.

As the President called upon various industries to donate what items they could to hospitals and other essential industries, the THRIVE initiative (Transforming Health Regionally in a Vibrant Economy), a co-led initiative between the Michigan Health The link between Improvement Alliance (MiHIA) and the Great population health and the Lakes Bay Regional economy has never been Alliance (GLBRA), quickly acted and began so pronounced, and THRIVE coordinating the PPE is proud to assist in these donation, distribution regional efforts to combat and manufacturing the effects of COVID-19. process for the Great Lakes Bay Region.

With the help of partners like Saginaw Valley State University to house the donations, local partners donating their supplies, and organizations like Dow and Nexteer pivoting their manufacturing processes, universities bringing in their research

labs, 3D printing assets and other business support, THRIVE has been able to help supplement essential businesses with the items they needed.

In the coming months as our region will work to gain back momentum and re-establish our economy post-pandemic, THRIVE is pleased to announce that we are hosting a virtual event with the Surgeon General on Tuesday, May 26. The Surgeon General's national platform, Community Health and Economic Prosperity, is a welcome message in our region, as it seamlessly aligns with THRIVE's mission to deliver improved health and sustained economic growth in our communities.

It is noteworthy that the Surgeon General’s motto is "Better Health Through Better Partnerships," and he seeks to forge new partnerships with non-traditional partners.

On Friday, May 15 from 9-9:45 a.m., THRIVE is hosting a webinar overview as a lead-in to the Tuesday, May 26 virtual webcast from 2-4 p.m. featuring a keynote speech by VADM (Vice Admiral) Jerome M. Adams, MD, MPH, U.S. Surgeon General and a multi-sector regional panel discussing his national platform, Community Health and Economic Prosperity and the community-wide THRIVE effort in the Great Lakes Bay region. Registration information follows.

The link between population health and the economy has never been so pronounced, and THRIVE is proud to assist in these regional efforts to combat the effects of COVID-19. If you would like more information, please visit our website at https://thrivegreatlakesbay.org/ and follow us on Facebook at @thrivegreatlakesbay.

Learn More About THRIVE Webinar!

THRIVE Webinar: Shared Path to a Positive Future Friday, May 15 | 9 - 9:45 a.m.

• Foundation of THRIVE: Backbone Organizations and Steering Team • Path to Implementation • Balanced Portfolio • Funding & Financing: Capacity Funding • Implementation for Impact: Phase 1 Progress • Your Important Actions Click HERE to register

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The Bulletin | May 2020

ALL OF US – TOGETHER DRIVING ALL OF US – TOGETHER HEALTH AND ECONOMICDRIVING SUCCESS HEALTH AND ECONOMIC SUCCESS Tuesday, May 26th, 2020 | 2pm - 4pm Virtual Webcast Tuesday, May 26th, 2020 | 2pm - 4pm Virtual Webcast

Join us as we work to improve health and economic success in the Great Lakes Bay Region through highly effective and coordinated stakeholder collaboration. This Join us as we work to improve health and economic success in the Great Lakes Bay powerful webcast will feature a keynote speech by VADM (Vice Admiral) Jerome Region through highly effective and coordinated stakeholder collaboration. This M. Adams, M.D., M.P.H., U.S. Surgeon General and a multi-sector regional panel powerful webcast will feature a keynote speech by VADM (Vice Admiral) Jerome discussing his national platform, Community Health and Economic Prosperity and the M. Adams, M.D., M.P.H., U.S. Surgeon General and a multi-sector regional panel community wide THRIVE effort in the Great Lakes Bay region. discussing his national platform, Community Health and Economic Prosperity and the community wide THRIVE effort in the Great Lakes Bay region.

“The Surgeon General’s keynote address will build upon the momentum in the region and address bring focus weupon “The Surgeon General’s keynote will as build address both our and community well-being for the momentum ineconomy the region and bring focus as we now and both the long-term future,” Dr. Cathy Baase,for address our economy and states community well-being senior fellow of THRIVE future,” and board chair MiHIA. now and the long-term states Dr.ofCathy Baase, senior fellow of THRIVE and board chair of MiHIA.

AGENDA AGENDA Welcome Jim Fitterling, Chairman and Chief Executive Officer at Dow

Welcome Jim Fitterling, Chairman and Chief Executive Officer at Dow Keynote VADM (Vice Admiral) Jerome M. Adams, M.D., M.P.H., U.S. Surgeon General Community Health and Economic Prosperity Keynote VADM (Vice Admiral) Jerome M. Adams, M.D., M.P.H., U.S. Surgeon General Community Health and Economic Prosperity Q&A Ursula E. Bauer, PhD, MPH, Centers for Disease Control and Prevention; On detail to the OfficePhD, of the Surgeon General Q&A Ursula E. Bauer, MPH, Centers for Disease Control and Prevention;

On detail to the Office of the Surgeon General THRIVE Reporting Progress, Celebrating Partners, Important Regional Commitment Announcement, Launch Phase 2 Implementation THRIVEof Reporting Progress, Celebrating Partners, Important Regional Commitment Announcement, Launch of Phase 2 Implementation THRIVE Panel Session All of Us Together: Advancing Health and the Economy

THRIVE Panel Session All of Us Together: Advancing Health and the Economy

REGISTER TODAY! REGISTER TODAY! “I invite you all to help me create a future where communities are “I invite you all can to help me create a future where communities are built so people more easily make healthy choices, and where built so people morecommunities easily makeashealthy choices, and where businesses investcan in those a way of achieving a healthier businessesand invest in those bottom communities workforce a healthier line.” as a way of achieving a healthier workforce and a healthier bottom line.”

VADM (Vice Admiral) Jerome M. Adams, M.D., M.P.H., U.S. Surgeon General VADM (Vice Admiral) Jerome M. Adams, M.D., M.P.H., U.S. Surgeon General

For more information visit www.thrivegreatlakesbay.org For more information visit www.thrivegreatlakesbay.org The Bulletin | May 2020 9

College of

Medicine COVID-19 CME Extended to June 9, 2020 The CLINICIAN LEARNING FROM CORONAVIRUS COVID-19 CREDIT DOCUMENTATION FOR AMA PRA Category 1 CreditTM and AOA Category 1-B credit has been extended by Executive Order 2020-82 through June 9, 2020, at 11:59 p.m. Claim forms are due to CMU College of Medicine Office of Continuing Medical Education by June 15, 2020. If you have already submitted a form for credit from March 17 through May 12, you can send an additional Credit Documentation form for May 13 through June 9. Credit applies ONLY to COVID-19. Questions and completed forms should be sent to CMEDCME@CMICH. EDU or call the CME Administrator at 989-746-7555.

Click HERE to access the updated COVID-19 Credit Documentation form.

Dr. Pruitt Named Medical Director of Saginaw County Health Department CMU Health’s very own Delicia J. Pruitt, MD has been appointed Medical Director of the Saginaw County Health Department (SCHD).

As the top physician for Saginaw County, Dr. Pruitt serves as a liaison among the county, community organizations, health care providers and allied health organizations. Her public health skillset has been put to great use in the Saginaw community during the COVID-19 pandemic.

She will remain in her role as Assistant Professor of Family Medicine at CMU College of Medicine. This added role helps to introduce public health to CMU medical students and residents in multiple fields while being a connector to a leading academic medical provider in the state.

Dr. Pruitt received her medical degree from Wayne State University, and completed her Family Medicine Residency at Synergy Medical Education Alliance in Saginaw, and has been a member of the Saginaw County Medical Society for over 16 years. She has been practicing medicine in the region for more than 15 years, and has overseen resident education and care as Program Director for the CMU Medical Education Partners Family Medicine Residency Program since 2016.

We are delighted Dr. Pruitt will be representing CMU to the region. Her transition to the Medical Director role will help us achieve our mission of reaching more medically underserved patients and families in the Great Lakes Bay Region. In assuming her additional role as SCHD Medical Director, Dr. Pruitt will remain an Assistant Director for our Family Medicine Residency Program.

10 The Bulletin | May 2020

Dr. Dhaliwal Returns to CMU as Family Medicine Residency Program Director Dr. Amandeep Dhaliwal, family medicine physician and past CMU Health employee, has returned to CMU Health’s Family Medicine department. In addition to seeing patients, he will assume Program Director leadership of the residency program as Dr. Delicia Pruitt began her new role as the Medical Director for the Saginaw County Health Department in April.

“Dr. Dhaliwal is returning to a formal educational role after a short tenure as a Covenant HealthCare hospitalist. He was missed, and will make a great impact on the program that is creating primary care physicians for our region and state,” says Dr. Samuel Shaheen, Executive Director of CMU Medical Education Partners.

We are ecstatic to have Dr. Dhaliwal serving the community and representing our organization once again. We look forward to seeing the positive impacts he has on our patients, residents and region.

Match Day 2020: 40% Match to In-State Residencies 40% of CMU’s MD graduates staying in-state 75% of graduates will do their residencies in primary care While the coronavirus ruined the party, it couldn't dampen the spirit of the Central Michigan University College of Medicine's 2020 graduating class on Match Day 2020. Normally, class members gather for Match Day at a nice venue to find out at noon with graduates from around the nation where they will spend their next several years in residency. This year, social distancing took precedence.

"It's not the ideal situation," said graduate Adam Kloha from Bay City, who aims to practice internal medicine in the Midwest.

"I would have rather been with my classmates, but we know it's a necessary step to help flatten the curve of the coronavirus victims." The medical school's fourth graduating class planned to get together on social media later in the day.

"Match Day is one of the most joyous days of the year at medical schools," said Dr. Tina Thompson, the College of Medicine's Senior Associate Dean, Academic Affairs. "While the day is bittersweet this year as we are unable to host a live event, the College of Medicine family is together in spirit and joins in celebration of our students' success," she said.

"We are proud of our students' continued success matching in competitive programs in Michigan and nationally," said College of Medicine Dean Dr. George Kikano. continued on page 11

continued from page 10

The matches are determined by a computerized algorithm used by the National Resident Matching Program to align the specialty and location requests of students with the preferences of program directors at U.S. teaching hospitals.

Dr. Kikano said by all measures, Match Day this year was a great success, as 40% of CMU students matched to a residency program in Michigan, and 75% matched to primary care. "We are especially proud of our three students who matched into military residencies," he said. "The match, the culmination of four years for medical students, is a very stressful yet gratifying time and the next step for them developing as physicians. We are proud of all of them," said Dr. Mildred Willy, Associate Dean, Student Affairs.

CME eLearning Two new eLearning materials on Violence in Healthcare: Protecting the Healthcare Workforce and Update on COVID-19 are now available free of charge at CMU College of Medicine’s CME Online.

• Part 1 features James Phillips, MD, Assistant Professor, Chief of Disaster and Operational Medicine, George Washington University in Washington, DC. Dr. Phillips is frequently on CNN with COVID-19 updates.

• Part 2 features Michael J. Peterson, MD, PhD, Associate Professor of Psychiatry at the University of Wisconsin School of Medicine and Public Health, and Director of Hospital Psychiatric Services at University Hospital in Madison.

Both sessions are extremely timely as they address the COVID-19 pandemic, as well as, anticipated increased violence against the healthcare workforce specifically due to the COVID-19 emergency.

Above: clockwise, M4's Ashley Stantz, Lindsay Murphy and Rebecca Russell; Test Kit; M4 Patrick Bishop and Dr. Derek Williams of GLBH

patients, speaking reassurances to them from six feet away.

The medical students were always gowned in full protective equipment. “Our clinicals were canceled, but we are still serving our community,” said Lindsay Murphy, M4. “It’s going to take all of our efforts to combat this disease. We could not in good conscience sit back when we could make a difference on the front lines.” Fourth-year medical student volunteers were Patrick Bishop, Sara DeLap, Lindsay Murphy, Rebecca Russell and Ashley Stantz.

Medical Student Volunteers - Assisting Patients with Telemedicine

Increasing the use of Telemedicine, CMU College of Medicine medical students along with Heidi Hall, EMR coordinator, CMU Health, coordinated A group of medical student volunteers assisted with COVID-19 telehealth efforts during COVID-19. screenings at the Great Lakes Bay Health Center (GLBHC) David They volunteered to participate in R. Gamez site in Saginaw. They worked with GLBHC staff at an calling patients who were scheduled outdoor drive-through COVID-19 testing site. Patients with for appointments with CMU Health to a doctor’s note for a test came to the testing center, and the assist them in setting up their MyChart accounts. Access to medical students assisted with logistics for taking the tests, MyChart accounts enables patients to participate in telehealth making sure vials were labeled properly, bagged the tests and visits, allowing them to receive the medical care they need completed paperwork. and improve continuity of care. There are also the additional “The staff was incredibly grateful for our help, and I believe benefits of improving patient safety and contributing to we made a true difference in this battle here on the front lines,” stated Ashley Stantz, M4. The volunteers were the assistants for Above: M4 Kristen Carrillo-Kappus the staff that had direct contact with very often scared and sick

Medical Student Volunteers - Assisting with COVID-19 Screenings

continued on page 12

The Bulletin | May 2020 11

continued from page 11

#flatteningthecurve. "This pandemic has many patients feeling overwhelmed, confused and concerned. However, by embracing telemedicine, patients have the opportunity to address their health concerns in real-time, while optimizing their safety. This allows patients to continue to be active members of their healthcare management team," said Yasmeen Mann, CMU College of Medicine student. Volunteers working on the project were Yasmeen Mann, Jason Lafave, Kristen Carrillo-Kappus, Emilee Khair, Adam Kloha, Marisha Schwab, Sara Robinson, Alexandra Manolis, Paul Zeller, Sulmaz Zahedi, Jordan Killingsworth, SeanMatthew Gogola Calo, Rabia Mahmood, Jenny Riepma and Shing Chao.

Medical Student Volunteers - Processing Health Care Exposure Data A group of medical student volunteers made phone calls to Covenant employees who had been exposed to patients with confirmed positive COVID-19, assessing the type of PPE worn during the encounter, whether or not the patient was wearing a mask, and from that information, assessed their risk of transmission. They have been working with CMU College of Medicine Associate Dean for Clinical Education, Dr. Steve Vance and emergency medicine residents, specifically Dr. Bryan Brazeau and Dr. Matthew Wolf, who organized this endeavor.

"Those of us who are quarantined at home, away from Saginaw, have the opportunity to help out with this massive effort. There is so much to do remotely, and we were the ones with time to do it right now. Even those of us juggling care of our families are taking this effort extremely seriously,� said Alexandra Ortiz M4. Volunteers on this project were Dr. Steve Vance, Dr. Bryan Brazeau, Dr. Matthew Wolf, and medical students, Merna Abdou, Kaitlyn Bates, Rebecca Hamburger, Whitnee Essenmacher, Kultaj Kaleka, Jason LaFave, Lindsay Murphy, Alexandra Manolis, Alexandra Ortiz, Marisha Schwab, and Zachary Yaker.

M3 Zach Yaker

Dr. Steve Vance

MAY/JUNE BIRTHDAYS MAY

JUNE

Joseph G. Adel MD Marina I. Ananich MD Christa Ann Arefieva MD Binish Ather MD Keri Benkert Eventure D. Bernardino MD Sultan M. Bhimani MD Gregory A. Bohn MD Adam Z. Cote DO Ryan L. Cox MD Del J. DeHart MD Kenneth W. Distler MD Daniel J. Dymek MD

Khurshid Ahmad MD Christopher J. Allen MD Abishek Bala MD Kayla J. Balaj MD Usha K. Bulusu MD William M. Capina MD George A. Carty MD Steven G. Fettinger MD Joshua D. Forsyth MD Michael D. Gallo MD Rao V.C. Gudipati MD Val Hereza MD James R. Hines MD

Thomas A. Egleston MD Douglas B. Forsyth MD Pruthvi Goparaju MD Suhasini Gudipati MD George J. Gugino MD Enam B. Hanna MD Mayar M. Jundi MD Ryan J. Kim MD Michael T. McAvoy MD Igor D. Middlebrook DO Jeffrey S. Milewski DO Thomas M. Minnec MD Rajesh Mithalal MD Yvonne V. Pacquing MD Jill M. Paveglio MD Olivia A. Phifer-Combs MD Gregory A. Pinnell MD J. M. Prasad MD Kala K. Ramasamy MD Chalichama A. Rao MD Happy Special Birthday!

K. K. Ravindran MD Thomas M. Raymond MD Stuart J. Rupke MD Insija I. Selene MD Samuel J. Shaheen MD Faiz Tuma MD Vivek Variar MD Lester E. Webb MD Harrison J. Zeitler MD

James J. Jesko DO Tareq Q. Kamal MD Larry S. Kelly MD Zubeda S. Khan MD Asim A. Kichloo MD Tiffany K. Kim MD John A. Kremski MD Lakshmana R. Madala MD Binu Malhotra MD Albert S.M. Manlapit MD Lydia T. Mansour DO Elizabeth M. Marshall MD Rama C. Mulpuri MD Manuel M. Perea MD Juliette M. Perzhinsky MD Isaac T. Prows DO Nasser O. Qadri MD Zhilwan K. Rahim DO Todd G. Richardson MD Chad D. Ringley MD Kyle J. Rutledge DO Raghu Sarvepalli MD Robert A. Sasso MD Keith E. Scharf MD Benjamin R. Schoener MD Rajeev S. Sudhaker MD Joseph E. Talbot MD William G. Underhill MD Thomas J. Veverka MD Antonio J. Williams, Sr. MD Haritha Yedla Schultz DO Susanna M. Zurecka MD

Hani H. Zreik MD 12 The Bulletin | May 2020

COVID-19 Telehealth Program | Connected Care Pilot Program The AMA would like to alert you to a recent funding opportunity from The Federal Communications Commission (FCC) related to its COVID-19 Telehealth and Connected Care Pilot Programs.

About the COVID-19 Telehealth Program This $200 million program supports health care providers responding to the COVID-19 pandemic by providing eligible health care providers support to purchase telecommunications services, information services, and devices necessary to enable the provision of telemedicine services during this emergency period. It will provide selected applicants with full funding for these eligible telehealth services and devices. In order to receive funding, eligible health care providers must submit an application to the Commission for this program, and the Commission will award funds to selected applicants on a rolling basis until the funds are exhausted or until the current pandemic has ended.

About the Connected Care Pilot Program This three-year Pilot Program will provide universal service support to help defray health care providers’ qualifying costs of providing connected care services. It will target funding to eligible health care providers, with a primary focus on pilot projects that primarily benefit low-income or veteran patients. The Pilot Program will make available up to $100 million, which is separate from the budgets of the existing Universal Service Fund (USF) programs and the COVID-19 Telehealth Program. The Pilot Program will provide funding for selected pilot projects to cover 85 percent of the eligible costs of broadband connectivity, network equipment, and information services necessary to provide connected care services to the intended patient population. In order to participate, eligible health care providers must submit an application to the Commission for the Pilot Program and the Commission will announce the selected pilot projects.

Click HERE for more information.

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The Bulletin | May 2020 13

Technology focus

Newsletter Date May 2020

Fundamental Benefits Providers ✓

Cost efficiencies

✓

No physical office visits necessary

✓

Improved quality of care, especially in chronic disease

✓

Increased overall patient volume

✓

Improves overall patient satisfaction

✓

Patient monitoring and adherence

✓

Reduced emergency department utilization and patient readmissions

✓

Faster access to specialists when required

Patients and Caregivers ✓

Enhanced and faster access to care

✓

Increased convenience

✓

Reduction in stress, avoid the hustle and bustle

✓

Reduced wait time for appointments and followup

✓

Reduced out-of-pocket costs, e.g. travel expenses

14 The Bulletin | May 2020

Volume 1 Number 5

The Telemedicine Revolution Has Begun!

With the current COVID-19 crisis, more practitioners have begun migrating to telemedicine. It’s time to take another look at this rapidly changing clinical technology. It is being embraced as an effective way to see patients without an office visit, reduce costs, increase patient satisfaction, improve overall outcomes and increase patient throughput – specifically in chronic disease patients. Efficient long-term management of chronic disease is one of the greatest challenges facing today’s healthcare system. The advantages in leveraging telemedicine are now greater than ever.

Fundamental Benefits for Providers and Patients

Virtual visits can help providers deliver convenient, routine patient evaluations outside the confines of a physical office space. It adds flexibility and convenience to the clinical process. In addition to the advantages offered by telephonic consultations, wearables and smartphone technologies have now progressed to the point where they can serve as useful tracking tools for monitoring vitals and adherence. They can also send alerts when a care plan is disrupted or not producing treatment goals. With this in mind, smartphones and other technologies are likely to become an integral part of the healthcare monitoring of many – if not most – chronic disease patients.

While the adoption of technology can sometimes come with a learning curve, the potential advances in provider/patient communications and resulting improvement in outcomes are likely to far outweigh initial implementation challenges. Providers should begin investigating how telemedicine can fit into and enhance their current practices.

Provider Advantages in Adopting Telemedicine Technologies

There are a number of areas in which Telemedicine can be beneficial to providers involved in the care of chronic disease patients, including: Improved Quality – Studies have shown that the quality of healthcare services delivered via telemedicine is as good as that provided through traditional in-person office visits. In some settings, such as ICU care, telemedicine has also been associated with increased patient outcomes and satisfaction.

Billing Requirements for CCM Code 99490 Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements: ✓

Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient

✓

Chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation or functional decline

✓

Comprehensive care plan established, implemented, revised or monitored Assumes 15 minutes of work by the billing practitioner per month Subscribe?

Find valuable information in the CQ “Technology focus” Newsletter? Subscribe here:

Sign Me Me Up! Sign Up! <Ctrl+Click to follow link> Simply Click Send After That!

You may unsubscribe at any time <Click Here> Technical Writer David Tucker has been involved in Information Technologies for over 35 years, much of that time has been devoted to the Healthcare Industry.

Improved Access – Telemedicine can improve patient outcomes and satisfaction. frequency and timeliness of care access for patients, just as importantly also allows physicians and health facilities to expand their reach and patient volumes. Given increasing demands of providers time, telemedicine has the unique capacity to improve provider efficiency and thereby enable them to serve more patients.

Patient Demand – Consumers want telemedicine. Indeed, the greatest positive impact of telemedicine is on the patient and families or caregivers. Telemedicine by nature reduces travel time, stress and inconvenience for the patient. Tele-services can also offer patient access to providers who might not otherwise be available to them – or at least offer initial access to these specialists in an expedited manner.

Cost Efficiencies – Reducing or containing the cost of healthcare is a fundamental driver of the emerging reimbursement model.

Telemedicine has been shown to reduce healthcare costs and increase efficiency through improving management of chronic diseases, enabling more efficient professional staffing, reducing travel times and shortening hospital stays.

Exploring and Evaluating Telemedicine Taking the First Steps:

As providers begin to evaluate their virtual care options, a number of key factors should be considered.

First, providers should gauge the need and urgency for telephonic services in their specific market, and then craft a strategic plan to best address the proposed new offerings.

Second, providers should assess capacity for any new patients they hope to recruit. Shifting patients who are historically high utilizers to a mix of in-person and virtual visits will likely expand patient load capacity.

Finally, as providers look to incorporate new technologies, they must become familiar with all aspects of the new technologies – or bring in outside expertise to help navigate both the technology itself and the methodologies and safeguards that must be employed in terms of patient privacy, billing practices, etc.

Telehealth Services and Reimbursement

Private and public payers have been expanding coverage for chronic disease management. In January 2015, Medicare began reimbursing telehealth providers for remote chronic care management (CCM) under CPT code 99490. Eligible providers include physicians and select nonphysician practitioners. The CCM billing code can be used for services relating to care plan development, communication and coordination with other treating health professionals, and medication management.

The code may be billed once per month for qualified patients.

Questions? Further Information? Discussion?

Whether you have a question, would like further information, have a group or individual, I would be happy to schedule some time to speak with you! Please feel free to contact me at: David Tucker, CQ Technologies, 5103 Eastman Avenue, Midland, MI 48640.

Phone: (989) 492-7068 or email: dtucker@cqsimple.com

The Bulletin | May 2020 15

MENTAL HEALTH RESOURCES Dear Members,

I

am highlighting Mental Health Resources in this issue of The Bulletin. You, as well as, all health care providers and emergency responders, have been on the frontline of the COVID-19 pandemic. I am certain it has affected all of you, albeit in different ways. Please visit our website at www.SaginawCountyMS.com for a list of MENTAL HEALTH RESOURCES on the home page.

I was saddened to learn of the prominent Manhattan emergency physician on the coronavirus front lines who recently died by suicide as reported on April 27 by the New York Daily News. Dr. Lorna Breen, 49, was the medical director of New York-Presbyterian Allen Hospital’s Emergency Department. Dr. Breen had treated a staggering number of coronavirus patients. As reported, police responded to a call seeking medical help, and Dr. Breen was rushed to UVA Health System University Hospital in Virginia, but succumbed to selfinflicted injuries.

Her father, also a physician, reportedly stated the crush of coronavirus cases his daughter handled was overwhelming, and that she herself became ill with COVID-19, though she went back to work after a week and a half. Her father said “she had no history of depression, and she was a very outgoing, very energetic person who, I don’t know what snapped, but something blew up in her, and so she ended up taking her own life. She just ran out of emotional gas.” He said his daughter traveled to Charlottesville, Virginia to stay with her sister after the hospital sent her home a second time.

READ THE FULL ARTICLE HERE. It is my hope the resources provided in this issue, and on our website will be beneficial as you continue to care for COVID-19 patients, as well as in many instances, rebuild your practice after the pandemic. My prayer is for health, well-being and safety for you and your family, friends and staff.

Joan M. Cramer, Executive Director

Meeting Mental Health Needs During COVID-19 The novel coronavirus disease (COVID-19) has wreaked havoc on the nation. It has changed the normalcy within our families, workplaces and communities, resulting in fear, anxiety and depression which can make it difficult to manage on one’s own. During these challenging times, it is important to have resources to share with patients and colleagues, to help support those who are having difficulty coping with the emotional toll and uncertainty of COVID-19.

Below is a list of resources to help ease stress, anxiety and mental fatigue. We hope you will take the opportunity to not only support your patients by encouraging the importance of mental health, but to ensure that you are taking care of yourself as well.

• SAMHSA COVID-19 Resources and Information • Resources from Mental Health First Aid o How to Care for Yourself While Practicing Physical Distancing o How Do I Know Someone is Experiencing Anxiety or Depression? o How to Help Someone with Anxiety or Depression During COVID-19 o How to Support a Loved One Going Through a Tough Time During COVID-19 • Headspace • Mental Health America – COVID-19 Resources • Michigan Psychiatry Resources for COVID-19 • MDHHS Warmline • Mental Health Foundation of West Michigan • Supporting Emotional Health of the Behavioral Health Workforce • Supporting Emotional Health of the Health Care Workforce • NAMI COVID-19 Resource and Information Guide

16

The Bulletin | May 2020

IDENTIFYING STRESS Physical

Cognitive

Healthcare workers experiencing any of the following symptoms should seek IMMEDIATE medical attention: ▪ Chest pain ▪ Difficulty breathing ▪ Severe pain ▪ Symptoms of shock

If these symptoms occur on the scene, workers may not be able to stay clearly focused to maintain their own safety or to help patients in distress.

If healthcare workers experience symptoms over time or if they become severe, workers should seek medical attention.

▪ Fatigue ▪ Nausea/vomiting ▪ Dizziness ▪ Profuse sweating ▪ Thirst ▪ Headaches ▪ Visual difficulties ▪ Clenching of jaw ▪ Nonspecific aches and pains

Healthcare workers may experience momentary cognitive symptoms; however, if symptoms are chronic or interfere with daily activities, workers should seek medical attention. These symptoms include: ▪ Confusion ▪ Disorientation ▪ Heightened or lowered alertness ▪ Poor concentration ▪ Poor problem solving ▪ Difficulty identifying familiar objects or people ▪ Memory problems ▪ Nightmares

Behavioral

Emotional

As a result of a traumatic incident, healthcare workers may notice the following behavioral changes in themselves or coworkers: ▪ Intense anger ▪ Withdrawal ▪ Emotional outburst ▪ Temporary loss or increase of appetite ▪ Excessive alcohol consumption ▪ Inability to rest, pacing ▪ Change in sexual functioning

Strong emotions are ordinary reactions to a traumatic or extraordinary situations. Health care workers should seek mental health support from a disaster mental health professional if distress continues for several weeks or if they interfere with daily activities. Emotional symptoms include: ▪ Anxiety or severe panic (rare) ▪ Guilt/sense of failure ▪ Denial ▪ Grief ▪ Fear ▪ Irritability ▪ Loss of emotional control ▪ Depression ▪ Feeling overwhelmed ▪ Blaming others or self

The Bulletin | May 2020 17

MANAGING STRESS Recognizing stress in yourself is important. Here are some things you can do for yourself to help you manage your stress: Talk to your peers about the stresses of the day, jobs, and other worries you share. Place an emphasis on validating one-another’s concerns without focusing on the grim. Help point out positive elements of the shift or day for one another.

Seek help from support systems available in the healthcare environment. Many systems have point people or resources to help with burnout, fatigue and other concerns. Conversations about your worries can help reduce anxiety. Check out the list of resources in this document as well.

Self-care helps you stay strong in order to better help others. Self-care can be eating healthy, exercising and getting good sleep. Self-care may also include taking care of family, including children and others. Making sure you fill your own cup is just as important as pouring from it to serve others.

Stay in touch with older parents and family members you would normally visit. Connect by phone or video chat, write letters, or send supplies safely to their residence to maintain your connectedness.

Take things one day at a time - step back from the “sprint” mentality.

Remember that this pandemic will not be solved quickly, treat it like a marathon.

Take mindful minutes. Slow breaths on the top of the hour, taking time to recognize all the small things around you, acknowledging them, and letting them go. Getting outside or stepping away from your workspace regularly.

National Disaster Distress Helpline Call 1-800985-5990

18

The Bulletin | May 2020

Text TalkWithUs to 66746

National Suicide Prevention Lifeline Call 1-800273-8255

Text TALK to 741741

Fulfill Your Board of Medicine Requirements on Your Time Mental health services are vital during the COVID-19 crisis. Child & Family Services of Saginaw’s priority during this challenging time is to assure that our community knows that counseling services and mental health treatment is still available through telehealth appointments.

A public health crisis like the coronavirus can cause an uncertainty and stress. That is why our team has worked very hard to ensure that our Counseling Center, Employee Wellness Center and Sexual Assault Center have shifted all therapy visits to telehealth appointments via phone or video counseling.

Child & Family Services provides close to 1,000 counseling sessions a month to individuals in our community. We help clients improve relationships, gain insight, increase coping skills, promote personal growth, cope with stress, treat depression/anxiety, overcome trauma and negate personal challenges. This social distancing and isolation necessary to stop the spread of the virus can also increase the feelings of loneliness and need for support. To access services, you are encouraged to contact our office at (989) 790-7500 or e-mail us at intake@cfs-saginaw.org.

Child and Family Service of Saginaw County is dedicated to enhancing the quality of life in our community by fostering personal growth, emotional development, trauma recovery, self-reliance and healthy relationships.

Margie Bach President/CEO (989) 393-4234 mbach@cfs-saginaw.org

MSMS offers numerous on-demand webinars that fulfill the Michigan Department of Licensing and Regulatory Affairs requirements for continuing medical education, including: • A series of 12 covering Pain and Symptom Management • Three on Medical Ethics • Human Trafficking Download and watch at your convenience 24/7.

For a complete list and to register click HERE

Focusing our practice on the needs of our community, we provide the following services for both individuals and businesses: n Monthly Accounting n Tax Planning n Financial and Business Consulting Service n Payroll Service n Tax Preparation Service n Retirement Planning Contact us for a complimentary visit at 989-791-1040.

Three convenient locations to serve you in: Saginaw | Vassar | Frankenmuth

“Attention to detail since 1980.”

An office remodel could prepare your practice for modern challenges for patient flow changes, documentation storage, HIPAA compliance, and succession

800-WOLGAST

Design & Construction - Start with Us!

www.wolgast.com/blog/topic/medical-office-construction The Bulletin | May 2020 19

Michigan's Chief Medical Executive, Joneigh Khaldun, MD Addresses Temporary Restrictions On May 3, 2020, Michigan’s Chief Medical Executive, Joneigh Khaldun, MD, MPH, FACEP, sent a letter to Michigan clinicians providing further guidance related to Executive Order (EO) 2020-17 and the delivery of health care procedures deemed to be non-essential. In her letter, Dr. Khaldun strongly encouraged providers to resume services and procedures that are important for patient health and well-being, while also adopting protocols to ensure staff and patient safety. CLICK HERE FOR MORE INFORMATION. CME CREDIT FOR COVID-19 Extended through June 9, 2020, at 11:59 p.m.

(EO 2020-82 issued 5/12/20)

Thank you for everything you are doing during the COVID-19 crisis! To recognize your efforts, LARA may recognize hours worked responding to the COVID-19 emergency as hours toward continuing education courses or programs required for licensure. MSMS has developed a survey designed to assist you with tracking these hours. A summary of your hours tracked will be provided once normal operations resume. To access the survey, please click https://www.surveymonkey.com/r/ MSMSCOVID19.

Executive Order 2020-82 dated May 12, 2020, states that “effective immediately and continuing through June 9, 2020, at 11:59 p.m., LARA may recognize hours worked responding to the COVID-19 emergency as hours toward continuing education courses or programs required for licensure.” As a MSMS/SCMS member, physicians may choose to complete this survey describing what you learned from the COVID-19 emergency, and submit it to the MSMS Education Department where we will issue CME credit.

Please only claim hours worked directly responding to the COVID-19 emergency. This would include research, reading articles, listening to podcasts, discussing plans and direct clinical care of COVID-19 patients.

YOU MUST COMPLETE THE SURVEY IN ITS ENTIRETY and thoroughly document what you learned or we cannot issue CME credit. Incomplete surveys cannot be processed. Please submit a new survey for each DAY spent responding to COVID-19 The dates applicable are only per the Governor of Michigan’s Executive Order (currently May 12, 2020 – June 9, 2020).

All hours must be submitted by June 23, 2020. To access the survey, please click https://www.surveymonkey.com/r/ MSMSCOVID19 For questions, please contact Brenda Marenich at or 517336-7580.

20 The Bulletin | May 2020

COVID-19 ON-DEMAND WEBINARS FREE Educational Opportunities for MSMS/SCMS Members & Staff CARES Act Impact During this 35-minute webinar, Sarah Jennings, CPA, CFE, CAE and Jessica Fleet, CPA of Maner Costerisan, will help explain the CARES Act Package. The first part focuses on “Keeping American Workers Paid and Employed Act” or the Paycheck Protection Program. This includes a summary of eligibility requirements and steps to apply. The second half is on “Assistance for American Workers, Families and Businesses.”

Participants will learn about loan forgiveness, emergency EIDL grants, and more. This course offers .5 CME credits. WATCH Statement of Accreditation: The Michigan State Medical Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

AMA Credit Designation Statement: The Michigan State Medical Society designates this enduring material for a maximum of .50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Telemedicine and Other Technology Codes in a COVID-19 Environment As we find ourselves in unprecedented times, telemedicine has become a part of the daily routine for many physician offices. This webinar is intended to give you information about telemedicine and how to use it and code it in your office. Listen to Jill Young provide guidance on telemedicine and other technology codes in the COVID-19 environment. This course offers .75 CME credits. WATCH Statement of Accreditation: The Michigan State Medical Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

AMA Credit Designation Statement: The Michigan State Medical Society designates this enduring material for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

What Physicians Need to Know as Employers During the COVID-19 Pandemic During this one-hour webinar, Jodi Schafer, SPHR, SHRMSCP and principal of HRM Services, will provide a summary of what physicians need to know about unemployment and the Families First Coronavirus Act. Additional resources for employers are also provided. This course offers 1 CME credit.

WATCH Statement of Accreditation: The Michigan State Medical Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

AMA Credit Designation Statement: The Michigan State Medical Society designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

continued on page 21

continued from page 20

TELE-TOWN HALL FOR PHYSICIANS ON COVID-19 MSMS has started a weekly Tele-Town Hall for physicians on COVID-19. Guest speakers will provide brief presentations and take questions on a wide range of topics important to physicians. The schedule to date is as follows: New Waivers and Billing Changes for Telemedicine From the April 30 CMS Release (Interim Rule 5531) Tuesday, May 19, 12-12:45 p.m.

Speaker: Jill Young, CPC, CEDC, CMC CLICK HERE TO REGISTER New Employment Policies for Practices Thursday, May 21, 12-12:45 p.m.

Speaker: Jodi Schafer, SPHR, SHRM-SC, HRM Services CLICK HERE TO REGISTER

Race Inequalities: Contagion, Severity, and Social Systems Thursday, May 28, 12-12:45 p.m.

Speaker: Jason Adam Wasserman, PhD, Associate Professor Oakland University William Beaumont School of Medicine CLICK HERE TO REGISTER Questions can be submitted during the Town Hall or in advance to rblake@msms.org. MSMS will continue to host these weekly Town Halls for the next few months. Send ideas for future topics to belliott@msms.org.

Recent Tele-Town Halls – Watch or Listen Now U.S. Rep Fred Upton recorded April 15, 2020 Q&A with CPAs recorded April 23, 2020 AMA Advocacy and Physician Resources recorded May 7, 2020 Safe and Innovative Office Procedures for Seeing Patients recorded May 14, 2020 COVID-19 Tele-Town Hall for Physicians with Governor Gretchen Whitmer recorded May 15, 2020

www.SaginawCountyMS.com

ABIM Increases Flexibility to Maintain Certification On Monday, April 13, the American Board of Internal Medicine (ABIM) issued the following statement on MOC requirements, from ABIM President and CEO, Richard J. Baron MD. Expert internists and subspecialists are on the front line of the national response to the COVID-19 pandemic. Recognizing the unprecedented demands being placed on all of our board certified physicians, ABIM wants to be sure you are able to maintain your certification despite the stresses you are facing.

That’s why today I am sharing an important update with you: No one will lose certification if they aren’t able to complete a requirement this year.

Any physician who is currently certified and has a Maintenance of Certification (MOC) requirement due in 2020 - including an assessment, point requirement or attestation will now have until the end of 2021 to complete it. Physicians currently in their grace year will also be afforded an additional grace year in 2021. READ MORE

Financial Assistance for Physician Medical Practices As elective medical procedures and visits have been postponed due to COVID-19, physicians are struggling to continue their duty to treat patients whose health conditions warrant immediate attention while practice revenue and cash flow trend downward. Below are some financial assistance opportunities intended to help practices maintain solvency in the short-run. CLICK HERE FOR MORE INFORMATION.

CONTACT YOUR LAWMAKERS TODAY AND URGE THEM TO SUPPORT SB 899 SB 899 Ensures Physicians and Other Health Care Providers are Provided Immunity Regarding Medical Liability Due to COVID-19 Michigan changed on March 10, 2020. On that day, our state had its first two cases of COVID-19 and nothing has been the least bit normal since.

For the past few months, physicians and health care providers across the state have worked tirelessly to better understand this novel coronavirus and treat the afflicted who are suffering. Health care providers are doing their best every day to adapt to the fluid and rapidly changing circumstances surrounding this pandemic, all the while risking their lives and the lives of their families along the way. READ MORE AND CONTACT YOUR LAWMAKERS. The Bulletin | May 2020

21

COVID-19 CMS Advocacy Talking Points CONTACT YOUR LAWMAKERS NOW!

Appropriations Ask •

•

$100 million for direct stipend payments to physicians to offset costs that are not reimbursable under the SBA’s Paycheck Protection Program. Such costs may include: • restocking PPE • ongoing liability insurance premiums • technology improvements and support Assuming Michigan has approximately 30,000 actively practicing licensed physicians, this would equate to just more than $3,000 per physician.

Medicaid uplifts for all specialties during Fiscal Year 2020-2021 to at least 85-100 percent of Medicare rates.

Implementation of an uplift program across the board will assist medical practices to increase or maintain their capacity to care for Medicaid beneficiaries when pandemic-related restrictions are removed.

Ask the Governor to Rescind EO 2020-17: •

•

•

•

Many physician practices have seen a 40% or more, decline in patient volumes over the last six weeks. There are two apparent reasons for this – patient fear of contracting COVID-19 in health care settings, and governmentimposed limits on the types of procedures that can be performed.

Starting on March 21, 2020, the Governor ordered the postponement of non-essential procedures, which means a medical or dental procedure that is not necessary to address a medical emergency or to preserve the health and safety of a patient, as determined by a licensed medical provider.

The postponement of routine medical care has built up demand and needs to be addressed soon. Physician offices are controlled environments, prepared to implement mitigation strategies and engineer business practices around risk of infectious disease.

If physician offices, who are best equipped to mitigate the risk of infectious disease, can’t engage in regular business practice during this time, no one should.

Liability Protections: •

Physicians are at increased risk of liability during for two reasons: • Because COVID-19 is a new virus, treating it effectively has challenges that require civil and criminal liability protection for physicians, except in the case of gross negligence.

• Because of EO 2020-17, physicians have not been able to perform preventive care that serve to protect patients. With the postponement of so many visits and procedures, physicians need additional civil and criminal liability protections, except in the case of gross negligence, to protect them from any harm that may arise from them not being able to see patients for routine visits.

www.MSMS.org 22

The Bulletin | May 2020

www.SaginawCountyMS.com

Christina A. Harrington, M.P.H. Health Officer

Delicia J. Pruitt, M.D., F.A.A.F.P. Medical Director

Christina A. Harrington, M.P.H. Health Officer

Delicia J. Pruitt, M.D., F.A.A.F.P. Medical Director

May 4, 2020 Colleagues, As you know, COVID-19 has changed our way of practice. We have been utilizing telehealth more than ever. Based on recent Executive Orders from the Governor, I suspect we will continue social distancing for months to come. The Medical Command and Control, a group of physician leaders in Saginaw County, has approved the following guidance for integrating patients with chronic diseases back into your practices. We are aware that each practice has different needs and workflow. The updated Phase 2 Guidance for Ambulatory Medical Command and Control is provided for guidance only, and is available to view by clicking HERE. We also wanted to inform you that, during these times, if you get a patient who needs emergency dental care and doesn’t have access to their own private dentist, Great Lakes Bay Dental Center on Warren Avenue is open for emergency dental procedures.

Please call 989-754-7771.

Asymptomatic healthcare workers who desire to be tested for COVID-19 can go to Great Lakes Bay Health Center at 501 Lapeer in Saginaw for testing if testing cannot be obtained from their health care system. No lab order is needed.

The Respiratory Care Clinic (RCC) from Ascension St. Mary’s has capacity to accept more patients. Any patients with suspected COVID-19 and respiratory symptoms can be referred to RCC. ASR patients have been approved by Covenant to be seen at the RCC if they need respiratory evaluation. Ascension St. Mary’s has updated their process for obtaining appointments, and offers COVID testing at the RCC site for patients that are seen there, if necessary. Click HERE for more information.

The Covenant Hotline is available for questions, screening, recommendations and ordering COVID-19 test at (989) 583-3135.

If you need PPE, please CLICK HERE and complete the emergency request form. We will try to accommodate your request, but there are no guarantees.

Finally, every Wednesday at 10 a.m., we will be having a live session on topics related to COVID-19 at our Facebook page, Saginaw County Health Department. If you are unable to view it live, you can view at a later time. The Facebook page provides important information for our community.

Please know that the Saginaw County Health Department is a resource for you.

Best, Dr. Delicia Pruitt Medical Director P.989.758.3719 | dpruitt@saginawcounty.com

1600 N. Michigan Avenue • Saginaw, MI 48602 • 989.758.3800 • www.saginawpublichealth.org 1600 N. Michigan Avenue • Saginaw, MI 48602 • 989.758.3800 • www.saginawpublichealth.org The Bulletin | May 2020 23

Ascension Mid-Michigan Hospitals Participating in Plasma Trial to Fight COVID-19 Ascension St. Mary’s and Ascension Genesys are participating in a national trial to determine if convalescent plasma therapy is an effective treatment for critically ill COVID-19 patients. Both Ascension hospitals are registered participants in this nationwide clinical trial coordinated by the Mayo Clinic.

Convalescent plasma is the liquid part of blood that is collected from people who have recovered from an infection.

Antibodies present in convalescent plasma are proteins that might help fight the infection. While there is no approved treatment for coronavirus at this time, further investigation is still necessary to determine if convalescent plasma therapy might shorten the duration of illness, reduce morbidity or prevent death associated with COVID-19.

“Convalescent plasma therapy is being given to COVID-19 patients who meet established criteria, within three to five days, to help them build immunity against the virus, to help fight the infection,” states Suhasini Gudipati, MD, Medical Director of Infectious Disease and Infection Prevention at Ascension St. Mary’s Hospital. “The possibilities of this new treatment are encouraging. While it is not known if convalescent plasma will be an effective treatment against COVID-19, there is anecdotal evidence that it might be helpful for some patients. We are optimistic.”

Convalescent plasma must be collected from fully recovered patients who had a prior diagnosis of COVID-19 documented by a laboratory test and meet screening criteria. Ascension Genesys and Ascension St. Mary’s work with Versiti, a blood bank provider in the Mid-Michigan region, to collect donated plasma and provide it directly back to the hospital so it can be administered to critically ill patients. Combined, the two Ascension hospitals have treated nearly a dozen COVID-19 patients with convalescent plasma as of April 28, 2020.

“Treatment for COVID-19 is personalized to a patient’s individual circumstances and we are doing everything we can to provide hospitalized patients with options, including potential use of certain investigational therapies such as convalescent plasma for critically ill patients,” said Muhammad Aboudan, MD, Medical Director, Ascension Genesys Hospital Critical Care Units. “Convalescent plasma has been used in the past as a potential life-saving treatment when there are new diseases, like SARS and Ebola, but no treatment or vaccine exists. If this is effective, it could be a bridge until we have a vaccine or until other effective drugs and treatments are available.”

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The Bulletin | May 2020

Staff from Ascension St. Mary’s and Ascension Genesys are contacting recovered COVID-19 patients to ask if they would be interested in donating plasma. Collecting the plasma takes 30-40 minutes and is done at a local blood donation center. Any person who has recovered from COVID-19 and is interested in donating blood should register by visiting www. versiti.org/covid19plasma or call 866-702-HOPE (4673).

Ascension St. Mary’s Hospital Earns Comprehensive Stroke Center Certification Among the three percent of all U.S. hospitals that have achieved this stroke recognition

Ascension St. Mary’s Hospital earned Comprehensive Stroke Center (CSC) certification in early March from The Joint Commission and with zero findings! Ascension St. Mary’s is the first hospital north of Flint, and only the 11th Michigan hospital, to achieve this designation. They are among the three percent of all U.S. hospitals that have CSC certification as there are fewer than 200 across the country. This designation means the hospital is ready 24/7 to deliver advanced stroke care. It's the highest level of stroke certification, earned by meeting standards for the most complex stroke cases.

“Our commitment to delivering high quality stroke care using the most advanced procedures, technologies and treatments has made Ascension St. Mary’s a destination institution for stroke patients in our area and throughout the region,” says Stephanie Duggan MD, FACEP, CPE, Regional President, Ascension Michigan Northern Ministries. “We are so excited that we have earned Comprehensive Stroke Center certification. We have a legacy of being a center of excellence for stroke and neuroscience care, and we are very proud that we are continuing to raise the bar for stroke care excellence.

Achieving this designation demonstrates we are providing clinical care that meets or surpasses national standards of excellence.”

Before receiving this CSC certification, Ascension St. Mary’s Hospital was certified by The Joint Commission as a Primary continued on page 26

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The Bulletin | May 2020 25

continued from page 24

Stroke Center, which means that a facility is equipped to provide advanced stroke care, including administering tissue plasminogen activator (tPA), a “clot-busting” medication.

Ascension St. Mary’s Hospital achieved its upgraded CSC certification status as a result of interdisciplinary program enhancements, including: • The ability to treat both ischemic and hemorrhagic strokes, including brain aneurysms; • Offering the most complex neurosurgical procedures, including intra-arterial stroke treatment procedures, such as thrombectomies to remove blood clots; and • Establishing dedicated patient care units that provides specialized post-stroke care.

“Ascension St. Mary’s has a highly collaborative and committed stroke team who made our CSC designation a reality,” said Joseph Adel, MD, FAANS, cerebrovascular, endovascular and skull base neurosurgeon. “Certification recognizes health care organizations who are committed to fostering continuous quality improvement in patient safety and quality of care. Our physicians, nurses and clinicians are ready and able 24/7 to provide patients with the best possible stroke care for the most complicated and serious strokes when seconds count.”

To earn CSC designation, the Ascension St. Mary’s stroke care team was required to collect and report data showing that the hospital met or exceeded standardized performance measures.

They must follow advanced standards and practices, provide specific procedures to a defined number of patients annually, and offer advanced, round-the-clock expertise, neurological services and resources.

“Strokes require urgent care to restore blood flow to the brain and begin the recovery process.

Being designated a Comprehensive Stroke Center means that we’ve been recognized for our ability to quickly and effectively treat all strokes so patients have the best opportunity at a full recovery,” said Nnenna Mbabuike, MD, endovascular and cerebrovascular neurosurgeon. “Having worked alongside Dr. Adel and the rest of the extremely highly trained members of the stroke team, the residents across mid and northern Michigan can be assured they have a choice where to receive care for stroke or other neurological conditions close to home.”

Ascension St. Mary’s joins three other Ascension Michigan hospitals that have earned comprehensive stroke center certification - Ascension Providence Hospital in Southfield, 26

The Bulletin | May 2020

Ascension St. John Hospital in Detroit and Ascension Borgess Hospital in Kalamazoo.

Director of Cardiovascular Services Announced Tricia Engler, MSN, RN, has been selected as the new Director of Cardiovascular Services for Ascension St. Mary’s, Ascension Standish and Ascension St. Joseph. Tricia has been with Ascension St. Mary’s for 14 years; as part of the Clinical Informatics team for the past six years and appointed as Regional Director of Clinical Informatics in 2018. Prior to that, Tricia was a registered nurse for 13 years with experience in cardiac care and telemetry, intensive care and serving as charge nurse for nursing assignments and patient bed placement. She was also a nurse preceptor to new graduates and trained nurses on the electronic health record.

Tricia is a dedicated professional, providing evidence-based care to all people and has a passion for regulatory and patient safety. She has a strong commitment to delivering high quality, patient focused care with compassion and empathy while caring for individuals with life-threatening illnesses. She is a highly respected leader who uses her skills, knowledge and compassion for providing a positive experience for all.

Tricia holds a Master of Science in Nursing degree, with specialization in Clinical Informatics from Capella University.

She received her nursing education from Davenport University.

As Director of Cardiovascular Services, Tricia will work together with the cardiologists and cardiovascular care teams and lead them well into the future in providing compassionate care and serving our mission to this community. Tricia can be contacted at tricia.engler@ascension.org.

Vice President of Operations Named for Ascension Medical Group - Mid/Northern Michigan We are pleased to introduce Jennifer Cobb as the Vice President, Operations, Ascension Medical Group (AMG), Mid/Northern Michigan.

As a dyad partner with William Edgar, MD, Jennifer is responsible for regional AMG operations/business leadership, while Dr. Edgar continues to provide clinical leadership.

Jennifer brings a wealth of strategic and operations experience from her more than 20-year tenure at Trinity Health, most recently in the role of Vice President, Operations, Integrated Health Associates - a multi-specialty medical group.

She has held regional and hospital leadership roles within the St. Joseph Mercy Health System Physician Network, and was Chief Experience Officer for St. Joseph Mercy Oakland Hospital.

We look forward to her leadership in continuing to grow AMG in our Mid/Northern region.

IN MEMORY Rustico B. Ortiz, MD Beloved husband, father, grandfather, brother and friend, Rustico B. Ortiz, MD peacefully passed away at home on Monday, March 30, 2020, at the age of 78, one day before his 79th birthday. Son of Jesus and Felisa Ortiz, he was born in Roxas City, Philippines on March 31, 1941. He attended high school at Ateneo De Manila, and graduated from the University of Santo Tomas School of Medicine in 1964.

Dr. Ortiz is survived by his wife of 55 years, Ricarda L. Ortiz, his four children, Benjamin and his wife Whitney, Rustico (Rusty) and his wife Abby, Jacob and his wife Laura, and Rachel Magno and her husband Emmanuel (Manny).

He is also survived by seven grandchildren; Nicholas and Sydney Ortiz, son and daughter of Benjamin and Whitney, Henry, Helena, and Louis Ortiz, sons and daughter of Jacob and Laura, and Jayden and Liam, sons of Rachel and Manny.

In 1965, Dr. Ortiz arrived in Saginaw with Ricarda to start his one-year internship and three-year residency at Saginaw General Hospital, which he completed in 1969. He then completed a residency at the University of Michigan. Once finished, he completed a Fellowship in Gastroenterology at Harper Hospital in Detroit, before returning to Saginaw to start his private practice in 1971.

He practiced for 37 years, until his retirement in 2007.

From 1986-87, Dr. Ortiz was Chief of Staff at Saginaw General Hospital. Through his patient-first approach in caring for patients, he built lasting relationships with them. In 2008, he was named Covenant HealthCare’s Distinguished Physician of the Year, as nominated by his peers for his service. He was also a member of the Covenant Emeritus Medical Staff. Dr. Ortiz also cared for patients at St. Mary’s Hospital. Dr. Ortiz was a member of the Saginaw County Medical Society and Michigan State Medical Society for 49 years. He served as a Director on the SCMS Board from 1996-98, and most recently as Retiree Representative from 2018 until his death.

In 1978, Dr. Ortiz and Dr. Senen Asuan founded the Philippine Association of Northeastern Michigan (PANEM), to foster closer friendship among Filipino residents of Northeastern Michigan.

Dr. Ortiz served as president from 1981-83, the first person to serve two years as president of the organization. His other activities included tennis and golf. Whilst playing golf, he recorded his only hole-in-one on July 31, 2009, with his “partner,” Dr. Edgar Balcueva, as his witness.

A private funeral service was held on April 2, 2020, at St. Dominic Parish in Saginaw. Honoring Dr. Ortiz’s wishes, cremation has taken place. Those planning an expression of sympathy may wish to consider memorials to St. Dominic Parish, 2711 Mackinaw Street, Saginaw, Michigan 48602.

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Covenant Receives Fourth Consecutive ‘A’ for Patient Safety Covenant HealthCare was again awarded an ‘A’ in the spring 2020 Leapfrog Hospital Safety Grade, a national distinction recognizing Covenant HealthCare’s achievements providing safer health care. This is the fourth consecutive “A” Covenant has received recognizing efforts in protecting patients from harm and meeting the highest safety standards in the United States.

“The region counts on Covenant to be a resource for the community providing high-quality care,” said Dr. Michael Sullivan, Vice President of Performance Improvement and Chief Medical Officer. “Now, more than ever, we appreciate the validation we are doing the right things to live up to patients’ expectations. We want people to know that during these trying times, the hospital continues to provide safe care for medical needs. Every single person on the Covenant HealthCare team makes a difference, and we thank them for their commitment to delivering safe care.”

The Leapfrog Group is an independent national watchdog organization committed to health care quality and safety. The Safety Grade is a letter grade assigned to all general hospitals across the country and updated every six months, assessing how well the hospital prevents medical errors and other harms to patients.

“As the nation copes with a challenging pandemic, our gratitude extends to hospital leadership and health care workers everywhere for their tremendous dedication,” said Leah Binder, president and CEO of The Leapfrog Group.

“We hope this ‘A’ helps to thank the people who work and volunteer for Covenant HealthCare. They are role models in putting patients first, and their service has been extraordinary in our country’s time of need.”

Developed under the guidance of a national expert panel, the Leapfrog Hospital Safety Grade uses up to 28 measures of publicly available hospital safety data to assign grades to more than 2,600 U.S. acute-care hospitals twice per year. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public.

To see Covenant’s full grade details and access patient tips for staying safe in the hospital, visit hospitalsafetygrade.org.

Covenant COVID-19 Update Covenant Laboratory Processing COVID-19 Tests Covenant HealthCare Laboratory was validated to process tests for COVID-19/SARS2. At this time, due to the limited number of test kits, the Covenant Lab is only being used 28

The Bulletin | May 2020

to process tests for patients who are hospitalized, and patients admitted through the Covenant Emergency Care Center (ECC) with suspected COVID-19 infection.

Tests taken at the Covenant COVID-19 Sampling Center will continue to be sent to an affiliated reference laboratory.

“Several years ago, Covenant purchased equipment to improve the accuracy of influenza testing. That same equipment was updated in March and that is what allows us to process this critical COVID-19 testing,” said Michelle Bauer, manager of Covenant Laboratory Pathology Services.

Covenant laboratory technologists prepared quickly to perform COVID-19 testing on the Cepheid Infinity Instrument, using RNA amplified PCR for patient placement and isolation status purposes. Prior to acquiring the in-house testing update, samples were sent to the state laboratory, with a turnaround time of several days. Now with capabilities on-campus, Covenant offers critically ill patients a faster turnaround time of 90-minutes from receipt in the laboratory.

Hotline Available as a Resource As a means to provide a resource to staff, providers and the community, Covenant also established a COVID-19 Hotline (989.583.3135) staffed by advanced practice providers and nurses to handle COVID-19 screenings and questions via telephone. Covenant strongly recommends that people concerned they may have contracted COVID-19 call their doctor or the Covenant COVID-19 Hotline. If someone is experiencing severe symptoms, they should go immediately to an emergency department, or call 911. To-date, the hotline has supported more than 10,000 phone calls.

Screening & Sampling Center Open Alongside Others in the Region As part of a county-wide effort to screen people for COVID-19 and sample those meeting the CDC recommendation for testing, Covenant offers a drive-through site at a Covenant campus, similar to others in the county.

These centers are specifically designed for people who already have a physician order to proceed with COVID-19 testing. The on-site providers first screen individuals to ensure they have a physician order to be sampled for testing.

Individuals who do not have such an order will be referred to a telephone screening to determine if they meet the CDC criteria for testing. Those with a doctor’s order are swabbed and the sample will be sent out for testing. continued on page 29

continued from page 28

Strategic Design Solutions There is Nothing More Extraordinary Than a Caring Community As this pandemic unfolds, one thing is certain - our community is extraordinary. While things can be challenging and at times unsettling, the regional collaboration, priority to care for patients, willingness to educate the community, and the desire to support healthcare workers has been inspiring.

Our heartfelt thanks go out to everyone who has stepped up to support Covenant and one another during this unprecedented time. We are better together, stronger together and… #ExtraordinaryTogether.

advertising | marketing | publications logo design | direct mail brochures | flyers | newsletters print and digital creative direction and consulting Lori Krygier | Graphic Designer 989.239.1056 | lkrygier@charter.net

Wound Healing Center WE LEAD IN EXTRAORDINARY CARE • Wounds that fail to respond to traditional treatment after 30 days, have become infected, or appear to heal but continue to recur • Diabetic ulcers, especially on the feet • Venous or lower leg ulcers • Pressure ulcers, such as bed sores • Skin tears or lacerations • Failing skin/muscle grafts or flaps • Slow or non-healing surgical wounds • Post-operative infections • Bone infections (osteomyelitis) • Radiation tissue injuries • Lymphedema • Burn care • Brown recluse spider bites © 2020 Covenant HealthCare. All rights reserved. PK 1/20 11672

COVENANT HEALTHCARE WOUND HEALING CENTER 900 Cooper, Saginaw, Michigan 989.583.4401 covenanthealthcare.com

The Bulletin | May 2020 29

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13 25 8 2 29 27 30 29 19 7 19

Amid COVID-19 Upheaval, Know Your Rights as an Employed Physician The United States has surpassed more than half a million confirmed cases of COVID-19 and as the pandemic continues, businesses of all kinds continue to struggle as they face complex decisions. For hospitals and health systems, the transition to providing only urgent, essential services has been particularly difficult. Many health care organizations are determining whether to modify or sever existing employment or service arrangements with employees, including physicians.

In an effort to help physicians better understand these complicated situations brought about by COVID-19, the AMA has developed the “Know Your Rights: Navigating Employment During COVID-19,” a guide that concisely covers key strategic, legal and contractual considerations. The information is not to be construed as legal or financial advice, but is meant to help physicians understand their rights and the opportunities available to them. continued on page 31

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The Bulletin | May 2020

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Know Your Rights It is important for all physicians to review and understand the work details and expectations documented in their contract, particularly with regards to expected duties. That knowledge can become useful if physicians shift their duties to aid in pandemic relief or are unable to perform their day-to-day responsibilities.

Prior to the COVID-19 global pandemic, hospitals and health systems were bound to comply with specific federal laws - including the Stark law - that prohibit compensation to a physician that is above “fair market value.” The pandemic, however, led the federal government to create waivers for these laws and state that, to some extent, they will not be enforced during the public health emergency. That temporary change in policy means that physicians have added flexibilities when it comes to negotiating compensation packages. Among other things, this means that: • A physician can negotiate a higher payment rate per hour for work performed outside of normal duties in order to address COVID-19 patient care needs in the form of hazard pay.

• A hospital can agree to guarantee a certain level of financial compensation for physicians who are paid based on their productivity, but whose production has decreased due to the inability to perform elective surgeries.

• A physician and employer can mutually agree to a onetime severance agreement that pays the physician a defined amount of compensation in case of termination.

Caduceus Meeting for Recovering Health Care Professionals Third Thursday of each month at 7 p.m.

Zion Lutheran Church 454 7th Street, Freeland, Michigan (Behind Pat’s Grocery Store on Midland Road in Freeland)

Although certain federal laws may not be enforced at this time, similar state laws may not be waived. Physicians should consult with health care regulatory and employment counsel to have a full understanding of policies and limitations enforced at the state level.

Understand Employer Flexibilities Just as it is imperative to know what rights are set out in a contract, it is also important for physicians to recognize the opportunities to negotiate should their employer terminate their employment. These negotiations can make an enormous difference in the physician’s next job location or how quickly they need to find a new position.

As the COVID-19 pandemic continues, hospitals and health systems will have an added amount of flexibility in the agreements they are able to make with physicians who negotiate as part of the termination process. For example, physicians whose positions are terminated can try and negotiate for: • Severance packages.

• Waivers of noncompete clauses that would allow the physician to continue practicing in the immediate vicinity of the employer.

• Access to the employer’s electronic health record or other technology and resources at a free or reduced rate for the duration of the COVID-19 pandemic.

The AMA guide includes additional examples of employmentrelated concessions that terminated employees can seek from their employer.

Advocate for Patient Rights One right the AMA continues to stand behind is advocating on behalf of patients’ best interests. Within the past few weeks, news outlets across the country have told the stories of doctors who reported they were fired for discussing unsafe hospital conditions during the pandemic. In response to the growing number of accusations, the president of the AMA issued a statement on behalf of the AMA, which “calls for reinforcing the principle that places patients’ welfare as the first priority in any situation where the interests of physicians and hospitals are in conflict. No employer should restrict physicians’ freedom to advocate for the best interest of their patients.”

Marc Zarefsky, AMA

Caduceus meetings are available to health care industry professionals, and have adopted many of the principles of 12-Step programs.

Caduceus meetings are “closed” meetings for recovering health care professionals including, but not limited to, nurses, doctors, dentists and pharmacists.

We engage in group discussions where members may want to speak up, ask questions or share thoughts with fellow members.

All statements or comments in The Bulletin are those of the writer, and not necessarily the opinion of the Saginaw County Medical Society.

The Bulletin | May 2020 31

PRSRT STD U.S. POSTAGE PAID Saginaw, MI 48605 PERMIT #189

350 ST. ANDREWS ROAD | SUITE 242 SAGINAW, MI 48638-5988

ADDRESS SERVICE REQUESTED

2019-2020 KEY PROVIDERS

These Area Businesses Support Saginaw County Medical Society Membership Meetings. When you have a need for a service, please consider our Key Providers.

Due to COVID-19, the SCMS has cancelled the May and September Membership Meetings, as well as, the Foundation Golf Outing.

The Health Fair will not be rescheduled this fall (see page 5 for more information). Board meetings for the immediate future will be held virtually.

COVID-19 Resources and Information Available at www.SaginawCountyMS.com

American College of Emergency Physicians

In an attempt to keep members informed, the SCMS website, www.SaginawCountyMS.com is updated on a regular basis. The home page is filled with COVID-19 resources from and on the following topics:

Entries are tagged with date of posting.

Some entries are listed under multiple categories depending on source and type of information (e.g., financial, PPE, etc.)

Personal Protection Equipment

Saginaw County Health Department Michigan State Medical Society (including FREE COVID on-demand webinars) CMU College of Medicine OCME Telemedicine Financial Resources American Medical Association Michigan Department of Health & Human Services Centers for Medicare & Medicaid Services Mental Health Resources Centers for Disease Control Joan Cramer/SCMS | Office 790-3590 | Fax 790-3640 | Cell 284-8884 | jmcramer@sbcglobal net | www.SaginawCountyMS.com