SCMS BULLETIN - September 2022

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The

Bulletin Saginaw County Medical Society

September 2022 | Volume 80 | No 5

REGISTER NOW!

September Membership Meeting - Adverse Childhood Experiences (ACEs) p. 9

REGISTER NOW!

Implicit Bias Training 2022 Saturday, October 8 p. 10

www.SaginawCountyMS.com

SCMS BENEFITS OF MEMBERSHIP MSMS/SCMS 2023 Dues Renew before 11/30/22 for $100 CME Coupon p. 16-17


COVENANT CANCER CARE CENTER THORACIC ONCOLOGY PROGRAM

Lung Cancer Screenings

Lung Cancer is More Deadly than Breast, Prostate and Colon Cancer Combined. OUR COMPREHENSIVE IMAGING AND DIAGNOSTIC SERVICES INCLUDE • American College of Radiology designated Lung Cancer Screening Center • Comprehensive imaging and diagnostic services including MRI and PET CT • Image-guided biopsy services • Endobronchial Ultrasound (EBUS) technology featuring Super DimensionTM capabilities

LDCT LUNG CANCER SCREENING The purpose of Low-Dose Computerized Tomography (LDCT) for lung cancer screening is to look for nodules or masses in the lungs of people who do not have symptoms but are at a greater risk for the disease. Smoking is the biggest risk factor for lung cancer – increasing with the amount and length of time a person has smoked. Lung cancer screenings are recommended by the US Preventive Services Task Force for: • Anyone 50-77 years of age

• Biomarker testing

• Current smokers or former smokers who have quit in the last 15 years

NURSE NAVIGATION Our certified thoracic nurse navigator works with the patient, patient’s family and multidisciplinary team to identify possible barriers and to promote a team-based approach to care.

• Heavy smokers with a history of 20 pack years or more A pack year = smoking an average of 1 pack of cigarettes per day per year.

The nurse navigator can help:

(Example: A 20 pack year = 1 pack a day for 20 years or 2 packs a day for 10 years.)

• Make the complicated more understandable, the overwhelming more manageable and the overall health experience patient-centered.

HOW DO I SCHEDULE A LDCT LUNG SCREENING EXAM?

• Coordinate the multidisciplinary conference and expedite various tests and appointments in collaboration with physician offices. • Serve as a resource for education and support throughout the diagnostic, treatment and survivorship process.

Patients need to participate in a lung cancer screening, counseling and shared decision-making appointment with their primary healthcare provider. The provider can then schedule a LDCT screening for those patients who qualify.

For more information about the Covenant Thoracic Oncology Program, LDCT or FREE Smoking Cessation classes, please contact Thoracic Nurse Navigator Ann Werle, RN, BSN, ONN-CG (T) at 989.583.5014. ©2022 Covenant HealthCare. All rights reserved. Bus. Dev. (AQ/RF) 8/22 14906


The

Bulletin Saginaw County Medical Society

2022-2023 OFFICERS AND DIRECTORS President Tiffany K. Kim MD President-Elect Mark G. Greenwell MD Past President Anthony M. Zacharek MD Secretary Caroline G.M. Scott MD Treasurer Miriam T. Schteingart MD Board of Directors Christopher J. Allen MD Furhut R. Janssen DO Mary J. McKuen MD Kai Anderson MD Jennifer M. Romeu MD Elizabeth M. Marshall MD Bulletin Editor Louis L. Constan MD Retiree Representative Caroline G.M. Scott MD Resident Representatives Jessica H. Faris MD (OB) Mohammed A. Saiyed MD (FM) Yuri J. Kim MD (IM) Medical Student Representatives Ann Sobell, MD Candidate, Class of 2023 Mary Galuska MA, MD Candidate, Class of 2024 MSMS Delegates Elvira M. Dawis MD Anthony M. Zacharek MD Christopher J. Allen MD Miriam T. Schteingart MD Kala K. Ramasamy MD Jennifer M. Romeu MD Karensa L. Franklin MD Judy V. Blebea MD Elizabeth M. Marshall MD MSMS Alternate Delegates Caroline G.M. Scott MD Waheed Akbar MD Mohammad Yahya Khan MD Nicholas E. Haddad MD Mary J. McKuen MD Kai Anderson MD Claudia C. Zacharek MD Cecilia E. Kraus-Horbal DO Peer Review Ethics Committee Waheed Akbar MD, Chair Caroline G.M. Scott MD James R. Hines MD MSMS Region 7 Representative Mildred J. Willy MD MSMS President Thomas J. Veverka MD Executive Director Joan M. Cramer Administrative Assistant Keri L. Benkert MSMS Member Service Representative Heather L. Foster (517) 336-5719

contents

5 8 9 9 4 4 6 7 7 8 8

12 13 14 18 18 20 20

SCMS/MSMS 2023 Membership Dues Now Payable Free CME if paid by 11/30/22 National Physician Suicide Awareness Day 9/17/22 REGISTER NOW! September Membership Meeting Adverse Childhood Experiences (ACEs)

10 11 12

CMU CME REGISTER NOW! 31st Annual Robert M. Heavenrich, MD Endowed Guest Lecture

16-17

Calendar of Meetings and Events for 2022-2023 President’s Letter Guest Writers Welcome From the Editor Retirees Meet for Lunch Office Space for Sale or Lease Barb Smith SRRN Caduceus Meeting for Recovering Health Care Professionals Peer Review Ethics Committee Key Provider of the Month Bieri Hearing Specialists In Memory J. Eugene “Gene” Rank, MD Applications for Membership SCCMHA Free Confidential Counseling Covenant HealthCare October Birthdays

REGISTER NOW! CMU CME Implicit Bias Training 2022

MSMS President Thomas J. Veverka, MD Pay your 2023 Dues by 11/30/22 and Get Free CME! Benefits of Membership

21 22 24

Thank you Key Providers! Ascension St. Mary’s GLBHC Now Accepting Adult Outpatient Psychiatry Referrals CMU College of Medicine CMU Health ACEP Reacts to Final Rule of No Surprises Act MSMS • A Day of Board of Medicine Renewal Requirements 9/23/22 • And more! MSMS Resource Guide Advertiser Index CMU Telehealth Suicide Prevention Toolkit Key Providers Calendar of Meetings and Events for 2022-2023

26 27 28

29 30 31 32 33

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

COVER PHOTO: TURNIP ROCK, PORT AUSTIN, MICHIGAN EDITOR Louis L. Constan, MD EXECUTIVE DIRECTOR Joan M. Cramer DESIGNER Lori Krygier

PUBLISHER Saginaw County Medical Society 350 St. Andrews Rd., Ste. 242, Saginaw, MI 48638-5988 Telephone (989) 790-3590 | Fax (989) 331-6720 Cell (989) 284-8884 | jmcramer@sbcglobal.net Hours By Appointment | SaginawCountyMS.com

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 | September 2022 3


PRESIDENT'S LETTER

Kindness is Key! Tiffany K. Kim, MD

A

s physicians, we are taught so much during our training and throughout our careers – how to diagnose and treat our patients, how to give bad news and how to multitask, just to name a few. Some traits are modeled for us during our training: How to be a leader; how to have a good bedside manner; how to be empathetic; and, from some, how to be kind. But do we realize the importance of being kind? Can we learn it or is it inherent? For many of us, it is what helped drive our decision to become a physician, but is it something that is routinely practiced in all aspects of our lives? What is kindness? Aristotle defined kindness as "helpfulness towards someone in need, not in return for anything, nor for the advantage of the helper himself, but for

that of the person helped." I feel that this definition is who we are as physicians. Can kindness be taught or is it innate? It seems to be a combination of both for most humans, but continuing to learn how to implement kindness can have a dramatic impact on our lives. According to UC Berkeley’s Greater Good program: Kindness bridges those gaps and helps build a sense of connection among the students, the teachers, and even the parents. Learning to strengthen their attention and regulate their emotions are foundational skills that could benefit kids in school and throughout their whole lives. They have found that curriculum that includes cultivating kindness can improve students’ grades, cognitive abilities and relationship skills.

What is the importance of kindness? Kindness has many reasons to be important. According to “Practicing Kindness is the Best Medicine” by Hazan, Alberto MD; Haber, Jordana MD: Our mood is instantaneously positive when we are kind. Dopamine, serotonin, oxytocin and endorphins are all associated with generosity. Being kind is also associated with success in the workplace, an overall decrease in stress and just a good feeling. It is easy to lose our ability to be kind. We have intense responsibilities, increasing demands from all angles and less appreciation in our field. It is easy to dwell on the negatives in our work, at home and during our day to day interactions. But if we are able to adjust our focus away from all the negatives and instead on kindness, focus on ways to be kind on a daily basis, we may accomplish so much more and enjoy it at the same time!

“Our mood is instantaneously positive when we are kind. Dopamine, serotonin, oxytocin and endorphins are all associated with generosity."

GUEST WRITERS WELCOME! If you would like to write an article of interest to your colleagues for publication in a future issue of The Bulletin, please contact Joan Cramer at jmcramer@sbcglobal.net for further information. Articles are not designed for self-promotion, but rather as information for members. 4

The Bulletin | September 2022

Read previous issues of The Bulletin at www.SaginawCountyMS.com under the Bulletin tab


SCMS/MSMS 2023 MEMBERSHIP DUES NOW PAYABLE

ifference D e h T e e S e m o “C

!”

Free CME for Your SCMS/MSMS Membership Renewal by November 30 As a thank you for your loyalty as a member of the SCMS/ MSMS and for paying early all physicians who pay their 2023 dues in full by November 30 will receive a $100 coupon towards a CME course at an MSMS educational session. Visit https:// msms.org/lms for upcoming live events and on-demand webinars. HOW TO PAY • Online CLICK HERE • Fax to (517) 481-3976 • Mail to: MSMS Membership Department | PO Box 950 East Lansing, MI 48826-0950 • Installment payments available – call (517) 336-5716 Tax Information SCMS/MSMS dues are not deductible as a charitable contribution but may be deductible as an ordinary and necessary business expense (check with your tax specialist). SCMS dues are 100 percent deductible, and 81.1 percent of MSMS dues are deductible (a portion of MSMS dues is attributable to lobbying activities). The SCMS and MSMS are non-profit organizations focused on improving the lives of physicians so they may best care for the people they serve. Click HERE for Benefits of SCMS membership. The strength and effectiveness of SCMS/MSMS as your professional association is predicated on strong membership. The free CME course is just a small token of appreciation for your continued support of organized medicine. For questions about membership or if you have not yet received your 2023 dues invoice, please contact Joan Cramer, SCMS Executive Director at jmcramer@sbcglobal.net or (989) 284-8884. WHY PAY DUES? • Because all physicians need to “fund their voice.” • National polls show physicians as one of the most respected professions. Sadly, they don’t use their clout often enough to preserve their profession and protect their patients. • There is strength in numbers. Together we are stronger.

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Proud to be the Designer for the Saginaw County Medical Society Lori Krygier | Graphic Designer 989.239.1056 | lkrygier@charter.net lorikrygier.com

The Bulletin | September 2022 5


FROM THE EDITOR

Bad Faith By Louis L. Constan, MD

F

aith Healers inhabit a different world, alien to that of the scientifically trained physician. They hold very public, very large events; during which a sick person, perhaps a cripple, is called up to a stage, with vocal encouragement by the crowd, undergoes a dramatic “Laying on of Hands,” followed by vigorous praying for him. The crippled person then throws away his crutches - or gets out of his wheelchair - and walks. I have been at these events…and their results are impressive. Faith Healers became the first to practice “Tele-health,” asking their TV viewers to “place your hands on the Television,” while they did the praying. Like it or not, a patient’s visit to our office contains elements analogous to Faith Healing. The patient needs to summon up the courage to “come to the front,” which is our very imposing office setting; he needs to have faith (may I say Trust here) in the Healer (us); and there is commonly a laying on of hands in some fashion (Physical Exam). Finally, and perhaps most important, the sick person must have “Faith,” a firm expectation that all this trouble will have a positive outcome - healing. Else why would he jump through all the hoops - financial, transportation, cost, limited available appointments, and interminable (perhaps) waits in that aptly named “waiting room?”

In my last article, I went into detail about the impediments we face when patients lie to us and the ways we must strive to get accurate “data” about our patients’ problems. Today I will argue that overcoming these impediments is actually the easy part. The bigger roadblock to a patient’s successful diagnosis and treatment is his inability to be in an emotionally vulnerable position where he must admit that he cannot fix his problem alone but needs to place his “faith” in another person (you). Many adults, especially male adults, do not like to do this. They have perfected the art of lying to themselves. The result? Patients refuse to see a doctor, their frustrated family often begging and pleading; men dying, on average, seven years earlier than women! The psychological mindset that denies the need of a doctor’s help can be as serious as any disease, and, if untreated, leads to premature morbidity and mortality. I’ve seen some dramatic examples of this playing out. The man who called in to a medical advice radio show, bragging to the doctor that “he was-70-years-oldand-had-never-seen-a-doctor-and-whatgood-are-doctors-anyway?” The doctor wisely suggested that “someday” he would get sick and be grateful he could see a doctor. The man with chest pain, who, after being cajoled into a visit by his

wife; refuses the stress test; lies to his wife that the doctor told him he was fine; then dies later of a heart attack. This unwillingness to put one’s faith in a doctor has dramatic consequences population-wide. Despite our best efforts to get the population vaccinated and socially distanced, many insisted on “doing their own research” instead of trusting in the advice of someone who knew what he was talking about. A million Americans died; many, many more suffered and continue to suffer. It seems, then, that we doctors must find ways to break through these walls of denial. Perhaps, like the Faith Healer, a bit of showmanship is in order: • Optics are important. The patient’s first impression can be crucial. Our office must seem warm and inviting. Our staff friendly and welcoming. “Come on down, we’re glad to see you, we can help you.” • We must greet the patient, establish good eye contact (avoiding at all costs focusing on the computer screen). • Touch the patient (lay on those hands). • Acknowledge the patient’s uncertainty and fears. “What can I do for you today?” Always a good way to start the visit. • Reassure him that we intend to help. For the Faith Healer, the faith itself is essential to this goal. And we should remember that the patient continued on page 7

The psychological mindset that denies the need of a doctor’s help can be as serious as any disease, and, if untreated, leads to premature morbidity and mortality. 6

The Bulletin | September 2022


RETIREES MEET FOR LUNCH!

Retired physicians meet for lunch every Wednesday at 12 noon at IHOP, 2255 Tittabawassee Road in Saginaw. Those attending are responsible for their own lunch, and the informal gathering lasts about an hour. Join your retired colleagues whenever you like!

continued from page 6

THE GROUP ALWAYS MEETS IN THE BACK ROOM. If you are told no one from the group is there, please go directly to the back room and check for yourself!

wants complete healing, not an interim result such as “feeling better” or “being educated.” We need to impress on the patient, if he puts his faith in us, we will strive for full healing. Some of this may seem obvious. Years ago it was “oldfashioned doctoring;” but hardly seemed necessary when modern medical treatments became available. Clearly this was needed, and its absence left a vacuum eagerly filled by charlatans, hawkers of herbal medicines, and unscrupulous politicians. It is time to refocus attention on ALL the patient’s needs - especially on the need to put their faith in a provider who deserves that faith. If you find it difficult to communicate with your doctor; if you find it hard to get personal attention from an 'impersonal healthcare industry'; if you don't understand all those insurance-company rules; if you don't know how to change your bad health habits; if you think you may be on unnecessary medications; if you are perplexed by those annoying health-product advertisements; and if you'd like to know which are your greatest health risks - you'll appreciate this Family Doctor's advice, gleaned from 44 years of practice. Each chapter is illustrated with real-life examples from his and other doctors' practices. Each chapter ends with 'bonus' essays written by the author and published in newspapers and magazines giving the doctor's viewpoint. This will give you a unique perspective and allow you to 'get into the mind' of a doctor. Sweet! Available on Kindle (different cover but same book) and paperback.

Available on Amazon by clicking HERE

All statements or comments in The Bulletin are those of the writer, and not necessarily the opinion of the Saginaw County Medical Society (SCMS). The Bulletin is made available electronically for members as an informational service. Reliance on any such information is at the user's own judgment. The SCMS, its officers and employees, cannot guarantee the accuracy, reliability, completeness or timeliness of any information, and may not be held liable for any individual’s reliance on our web or print publications. For questions or the latest information, please contact Joan Cramer of the SCMS at (989) 284-8884 or jmcramer@sbcglobal.net.

If you have questions, please contact Joan Cramer at (989) 284-8884 or Dr. Caroline Scott at (989) 295-2721.

OFFICE SPACE FOR SALE OR LEASE Medical Arts Building I 4705 Towne Centre Road, Suite 204 Saginaw, Michigan 48604 2,450 square feet Call for details (989) 284-2659

Creating a 1

safety network for our

community Our goal is to save lives through prevention, intervention, and aftercare.

Our Network trains individuals in evidence-based suicide prevention with the hope of destigmatizing suicide, increasing help-seeking behaviors, and caring for those impacted by suicide. To request trainings or resources, contact info@srrn.net I www.srrn.net I 989.781.5260 The Bulletin | September 2022 7


National Physician Suicide Awareness Day Shine a Light. Speak its name. Saturday, September 17, 2022 Mission: To prevent suicide through education, connection to resources, and support for those impacted by suicide. INTERNATIONAL SURVIVORS OF SUICIDE LOSS DAY A DAY TO SUPPORT FAMILY AND FRIENDS IMPACTED BY A LOSS TO SUICIDE

“Our goal, not to lose one.” - Thomas J. Nasca, MD MACP The Council of Residency Directors in Emergency Medicine (CORD), in collaboration with ACEP, AAEM, ACOEP, EMRA, RSA, RSO and SAEM have come together to annually dedicate September 17th as National Physician Suicide Awareness (NPSA) Day.

Vision Zero

HOSTED BY: BARB SMITH SUICIDE RESOURCE & RESPONSE NETWORK

SAVE THE DATE SATURDAY, NOVEMBER 19, 2022 BAVARIAN INN LODGE, FRANKENMUTH For more information call 989-781-5260 ext. 2

barb.smith@srrn.net

www.srrn.net

The National Suicide Prevention Lifeline is now 988 Suicide & Crisis Lifeline 988 has been designated as the new three-digit dialing code that will route callers to the new Suicide & Crisis Lifeline. The old Suicide Prevention Lifeline phone number (1-800-273-8255) will remain available to people in emotional distress or suicidal crisis, even after 988 was launched nationally. The Lifeline’s network of over 200 crisis centers has been in operation since 2005, and has been proven to be effective. It’s the counselors at these local crisis centers who answer the contacts the Lifeline receives every day. Numerous studies have shown that callers feel less suicidal, less depressed, less overwhelmed and more hopeful after speaking with a Lifeline counselor.

New Location for Support Group!

Our Survivors of Suicide support group has changed locations. We meet on the first and third Tuesday of the month from 6:30-8 p.m. in Saginaw. If you or someone you know has been impacted by suicide, call us at (989) 781-5260 ext. 2 to learn more about our support group. Are you in a crisis? Call 988 or text TALK to 741741. Anyone who needs help can call the Suicide & Crisis Lifeline 24 hours a day, seven days a week, at 988. Press 1 for the Veterans Crisis Line. Anyone under age 21 can ask to talk to a peer at Teen Link, 1-866-833-6546. TTY users can use their preferred relay services or dial 711 then 1-800-273-8255. 8

The Bulletin | September 2022

Physician suicide is a tremendous issue in healthcare today. While estimates of the actual number of physician suicides vary, literature has shown that the relative risk for suicide being 2.27 times greater among women and 1.41 times higher among men versus the general population. Each physician suicide is a devastating loss affecting everyone - family, friends, colleagues and up to 1 million patients per year. It is both a very personal loss and a public health crisis. Vision Zero calls on individuals, residency programs, health care organizations and national groups to make a commitment to break down stigma, increase awareness, open the conversation, decrease the fear of consequences, reach out to colleagues, recognize warning signs and learn to approach our colleagues who may be at risk. Let us challenge each other as individuals, communities, institutions and organizations to make changes to reach zero physician suicides. Learn More: • Physician & Resident Curriculum • Suicide Postvention During Residency Resources • Podcasts & Videos • Blogs & Additional Resources

Caduceus Meeting for Recovering Health Care Professionals Third Thursday of each month at 7 p.m. Zion Lutheran Church 545 7th Street, Freeland, Michigan (Behind Pat’s Grocery Store on Midland Road in Freeland)

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.


CALENDAR OF MEETINGS AND EVENTS FOR 2022-23* REGISTER NOW FOR THE SEPTEMBER MEETING! DEADLINE FOR RESERVATIONS 9/14/22 Tuesday, September 20, 2022 - Horizons Conference Center, 6200 State Street, Saginaw Board Meeting - 5:30 p.m. Membership Meeting Joint with the Saginaw Valley Osteopathic Society - Social (cash bar) at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Speaker - Alison Arnold, Ed.D., Director, Interdisciplinary Center for Community Health & Wellness, Central Michigan University “Revisiting ACEs: The Roots of Wellness and Building Our Inner and Collective Resilience” Approved for 1.5 AMA PRA Category 1 CreditsTM Learning Objectives: • Review the discoveries of the Adverse Childhood Experiences study and the significant life-long health impacts of early trauma and toxic stress • Understand why children exposed to ACEs are at elevated risk for chronic disease and risky behavior • Increase awareness of trauma-responsive practice and the ripple effects of secondary traumatic stress • Develop strategies to respond to children who present with trauma symptoms • Increase awareness of statewide resources, including the Prevention of ACEs Data to Action Project and the Michigan ACEs Initiative Online reservations are required by 9/14/22 CLICK HERE TO MAKE A RESERVATION Or scan the QR Code Accreditation Statement: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Central Michigan University College of Medicine and the Saginaw County Medical Society. CMU College of Medicine is accredited by the ACCME to provide continuing medical education for physicians. Central Michigan University College of Medicine designates this live activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Disclosure: The planners and speaker have no relevant financial relationships with ineligible companies to disclose.

Saturday, October 8, 2022 – Horizons Conference Center, 6200 State Street, Saginaw CMU CME presents “Implicit Bias Training” (required for licensure) Time: 8-11 a.m. 3 AMA PRA Category 1 CreditsTM Available Click HERE to register and for more information, disclosures and accreditation (see page 10 in this issue for more information). Tuesday, October 18, 2022 - Horizons Conference Center, 6200 State Street, Saginaw Board Meeting - 5:30 p.m. Membership Meeting - Social (cash bar) at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Speaker - Thomas J. Veverka, MD, MSMS President *subject to change rev 8/3/22 “The Future of Medicine”

Program - Candidates’ Forum for the November election Email meeting notices will be sent in early October. Online reservations are required. Tuesday, November 15, 2022 - CMU College of Medicine, 1632 Stone Street, Saginaw Board Meeting - 5:30 p.m. There is no Membership Meeting in November. There is no Board or Membership Meeting in December. Tuesday, January 17, 2023 - Horizons Conference Center, 6200 State Street, Saginaw Board Meeting - 5:30 p.m. Membership Meeting Joint with the Saginaw County Dental Society - Social (cash bar) at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Speaker - TBD Topic - TBD Email meeting notices will be sent in early January. Online reservations are required. Tuesday, February 21, 2023 - CMU College of Medicine, 1632 Stone Street, Saginaw Board Meeting - 5:30 p.m. There is no Membership Meeting in February. SCMS Health Fair “The Doctor Is In!” Horizons Conference Center Date TBD Tuesday, March 21, 2023 - CMU College of Medicine, 1632 Stone Street, Saginaw Board Meeting - 5:30 p.m. There is no Membership Meeting in March. Tuesday, April 18, 2023 - Horizons Conference Center, 6200 State Street, Saginaw Board Meeting - 5:30 p.m. Membership Meeting - Social (cash bar) at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Speaker - TBD Topic - TBD Email meeting notices will be sent in early April. Online reservations are required. Saturday-Sunday, April 22-23, 2023 - The Henry in Dearborn 158th Annual MSMS House of Delegates Tuesday, May 16, 2023 - Horizons Conference Center, 6200 State Street, Saginaw Board Meeting - 5:30 p.m. Annual SCMS and SCMS Foundation Membership Meetings - Social (cash bar) at 6:30 p.m., followed by dinner, meetings and program at 7 p.m. Email meeting notices will be sent in early May. Online reservations are required. 12th Annual SCMS Foundation Golf Outing – date TBD The Bulletin | September 2022 9


Implicit Bias Training 2022 Saturday, October 8, 8:00 - 11:00 am Breakfast at 7:30 am

Horizons Conference Center, 6200 State Street, Saginaw, MI Funded by a grant from the Saginaw Community Foundation

Defining, understanding and applying practical strategies to improve provider interactions and client care. Introduce the many aspects of diversity and how identity develops. Explore the process of socialization and the development of values shaped by our interaction with the world around us. Meets all of the State of Michigan's Implicit Bias training requirements.

Speakers: Sheri Pickover, Ph.D., LPC, BC-TMH Professor of Counseling and Special Education Department of Counseling, Educational Leadership, & Higher Education (CEH) Central Michigan University Allison Arnekrans, Ph.D. Associate Professor of Counseling Department of Counseling, Educational Leadership, & Higher Education (CEH) Practicum & Internship Coordinator, Mu Kappa Chapter of Chi Sigma Iota, Chapter Faculty Advisor, Central Michigan University Deborah L. Virant-Young, Pharm. D., BCPS Assistant Professor Department of Pharmacology Toxicology Systems Biology Faculty Director of Faculty Development Statewide Campus System Michigan State University College of Osteopathic Medicine

REGISTRATION:

10 The Bulletin | Summer 2022

Target Audience

All Healthcare Professionals

Objectives

At the end of this presentation, you will be able to: • Define implicit bias in the context of equitable access to healthcare • Understand best practices in serving diverse populations • Implement diversity and inclusion initiatives • Identify and describe cultural sensitivity in clinical practice • Describe, in depth, their own social identities • Discuss how implicit biases impact human behavior • Recognize personal biases and be able to interrupt and counteract them

Disclosure

Speakers and planners have no relevant financial relationships with ineligible companies.

Accreditation

Central Michigan University College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Central Michigan University College of Medicine designates this live activity for a maximum of 3.00 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The Central Michigan Social Work Program, an accredited social work education program, is authorized by the Michigan Licensure Law Administrative Rule 33.2965 to award Michigan social work continuing education credit contact hours. For this program, 3.0 CE hours will be awarded.

https://bit.ly/3Ipk49J

or use the QR code

CMU, an AA/EO institution, strongly and actively strives to increase diversity and provide equal opportunity for all individuals, irrespective of gender identity or sexual orientation and including but not limited to minorities, females, veterans and individuals with disabilities.

Course Description


Continuing Medical Education CME WEBSITE – click HERE CME CALENDAR: For a complete list of our CME accredited courses for September 2022 click HERE. CME ONLINE - eLearning Activities: CMU CME ONLINE These courses are free of charge to all CMU faculty, residents, students and our affiliated partners: Covenant, Ascension St. Mary’s, and the VA, as well as, to those who teach our medical students throughout Michigan and Ohio. Courses are also included from the Michigan Public Health Institute with links to their large eLearning library. Recently added eLearning enduring materials include: • Human Trafficking Update 2022 Theresa Wyatt, PhD, CCM, CFN, CCRE, FACFEI Dr. Wyatt has been a registered nurse for 36 years, with 16 years in the Emergency Department and five years as a Forensic Nurse Examiner. She has a Master’s in Forensic Nursing and a PhD in Nursing with an emphasis on vulnerable populations. She works closely with the MidMichigan Human Trafficking Task Force. This course provides an overview of the types of human trafficking, current U.S. statistics, recommendations for screening, assessment of human trafficking victims and reviews available resources. This course meets the State of Michigan licensing requirements for healthcare professionals.

CREDIT FOR TEACHING - CMU College of Medicine appreciates ALL that you do in teaching our residents and medical students! To ensure that you adequately obtain your Category 2 Credit for Teaching, all forms (2019 to 2022) and instructions are available on our website at med.cmich.edu/ cmecert under Category 2 Physician Teaching Credit Forms. CME COMMENTS AND SUGGESTIONS - Your comments and suggestions about CME are always invited (and are very important to us). They may be submitted at any time on our website at med.cmich.edu/cme under Comments and Suggestions. Email: CMEDCME@cmich.edu P: 989-746-7602 | F: 989-746-7579 Administrator: joan.ford@cmich.edu | 989-259-4036 Website: med.cmich.edu/cme

120 Years of Serving the Residents of Saginaw County! www.SaginawCountyMS.com

• Using Narrative Comments in Medical Education Assessment: Good or Bad or Just Ugly? Wendy S. Biggs, MD, Director of the Comprehensive Community Clerkship and Professor of Family Medicine at Central Michigan University College of Medicine. This course reviews the use of narrative comments in medical education assessment. It examines the “who, what, where, when, why and how's” of medical education assessment. The speaker also explores various potential scenarios using the 5 W’s and How’s. • Recognizing Dementia at Home Catherine A. Macomber, PhD, MSW This one-hour workshop introduces participants to the differences between Alzheimer's disease and related dementias, as well as, the connection between communication and behavior when working with a person with memory loss. The workshop ends with an invitation for participants to create at least one item to address with their own cognitive health or that of a loved one. CLAIM CME CREDIT and CERTIFICATE PROCESS – click HERE

The Bulletin | September 2022 11


REGISTER NOW!

31st Annual Robert M. Heavenrich, MD Endowed Guest Lecture Thursday, October 20, 2022 Victoria Fitton, PhD, LMSW Retired, Clinical Associate Professor Michigan State University School of Social Work Dr. Fitton will present at our PEDIATRIC GRAND ROUNDS from 8-9 a.m. at the Sparrow Hospital Auditorium • Topic: “Protective and Risk Factors of Mother-Child Attachment in the Treatment of Complex Childhood Trauma” Dr. Fitton will also present an EVENING LECTURE from 6-8:30 p.m. at Horizons Conference Center, Saginaw • Topic: “Complicating Family Factors in Medical Trauma: A Case Study” We are very happy to welcome Dr. Victoria Fitton! Victoria A. Fitton, PhD, LMSW, is a retired Clinical Associate Professor for the Michigan State University School of Social Work. She taught Master of Social Work practice courses in a variety of formats: Face-to-face, hybrid and online. She continues to teach for the Continuing Education Department on a wide variety of clinical issues. She held the Ruth Koehler Endowed Clinical Professorship in Children Services and was the MSW Program Director. Dr. Fitton is a clinical social worker, expressive therapist, clinical supervisor, and consultant with a specialization in complex trauma including childhood sexual abuse with complicating factors. She has specialized training in attachment, child development, adolescents and technology, psychoanalytic psychotherapy, play therapy, sand play therapy and neurobiology. Dr. Fitton is a frequent invited speaker and

presenter on multiple clinical topics that cross the lifespan. She has published several articles and a book chapter in the areas of attachment and child development. Her current work focuses on neurobiology and trauma. Her greatest loves are teaching and private clinical practice. On a personal note, Dr. Fitton is a wife, mother and grandmother. She travels extensively across the globe and reads voraciously. Questions? Contact Liz Stanton, CHRS, CWI&D Email stanto52@msu.edu | Phone (517) 355-3308 Cell Phone (517) 290-5788

CLICK HERE TO REGISTER Deadline to Register: October 10, 2022 Event Coordinator: Liz Stanton, stanto52@msu.edu (517) 355-3308 Pediatric Grand Rounds AM Zoom ID: https://msu.zoom.us/j/99856677928 Passcode: 032590 Heavenrich Lecture PM Zoom ID: https://msu.zoom.us/j/96369736106 Passcode: 857189 Michigan State University is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Pediatric Grand Rounds: Michigan State University designates this live activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Heavenrich Lecture: Saginaw, MI: Michigan State University designates this live activity for a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

PEER REVIEW ETHICS COMMITTEE The Saginaw County Medical Society has a Peer Review Ethics Committee (“Committee”) which is comprised of Waheed Akbar, MD – Chair, Caroline G.M. Scott, MD and James R. Hines, MD. Members of the Committee are elected by the membership. The following is the definition of the Committee pursuant to Chapter IX Conduct and Discipline of Members of the SCMS Bylaws: Section 5. PEER REVIEW ETHICS COMMITTEE. This Society shall have a standing committee designated the Peer Review Ethics Committee, charged with duties and powers concerning the maintenance of standards of conduct and discipline of members including the duties and powers specifically set forth in this chapter. Whenever any matter of alleged misconduct is referred to the Peer Review Ethics Committee, such Committee shall have the right to conduct investigations and hearings thereon, both informal and formal, and to make findings of fact and recommendations for discipline. If you need to refer a matter to the Committee, please contact Drs. Akbar, Scott or Hines, or Joan Cramer at the Saginaw County Medical Society office. All matters are confidential and are not to be disclosed to the Board or membership.

12 The Bulletin | September 2022


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IN MEMORY J. Eugene "Gene" Rank, MD At age 93, death occurred on Saturday, August 27, 2022. Gene was born on November 9, 1928, in Saginaw, son of John E. and Violet J. (Hager) Rank. He graduated from Saginaw High School in 1946, Master Gunner’s School with the U. S. Army, Ft. Bliss, Texas in 1951, Central Michigan University (Class Valedictorian) in 1956, Medical School at the University of Michigan in 1963, and a pediatric residency in 1963. After retirement, he studied Fine Arts at Delta College from 19982000. During his years in medicine, he was in a partnership in the practice of pediatrics with Drs. Heavenrich, Jarvi and Mason. Gene was a Diplomat of the American Board of Pediatrics, a Fellow of the American Academy of Pediatrics, a member of the Michigan State Medical Society, Saginaw County Medical Society, Michigan Pediatric Society and Northeastern Michigan Pediatric Society. He served seven years as Chairman of Pediatrics at Saginaw General Hospital, and was also an off-campus Associate Professor of Pediatrics at Michigan State University Medical School.

14 The Bulletin | September 2022

During life, Gene enjoyed camping, fishing, gardening, photography, painting, writing and the study of mythology and historicity of religion. He was a member of the Saginaw Area Watermedia Artists, and of the education and discussion group, Serendipity. He is survived by his wife, Janet C. (nee Savage); two sons, David and Andrew (Wendy) Rank; stepson, Mark (Kristi) Sauve; stepdaughter, Linda (Bob) (nee Sauve) Leaym; daughter-in-law, Sue Rank; sister, Mary Lou Visnaw; brother, Charles R. Rank; seven grandchildren; and five great-grandchildren. He was preceded in death by his son, Stephen Rank. In keeping with Gene’s wishes, cremation has taken place. His family will gather privately to celebrate his life.

Read previous issues of The Bulletin at www.SaginawCountyMS.com under the Bulletin tab


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MSMS/SCMS 2023 Dues Renew before 11/30/22 for $100 CME Coupon

Dear Members,

F

irst and foremost, we want to thank you for your continued investment with the Michigan State Medical Society (MSMS) and Saginaw County Medical Society (SCMS). Without your loyalty and support, we would not be able to continuously provide benefits and protection of Michigan physicians and patients. Put simply, you make what we do possible. It’s time to renew your membership for 2023! Your membership has enabled us to accomplish so many initiatives: • Prior Authorization Reform has been signed into law! Led by MSMS, Health Can’t Wait was formed to end delays in care. On April 7, 2022, Senate Bill 247 was signed into law, reforming prior authorization process by reducing wait times and streamlining how physician offices and payers interact, ultimately improving access to care for patients. • MSMS crafted legislation for Telehealth Parity, that requires payment and coverage for telehealth visits as if the service were provided in-person. House Bill 5651 ensures these equitable payments and coverage policies greater access to care and telehealth will remain a sustainable option for providers to offer. • MSMS is working to improve access to mental health services in Michigan and the Michigan State Senate recently adopted two MSMS-initiated budget proposals to provide support to primary care providers. The first

16

The Bulletin | September 2022

of these programs is for practices in smaller counties facing access to care struggles and allowing them to get on their financial feet and thrive long term. The second, would provide a Medicaid reimbursement uplift for primary care services totaling roughly $100 million, expanding access to care and allow primary care practices to remain financially sustainable. To change hearts and minds in Michigan, we need to keep the conversation going, broaden our understanding, and learn to make lasting and positive impacts on the patients and communities we serve. We hope you’ve benefited from your membership with MSMS and SCMS. If not, let us know how we can provide benefit to you, personally. Contact Joan Cramer/SCMS at 989-284-8884 or jmcramer@sbcglobal.net or Heather Foster/ MSMS at 517-336-5719 or at hlfoster@msms.org to see how we may meet your needs. If, like most of our members, you are satisfied with your membership, consider renewing now at MSMS.org/Renew. If you renew by November 30, you will receive a $100 CME coupon to be used for any MSMS CME program. Kind regards,

Thomas J. Veverka, MD, FACS MSMS President


BENEFITS OF SCMS/MSMS

MEMBERSHIP T he Saginaw County Medical Society (SCMS) is the professional association of physicians in Saginaw County, and a component of the Michigan State Medical Society (MSMS). In order to be a member of one, you must be a member of both. I have been asked many times by both members and nonmembers “Why should I belong to the SCMS and MSMS?” “What do you do for me?” Some have responded they “don’t use their membership because they don’t attend SCMS meetings.” SCMS and MSMS membership is so much more than membership meetings. We are not only support for you, but for your office staff as well. I’m hoping the information below will help members who are on the fence about paying their dues decide to remain members, and also convince nonmembers why they should belong. We represent physicians in all specialties and in all types of practices – solo, group, employed, etc. Active membership is open to MDs and DOs. • Active physician dues are $795 per year ($495/MSMS and $300/SCMS). One hundred percent of SCMS dues and 81 percent of MSMS dues are tax deductible as a business expense. • The SCMS offers a discount for first year physicians, and MSMS offers discounts for first, second and third year physicians, as well as, physician spouses when both are members. • Resident and medical student memberships are also available.

What We Offer SCMS Members and Their Staff: • Five Membership Meetings per year where our members have an opportunity to network and enjoy the camaraderie of fellow physicians who love the practice of medicine and want to see progress made in the Saginaw medical community. In addition, our meetings include interesting speakers and an opportunity to earn FREE CME credit. A few recent and future program topics include: - Ethics - Physician Compassion - Human Trafficking Fatigue/Burnout - Implicit Bias - Workplace Violence - Opioids - Overcoming Obstacles - Adverse Childhood in Health Care Experiences (ACE’s) - What to do if a complaint has been filed against you • Representation of physicians in all specialties and in all types of practices–solo, group, employed, etc. • Communication and camaraderie with physicians of other specialties in a neutral setting. • Liaison with MSMS for assistance on practice issues, billing and coding, health information technology, legal alerts, legislative issues, insurance and much more. • An independent voice for physicians on issues they face at the hospitals.

120 Years of Caring for Saginaw County Residents Joan M. Cramer, SCMS Executive Director

• The Bulletin with articles and information pertinent to SCMS members and their staff. • Pictorial Membership Directory is published annually and used by members and their staff on a regular basis. Our Private Directory provides information on your practice to other member physicians outside your specialty. In addition, a Public Directory that includes office address and phone (but not fax numbers or email) is printed and distributed to 1,000+ households in Saginaw County. The response from the public on this listing of SCMS physicians has been extremely positive. • Website which is full of useful information and resources www.SaginawCountyMS.com. • Referrals to patients seeking a physician. • Contact with local, state and federal legislators regarding issues of importance in Saginaw County. The SCMS maintains contact with local legislators to provide issue education and help them understand the impact of healthcare legislation. • A unified voice on medical issues to our legislators, our area hospitals, insurance companies, etc. • Loans and scholarships to local medical students, residents and nursing students. • Community service to actively and tangibly give back to the community where you live and work through SCMS sponsored projects, such as our annual Health Fair for the Saginaw community attended by 1,100+ offering free health screenings and information, plus the opportunity for residents to speak with our member physicians directly to answer questions and promote your practice. • An active Peer Review Mediation Committee to provide a forum for patient complaints to be heard. Peer Review reduces the number of malpractice lawsuits. • An active Peer Review Ethics Committee for physician to physician issues. • Confidential assistance for members with substance abuse or personal issues affecting their practice of medicine. • And more!

WHY PAY DUES? • Because all physicians need to “fund their voice.” • National polls show physicians as one of the most respected professions. Sadly, they don’t use their clout often enough to preserve their profession and protect their patients. • There is strength in numbers. Together we are stronger. If you or your office staff need assistance on an issue of any kind, please feel free to contact me at jmcramer@sbcglobal. net, (989) 790-3590 (office) or (989) 284-8884 (cell) and I will work with you to come up with a resolution for your problem through a variety of resources available to you as a SCMS/ MSMS member.

SERVING ALL SPECIALTIES AND SOLO, GROUP AND HOSPITAL EMPLOYED PHYSICIANS SINCE 1902 Visit www.SaginawCountyMS.com for a Membership Application under the “Membership” tab


APPLICATIONS FOR MEMBERSHIP FIRST READING: Applications for membership for first reading at the September 20, 2022, Board Meeting:

Residency: New York Methodist-Cornell University Hospital, General Surgery, 1994-99 Fellowship: University of Massachusetts, Worcester, MA, Surgical Critical Care, 1999-2000 Rikat E. Baroody MD (CMU Health - Surgery) Fellowship: University of Minnesota, Minneapolis, MN, Specialty: Surgery - Trauma, Critical Care - Board Certified 2021 Surgical Research, 2000-01 Medical School: State University of New York (SUNY) Upstate Sponsors: Doctors Chet A. Morrison and Samuel J. Shaheen Medical University, College of Medicine, Syracuse, NY, 2013 Residencies: The Alpert Medical School of Brown University, Christina L. Maser MD (CMU Health-Surgery) Providence, RI, Surgery Preliminary, 2013-14; Lincoln Medical Specialty: Surgery - General - Board Certified 2006; Surgery Center, Bronx, NY, Surgery Categorical, 2014-15; and CAMC – - Endocrine WVU Charleston Division, Charleston, WV, General Surgery, Medical School: Michigan State University College of 2015-19 Human Medicine, 1999 Fellowship: Wright State University, Dayton, OH, Surgery Residency: William Beaumont Hospital, Royal Oak, MI, Critical Care, 2019-20 Surgery, 1999-2005 Fellowship: Yale University School of Medicine, New Haven, Sponsors: Doctors John Blebea and Chet A. Morrison CT, Surgical Endocrinology, 2005-06 Franchesca Garcia Robles MD (CMU Health - Pediatrics) MHA: University of Southern California, Price School of Public Specialty: Pediatrics - Board Certified 2016; Palliative and Policy, Healthcare Administration, 2017-19 Hospital Medicine Sponsors: Doctors Samuel J. Shaheen and Julia M. Walter Medical School: University of Puerto Rico School of Medicine, *Application for Affiliate Member San Juan, PR, 2013 Brianna C. Pitre DC (Shields Chiropractic) Residency: University of Puerto Rico, Pediatrics, 2013-16 Specialty: Chiropractor Research: Research Fellow at San Juan City Hospital-Centro Education: Palmer College of Chiropractic, Davenport, IA, Medico PR, Pediatrics, 2016-18 and Post-Doctoral Master’s in 2021 Clinical and Translational Research, University of Puerto Rico, Sponsors: Doctors Anthony M. Zacharek and Claudia C. 2016-20 Fellowship: Mercy Health, St. Mary’s Hospital, Grand Rapids, MI, Zacharek Hospice and Palliative Medicine, 2018-19 Sponsors: Doctors Anthony M. Zacharek and Claudia C. Zacharek A new service to Steven Hermiz MD (Covenant Plastic Surgery) Specialty: Surgery - Plastic, Hand, Reconstructive and Cosmetic, Board Certified 2020 Medical School: Ross University School of Medicine, New Brunswick, NJ and Dominica, West Indies, 2012 Residency: University of South Carolina/Palmetto Health, Columbia, SC, General Surgery, 7/12-6/18 Research Fellowship: University of North Carolina, Chapel Hill, NC between PGY-3 and PGY-4 Academic Year of General Surgery Residency, 7/15-6/16 Fellowship: Medical University of South Carolina, Charleston, SC, Plastic, Reconstructive and Hand Surgery, 7/18-6/21 Sponsors: Doctors Ronald C. Barry and Anthony M. Zacharek Adeeba S. Khan MD (CMU Health - Pediatrics) Specialty: Pediatrics - Board Certified 2011; International Board of Certified Lactation Specialist - Board Certified 2017 Medical School: Sri Venkant Sai Medical College, India, 2006 Residency: Children’s Hospital of Michigan/Detroit Medical Center, Pediatrics, 7/8-8/11 Sponsors: Doctors Christopher J. Allen and Dafina W. Allen Narong Kulvatunyou MD (CMU Health-Surgery) Specialty: Surgery - Acute Care - Board Certified 2002; Surgery General - Board Certified 2001 Medical School: University of Alabama at Birmingham, Birmingham, AL, 1994 18

The Bulletin | September 2022

support and assist frontline healthcare workers with behavioral health services is now available from the Saginaw County Community Mental Health Authority.

Free Confidential Counseling for Frontline Healthcare Workers Free, confidential counseling services are available for healthcare professionals and their immediate family to provide help coping with the stress and anxiety due to the COVID-19 pandemic. Professional counselors provide primary care screening, assessment and monitoring of key health indicators. These services are available to those that need extra help coping during this extremely stressful time. There is no shame in talking, in person or virtually, with someone.

Call the Saginaw Community Care HUB at

989.498.2266

for an immediate appointment


COVENANT MEDICAL GROUP

GENERAL, BARIATRIC & COLORECTAL SURGERY JORGE HERNANDEZ, MD, FACS, FACSCRS

CHAD D. RINGLEY, MD, FACS

COLON AND RECTAL SURGERY Board Certified by the American Board of Surgery/General

BARIATRIC, GENERAL, LAPAROSCOPIC AND ROBOTIC SURGERY

Surgery and the American Board of Colon and Rectal Surgery

Board Certified by the American Board of Surgery/ General Surgery

JASON KUHN, DO BARIATRIC, GENERAL, LAPAROSCOPIC AND ROBOTIC SURGERY Board Certified by the American Osteopathic Board of Surgery/General Surgery

SUJAL G. PATEL, MD, FACS GENERAL, LAPAROSCOPIC, ROBOTIC AND TRAUMA SURGERY Board Certified by the American Board of Surgery/ General Surgery

JOHN P. SHARPE, MD, MS, FACS GENERAL, LAPAROSCOPIC, ROBOTIC AND TRAUMA SURGERY Board Certified by the American Board of Surgery/ General Surgery and Surgical Critical Care

ANDREW VASYLUK, MD GENERAL, LAPAROSCOPIC, ROBOTIC AND TRAUMA SURGERY Board Certified by the American Board of Surgery/ General Surgery and Surgical Critical Care

TODD G. RICHARDSON, MD, FACS GENERAL, LAPAROSCOPIC, ROBOTIC AND TRAUMA SURGERY Board Certified by the American Board of Surgery/ General Surgery

SAGINAW 5415 Cardinal Square, Saginaw, Michigan 48604 Phone: 989.583.5679 Monday-Thursday: 8:00 am-12:00 noon and 1:00-5:00 pm Friday: 8:00 am-12:00 noon © 2022 Covenant HealthCare. All rights reserved. PK 8/22 14931


Covenant HealthCare Nationally Recognized for Commitment to Providing High-Quality Stroke Care The American Heart Association presents Covenant HealthCare with the Get With The Guidelines® - Stroke GOLD PLUS with Target: Stroke Honor Roll Elite Plus and Target: Type 2 Diabetes Honor Roll award for proven dedication to ensuring all stroke patients have access to best practices and life-saving care Covenant has received the American Heart Association’s GoldPlus Get With The Guidelines® - Stroke quality achievement award for its commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines, ultimately leading to more lives saved and reduced disability. “Our teams work diligently to provide high quality neurological and cardiovascular services from onset through rehabilitation to patients in the region,” says David D. Gill, DO, Covenant Stroke Medical Director. Covenant is proud to be one of four hospitals in the state recognized for 10 or more consecutive calendar years of Gold Plus achievements in Get With the Guidelines® - Stroke and/or Get With the Guidelines® Heart Failure.” Each year, program participants qualify for the award by demonstrating how their organization has committed to providing quality care for stroke patients. In addition to following treatment guidelines, Get With The Guidelines® participants also educate patients to help them manage their health and recovery at home.

Covenant HealthCare also received the American Heart Association’s Target: Stroke Honor Roll Elite Plus. To qualify for this recognition, hospitals must meet specific criteria that reduce the time between an eligible patient’s arrival at the hospital and treatment with the clot-buster alteplase. Additionally, Covenant HealthCare received the American Heart Association’s Target: Type 2 Honor Roll award. Target: Type 2 Diabetes aims to ensure patients with Type 2 diabetes, who might be at higher risk for complications, receive the most up-to-date, evidence-based care when hospitalized due to stroke. What’s more, Covenant HealthCare met specific scientific guidelines as a Primary Stroke Center, featuring a comprehensive system for rapid diagnosis and treatment of stroke patients admitted to the emergency department.

Covenant Kids Gala | October 7 Please join us on Friday, October 7, 2022, for the Covenant Kids Gala at Horizons Conference Center. This elegant black-tie affair will feature the outstanding showband, Persuasion and the Backstreet Horns, performing a vast musical selection, a unique four-course meal, festivities and fellowship all while raising money for state-ofthe-art equipment for our region’s pediatric patients in the Covenant Emergency Care Center. Tickets for this fundraising event are $200 per person or $1,600 for a table of eight. For more information about supporting this amazing effort, contact Aimee Minard at aimee.minard@chs-mi.com or 989.583.7602.

OCTOBER BIRTHDAYS Allen J. Solomon MD Happy Special Birthday!

Bala Srinivasan MD Happy Special Birthday!

Matthew L. Abrell DPM

Marilyn T. Haupt MD

Anushka N. Magal MD

Sara E. Schambach MD

Mahela S. Ashraf MD

Michael L. Hudson Student

Iris A. Marteja MD

Alaa Shanbour MD

Rikat E. Baroody MD

Thomas J. Hyde DMD

Ahmed Munir MD

Kamran K. Shokoohi MD

Alexander Bejna DO

John B. Johnson MD

Kristi M. Murphy MD

Raivinder Singh MD

Peter J. Biggane MD

Bong Jung MD

Karim Nasra MD

Chai-Yakarn Soontharotoke MD

Kaitlyn A. Blanchard MD

Vipin Khetarpal MD

Kristin M. Nelsen MD

Kizhakepat P. Sukumaran MD

Judy V. Blebea MD

Lioudmila Kinachtchouk MD

Zenobia E. Ofori-Dankwa MD

Sanjay J. Talati MD

Jonathan T. Broadwell MD

David J. Kramp MD

James M. Parkkonen MD

George K. Tong MD

Ileana Marie Daly MD

Cecilia E. Kraus-Horbal DO

Krishna J. Patel DO

Samuel S. Valia MD

Najiha B. Farooqi MD

David B. Krebs MD

Delicia J. Pruitt MD

Noel D. Wagner MD

Gerard P. Farrar MD

Ian Kuo Student

Gerardo Dizon Reyes MD

Matthew Welch Student

Jade Foldie Student

Paul A. LaClair MD

Sara L. Rivette MD

Mark A. Zaki MD

James A. Fugazzi MD

Naa Atswei Laryea Student

Christopher J. Robertz MD

Joshua S. Grant MD

Chris Paul Liakonis DO

Jacquelyn A. Robinson MD

Manasa Gudur MD

Bei F. Liu MD

Majed J. Sahouri MD

20 The Bulletin | September 2022


Thank You Key Providers! The SCMS would like to thank our dedicated Key Providers, old and new, for continuing to provide support for SCMS Membership Meetings. When you have a need for a service, please consider our Key Providers!

WE LEAD IN HEALING CHRONIC WOUNDS What is Hyperbaric Oxygen Therapy? Hyperbaric Oxygen Therapy (HBOT) is the administration of 100% oxygen in a pressurized environment. Diffusing oxygen throughout the body promotes angiogenesis, allowing a chronic wound to get the nutrient and oxygen rich blood it needs to heal. Specialized wound care, including HBOT, is often necessary for optimal treatment of chronic wounds. HBOT is an effective adjunctive therapy used in conjunction with advanced wound care. Along with proper attention to nutrition and other underlying medical problems, we achieve greater healing results. HBOT is a proven treatment for: • Chronic Refractory Osteomyelitis • Lower Extremity Diabetic Ulcers • Radiation Cystitis/Proctitis or Radiation Necrosis

David Gustavison, DO Medical Director

Covenant Wound Healing Center “There are approximately 6.5 million patients in the U.S. suffering from chronic wounds (e.g. diabetic foot ulcers and pressure ulcers) and approximately 140,000 patients are hospitalized every year with new wounds. Currently, over 23 million people have been diagnosed with diabetes.”* Covenant Wound Healing & Hyperbaric Medicine Center has a team of experts trained to evaluate your patient’s wound and develop a treatment plan. Using the most advanced technology and research, our wound care team can work with you and your patients to heal wounds quickly.

Anthony de Bari, MD, CWSP

Scott Byron, DPM, FAAPSM

Mark Bullock, DPM

Khalid Malik, MD

*https://WWW.NCBI.NLM.NIH.GOV, article PMC6161627 • © 2021 Covenant HealthCare. All rights reserved. PK 5/21 13958

ONLY ACCREDITION IN MICHIGAN; SECOND IN THE U.S. COVENANT WOUND HEALING & HYPERBARIC MEDICINE CENTER 900 Cooper, Saginaw, Michigan 989.583.4401 • covenanthealthcare.com

The Bulletin | September 2022

21


Ascension St. Mary’s Hospital Announces Surgical Services Director Kitty Bouchard, RN, has been selected as Director of Surgical Services at Ascension St. Mary’s Hospital. She will oversee daily operations of the pre- and post-operative units and surgical suites. With more than 40 years of nursing and leadership experience, including serving as Clinical Director at Towne Centre Surgery Center (TCSC) which she will continue to oversee, Kitty will provide leadership to patient care and service areas, including staff, budget and quality issues. Ascension St. Mary’s Hospital Bariatric Surgery Program Re-accredited Ascension St. Mary’s Hospital bariatric surgery program has been re-accredited as a Comprehensive Center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). This is the highest level of accreditation provided by MBSAQIP, which is a collaboration of the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery. This accreditation formally acknowledges Ascension St. Mary's Hospital for its commitment to providing and supporting quality improvement and patient safety efforts for metabolic and bariatric surgery patients. Ascension St. Mary's Hospital was recognized as having a very strong multidisciplinary team, including two dedicated dietitians who serve as great resources for patients, as well as, excellent patient educational materials. Ted’s Treasures Gifted to Ascension St. Mary’s Bariatric Program Thaddeus (Ted) Wiecek was considered a gentle soul by many people. He cared deeply about others, valued family, nature and the joy of shared laughter. But, like many people, he had struggles. It was the bariatric center at Ascension St. Mary’s Hospital and its support community (Ted’s bariatric family) that helped him persevere. Ted was proud of his weight loss journey Daryl Gross, a bariatric and adored his bariatric family. program participant benefiting from Ted's Sadly, Ted passed away from Treasures complications of a rare, untreatable cancer unrelated to his bariatric surgery journey. Like many, he was challenged after his bariatric surgery with not having the right size clothes to wear and burdened by the high cost of protein and vitamins. To honor Ted, the Wiecek family celebrated the opening of Ted’s Treasures with his bariatric family during a recent support night. Located at Ascension St. Mary’s Hospital Bariatric Center, 1015 S. Washington Avenue in Saginaw, Ted’s Treasures helps 22

The Bulletin | September 2022

individuals celebrate their weight loss success by having access to clothes that fit, as well as, ease the cost of the protein and vitamins Members of the Wiecek family, along with Ascension bariatric patients need St. Mary’s Hospital bariatric associates, cutting the post-surgery. Individuals ceremonial ribbon can select clothing based on their weight loss progress so they can look and feel good on their journey, and bariatric center staff can assist them with protein and vitamins. Clothing is available thanks to donations from various retailers and suppliers, and gently used clothing is also accepted. “Ted had a beautiful giving spirit and his family continues his legacy by helping others within his ‘bariatric family,’” said Lisa Guyton, Ascension St. Mary’s Hospital Bariatric Program Manager. “This is an amazing resource for our current and future patients as they go through their weight loss journey. We will miss Ted always, but having Ted’s Treasures keeps him near at heart.” Advanced Cancer Treatment Now at Ascension St. Mary’s Hospital Seton Cancer Institute - West Branch Ascension St. Mary’s Hospital Seton Cancer Institute is advancing its cancer-fighting technology with a new, state-ofthe-art TrueBeam® radiotherapy system at their West Branch location. The new system delivers more powerful cancer treatments with pinpoint accuracy and precision. It provides optimal treatment for every type of cancer and enables the treatment team to bring a wide spectrum of advanced radiotherapy treatment options to patients. “This new system represents a quantum leap in the ability to help people fight cancer,” said Kathi Smith-Nowlin, RN, Director, Cancer Care Services. “This system lets us treat even the most challenging cases with tremendous speed and precision. We can offer patients fast, more targeted treatments for tumors — even those that move when the patient breathes, such as lung tumors. This advanced technology lets our team offer safe, accurate and precise treatment and an outstanding patient experience.” continued on page 24


Stroke care can’t wait Get advanced care at Ascension St. Mary’s ERs and stroke center When you experience signs of a stroke, it’s important to call 911 or go to the nearest emergency room. Ascension St. Mary’s emergency rooms provide early stroke intervention, and all of our ERs are connected to specialists at our Comprehensive Stroke Center, recognized for excellence in the care of stroke patients. Through the latest technology, our team of stroke specialists collaborate on diagnosing your stroke in as little as seconds and deliver the care that’s right for you. We’re beside you from the ER through recovery and rehabilitation.

Find your closest ER location at ascension.org

If you are experiencing a life-threatening emergency or difficulty breathing, go directly to the ER or dial 911.

© Ascension 2022. All rights reserved.


continued from page 22

Save the Date - 2022 Cornette Ball Ascension St. Mary's Hospital Foundation is pleased to announce the return of the Cornette Ball. Mark your calendar for Saturday, November 19, 2022. The time-honored event will be held at Horizons Conference Center in Saginaw. The Cornette Ball is one of the grandest black-tie galas in the region. The festive evening will include a cocktail hour, gourmet meal and live music. The Spirit of St. Vincent Award will also be presented. For sponsorship information or event details, contact Tammy Weighman at (989) 9078875 or tamera.weighman@ascension.org.

SCMS/MSMS 2023 MEMBERSHIP DUES NOW PAYABLE Free CME for Your SCMS/MSMS Membership Renewal by November 30! See page 5 for details

24

The Bulletin | September 2022

Now accepting referrals!

Adult Outpatient Psychiatry Medicaid welcome!

GLBHC priority is to serve the underserved, uninsured, and underinsured. We offer transportation along with multiple other integrated services to address your patients’ needs like dental, laboratory and on-site pharmacy, and community health workers to address social disparities. This is our priority population and we do well serving them!

Who: Adults with mild to moderate mental health conditions What: Outpatient psychiatry services When: Now! Where: Davenport Location

3023 Davenport Ave Saginaw, MI 48602

Bay City South Location 690 S Trumbull St Bay City, 48708

How: To learn more about our new referral process, please

contact Amra Bader, Behavioral Health Supervisor at (989) 9072765 or abader@glbhealth.org

Of Special Note: GLBHC is not a crisis intervention program. If patient is currently suicidal/homicidal/danger to self or others, please seek emergency intervention for them by contacting your local Community Mental Health or sending to the Emergency Room *Saginaw Community Health Mental Health Authority (800) 233-0022 *Bay Arenac Behavioral Health (800) 327-4693


WE’VE GOT MID-MICHIGAN COVERED. 16 convenient locations There is a difference between going to therapy and truly getting healthy. At Renue Physical Therapy, we don’t rely on machines or equipment to do the work for us. Our patients benefit from hands-on, one-on-one treatment with the same therapy team throughout the treatment process.

AUBURN • AU GRES • BAY CITY • BRIDGEPORT • CARO • FRANKENMUTH • FREELAND • MIDLAND • SAGINAW • SHIELDS • TAWAS “After dealing with my back pain for almost a year and a year’s worth of visits to the chiropractor I thought the pain would never go away. After completing physical therapy I can finally sleep through the night and wake up without horrible pain.” (Amy, Bridgeport)

“I would say I’m a ‘patient for life.’ I have come to Renue for therapy for 3 different conditions and I have been treated with respect, kindness, and professionalism. The staff was very knowledgeable and I ended my treatment with a total recovery of flexibility and range of motion exceeding my expectations.”

“What a great experience! I was not looking forward to physical therapy but one visit here changed my mind. Great staff who always know your name and makes you feel like you are the most important person. Great job to everyone!” (Susan, Saginaw)

(Pamela, Freeland)

The Bulletin | September 2022 25


Courtesy of CMU College of Medicine

CMU College of Medicine Graduates Sixth Class of New Physicians, Celebrates 500 Alumni

CMU Resident Project Earns Best Project Award at National Conference

At the May 2022 Commencement, the CMU College of Medicine graduated its 500th physician—a major milestone that solidifies the college’s transition from a newly formed institution to an established school of medicine. CMU formed the College of Medicine to address a national and statewide shortage of physicians, particularly those in primary care. When the first students arrived on the Mount Pleasant campus in 2013, they embraced the opportunity to be part of something new and the responsibility of building a reputation for themselves, the college and future classes. In a Fired Up for 500 video celebrating the achievement, Nicholas Cozzi, MD, ’18, currently an EMS fellow with a fire department in New York City, said he attributes his success to the College of Medicine. “I chose the right destination in CMU College of Medicine—from the faculty to the staff to the community. Thank you to all of our donors who have made this day and all these memories possible.” In August of 2022, the College of Medicine’s tenth class arrived on the Mount Pleasant campus. They were welcomed by faculty and staff well-prepared to deliver an outstanding education and support student success and wellbeing. They will be taught by a growing network of physicians and staff at our partner hospitals throughout the state, plus community educators who are committed to the college’s mission. They will benefit from the experience and comradery of those who preceded them, and they will be part of the solution to providing quality, comprehensive care to underserved communities in both rural and urban areas.

Congratulations to Mohammed Aamir Saiyed, MD—a secondyear resident at Central Michigan University Family Medicine Residency in Saginaw—whose Family Medicine Leads Emerging Leader Institute (ELI) project was selected as a 2021-2022 Best Leadership Project Award winner. AAFP Foundation presented the award to Dr. Saiyed at the American Academy of Family Physicians’ 2022 National Conference of Family Medicine Residents & Medical Students, held July 28-30, in Kansas City, Missouri. The year-long ELI focuses on ensuring the future of the Family Medicine specialty by increasing the number of future Family Medicine leaders and provides training for this important role. The course includes in-depth, in-person workshops, a project management session, assignment of a family physician mentor, and the opportunity to complete a leadership project related to the scholar's interests. Dr. Saiyed’s project within ELI’s Personal & Practice Leadership track focused on designing and implementing the CMU Family Medicine Residency Sports Medicine Track. According to the needs statement on Dr. Saiyed’s poster, which was selected for presentation at the National Conference, “The Central/Mid-Michigan area needs primary care physicians with enhanced training in musculoskeletal and non-operative orthopedic medicine to promote safe physical activity and healthy diet in order to tackle rising rates of obesity and diabetes in adults and adolescents.” Saginaw’s adult obesity rate of 36.5 percent exceeds the state’s rate of 32 percent, while 16 percent of Saginaw-area high-schoolers are obese—a rate that is higher than both the state and nation of 16.75 percent and 14.8 percent, respectively, for this age group. Saginaw residents with diabetes nears 35 percent, significantly higher than Michigan’s rate of 22.5 percent. The new CME Family Medicine Residency Sports Medicine track, as designed by Dr. Saiyed in partnership with his residency program director, Amandeep S. Dhaliwal, MD, provides education, training and exposure to primary care sports medicine experiences that surpass the required core education and training during residency. Its curriculum includes eight weeks each of core and elective rotations, event/game coverage under the supervision of a dedicated sports medicine faculty mentor, research and scholarly activities and monthly didactics and journal club discussions.

American Osteopathic Association Appoints Dr. Janssen The American Osteopathic Association appointed Furhut Janssen, DO, FACN, CMU Assistant Professor of Psychiatry and Director of Community Behavioral Health Initiatives, as the Vice Chair of the Bureau of Osteopathic Specialists (BOS). For more than 80 years, the BOS has served as the certifying body for all American Osteopathic Association specialties and subspecialties. Janssen has served as an executive member of the BOS for the past three years. “I am excited to continue this work in certification standards and working along stakeholders nationally,” said Janssen. “I am equally excited to be a part of the CMU College of Medicine and CMU Medical Education Partners as we teach medical excellence to the next generation of physicians.” Congratulations, Dr. Janssen! 26

The Bulletin | September 2022

continued on page 27


continued from page 26

Community outreach—giving back to the community—is also a large focus of the curriculum. Residents within the track spend time representing the CMU Family Medicine Residency program at local sporting events, as well as, educating community members on healthy lifestyle practices focused on nutrition, safety and preventive healthcare. “Coupled with MIDOCs, this track will allow [family medicine] residents with roots in Saginaw to stay local, rather than go outof-state, for the training and experience needed to deliver highly effective musculoskeletal and sports medicine care in the community setting,” said Dr. Saiyed. The curriculum is also designed to prepare participating residents to pursue a sports medicine fellowship program for extended training. For information about participating in a future AAFP Foundation Family Medicine Leads Emerging Leader Institute cohort as a resident or student, or serving as a faculty mentor, click here. Congratulations, Dr. Saiyed!

Diversity, Equity and Inclusion Director Joins College of Medicine Staff The College of Medicine welcomed Donnesha Blake, PhD, as the Director of Diversity, Equity and Inclusion (DEI) for the College of Medicine. DEI efforts are central to the College of Medicine’s excellent education. Blake’s position collaborates with leaders and colleagues at CMU, the College of Medicine, CMU Medical Education Partners, and affiliate hospitals, as well as, with students to create an inclusive learning climate. Blake holds a bachelor’s in communication from CMU, and a master’s and a PhD in women’s studies from the University of Maryland, College Park.

Coming Soon! CMU Health Women and Children Center The CMU College of Medicine, in collaboration with multiple community organizations and clinical partners, is creating the CMU Health Women and Children Center in Saginaw. Supported by generous donations from the C.K. Eddy Family Memorial Fund administered through Huntington Bank and the Harvey Randall Wickes Foundation, the Center will serve children from birth through adolescence and provide personalized care for women throughout their entire lives. Designed to provide cutting-edge treatment and diagnostics, the Center will provide prenatal care and support the needs of families from diagnosis and counseling through treatment and follow-up. The Center will also provide a clinical learning site for medical students and residents. In addition to outstanding health care, women and children will receive assistance with socio-economic issues such as food insecurity, domestic violence and substance abuse; obtain support from other women with similar backgrounds and concerns; and have nearby access to hospital and subspecialty services with care coordination to enhance quality and reduce disparities in care. The CMU Health Women and Children Center is slated to open in early 2023.

ACEP Reacts to Final Rule of No Surprises Act On August 19, 2022, the federal government issued a final rule implementing part of the No Surprises Act addressing a problematic policy included in previous regulation that gave unequal weight to the Qualified Payment Amount (QPA) during the independent dispute resolution (IDR) process, tilting the process unreasonably in favor of insurance companies. ACEP joined with the American College of Radiology and the American Society of Anesthesiology to file a lawsuit against the government on this issue, as did several other organizations. In late February, the U.S. District Court for the Eastern District of Texas, in response to one of these suits filed by the Texas Medical Association, ordered that the flawed policy be withdrawn and invalidated immediately on a nationwide basis. ACEP is pleased that the final rule specifies the QPA will no longer be the presumptive factor. Less favorably, the rule claims that some additional factors, such as patient acuity, could already be reflected in the QPA, and therefore allows IDR arbitrators to omit them from consideration when choosing the proper payment amount. The rule does call out insurers for requiring providers to use a proprietary web portal to initiate open negotiation, and reaffirms they cannot require that. Notably, in a major win for emergency medicine, the rule adds an official definition of downcoding and adds a new requirement that if a QPA is based on a downcoded service code or modifier, the plan must provide an explanation of why the claim was downcoded, and the amount that would have been the QPA had the service code or modifier not been downcoded. The rule notes that without information on what the QPA would have been had the claim not been downcoded, the provider may be at a disadvantage during open negotiation compared to the plan or issuer. ACEP had strongly advocated for this additional disclosure requirement from health plans, and we are happy that the Departments have adopted the new policy. ACEP is still reviewing the rule, as well as additional information that the Departments released in conjunction with the rule. A more detailed analysis is coming soon. www.acep.org

The Bulletin | September 2022 27


A Day of Board of Medicine Renewal Requirements Let MSMS be your resource to earn the Michigan Board of Medicine CME - all in one day A Day of Board of Medicine Renewal Requirements Friday, September 23, 2022 | 8:30 a.m. - 4:15 p.m. Marriott East Lansing, 300 MAC Ave., East Lansing, MI 48823 Approved for 7 AMA PRA Category 1 Credits™ 8:30 - 10:30 a.m. Pain and Symptom Management Carl Christensen, MD, PhD, D-FASAM, FACOG, cMRO, Clinical Associate Professor, Dept. of Psychiatry and OB GYN, WSU School of Medicine 10:30 - 11:30 a.m. Balancing Pain Treatment and Legal Responsibilities Aaron J. Kemp, Chapman Law Group 12:15 - 1:15 p.m. Legal and Ethical Issues in ED Boarding of Psychiatric Patients Michael Redinger, MD, MA, Department of Psychiatry, Co-Chief, Program in Medical Ethics, Humanities & Law, Western Michigan University Homer Stryker MD School of Medicine 1:15 - 4:15 p.m. Implicit Bias Training MSMS is offering this course again on Friday, November 4, 2022, at the Sheraton Ann Arbor. Statement of Accreditation The Michigan State Medical Society (MSMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. AMA Credit Designation Statement The MSMS designates this live activity for a maximum of 7 AMA PRA Category Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

FOR MORE INFORMATION AND TO REGISTER, CLICK HERE

Court of Appeals Decision Represents Major Victory for Survivors of Catastrophic Crashes and Their Families Decision has binding effect on retroactive application of benefit reductions In a major victory for survivors of catastrophic crashes and their loved ones, the Michigan Court of Appeals ruled on 28

The Bulletin | September 2022

August 26, 2022, that benefit reductions passed as part of 2019 auto insurance reforms could not be applied retroactively. The Court ruled 2-1 in favor of the plaintiffs in the case of Andary et al. v USAA Casualty Insurance Company et al. The lawsuit was filed in 2019 by guardians of two catastrophically injured auto accident victims - along with the nationally renowned brain injury rehabilitation clinic Eisenhower Center - and names Citizens Insurance Company of America and USAA Casualty Insurance Company as the defendants. The victims, on whose behalf the lawsuit was filed, are Ellen Andary of East Lansing, and Philip Krueger of Ann Arbor. “The decision will enable thousands of severely injured accident victims to continue receiving medical expense and home care reimbursement at the benefit levels that were legally enforceable under insurance policies that those victims bought and paid for years before the new laws went into effect,” said George Sinas, lead counsel for the plaintiffs in Andary. Mr. Sinas is also general counsel for CPAN. “In addition, the decision will prevent insurance companies from reaping windfall profits by retaining premiums they collected to pay benefits they would no longer be required to provide,” said Mr. Sinas. Most significantly, the ruling determined that: • The legislation did not contain specific and sufficient language confirming that the legislature intended to apply these changes retroactively. • Even if the legislation contained sufficient provisions intending to apply benefit reductions retroactively, such an application would have been an unconstitutional violation of the Contracts Clause of the Michigan Constitution. • The trial court improperly dismissed the plaintiffs’ constitutional equal protection and due process challenges, which alleged that such benefit reductions would violate these constitutional provisions if applied to future accident victims, for the reason that such allegations required factual development in the trial court. Under the Michigan Court Rules, this published opinion has immediate, binding, precedential effect unless it is overturned by the state Supreme Court.

MSMS Reimbursement Advocate Alert BCBSM/BCN - CS modifier limited to specific codes that result in COVID-19 testing for commercial plans, effective September 1 To make physician billing practices more uniform, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) commercial plans will limit the use of the CS modifier to continued on page 30


MSMS Resource Guide For information on the topics listed here, dial 517/336-plus the four digit extension (unless full number is provided). For information on a topic not listed here, call MSMS at 517/337-1351 or 800/352-1351. YOUR ACCOUNT SPECIALIST

Heather Foster

517-336-5719 hlfoster@msms.org

EDUCATION

Rebecca Blake

517-336-5729 rblake@msms.org HUMAN RESOURCES

Jodi Schafer, SPHR, SHRM-SCP 517-336-5716 msms.org/HR

INSURANCE/ MEDICAL, DENTAL, VISION

Diane Wheelock

517-336-7591 dwheelock@msms.org INSURANCE/LIABILITY

Julie Ozbun

517-899-1457 jozbun@msms.org LEGISLATIVE ADVOCACY

Josiah Kissling

517-336-5737 jkissling@msms.org MEDICAL/ REGULATORY POLICY

Stacey Hettiger

517-336-5766 shettiger@msms.org PHYSICIAN WELLNESS/ SAFEHAVEN™

Kevin McFatridge

517-336-5745 kmcfatridge@msms.org REIMBURSEMENT ADVOCACY

Stacie Saylor

517-336-5722 ssaylor@msms.org

Alliance........................................................ 313/408-1359 AMA Delegation..........................................................5731 Annual Scientific Meeting .......................................5789 Antitrust Issues. ...........................................................5766 Board of Directors ......................................................5735 Chief Executive Officer .............................................5735 Closing a Practice .......................................................5766 Coding & Billing Questions .....................................5722 Continuing Medical Education ..............................7580 • Accreditation .............................................................7580 Contracting Checklists..............................................5766 Committees ..................................................................5711 Corporate Compliance .............................................5766 County Medical Societies ........................................5729 Durable Power of Attorney (to order forms).....5727 E & M Coding................................................................5722 Educational Programs...............................................5723 Employed Physicians.................................................5716 Government Relations..............................................5737 Grassroots Action Center / Engage ......................5745 Grassroots Political Action ......................................5788 Group Practice Resources........................................5716 Health Care Law ..........................................................5766 Health Information Technology ............................5770 House of Delegates....................................................5723 Human Resource ........................................................5730 Immunizations ............................................................5770 Information Systems .................................................7604 Insurance – Medical, Dental, Vision, Liability......... 877/742-2758 International Medical Graduate Section ............5723 Legislative Advocacy – Federal & State ..................5737 Managed Care Contracting ....................................5766 Media Relations...........................................................5745 Medicaid & Medicare • Legislation/Funding ................................................5737 • Reimbursement ........................................................5722 Medical Education .....................................................5729 Medical Ethic ................................................................5789 Medical Records Release .........................................5766 Medical Student Section..........................................5723 Medigram ......................................................................5753 Meeting Registration ................................................5789 Membership • Account Specialists..................................................5716 • Applications ...............................................................5716 • Change of Address ..................................................5716

• Dues Processing .......................................................5716 • Retired/Life Benefits................................................5716 Michigan Doctors’ PAC..............................................5737 Michigan Medicine® • Advertising .................................................................5753 • Editor ............................................................................5753 • MSMS Publication Subscriptions........................5753 MSMS Foundation ......................................................5723 Organized Medical Staff Section...........................5723 Patient Centered Medical Home ...........................5770 Physician Organization and Group Relations...5745 Practice Solutions .......................................................5753 POs and PHOs (Management) ...............................5745 Professional Liability Insurance .......... 517/899-1457 Public Relations ...........................................................5745 Reimbursement Advocate ......................................5722 Resident and Fellow Section ..................................5723 Risk Management (The Doctors Company) ........................ 517/899-1457 Starting a Practice ......................................................5766 Third-Party Payer Issues ...........................................5722 Travel Programs ..........................................................5735 Website ..........................................................................5745 Workers’ Compensation ...........................................5722 Young Physician Section..........................................5723

MSMS SUBSIDIARIES & AFFILIATES MSMS Physicians Insurance Agency .. 877/742-2758 Physician Review Organization .......... 517/336-1400 MSMS Physician Services Inc. (PSI) .... 517/336-5745 Prof. Credential Verification Service.. 517/336-1400 Quantum Medical Concepts................ 517/336-5745

ADDITIONAL IMPORTANT NUMBERS American Medical Association ........... 800/262-3211 American Osteopathic Association... 312/202-8000 Drug Enforcement Agency .................. 202/307-1000 Medicaid Provider Inquiry, Medicare Customer Service ................. 800/292-2550 MI Board of Medicine ............................ 517/335-0918 MI Board of Osteopathic Medicine and Surgery ............................................... 517/335-0918 MI Department of Health and Human Services • Local........................................................... 517/373-3740 • Toll free..................................................... 800/292-2550 MI Health Prof. Recovery Corp ............ 800/453-3784

Michigan State Medical Society PO Box 950 East Lansing, MI 48826 | Membership Fax Line: 517-481-3976 Please email or call if you have any member benefit questions!


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a list of codes that is similar to the list published by the Centers for Medicare & Medicaid Services (CMS) on February 4, 2021. This change for their commercial plans will go into effect with dates of service on or after September 1, 2022. The CS modifier identifies that the services resulted in a COVID-19 test, and are subject to the member cost-sharing waiver during the public health emergency. CLICK HERE for more information.

Ask Our Lawyer: Is It Legal to Offer Discounts and Waive Patient Copayment and Deductible Obligations? QUESTION: I am planning to build my private practice by offering patients discounts and/or to waive their copayment or deductible obligations. Is this legal? Must it be done on an “across the board” basis or can I instead be selective in deciding which patients to offer the waivers? ANSWER: Unlike other businesses, physicians and others providing health care services are subject to constraints on their ability to determine the amount of the fees for their services and when waivers of copayments and deductibles is permissible. First, the terms and conditions of your contracts with third party payers must be considered. These contracts typically restrict your ability to discount your fee and waive copayment and deductible obligations. You must carefully review all these agreements prior to doing so. Second, Michigan's Health Care False Claim Act (the "False Claim Act") makes it illegal to submit a claim for payment to a third party payer that contains a statement of fact or that fails to reveal a material fact that is misleading. Discounting a fee for a patient covered under a policy issued by a health care corporation or health care insurer or waiving such patient's

copay or deductible obligation without disclosing this fact could constitute the submission of a claim which fails to reveal a material fact. In the absence of the disclosure, it will appear to the health care corporation or health care insurer that your fee for the service provided was more than what was actually charged. Therefore, the claim may be deemed "deceptive" and "false" under the False Claim Act. The False Claim Act also prohibits the "rebate" of all or any portion of your fee if the rebate is given to a patient in consideration of that patient providing you a referral(s) of other patients. Third, the Federal Department of Health and Human Services ("HHS") has taken the position that the routine (i.e., “across the board”) waiver of Medicare copayments and deductibles by health care providers could be a violation of the Federal False Claims Act and the Federal Anti-Kickback Statute. HHS' theory is that if the waiver of the patient's copayment and/or deductible was based upon any reason other than the patient's financial hardship (e.g., referrals of patients by the patient whose deductible or copayment had been waived) violations of these Federal statutes would likely be deemed to have occurred. In guidance issued by HHS, it has been made clear that only the "routine" Medicare and/ or Medicaid copayments and deductibles would subject the health care provider to HHS scrutiny for violation of these Federal statutes. To the contrary, waivers of Medicare and/ or Medicaid copayments and deductibles made on a caseby-case basis due to a finding of patient's financial hardship would not subject the health care provider to such scrutiny. To protect yourself, the best practice is to have a written policy in effect in your practice setting forth the criteria that is used to determine when copayment and deductible obligations will be waived, and to limit those waivers to only those cases where a financial hardship combined with a documented need for care is present. By Daniel J. Schulte, JD, MSMS Legal Counsel

SCMS/MSMS 2023 MEMBERSHIP DUES NOW PAYABLE Free CME for Your SCMS/MSMS Membership Renewal by November 30! See page 5 for details

ADVERTISER INDEX All Seasons Skin and Surgery Center Andersen Eye Associates Ascension St. Mary’s Hospital Barb Smith Suicide Resource & Response Network Covenant Healthcare 30

The Bulletin | September 2022

11 5 23 7 2

When you have a need for a service, please consider our dedicated advertisers first!

Covenant General, Bariatric & Colorectal Surgery Covenant Wound Healing Center Jan Hauck – Century 21 Healthway Compounding Pharmacy

19 21 15 15

Lori Krygier Graphic Designer Melissa Morse – Bricks Real Estate Renue Physical Therapy Shields Chiropractic Wellspring Lutheran Services Home Health & Hospice

5 16 25 24 14


New Telehealth Suicide Prevention Toolkit Resource! Preview the telehealth toolkit, developed by Central Michigan University. Your input will enhance and benefit the resources for service providers in Michigan! Preventing Suicide in Michigan Men is a five-year, Centers for Disease Control grantfunded program aimed at reducing suicide in men ages 25 and older. To achieve this goal, the Michigan Department of Health and Human Services has implemented a comprehensive, multi-sector partnership and action plan that targets the male population in the state. The Michigan PRiSMM project is being led by the MDHHS. By 2024, the statewide PRiSMM initiative will work to reduce the number of suicide deaths and attempts among men ages 25 and older by at least 10 percent. From 2014–2018, more than 6,700 Michiganders lost their lives to suicide. Two-thirds of the suicide deaths in Michigan are adult men. CMU’s partnership with the PRiSMM initiative is to create and disseminate the toolkit and, in the process, cultivate a statewide training network for suicide prevention and telehealth. For more information, sign up for an overview, or to give us feedback on the toolkit, please contact the CMU Interdisciplinary Center for Community Health and Wellness at icchw@cmich.edu.

Preview the PRiSMM Telehealth SP Toolkit: med.cmich.edu/prismmtoolkit or Scan QR Code

CMU, an AA/EO institution, strongly and actively strives to increase diversity and provide equal opportunity within its community. CMU does not discriminate against persons based on age, color, disability, ethnicity, familial status, gender, gender expression, gender identity, genetic information, height, marital status, national origin, political persuasion, pregnancy, childbirth or related medical conditions, race, religion, sex, sex-based stereotypes, sexual orientation, transgender status, veteran status, or weight (see http://www.cmich.edu/ocrie). 20237 MGX 100 qty (10/21)


PRSRT STD U.S. POSTAGE PAID Saginaw, MI 48605 PERMIT #52

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

ADDRESS SERVICE REQUESTED

2022 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.

CALENDAR OF MEETINGS AND EVENTS FOR 2022-23* REGISTER NOW FOR THE SEPTEMBER MEETING! DEADLINE FOR RESERVATIONS 9/14/22 Tuesday, September 20, 2022 - Horizons Conference Center, 6200 State Street, Saginaw Board Meeting - 5:30 p.m. Membership Meeting Joint with the Saginaw Valley Osteopathic Society - Social (cash bar) at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Speaker - Alison Arnold, Ed.D., Director, Interdisciplinary Center for Community Health & Wellness, Central Michigan University “Revisiting ACEs: The Roots of Wellness and Building Our Inner and Collective Resilience” Approved for 1.5 AMA PRA Category 1 CreditsTM Learning Objectives: • Review the discoveries of the Adverse Childhood Experiences study and the significant life-long health impacts of early trauma and toxic stress • Understand why children exposed to ACEs are at elevated risk for chronic disease and risky behavior • Increase awareness of trauma-responsive practice and the ripple effects of secondary traumatic stress • Develop strategies to respond to children who present with trauma symptoms • Increase awareness of statewide resources, including the Prevention of ACEs Data to Action Project and the Michigan ACEs Initiative Online reservations are required by 9/14/22 CLICK HERE TO MAKE A RESERVATION Or scan the QR Code

Accreditation Statement: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Central Michigan University College of Medicine and the Saginaw County Medical Society. CMU College of Medicine is accredited by the ACCME to provide continuing medical education for physicians. Central Michigan University College of Medicine designates this live activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Disclosure: The planners and speaker have no relevant financial relationships with ineligible companies to disclose.

Saturday, October 8, 2022 – Horizons Conference Center, 6200 State Street, Saginaw CMU CME presents “Implicit Bias Training” (required for licensure) Time: 8-11 a.m. 3 AMA PRA Category 1 CreditsTM Available Click HERE to register and for more information, disclosures and accreditation (see page 10 in this issue for more information). Tuesday, October 18, 2022 - Horizons Conference Center, 6200 State Street, Saginaw Board Meeting - 5:30 p.m. Membership Meeting - Social (cash bar) at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Speaker - Thomas J. Veverka, MD, MSMS President “The Future of Medicine” Program - Candidates’ Forum for the November election Email meeting notices will be sent in early October. Online reservations are required. Tuesday, November 15, 2022 - CMU College of Medicine, 1632 Stone Street, Saginaw Board Meeting - 5:30 p.m. There is no Membership Meeting in November. *subject to change

Joan Cramer/SCMS | Office 790-3590 | Fax 331-6720 | Cell 284-8884 | jmcramer@sbcglobal net | www.SaginawCountyMS.com