SCMS BULLETIN - February 2019

Page 1


Bulletin Saginaw County Medical Society

February 2019 | Volume 77 | No 6

Physician Well-Being p. 18-23

Tuesday, April 16 Membership Meeting “TED Talks: The Human Challenge of Healthcare” p. 5

15th Annual Health Fair “The Doctor Is In” p. 12-13

Covenant Cancer Care Center Experts

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Covenant Medical Group • Surgical Oncology

Medical Director, Med. Oncology and Hematology Program

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Covenant Medical Group Medical Oncology/Hematology 5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5060 Tel • 989.583.5097 Fax

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Gregory Sutton, MD

Medical Director, Covenant Radiation Center

Medical Director, Gynecologic Oncology Program

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Covenant Medical Group Medical Oncology/Hematology

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Your helping hands in the

fight against cancer. ©2019 Covenant HealthCare. All rights reserved. Bus. Dev. (AQ/RF) Rev. 1/19


Bulletin Saginaw County Medical Society


contents 5

Tuesday, April 16 Membership Meeting “TED Talks: The Human Challenge of Healthcare”


15th Annual Health Fair “The Doctor Is In!”


January Membership Meeting

Mildred S. Willy, MD


President’s Letter

Anthony M. Zacharek, MD


President Julia M. Walter, MD President-Elect Zubeda S. Khan, MD Past President Virginia R. Dedicatoria, MD


Secretary Caroline G.M. Scott, MD Treasurer Mohammad Yahya Khan, MD Board of Directors

Jorge M. Plasencia, MD Kala K. Ramasamy, MD

Save the Dates – 2019 Membership Meetings


Golf Outing – Save the Date!

Mark G. Greenwell, MD


From the Editor

Bulletin Editor Louis L. Constan, MD


Attention Retired Members

Resident Representative Mary J. McKuen, MD


Barb Smith SR&RN

MSMS Delegates


Tiffany K. Kim, MD

Retiree Representative Rustico B. Ortiz, MD

Elvira M. Dawis, MD Zubeda S. Khan, MD Julia M. Walter, MD Virginia R. Dedicatoria, MD Mildred J. Willy, MD Anthony M. Zacharek, MD Jorge M. Plasencia, MD Christopher J. Allen, MD MSMS Alternate Delegates Caroline G.M. Scott, MD Waheed Akbar, MD Mohammad Yahya Khan, MD Danielle C. Duncan, MD Steven J. Vance, MD Amandeep S. Dhaliwal, MD Miriam T. Schteingart, MD Peer Review Ethics Committee Waheed Akbar, MD, Chair Caroline G.M. Scott, MD James R. Hines, MD MSMS District 8 Director Thomas J. Veverka, MD EXECUTIVE DIRECTOR Joan M. Cramer ADMINISTRATIVE ASSISTANT Keri Benkert

10 11

PHYSICIAN WELL-BEING • Dodge These Five Organizational Miscues • Stigma Often Prevents Doctors Themselves from Seeking Help • Physician Heal Thyself: Bringing Physician Suicide Out of the Darkness • Michigan Health Professional Recovery Program


Ascension St. Mary’s Hospital


March Birthdays


Covenant HealthCare


CMU College of Medicine | CMU Health


Call for Resolutions: Who Sets MSMS Policy? You Do! Key Provider of the Month – Covenant HealthCare Nursing Scholarship and Medical Student Loan Applications Available


Caduceus Meeting


Applications for Membership


Advertiser Index


Key Providers


Calendar of Events

The Bulletin can be viewed online at under the Bulletin tab.

ON THE COVER: Drs. Toby Long and Chris Allen EDITOR Louis L. Constan, MD

PUBLISHER Saginaw County Medical Society


350 St. Andrews Rd., Suite 242, Saginaw, Michigan 48638-5988. Hours: Tuesday, Wednesday, Thursday 8:30 AM - 3:30 PM. Web:

DESIGNER Lori Krygier

Telephone: (989) 790-3590. Fax: (989) 790-3640 E-Mail:

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 | February 2019 3


Become a Leader By Julia M. Walter, MD


he SCMS is seeking members interested in serving in an elected position. The Nominating Committee (which consists of the President, Past President (chair) and President-Elect) will develop the slate of officers, directors, delegates and alternate delegates for the 2019-20 program year in early March. The slate will be announced in April, and elections will take place at the annual meeting in May. The 2019-20 program year begins June 1, 2019. Elected positions are open to all SCMS members in good standing. We are in need of members to serve as one-year directors, as well as, alternate delegates. Pursuant to the Bylaws, all officers, directors, delegates and alternates must attend 50 percent of Board Meetings (five out of ten) in order to retain their position. Delegates have a vote, but alternate delegates do not. Generally, physicians new to the Board start as alternate delegates and work their way up to a director or officer position if they choose.

Board meetings are held on the third Tuesday of the month (except for July and December) at 5:30 p.m. Board meetings are held prior to the membership meeting in January, April, May and September at Horizons Conference Center and at HealthSource Saginaw in October. Board meetings in February, March, June, August and November are held at the CMU College of Medicine on Stone Street in Saginaw, and dinner is provided. We try to keep Board meetings to an hour, although they do tend to run a bit longer on nights we don’t have a membership meeting as there is more time to discuss the issues at hand. We work at keeping those meetings to 90 minutes or less. Alternate delegates (in order of seniority) are asked to attend the annual MSMS House of Delegates (the policy-making body of MSMS), which is held the last weekend in April or first weekend in May, if we don’t have enough delegates that are available. The SCMS pays the cost of hotel and parking for delegates and alternates, and a ticket to the President’s Ball on Saturday evening. The 2019 MSMS

HOD will be held Saturday-Sunday, May 4-5, 2019, at The Radisson Hotel and Suites in Kalamazoo. The 2020 MSMS HOD will be held SaturdaySunday, April 25-26, 2020, at The Henry in Dearborn. While all are welcome, we would particularly like to invite some of our younger members to join us on the Board - the time commitment is minimal. We value your input as we work to address the needs of our members and work towards the future of medicine. Any physician who has been an SCMS member for at least five (5) years is eligible to become President. Those wishing to serve as president must serve a minimum of three years as a director, and one year as president-elect before taking office. A final year as past president is then required, with the member staying involved after that time as a delegate or alternate if desired. Please contact Joan Cramer at the SCMS office at 7903590 or email jmcramer@ sbcglobal. net if you would like to be considered for a position.

While all are welcome, we would particularly like to invite some of our younger members to join us on the Board - the time commitment is minimal.


The Bulletin | February 2019

Save The Dates For Our Upcoming Membership Meetings! Tuesday, April 16, 2019, Membership Meeting Mark your calendar now for our Tuesday, April 16, 2019, Membership Meeting at Horizons Conference Center. The social with cash bar starts at 6:30 p.m., followed by dinner, meeting and program at 7 p.m.


Topic: “TED Talks* - The Human Challenge of Healthcare” Speakers: Sussan M. Bays MD | Duane B. Heilbronn MD *tentative Samuel J. Shaheen MD | Kimiko D. Sugimoto MD Steven J. Vance MD | Thomas J. Veverka MD So what is a TED Talk? A TED Talk is about ideas. It is about real people making connections with other real people. These talks are concise, every word counts, lasting about 10 minutes. Generally these talks are delivered without notes, from memory, conveying passion and possibilities. The theme of the evening will be The Human Challenge of Healthcare.

Tuesday, May 21, 2019, Membership Meeting Mark your calendar now for our Tuesday, May 19, 2019, Annual Membership Meeting at Horizons Conference Center. The social with cash bar starts at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Featured will be an update on the CMU College of Medicine.

The SCMS Foundation will host its 10th Annual Golf Outing on Saturday, June 8, 2019, at the Saginaw Country Club. The SCMS Foundation makes low interest loans to medical students with ties to the Saginaw area in the hopes of encouraging the students to return to Saginaw to practice. Interest and principal can be forgiven if they return to Saginaw to practice as SCMS members.

Saturday, June 8, 2019 Saginaw Country Club Four Person Scramble 12 p.m. Registration - 1 p.m. Shotgun Start Watch upcoming issues of The Bulletin for information and sponsorship opportunities!

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989-272-8123 IT Specialist to the SCMS and many physician practices Hours: MON-FRI 9 AM to 5 PM The Bulletin | February 2019 5


Danger/Danger By Louis L. Constan, MD


oes it seem sometimes that you are overwhelmed with “stuff?” It’s spilling out of closets, cluttering attics, crowding basements to where you can’t even find that one thing you need because it’s buried in the muddle. If that’s the case, then I may have to take back my conclusions from last month’s column, my comparisons between yourself as a selfless giver and George Bailey, the hero from “It’s a Wonderful Life.” You see, George, leading a rather modest life, focusing mostly on his customers, living in a modest home, preferred to use the profits at his bank to increase the number of home mortgage loans he could provide for his struggling neighbors. I’m not sure I can see that type of selfless lifestyle in too many physicians today, myself included. We’re steeped in a materialistic culture, and psychologists have been sounding the alarm for two decades that this culture leads to social isolation, greed, depression and anxiety. For physicians, as we shall see, it can lead to a breakdown in that allimportant Hippocratic contract and that “wonderful life” ideal of selfless service. Those alarms are going off in two main areas of critical importance to us. The first is in the natural, innate, human difficulty we have giving to others while we are focused on our own materialism, on

accumulating possessions for ourselves. Our minds are constructed in such a way that we have a great deal of difficulty doing both well. We tend to do one or the other. It’s like being right-handed or left-handed; we cannot be both. If we’re focused on doing for others, we’re not focused on accumulating personal wealth and possessions. If we’re focused on accumulating wealth and possessions, we’re not focused on doing for others. Can’t do both. Can’t be Hippocrates and JP Morgan. Let’s consider current reimbursement models that incentivize us for performance rather than for quality of care. What does it mean when my friend, who is employed by a hospital, receives a letter from his employer telling him that he is not ordering enough mammograms? Can he order those extra, unnecessary mammograms and still care properly for his patients? What about seeking that bonus for decreasing hospital length-of-stays, or increasing admissions or referring to “preferred” consultants? Do we enrich ourselves; or do we serve our patients? Research says we cannot give them equal priority. We must choose one or the other. The second alarm is a very personal one: Materialism, in and of itself, leads to depression. Yes, you do remember that

we are in the midst of an epidemic of depression and suicide? Materialism, the psychologists say, is the trap that promises happiness but gives us only misery. Yes, in the most capitalistic society the world has ever known, in this era of pervasive advertising, in a civilization where every aspect of our lives is questioned by social media, corporations and institutions, it should be no surprise that so many are so unhappy with themselves. And so, for physicians, this pursuit of possessions, of “stuff,” becomes not only distracting from our goal of serving patients, but it is bad for us personally, leading to unhappiness and depression. George Bailey, 72 years ago, probably had a pretty good life before the evil Mr. Potter stole his bank deposit, threatening him with financial ruin and imprisonment. Since suicidal ideation was far from his normal thoughts, it was easy for him to snap back when reminded of all that he had to be thankful for. His life was one of giving to others. He was the quintessential physician. He didn’t have time to feel sorry for himself. Nothing would get him down for long. But for someone who is chronically unhappy and depressed because he continued on page 7

Yes, in the most capitalistic society the world has ever known, in this era of pervasive advertising, in a civilization where every aspect of our lives is questioned by social media, corporations and institutions, it should be no surprise that so many are so unhappy with themselves. Louis L. Constan, MD


The Bulletin | February 2019

continued from page 6

has bought into today’s materialistic culture, this transition is difficult. He must move his life away from dependence on things to dependence on service to others as the road to happiness; focus on what he has, not on what he does not have; appreciate people more than possessions. And as he moves his life along the continuum away from materialism towards selfless service, he has less cause and literally less time to be unhappy with himself. Other, no less important tasks, include the making of lists of blessings, photo displays of loved ones, phone calls to relatives, and greetings to friends and neighbors. In summary, this New Year, may we all renew our commitment to the ideals of selfless service as personified by George Bailey, Hippocrates, Marcus Welby, the Mayo Brothers, David Livingstone, (include your own hero’s name here) and put an end to senseless materialistic acquisitions.


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! If you have any questions, please contact Joan Cramer at the SCMS office at 790-3590 or by email at

Muniz-Velazquez, Personality and individual differences, 116. 123-132 GV Bodenhausen, Psychological Science 2012 May 1 (5)517-23 Daudi, Ajani, Journal of Affective Disorders, 150 (2), Apr 2013 1

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The Bulletin | February 2019 7

NO STATE INCOME TAX Note: The following email was sent from three CMU medical students to Dean Kikano and the SCMS CMED safeTALK Suicide Prevention Training Reflections Hello Dr. Kikano, Thank you for giving us the opportunity to host the safeTALK suicide prevention training at CMED. As medical students, it is heartening and empowering to have our initiatives/interests supported by faculty and leaders such as yourself, especially when the cause is as important as that of preventing suicide in the general population and amongst our fellow colleagues.

An update to the safeTALK suicide prevention training:

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Through Joan Cramer’s support and a great presentation/ training by Barb Smith (Executive Director of the Barb Smith Suicide Resource & Response Network), we successfully hosted two training sessions at CMED in January. Both sessions had a healthy representation of M1 students and other allied health care professions students (PA, PT, etc.). Feedback from all participants has been wholly positive and the training was well received.

We are excited for the M2 cohort receiving the same training/ skill building in March. Thank you, Rebecca Hamburger, Kultaj Kaleka and Derek Wolfe

How Can You Help? Do you want to raise awareness, volunteer or participate in an upcoming event? Contact Barb Smith at or 989-781-5260 and schedule a training or educational event or get more information. Barb Smith Suicide Resource & Response Network is supported solely by donations and grants. To make a donation, please make your check payable to Barb Smith SR&RN and mail to: Barb Smith Suicide Resource & Response Network PO Box 6712, Saginaw, MI 48608-6712 The organization is a 501(c)(3) nonprofit, and your donation is tax deductible (EIN 38-3400293). 8

The Bulletin | February 2019

Call for Resolutions: Who Sets MSMS Policy? You Do! The Michigan State Medical Society (MSMS) House of Delegates (HOD), comprised of 319 elected delegates, is the official legislative and policy-making body of MSMS and its component societies, including the Saginaw County Medical Society (SCMS). Resolutions debated during the annual MSMS HOD are the vehicles by which MSMS policies, priorities and directives are determined. Deadline for resolutions is March 1 at 5 p.m. Resolutions must be submitted via the online submission form. If you have any questions, contact Stacey Hettiger at (517) 336-5766. The best way to get your idea or recommendation adopted as MSMS policy or directive is at the grassroots level. As a member in good standing of MSMS/SCMS, you have the right to bring your ideas to the annual HOD for consideration by MSMS’ "legislators." To do so, present your suggestion and rationale at the SCMS meeting. If the SCMS agrees, the SCMS will work with you to draft a resolution to be presented at the next HOD meeting. The resolution should specify the desired MSMS policy or directive for MSMS action. If the SCMS does not agree with your idea, you may ask another delegate to submit a resolution on your behalf as an individual delegate. It is also prudent to check MSMS’ current Policy Manual and, if relevant, the AMA Policy Finder to determine if policy on the issue already exists.



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The Bulletin | February 2019 9

KEY PROVIDER OF THE MONTH! “Key Providers” provide support for SCMS membership meetings. Each month, a Key Provider is featured in The Bulletin.

te t Please dona


re so that we may ca for children tomorrow.

The Covenant Kids Telethon highlights the extraordinary care Covenant provides for kids in our region and helps raise money to continue our work for kids on into the future.

Watch the telethon Saturday, April 27, Noon - 5 pm on WNEM TV5. Learn more at

© 2019 Covenant HealthCare. All rights reserved. PK Rev 1/19 10541

NURSING SCHOLARSHIP APPLICATIONS AVAILABLE The SCMS Alliance and SCMS Foundation provide $500 nursing scholarships to Saginaw County residents. Over the years, we have awarded many scholarships to help students continue their nursing education. Requirements for consideration: • Must be a permanent resident of Saginaw County; AND • Currently enrolled in a nursing program or beginning nursing clinical core courses for award year; AND • Overall college GPA no lower than 2.79. Application packet MUST be complete for consideration. Incomplete applications will be denied. All applications must include a one page essay describing your nursing career goals and how this scholarship would help you financially in completing your nursing degree. Two letters of recommendation from past or current professors must be included. NOTE: Prior award recipients must complete a new application packet with new letters of recommendation. This scholarship is not for graduating high school seniors. Applications may be downloaded from the SCMS website under the “Nursing Scholarships” tab. Deadline for applications is March 31, 2019.

MEDICAL STUDENT LOAN APPLICATIONS AVAILABLE Do you know of a medical student (with ties to the Saginaw area) in need of a loan? The SCMS Foundation may be able to help. The Foundation was formed in 1968 and originally funded through physician donation of earnings from educational and charity work. The Annual Golf Outing and donations now fund the Foundation which makes low interest loans to medical students with ties to the Saginaw area. The intent is to encourage physicians to return to Saginaw County to practice medicine.

The terms of these loans are generous. No interest is charged while the student is in medical school, simple interest is charged at a rate of four percent per annum during a residency program, and interest is charged at a rate of eight percent per annum upon the completion of a residency program. As of 2012, the Foundation Board voted to forgive all interest if the student returns to Saginaw upon completion of a residency to practice. Additionally, the Board voted in May 2016 to start a loan forgiveness program. If the loan recipient returns to Saginaw to practice upon completion of their residency and they are a dues paying member of the SCMS/MSMS, 25 percent of the principal balance will be forgiven at the end of each year they are practicing in Saginaw County, with a maximum of $5,000 per year forgiven. The Foundation Board generally considers students who are past their first year of medical school, and among other things, according to: • Strength of connection to Saginaw • Financial need • Scholastic performance • Community service/extracurricular activities The intent of the Foundation loans are to assist and encourage students to return to Saginaw to practice medicine. Only applicants enrolled in a United States medical school will be considered. If any SCMS member knows of a medical student in need (with an interest in the Saginaw area), please encourage him or her to apply. Applications may be downloaded from the SCMS website under the “Medical Student Loans” tab. Deadline for applications is March 31, 2019.

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Remodeling or Building New - Start with Us! The Bulletin | February 2019 11

SAGINAW COUNTY MEDICAL SOCIETY  15th Annual Health Fair “The Doctor Is In!” Saturday, March 16, 2019, 9 a.m. – 12 p.m. (note new end time) Horizons Conference Center  6200 State Street  Saginaw, Michigan 48603 VENDOR REGISTRATION PLEASE NOTE: Registration fee prior to February 22, 2019, is $200. Registration fee after February 22, 2019, is $250. DEADLINE FOR RECEIPT OF ALL BOOTH RESERVATIONS IS WEDNESDAY, MARCH 6, 2019, or until we reach capacity NO EXCEPTIONS. Vendor booths include one eight foot skirted table and two chairs. Coffee, water and soft drinks will be provided, along with a continental breakfast. Sales from booths are prohibited, but giveaways are encouraged. If you require two tables, you will be charged for two booths. Booths are available on a first come, first served basis, and space is limited. Please note we have shortened the Health Fair from four hours to three, since traffic has been traditionally light after 12 noon. Participants are asked to staff their booth during the entire Health Fair. Tear down will not be allowed until 12 p.m. Anticipated attendance - 1,100. If you would like to participate in the 15th Annual Health Fair, please complete and return this form and your check in the amount of $200 per booth (before 2/22/19) or $250 per booth (after 2/22/19) BUT NO LATER THAN WEDNESDAY, MARCH 6, 2019, payable to the Saginaw County Medical Society, to 350 St. Andrews Road, Suite 242, Saginaw, Michigan 48638-5988. Please contact the SCMS – Joan at or Keri at or 989-790-3590 with any questions (fax 989-790-3640). The Vendor Registration form can also be downloaded from our website at under the Health Fair tab. The 15th Annual SCMS Health Fair is a privately sponsored event. The SCMS reserves the right to refuse any vendors, including but not limited to, those who do not fit the mission and scope of the SCMS, physicians and/or businesses owned by physicians who are not members of the SCMS, and hospitals outside of Saginaw County.

PLEASE PRINT Name of Organization Contact Person Address City


Office Phone


What is planned for your space?

Zip Code Cell/Mobile

Email Number of people working your booth

Will you provide a health screening? If so, what type?

Do you require electricity? Please do not request electricity if you do not need it. Electrical outlets are not available at all booth locations, and booth placement is based partly on electrical needs. If yes, please bring an extension cord.  YES, we need electricity  NO, we do NOT need electricity Each booth has two chairs. If you are performing a screening or have more than two people staffing your booth, please indicate the total number of chairs needed: # of Vendor Chairs Needed ____ # of Testing/Waiting Chairs needed ____ Will you donate an item to be raffled off at the Health Fair? If so, please bring the item the day of the Health Fair and label it with your organization’s name.  YES, we will donate an item for the raffle.

Planned in association with Ascension St. Mary’s Hospital, CMU Health, Covenant HealthCare, Great Lakes Bay Health Centers, Michigan CardioVascular Institute and the Saginaw Valley Osteopathic Society Effective 11/5/18

SCMS USE ONLY Access Confirmed Paid Amount $______ Check #______ Date Paid ___/___/2019

12 The Bulletin | February 2019

15th Annual FREE Health Fair “The Doctor Is In!”

Saturday, March 16, 2019 9 a.m. to 12 p.m. | Horizons Conference Center | 6200 State Street, Saginaw 80 Medically Related Booths Physicians to Answer Your Questions at the SCMS Booth Drawings for prizes • AND MUCH MORE! Free Screenings*

Free Health Information*

Balance • Blood Pressure • Body Mass Index Cholesterol • Depression Diabetic Foot Exam • Glaucoma • Glucose Hearing • Lung • Pre-Diabetes Sleep Apnea • Spine • Stroke

Assisted Living • Bariatric Surgery • Breast Health Breathing Equipment • Cancer • Chiropractic Diabetes • Diabetic Shoes • Domestic Violence Gift of Life • Health Insurance Home Health • Hospice • Long Term Acute Care Mental Health • Nutrition • Nursing Homes Physical Therapy • Sexual Assault • Spine Care Stroke • Suicide Prevention • Women’s Health • Vitamins • AND MUCH MORE!


*tentatively scheduled

DUMP YOUR DRUGS! The Saginaw County Health Dept. and Sheriff’s Dept. will collect your unused and expired medications

Accepting non-perishable food donations for the East Side Soup Kitchen

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Planned in cooperation with:

The Bulletin | February 2019 13

Local Gastroenterology Group Joins Ascension Medical Group Ascension Medical Group in Michigan continues expansion through acquisition of McLaren Bay Valley Gastroenterology Effective January 25, the physicians and staff of McLaren Bay Valley Gastroenterology will join Ascension Medical Group (AMG) as employed medical staff. The practice, comprised of Medley Larkin DO, Erika DeGayner DO, Shawn Ingles DO, Harprabhjit Singh MD and Rajeev Tummuru MD will become Ascension Medical Group Valley Gastroenterology.

“The gastroenterology team has had a long and successful affiliation with Ascension St. Mary’s, sharing a commitment to provide exceptional, compassionate care that is individualized for each person,” said Cheryl Gueldenzopf, President, Ascension Medical Group, Mid-Michigan. “Their transition to AMG builds upon that success to become a more clinically integrated system of care, delivering exceptional health outcomes and enhancing the patient experience through unparalleled coordination of care.” With over 30 years of experience, Ascension Medical Group Valley Gastroenterology will continue to offer all gastrointestinal services and provide preventative and management treatment of chronic diseases of the gastrointestinal tract and liver; including heart burn, anemia, acid reflux, ulcers, stomach pain, hemorrhoids and diverticulosis. Patients will not experience any disruption in the care or services they have come to expect. The office and phone number will remain the same. Ascension Medical Group Valley Gastroenterology is located at 4680 McLeod Drive East in Saginaw Township (behind Ascension St. Mary’s Towne Centre). For more information or to schedule an appointment, call the office at (989) 791-9133. New patients are being accepted.

Ascension Medical Group Physician Practices Earn Patient-Centered Medical Home Designation Blue Cross Blue Shield of Michigan (BCBSM) has designated 13 Ascension Medical Group (AMG) physician offices across the mid and northern Michigan region as Patient-Centered Medical Homes (PCMH) for 2018-2019.


The Bulletin | February 2019

The PCMH designation means these practices continue to make improvements in health care quality. The PCMH approach encourages patients to take a more active role in their health care, working closely with their physicians to better manage their concerns and conditions. PCMH is not just about treating an illness, but keeping patients healthy while developing health goals and setting up plans to manage each individual patient’s health care. PCMH practices are considered the patient’s “home” and should be the first-place patients think of for their medical needs. In the 10th year of its program, BCBSM has designated approximately 4,630 physicians in 1,700 practices across Michigan as Patient-Centered Medical Homes. This change in practice patterns has resulted in higher quality care with better outcomes and lower cost. In addition to the AMG employed practices, 10 community partner practices within the Ascension Genesys and Ascension St. Mary’s Physician Hospital Organizations (PHO) also received PCMH designation.

PCMH Designated Practices for 2018-2019 Ascension Medical Group practices: AMG – Birch Run Family Physicians AMG – Chesaning Family Practice AMG – Frankenmuth Family Physicians (10 years) AMG – Heritage Family Physicians (10 years) AMG – Saginaw Valley Pediatrics AMG – Vassar Family Medicine AMG – Bay City Family Physicians (10 years) (formerly Women’s Health Center) AMG – Primary Care Grand Blanc Ascension St. Joseph Hospital Huron Family Medicine Ascension St. Joseph Hospital Internal Medicine Ascension St. Joseph Hospital Oscoda Health Park Ascension St. Joseph Hospital Pediatrics (10 years) Ascension Standish Hospital – Standish Family Medicine PHO affiliated practices: Caro Health Plaza – Naveed Mahfooz MD Cass River Health Plaza – Nilufa Akhter MD Harpal Singh MD Ibtihaj Rajoulh MD (10 years) Karu Medical Associates (10 years) Nikolai Kinachtchouk MD and Lioudmila Kinachtchouk MD Rama Mulpuri MD Satnam Medical – BJ Singh MD Zubeda S. Khan MD

Welcome New Physicians

Employed Medical Staff Expands Ascension St. Mary's continues to expand our care team and welcomes several new physicians to our employed medical staff. • Neurosurgery Eric Bialaski, DO, specializes in complex and reconstructive spine surgery and spinal oncology surgery. He joins neurosurgeons E. Malcolm Field, MD, Joseph Adel, MD & Naman Salibi, MD. (855) 298-9888


Eric Bialaski, DO Neurosurgery

• Primary Care Rachael Kasperowicz, MD, joins St. Mary's of Michigan Bay City Family Physicians (formerly Women's Health Center). (989) 671-9153

• Orthopedics Kevin Lawson, MD, brings years of experience in orthopedics with a special interest in laser spine surgery. (989) 799-1350 • Podiatry Laura Reitz, DPM, specializes in foot and ankle surgery, wound care, hammertoes, tendon injuries and complex forefoot & rearfoot reconstruction. (989) 790-6719

• Hematology/Oncology Roma Srivastava, MD, joins medical oncologists Ernie Balcueva, MD and Asma Taj, MD to complement our comprehensive cancer care program. She will focus on the care of patients with disorders of the blood, bone marrow, and lymphatic systems. (989) 497-3226

Rachael Kasperowicz, MD Primary Care

Kevin Lawson, MD Orthopedics

Laura Reitz, DPM Podiatrist/Foot and Ankle Surgery

Roma Srivastava, MD Hematology/Oncology

All are accepting new patients. The Bulletin | February 2019 15

The 29th Annual Joint Membership Meeting with the Saginaw County Dental Society was held on Tuesday, January 15, 2019, at Horizons Conference Center. In the absence of President Julia M. Walter MD, SCMS Director, Mildred J. Willy MD, called the meeting to order at 7:10 p.m.

For more information on“Surviving Acts of Violence,” visit Henry Reyna’s website Secure Solution, LLC

Dr. Willy welcomed Saginaw County Dental Society members and guests; S. Bobby Mukkamala MD, Candidate for MSMS President-Elect; Pete Levine, Genesee County Medical Society Executive Director; and Henry Reyna (speaker). Dr. Willy thanked the following Key Provider in attendance for their ongoing support of SCMS programs: • Covenant Wound Healing Center – Anthony deBari MD, David Gustavison DO, Khalid Malik MD, Jackie Tinnin and Melissa Zaroff. Dr. Willy then conducted the following business of the SCMS: • The Minutes of the October 16, 2018, Membership Meeting were attached to the Agenda and published in the November Bulletin. MOTION: Accept the October 16, 2018, Meeting Minutes as printed. MOTION APPROVED. • Announced new members approved at the November and January Board Meetings: 1) Judy S. Blebea MD (CMU College of Medicine – Associate Dean, Faculty Affairs, Faculty Development) – Radiology; 2) Nicholas E. Haddad MD (CMU Health-Internal Medicine) – Internal Medicine and Infectious Disease; 3) Mark J. Hass MD (Advanced Diagnostic Imaging, PC) – Diagnostic Radiology and Breast Imaging;

January Me

Top Left to Right: Drs. Steve Vance, Tony Zacharek, Bobby Mukkamala and Millie Willy at Board Meeting (photo courtesy of Pete Levine); Drs. Wendy Biggs and Bobby Mukkamala; Henry Reyna, Ann and Dr. Bill Mason

4) Wynee S. Lou DO (CMU Health-Primary Care) – Internal Medicine and Sports Medicine; 5) Venkat Maganti MD (Ascension St. Mary’s Heritage Family Physicians) – Family Medicine; and 6) Michael W. Warren MD (Advanced Diagnostic Imaging, PC) – Diagnostic, Vascular and Interventional Radiology. • Introduced new members in attendance: Drs. Judy Blebea and Wynee Lou. • Referred members to “The Passage of Maintenance of Certification Legislation for Family Medicine, Internal Medicine and Pediatrics,” which was attached to the agenda. ANNOUNCEMENTS: • The Genesee County Medical Society has invited SCMS members to a Town Hall on “How to Stay Out of Trouble with the New Opioid Laws,” on Thursday, February 7 at the Flint Golf Club. • The 15th Annual Health Fair will be held on Saturday, March 16, 2019, at Horizons Conference Center in Saginaw from 9 a.m. to 12 p.m. SCMS physicians are needed to staff the SCMS booth and answer questions of those attending. • The Program Committee is looking for topics for 2019-20 Membership Meetings.

• The Nominating Committee is seeking physicians to serve on the Board of Directors. • The 2019 MSMS House of Delegates will be held on Saturday-Sunday, May 4-5, 2019, at the Radisson in Kalamazoo. Members with ideas for a resolution should contact a Delegate, Board Member or Joan. • The 10th Annual SCMS Foundation Golf Outing will be held on Saturday, June 8, 2019, at the Saginaw Country Club. Dr. Willy welcomed William E. Mason DDS to the podium. Dr. Mason introduced the evening’s speaker, Henry Reyna, who presented a CME-accredited program on “Surviving Acts of Violence.” Dr. Willy thanked everyone for attending, and reminded them to sign in at the registration table and complete the online evaluation for CME credit within 60 days. The next Membership Meeting will be held on Tuesday, April 16, 2019, at Horizons. The topic will be TED Talks focused on “The Human Challenge of Healthcare.” The meeting was adjourned at 8:15 p.m. Respectfully submitted, Joan M. Cramer Executive Director

eeting Minutes

Top Left to Right: Drs. Judy and John Blebea; Drs. Tim Kaufman, Danielle Duncan, Jorge Plasencia and Mark Greenwell; M3 Elise Edwards-Cavalieri, Drs. Steve Vance, Tom Veverka and Tim Kaufman

Physician Well-Being Dodge These Five Organizational Miscues to Boost Physician Well-Being Sara Berg, Senior Staff Writer - AMA Wire® Physician burnout continues to receive growing attention, with more health care organizations searching for solutions to improve the well-being of their doctors and other health professionals. But just implementing a program without defining the goals, objectives and what determines success is not enough. Leaders at MultiCare Health System - a Tacoma, WA nonprofit - explained the lessons they have learned in creating a physician well-being program that works. “We realized we weren’t addressing burnout. We weren’t acting in a way that was providing the right level of advocacy and support for our providers and the ripple effect that it had on our care teams,” Jason Epeneter said at the International Conference on Physician Health in Toronto. The event was co-sponsored by the AMA, Canadian Medical Association and British Medical Association. “There was a fundamental shift that needed to happen” where physicians and other health professionals could focus on their own well-being, said Epeneter, who is a practice optimization consultant at MultiCare. Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing, issues causing and fueling physician burnout - including time constraints, technology and regulations - to better understand the challenges physicians face. The AMA Ed Hub™ - your center for personalized learning from sources you trust - offers CME on professional wellbeing using the STEPS Forward™ open-access platform to provide innovative strategies that allow physicians and their staff to thrive in the new health care environment. These toolkits can help you prevent physician burnout, create the organizational foundation for joy in medicine, create a strong team culture and improve physician resiliency. With such a large group of doctors and successful implementation in only nine months, MultiCare normalized the conversation and approached physician burnout at the system level. Here are five myths to avoid and tips for how to implement a physician well-being program at your organization. The program can be run by a single person. Ensure the correct people are at the table. The physician well-being 18 The Bulletin | February 2019

program began as a small grassroots effort with multiple levels of leadership, as well as, the operational and clinical side. It eventually evolved into a cross-functional team. In collaboration with physicians and the care team, MultiCare addresses the “pain points that are keeping people up at night and contributing to a lot of the distress or even the pajama time that they may be using to wrap up notes,” Epeneter said. You can wing it. Preparation is key to obtaining your health system’s leadership support. “Let’s create a roadmap to get there, establish a charter and vet that with different individuals along the way,” Epeneter said. You can count on the word getting around. With any new product, service and department in a health system, you need to spread the word. Explain why the program exists, how it can help and what it can do - show why it is beneficial. “We are there to help you - we’re advocates” for doctors and other health professionals, Epeneter said. “Our first and foremost effort, and reason for being here, is to serve you and ensure your health and well-being, so you can care for patients and have better outcomes and better work-life balance.” Use various channels and resources to share the well-being program, such as newsletters, meeting with supervisors and medical directors, highlighting scope of service and honoring confidentiality. You can improve without measurement. This will show what kind of progress you’re making - or failing to make. At MultiCare, a physician well-being index survey is distributed to physicians, nurse practitioners and physician assistants. The provider efficiency profile (PEP), a report from Epic, is also used to validate what physicians are feeling. “If they are working at all hours of the night, the PEP will say exactly what their pajama time looks like and what kind of time they are spending in Epic on their days off,” said Ellie Rajcevich, also a practice optimization consultant at MultiCare. “That has helped us not only identify where some problems are, but also some opportunities.” You don’t need feedback. To have a successful well-being program, it is important to have feedback and support from physicians, the health care team and leadership. MultiCare has a wellness advisory group to ensure success of the program. This group of 20 physicians from across the organization help the team focus on areas that need attention. “We know so much from our data, but we learn so much from actually hearing people talk about their experiences,” Rajcevich said.

Stigma Often Prevents Doctors Themselves from Seeking Help Crain’s Detroit Business | JAY GREENE Physician suicides are higher than the general population, and they’re more likely not to seek help. • Physician suicide rates could be as high as 40 per 100,000, possibly higher than veteran suicide rates of 30 per 100,000 • Medical groups, hospitals have made efforts to reduce stress that leads to burnout, and encourage treatment • Early signs of suicidal thoughts in professionals can be hard to see When northern Michigan physician Barrett Zink, 65, died by suicide in August 2017, it was a shock to his family and patients he had treated over his 30-year plus career. Zink had struggled with depression his whole life, a common problem with suicide victims. With Henry Ford Hospital resident Ramesh Kumar, who shot himself at a rest stop east of Jackson, there were no warning signs. The 32-year-old Kumar, who friends and family described as outgoing and friendly, was two years away from becoming a practicing physician, a dream he had since fifth grade. Doctors who die by suicide often have untreated or undertreated depression, a fact that underscores the need for early diagnosis and treatment, said Katherine Gold, a family physician at the Depression Center at the University of Michigan and researcher who has published three studies on mental health. The irony? Doctors are often less likely than others to seek that treatment. The most recent meta-analysis study on physician suicide conducted by a Harlem Hospital researcher in New York showed a rate of 28 to 40 suicides per 100,000, which is higher than the rate among veterans of 30 per 100,000. The study, which was presented last summer as a poster at the American Psychiatric Association, was based on studies published over the past 10 years in various peer-reviewed journals. One of the most cited studies on physician suicide was another meta-analysis published in 2004 by physicians Eva Schernhammer and Graham Colditz. Their analysis showed

rates ranging from about 10 to 100 per 100,000 in men and that while female physicians attempt suicide much less often than men, their completion rate is much higher. Female doctors also are 2.3 times more likely to die by suicide than the general female population. “I did a study where I surveyed a group (2,106) of doctor moms on Facebook,” Gold said. “(About 50 percent) were depressed and needed help, but were afraid to seek help because it would be reported to the state medical board” and they feared they could lose their licenses. “Some drove out of state to seek mental health counseling” and others did not seek professional help because they feared stigma that could cost them their jobs or reputations. Barb Smith, founder of Barb Smith Suicide Resource & Response Network in Saginaw, said female doctors face additional stressors that helps to explain why female suicide rate for doctors is higher than the general female population. “They are torn between home, family and work pressures,” said Smith, who is working with the Saginaw County Medical Society and Central Michigan University College of Medicine to develop physician and medical student wellness programs. “They want to get ahead but the world doesn’t stop and (some) feel hopelessness because they don’t have time to take care of families, themselves, they feel like a burden and have no fear of death.” continued on page 20

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Gold said there is a need for more studies on physician suicide. But there have been multiple surveys and articles that show that physicians have higher rates of burnout, depressive symptoms and suicide risk than the general population. Residents and medical students also can experience high degrees of mental distress and are less likely than other members of the public to seek mental health treatment. For example, 28 percent of residents experience a major depressive episode during training, compared with eight percent of similarly aged individuals in the U.S. general population, one survey showed. “Unfortunately, mental health issues with physicians are underreported and undertreated due to many factors including stigma, shame but more importantly, antiquated questions on hospital privileges and state licenses. This latter issue has to be addressed from a policy perspective,” George Kikano, MD, Dean of the College of Medicine at Central Michigan University in Mt. Pleasant, said in an email to Crain’s. Richard Landau, a trial lawyer and licensed psychologist with RJ Landau Partners PLLC in Ann Arbor, said medical students, residents and practicing physicians face immense pressure in a changing health care system that also places doctors in highly stressful and repetitive situations where life and death literally hang in the balance.


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“Law and medical schools place levels of stress and sleep deprivation that is a type of torture,” said Landau, who also is a clinical psychologist. “(Training) is designed to create people who are stronger, but it also inflicts trauma on people that leads to vulnerabilities.” Gold said one reason physicians don’t seek help is because many doctors worry about confidentiality when it comes to seeking help and how it can affect their jobs. “Medical licensing boards ask questions about whether doctors have sought mental health counseling,” Gold said. That discourages physicians from seeking help when they face problems. “Michigan is more progressive and doesn’t ask those questions.” Gold said the Federation of State Medical Boards last year passed a resolution to reduce the stigma of mental health counseling and recommend state boards not ask mental health questions. She said some hospitals, medical schools and professional medical organizations are taking positive steps to help doctors manage stress and burnout. “It (improvement) is mixed,” she said. “More attention is being paid to work hours by residents, and there is more attention to burnout and satisfaction. The job has changed over the years. The family doctor is doing more work at


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20 The Bulletin | February 2019

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the computer, pushing buttons and spending less time with patients. There still is a lot of dissatisfaction.” More hospitals need to make mental health support more available in a confidential way, Gold said. For example, hospitals should try and minimize stress in the workplace and modify credentialing applications to avoid discouraging doctors from seeking mental health treatment. Last year, the Michigan State Medical Society passed a resolution to encourage suicide awareness training for doctors and it later was approved at the American Medical Association’s annual meeting. The resolution is also part of a national effort to improve identifying patients with mental health problems, but also encourage doctors to start thinking about how they can help themselves stave off burnout, depression and suicide, Smith said. Smith said the physician stress, burnout, substance abuse and suicide problem in Michigan is very serious and there is little support and time given by themselves and organizations they are affiliated with to get their own needs met. “This leads to burnout, sleep deprivation, hopelessness and suicide,” she said. The Michigan State Medical Society also has a referral relationship with the Michigan Psychiatric Society for physicians who want to speak with a professional. It also

supports Michigan’s Health Professional Recovery Program, a state program that encourages licensed professionals to go through a monitoring program for substance use or mental health disorders. After Kumar’s suicide last year, Lisa MacLean, director of the physician wellness program at Henry Ford Health System, said the Detroit-based system expanded its resident and fellow wellness program to all physicians, and is encouraging all doctors to recognize stress, burnout and suicide warning signs of their peers. For example, if there is a behavioral incident, a medical team huddles to discuss what led to the stressful situation, how to prevent it next time and provide emotional support. “There have been reporting, referrals, calls from a residency director about a change in behavior in a person and that is reported to the physician employee assistance program,” MacLean said. “We need to decrease the stigma so people receive the care they need,” she said. “We have created a policy to give residents time to get preventive medicine. They get two full days off to see a psychiatrist, get mental health counseling. We are getting reports they are using it.” Source URL: stigma-often-prevents-doctors-themselves-seeking-help

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Physician, Heal Thyself Bringing physician suicide out of the darkness Seeking respite from the all-consuming rigors of the cancer ward, I remember, I took my smartphone out of my pocket. As I aimlessly flicked through innumerable memes and videos posted on Facebook, I paused on one particularly painful post. A medical intern in New York at Presbyterian Hospital had jumped from his apartment to his death less than two months into his training. There was enough sadness to go around on the cancer ward, but this hit close to the heart. The medical profession is one of great privilege. Starting as medical students and continuing as trainees and attendings, physicians are bestowed the wonderful responsibility of taking care of patients. They are also very well respected professionals, have unparalleled job security and are extremely well reimbursed. Yet suicide seems to factor into their lives much more frequently than those of non-physicians, particularly early in their training. No matter how robust one’s training in medical school might be, few things can prepare one for a single day in the life of an intern. All of a sudden, the level of responsibility skyrockets and the number of critical decisions made multiply exponentially. It often takes the suicide of someone famous to make people take pause and pay attention. The last time people in general really cared about suicide occurred after Robin Williams’ untimely and tragic death, which brought the conversation about suicide back into the public’s focus. Physicians, however, are at an even higher risk of suicide compared to non-physicians. This risk remains even after accounting for all known confounders, such as age, gender, level of education, mental health, substance use and socioeconomic status amongst others. One estimate suggests that more than a million Americans lose their physicians to suicide every year. Suicide among doctors is particularly unnerving. Faced with an already burgeoning mental health crisis, the fact that even the supposed bulwarks of society against disease are vulnerable may lead one to question if there is any meaningful way of preventing suicide. Worryingly, psychiatrists are consistently reported to be at most risk for suicide amongst medical specialists. Younger physicians, those still studying and training, are particularly vulnerable: Suicide is responsible for a quarter of all young physicians dying in the United States. Yet, this is not only an American phenomenon. I remember when I was a medical student back in Pakistan and I returned from clinic to the dorms to see a large crowd gathered around the room of a medical student just in his first year. A loner, not many outside


The Bulletin | February 2019

his class knew of him until that day when he was found hanging by a rope in his room. Was he financially challenged? Was he homesick? Had he been dumped by his girlfriend? There were many theories but none fit. Like so many other suicides, though, while we always hope for there to be a narrative or a reason, there was none forthcoming. The reason why suicide continues to afflict doctors is similar to reasons why it continues unabated amongst non-physicians. Unlike ‘organic’ diseases, mental disease continues to be wrapped in stigma, and a culture of silence surrounds such incidents. Medical schools and hospitals, like other large organizations, frequently take the silent-treatment approach to suicide among students and employees, not wanting to attract (possibly negative) publicity. Not talking about it has not helped reduce the rate of suicide and mental illness among students and interns, and that culture has to change. The start of internship is perhaps the biggest transition doctors ever have to make - from students to practitioners - and it is also the time of greatest upheaval. Residency programs need to be explicit and upfront about having the ‘talk’: It is okay to be depressed, it is okay to seek help, and there is no such thing as being ‘weak.’ During my last year of residency, I got an unexpected invitation from my program director to meet her in her office. My first instinct, of course, was that I had done something wrong. I was pretty nervous because I had no idea what it could be. However, she had learned about a particularly stressful situation I had been going through. It was an extremely personal matter that I hadn’t even shared with my family. She offered me her full support, and on a small yellow sticky note, wrote the name of a psychiatrist whom the residents could see for free. When I walked out of her room, even though I never made that appointment, just having that note in my pocket seemed to take half my worries away. Before we arm medical students with unparalleled knowledge and immense skill and send them off to stamp out disease, perhaps it is time to revisit the biblical proverb, “Physician, heal thyself.”

Psychology Today Haider Warraich MD On Modern Medicine December 22, 2018

Health care professionals are not immune to substance abuse or mental health disorders. Many otherwise highly qualified professionals may develop these problems due to stress, long hours, a genetic predisposition, or a tendency to self-medicate. To assist health care professionals impaired by these disorders, consider the care monitoring services of the Health Professional Recovery Program (HPRP). The Michigan HPRP was established by legislation in 1993 to assist impaired professionals before their actions harm a patient or damage their careers through disciplinary action. Any licensed or registered health care professional in the State of Michigan is eligible to participate in the program. To maintain participant confidentiality, the HPRP is operated by a private-sector contractor under the authority of the Health Professional Recovery Committee (HPRC), a committee comprised of a representative from each of the health professional licensing boards. The Michigan Department of Community Health, Bureau of Health Professions provides administrative services to the HPRC.


Faith Abbott DO Raghav Dev Acharya Student Robert P. Ainsworth MD Joseph N. Aquilina MD Christopher M. Archangeli MD Edward S. Bernreuter MD Harold Blumenstein MD Bryan D. Brazeau MD Aditya D. Bulusu MD Louis F. Byrne MD Brenda M. Coughlin MD Ryan T. Davis Student Jonathon P. Deibel MD Stephanie J. Duggan MD Danielle C. Duncan MD Thomas G. Ferreri MD Maher Ghanem MD Timothy R. Hackett MD Laura Saleh M. Hijazi MD Timothy H. Kaufman MD Asif H. Khan MD Siang-Chean Kua Student Andrew M. LaFleur MD James R. LaFleur MD James A. Letson, Jr. MD Albert G. Linden MD Veronica E. Lorenzo MD Omar N. Marar MD Luigi Maresca MD Michelle M. McLean MD Kurt A. Menapace MD

3/1 3/3 3/29 3/7 3/16 3/19 3/22 3/24 3/18 3/30 3/13 3/8 3/20 3/21 3/9 3/6 3/8 3/24 3/31 3/29 3/11 3/17 3/22 3/9 3/29 3/12 3/27 3/17 3/19 3/27 3/6

Participation in the HPRP is confidential. If a licensee/ registrant is referred to the program, has a qualifying diagnosis and complies with the HPRP requirements, his/her name will not be disclosed to state regulatory authorities or the public. Provided there is no readmission, records of HPRP participants are destroyed five years after successful completion. Referrals to the HPRP may come in the form of a self-referral from a licensee/registrant or from colleagues, partners, employers, patients, family members or the State. Any of the 20 health professional licensing boards may also refer licensees/registrants to the HPRP for monitoring as a condition to regain or retain their license to practice. The names of individuals reporting a licensee/registrant suspected of impairment are also kept confidential. For more information on the HPRP, call 1-800-453-3784 or visit Informational presentations on the HPRP are available to employers and health professional groups at no charge. Call the toll-free number to arrange a presentation at your facility.


Omer S. Mirza MD James R. Mlejnek II MD Nobou Nakagawa MD Matthew C. Newman MD Paige M. Norwick Student Sajeda Nusrat MD Christopher J. Oravitz MD Rustico B. Ortiz MD Elizabeth S. Pagler MD Eric A. Pitts DO A. O. Rajagopal MD Shelby T.A. Reitzel MD Conchita D. Riparip MD Jennifer R. Schmidt DO Shiraz H. Shariff MD Maxim Shaydakov MD Alexa M. Shepherd MD Alana P. Siwicki Student Michael J. Slavin MD Wael A. Solh MD Kristine K. Spence DO Jared P. Steinberger MD Robert J. Toteff MD

3/28 3/17 3/8 3/10 3/15 3/24 3/3 3/31 3/27 3/20 3/27 3/4 3/20 3/17 3/3 3/2 3/2 3/17 3/7 3/19 3/29 3/6 3/7

Happy Special Birthday, Doctor Toteff!

Dorothy Wong Student Scott C. Woodbury MD Harvey K. Yee MD Yong C. Yoon MD Asim Yunus MD Paul E. Zeller Student

3/27 3/11 3/20 3/12 3/5 3/11

The Bulletin | February 2019 23

Covenant HealthCare ER Achieves Senior Accreditation Second Hospital in the State, Only Hospital in the Region

Covenant HealthCare added the Great Lakes Bay Region’s first Senior Emergency Care Center in 2017 with the senior population in mind. The Covenant medical team wanted to take this one step further, applying for Geriatric Emergency Department Accreditation (GEDA) from the American College of Emergency Physicians (ACEP) in 2018. In mid-January, ACEP announced the Covenant Emergency Care Center achieved the Bronze Standard – Level 3 GEDA Accreditation. Covenant is the second hospital in the state of Michigan to obtain this accreditation, and the only hospital in the region. In a letter to Covenant President/CEO, Ed Bruff, ACEP states, “Led by a remarkable team of inter-disciplinary leaders including Risty Kalivas, DO, and Jessica Dematio, BSN, CEN, Covenant Medical Center’s accreditation signals to the public that your institution is focused on the highest standards of care for your communities’ older adults.” “I’m incredibly proud of our team and their efforts to put our patients first every day,” says Patrice Lanczak, BSN, MSN, MHA, RN, Director of Emergency, Trauma and Stroke Services. “This validates the work we do to provide extraordinary care to every generation.” The GEDA program is the culmination of years of progress in emergency care of older adults. In 2014, ACEP along with Society for Academic Emergency Medicine, Emergency Nurses Association and American Geriatrics Society, developed and released geriatric ED guidelines, recommending measures ranging from adding geriatric-friendly equipment to specialized staff to more routine screening for delirium, dementia and fall risk, among other vulnerabilities. The voluntary GEDA program, which includes three levels similar to trauma center designations, provides specific criteria and goals for emergency clinicians and administrators to target. The accreditation process provides more than two dozen best practices for geriatric care, and the level of GEDA accreditation achieved depends upon how many of these best 24

The Bulletin | February 2019

practices an emergency department is able to meet. A Level III emergency department must incorporate many of these best practices, along with providing inter-disciplinary geriatric education, and having geriatric appropriate equipment and supplies available. Approximately 18 of the Covenant Emergency Care Center’s 65 beds have been designated for elderly patients. In designing an emergency center to meet the distinct needs of older patients, physicians, nurses and hospital leaders included best practices such as: - Board-certified emergency doctors, nurses and residents with specialized training in the care of senior patients. Seniors not only feel comfortable, but also understood. - Senior-friendly rooms keep patients comfortable while social work support, assessments and goals maximize independence. - All medications are closely monitored to avoid interactions, and more. Physicians and hospital leaders believe that providing specialized patient centric care to the elderly can reduce readmissions and improve patient satisfaction. As physician administrator of the Covenant Senior Care, Dr. Kalivas adds that senior emergency rooms can be the saving grace for many elderly patients who need specialized treatment. “This can improve outcomes and quality of life while reducing errors and costs,” he said. “The goal is to better serve this portion of our community and continue a tradition of providing extraordinary care for every generation.” The population of seniors in the United States has been growing steadily since 2011, which is the year the first Baby Boomers turned 65. Today individuals 65 and older represent 16.7 percent of Michigan’s population. By 2030, experts estimate that number will swell. Locally, the Covenant Emergency Care Center logged close to 94,000 patient visits in 2018. Of those patients: - 22,235 patients were older than age 65 (24 percent of the hospitals annual ECC visits) - Approximately 4,100 were age 85 to 94 - 514 patients were older than age 95

About the Covenant Emergency Care Center Covenant HealthCare is the most preferred hospital for emergency care, offering: - The only Level II Trauma Center verified by the American Academy of Surgeons for both adult and pediatric trauma care - The region’s only specialized Pediatric Emergency Care Center and Senior Emergency Care Center in the region - Only board-certified emergency physicians and trauma surgeons - More nurses with greater specialty training - Extraordinary compassion and service that has put Covenant in the top 10 percent for patient satisfaction among hospital emergency departments nationwide - The most comprehensive emergency department, caring continued on page 25

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for more patients than any other emergency department in our 20-county service area - Diagnostic equipment within the department - 65 private patient rooms - Free valet parking For more information, visit emergency

Covenant Receives Reverification as Level II Trauma Center for Adults and Pediatrics Covenant HealthCare has again been verified as a Level II Trauma Center for adults and pediatrics by the Verification Review Committee (VRC), an ad hoc committee of the Committee on Trauma (COT) of the American College of Surgeons (ACS). This achievement recognizes the trauma center’s dedication to providing optimal care for injured patients. Established by ACS in 1987, COT’s Consultation/Verification Program for Hospitals promotes the development of trauma centers in which participants provide not only the hospital resources necessary for trauma care, but also the entire spectrum of care to address the needs of all injured patients. This spectrum encompasses the pre-hospital phase through the rehabilitation process.

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30.3 million

people are living with diabetes – 84 million are living with prediabetes.

Verified trauma centers must meet the essential criteria that ensure trauma care capability and institutional performance, as outlined by ACS’ COT in its current Resources for Optimal Care of the Injured Patient manual. The ACS COT’s verification program does not designate trauma centers. Rather, the program provides confirmation that a trauma center has demonstrated its commitment to providing the highest quality trauma care for all injured patients. The actual establishment and the designation of trauma centers is the function of local, regional or state health care systems agencies, such as the local emergency medical services (EMS) authority. There are five separate categories of verification in COT’s program. Each category has specific criteria that must be met by a facility seeking that level of verification. Each hospital has an on-site review by a team of experienced site reviewers, who use the current Resources for the Optimal Care of the Injured Patient manual as a guideline in conducting the survey. ACS is a scientific and educational association of surgeons that was founded in 1913 to raise the standards of surgical education and practice, and to improve the care of the surgical patient. ACS has over 72,000 members, and it is the largest association of surgeons in the world. Longstanding achievements have placed ACS in the forefront of American surgery and have made it an important advocate for all surgical patients.

We are the region’s most experienced diabetes management team. Our program is certified by the American Association of Diabetes Educators (AADE) through the Michigan Department Health and Human Service (MDHHS). We are certified to provide education for patients of all ages and diabetes diagnoses, including pregnant women. Put your trust in the region’s most experienced diabetes management team . . . your PatientCentered Medical Home partner. We also have a Diabetes Prevention Program to help prevent or delay Type 2 diabetes. To refer a patient or for more information call 989.583.5193

©2018 Covenant HealthCare. All rights reserved.PK 1/18 10448

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College of

Medicine CMU Health Offers Convenient Service Options for Pediatric Patients in Saginaw We aim to satisfy our patients by providing excellent service, expert health care and convenient options. CMU Health now has an after-hours Pediatric Clinic at 1000 Houghton Avenue in Saginaw for sick visits on Mondays and Tuesdays from 5-7 p.m. In addition, CMU Health offers a Pediatric Asthma Clinic led by Adeeba Khan MD, a board-certified pediatrician. The goal of the clinic is to help children with asthma avoid frequent ER visits/hospitalizations, recurrent oral steroid burst to manage flares, and ultimately enjoy an active, happy and healthy life like their peers. Pediatric Asthma Clinic offerings include: • Managing day-to-day exposure • Inhaler technique demonstrations • Education in identifying asthma triggers • Medicine usage education • Action planning for emergency flare-ups • Comprehensive approach to improving health conditions Call (989) 746-7500 to schedule an appointment or make a referral.

Saginaw-area Supporters Advance Medical Simulation Center Capabilities Central Michigan University (CMU) College of Medicine leadership, faculty, students and residents wish to thank the Allen E. & Marie A. Nickless Memorial Foundation, Harvey Randall Wickes Foundation, the Margaret Jane Stoker Charitable Trust, administered by Huntington Bank, John Michael Jeffers Memorial Fund, administered by Huntington Bank, and the Wickson-Link Memorial Foundation for their generous support. Together, these investments in the education and training of our students, residents, physicians and regional health care professionals will enhance the spectrum and safety of care in the Great Lakes Bay Region. Endoscopic and Laparoscopic Virtual Reality-Based Simulation The Margaret Jane Stoker Charitable Trust, administered by Huntington Bank, provided funding to extend surgical simulation capabilities to include endoscopic and laparoscopic procedures required for our general surgery residency program. The Simbionix LAP Mentor™ III System and GI Mentor™ BRONCH Mentor™ System provide the learner with a robust virtual reality experience that is highly accurate and realistic. This support benefits current and future patients in Saginaw 26

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County and across the region by training a pipeline of new surgeons trained in these high-demand procedures. High-Fidelity Emergency Patient Simulator The John Michael Jeffers Memorial Fund, administered by Huntington Bank, provided support to purchase two Sim Man Advanced Life Support Manikins and the SimMan 3G High Fidelity Simulator used in cardiac arrest and medical crisis management training. Utilized heavily by emergency response teams, these simulators will improve crisis management, decision making, communication and handovers between health care providers. Pediatric Simulation Manikin The Harvey Randall Wickes Foundation has provided support to purchase a new manikin named Pediatric Hal – the world’s most advanced pediatric patient simulator – which will be used in the education and training of medical students, residents and area pediatric care providers. Video Recording and Communications Capabilities Upgrade The Wickson-Link Memorial Foundation and Allen E. & Marie A. Nickless Memorial Foundation teamed up to provide muchneeded financial support to upgrade digital video recording capabilities in our simulation center. These technologies support team debriefing sessions, critical to the success of our training programs.

Rehman Appointed Medical Director of Saginaw County Health Department Najibah K. Rehman, MD, MPH, has been appointed Medical Director of the Saginaw County Health Department (SCHD). In this new role, she will see patients at CMU Health as a Preventive Medicine provider while working on quality improvement initiatives with health care providers to improve patient care and screening for preventable diseases. At the SCHD, she will serve as the top physician for Saginaw County by addressing the public health needs of its citizens by serving as a liaison between the County, community organizations and health care and allied health organizations. “My dual role at CMU Health and SCHD is the best-case scenario for Saginaw County. I am seeing the needs of patients firsthand, which can then be applied to the unique needs of the Saginaw community as a whole. I am honored to be part of the movement to strengthen and improve upon public health initiatives already in place in the Great Lakes Bay Region,” says Dr. Rehman.

Cowling Joins American Health Council’s Physician Board Kathleen M. Cowling, DO, MS, MBA was recently selected to the American Health Council’s Board of Physicians. She is an Emergency Medicine professor and Director of the Emergency Medicine residency program with the College of Medicine. In addition to her positions with CMU College of Medicine, she has spent 25 years in the health care industry and has lectured nationally. Learn more here

250 Students and Faculty Receive safeTALK Training CMU College of Medicine, in partnership with the Barb Smith Suicide Resource & Response Network , is working to ensure that the next generation of health care professionals (providers) have the training needed to help prevent suicide as recommended by the American Medical Association. With the scheduled upcoming and completed safeTALK training, more than 250 students and faculty will have the tools needed to help us decrease the numbers of people dying by suicide. safeTALK is an evidence-based training program that teaches participants to recognize and engage persons who might be having thoughts of suicide, and to connect them with community resources trained in suicide intervention. safeTALK stresses safety while challenging taboos that inhibit open talk about suicide. This training has been successful in helping students both professionally and personally.

MSMS to Host Opioid Town Hall In late 2017, Michigan passed a series of opioid laws in an effort to address the State’s opioid epidemic. Several unintended consequences emerged as the laws took effect, some of which could negatively impact patient care and access to legitimate pain medication. Moreover, the laws failed to adequately address barriers to treatment. As part of its legislative priorities, MSMS will be working to address these barriers. This process began last year with MSMS’s successful Twitter chat on the opioid epidemic, which reached more than 250,000 separate Twitter accounts and gained more than two million impressions. The Twitter chat included 87 contributors, 659 retweets and a continued conversation that lasted several days. Now MSMS is turning its focus on the next iteration of education by hosting a Town Hall. MSMS’s Opioid Town Hall will bring together physicians and other interested stakeholders to discuss relevant issues and concerns related to the opioid and illicit drug crisis and related prescribing laws.

The Opioid Town Hall will be both an in-person, as well as, a livestreamed event. MSMS President Betty Chu, MD, MBA, will moderate a diverse panel of experts. The Opioid Town Hall will begin with a brief historical perspective regarding Michigan’s opioid epidemic, review case studies that will put in perspective the impact of the new laws on the epidemic and care delivery, and identify strategic goals and policy solutions to move forward. • Date: Monday, February 25, 2019 • Time: 7-8:30 p.m. EDT • Location: Henry Ford Allegiance Health Charles Anderson Building Auditorium 205 N. East Ave, Jackson, MI • Host: Michigan State Medical Society • Audience: Physicians, other prescribers and policy-makers • CME: 1.5 AMA PRA Category 1 Credits™ are available free of charge • Panelists: Betty S. Chu, MD, MBA (Moderator) Peter Graham, MD Edward A. Jouney, DO continued on page 28

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Rami Khoury, MD David Neff, DO Daniel J. Schulte, JD, MSMS Legal Counsel Senate Majority Leader Mike Shirkey (R-Clarklake) • Registration: For the in-person event, OpioidTownHall For the LIVESTREAM event, OpioidTownHallLIVESTREAM *Statement of Accreditation: MSMS is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. *AMA Credit Designation: The Michigan State Medical Society designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

New Controlled Substance Prescribing Rules in Effect Michigan prescribers and patients have experienced the implementation of several legislative and regulatory actions intended to address Michigan’s opioid crisis over the past year. Most recently, revisions to the Michigan Board of Pharmacy’s Controlled Substance rules were finalized and took effect immediately upon filing with the Office of the Great Seal on January 4, 2019. There were three important changes to the rules; perhaps most notable of which is the identification of exceptions to the “bona fide prescriber-patient relationship” requirement in MCL 333.7303a. On April 2, 2018, the Legislature responded to stakeholder concerns by delaying the effective date of the bona fide relationship provision to March 31, 2019, or upon the promulgation of rules carving out exceptions, whichever was sooner. Because the rule establishing these exceptions was finalized with immediate effect, the requirement of a bona fide prescriber-patient relationship prior to prescribing a controlled substance to patients also took effect on January 4, 2019. MSMS and many other health care stakeholders collectively advocated for exceptions that allow prescribers to provide timely, appropriate and non-duplicative care to patients. MSMS Legal Counsel has prepared a Legal Alert (member login required) detailing the statutory bona fide prescriber-patient relationship requirement, the administrative rule exceptions and suggested best practices for compliance. The related rule change is as follows: • R 338.3161a – Prescribers must be in a “bona fide prescriber-patient relationship” before prescribing a controlled substance listed in schedules 2 to 5. Exceptions allowing a prescriber to prescribe a controlled substance 28

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listed in schedules 2 to 5 without first establishing a bona fide prescriber-patient relationship are recognized in the following circumstances: o When a prescriber is providing on-call coverage or cross-coverage for another prescriber who is not available and has established a bona fide prescriberpatient relationship with the patient, as long as the prescriber or an individual licensed under article 15 of the act, reviews the patient’s relevant medical or clinical records, medical history, and any change in medical condition, and provides documentation in the patient’s medical record. o When the prescriber is following or modifying the orders of a prescriber who has established a bonafide prescriber-patient relationship with a hospital inpatient, hospice patient, or nursing care facility resident and provides documentation in the patient’s medical record. o When the prescriber is prescribing for a patient that has been admitted to a licensed nursing care facility or a hospice and completes the tasks required in subrule (2)(a) and (2)(b) in accordance with the nursing care facility or hospice admitting rules and provides documentation in the patient’s medical record. o When the prescriber is prescribing for a patient, and the tasks required in sub-rule (2)(a) and (2)(b) are complied with by an individual licensed under article 15 of the Public Health Code and the prescriber provides documentation in the patient’s medical record. o When the prescriber is treating a patient in a medical emergency, as defined in the rule. In addition, prescribers need to be aware of two other important changes as follows: • R 338.3125 - Gabapentin has been added to the schedule 5 drug list as a controlled substance. As a result of this change, any prescribers prescribing gabapentin must be registered with the Michigan Automated Prescription System (MAPS). Prescribers must also obtain and review the patient’s MAPS report if prescribing a quantity that exceeds a three-day supply, unless dispensed and administered to a patient within a hospital or freestanding surgical outpatient facility. • R 338.3135 - Licensees applying for or holding a controlled substance license, as well as, delegates who prescribe, administer, or dispense on behalf of a licensee, will be required to complete a one-time opioid and other controlled substances awareness training. This requirement continued on page 29

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does not take effect until September 1, 2019, for initial licenses and the first renewal cycle after the promulgation of this rule for controlled substance license renewals. More details will be forthcoming from the MSMS Education Department as the compliance deadline nears. A complete copy of the new Pharmacy - Controlled Substances Rule Set is available on the Michigan Department of Licensing and Regulatory Affairs website at www.michigan. gov/bpl. If you have additional questions, please contact Stacey P. Hettiger, MSMS Director of Medical and Regulatory Policy, at 517-336-5766.

Upgraded Online Licensing System Means New CSL and DCL Numbers for Some Licensees with Controlled Substance License and/or Drug Control License numbers that do not start with “5315” and “5307,” respectively, will be issued new numbers from the Michigan Department of Licensing and Regulatory Affairs (LARA) - Bureau of Professional Licensing. Affected licensees should have received an explanatory letter from LARA in January. If you would like to check your CSL and/or DCL license number, visit License/Search and then search by licensee name. LARA is transitioning to a new online licensing and regulatory database called the Michigan Professional Licensing User System (MiPLUS) . In order to be compatible with the upgraded licensing platform, CSLs need to start with “5315” and DCLs with “5307.” MiPLUS is expected to provide LARA staff and Michigan licensees with greater efficiencies including the following: • Individuals can apply online, track the status of their application, renew their license and receive electronic notifications. • Licensees can modify their existing licensing information and upload documents. • Licensees can self-report their convictions and disciplinary actions from other states. • Individuals can verify the status of a licensed professional, file a complaint against a licensed professional or report a change in staff privileges. • Licensees can delegate another individual to pay fee or upload documents. Nurses were the first to be phased in back in July 2017. Physicians and 10 other professionals will be part of Phase 2 which is scheduled to go live in early May. The date for Phase 3 is yet to be determined. The issuance of new CSL and DCL numbers for the affected licensees does not require any change to the licensee’s

permanent professional license (MD or DO). However, any licensees who are not currently registered in the Michigan Automated Prescription System (MAPS) will have to contact the United States Drug Enforcement Agency (DEA) at www. once they receive their new license number(s) from LARA. LARA is working with the DEA to provide them with the new license numbers for persons registered in MAPS. Additional assistance can be obtained from LARA by emailing or calling 517-241-0199. You may also contact Stacey P. Hettiger at shettiger@msms. org or 517-336-5766 with questions.

MiLES Provides $50,000 in Loan Repayment to Physician Residents A new physician loan program - the Michigan Loan Reimbursement and Employment Solution (MiLES) - will be accepting applications from January 2 through February 28, 2019. The program is open to MD or DO physicians in their last two years of residency in these specialties: Family Medicine, Internal Medicine, General Surgery, Pediatrics, Psychiatry or OB-GYN. READ MORE

Caduceus Meeting for Recovering Health Care Professionals Third Thursday of each month at 7 p.m. Zion Lutheran Church 454 7th Street, Freeland, Michigan (Behind Pat’s Grocery Store on Midland Road in Freeland)

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. The Bulletin | February 2019 29

APPLICATIONS FOR MEMBERSHIP SECOND READING: Applications for membership that may be recommended for acceptance at the February 19, 2019, Board Meeting:

Najibah K. Rehman, MD (Saginaw County Health Department – Medical Director, and CMU College of Medicine, Assistant Professor, General Preventive Medicine & Public Health) Kevin J. Lawson, MD (Ascension St. Mary’s Specialty: General Preventive Medicine and Orthopedics) Public Health Specialty: Surgery – Orthopedic (Board Medical School: Wayne State University School of Medicine, 2014 Certified 1991) Residency: Detroit Medical Center, Wayne State University, Surgery – Spine (Board Certified 2009) Detroit, Internal Medicine, 07/14 to 12/15 Pain Management Residency: University of Michigan, General Preventive Medicine Medical School: University of Michigan Medical School, 1983 and Public Health, 7/16 to 6/18 Internship/Residency/Fellowship: Cleveland Clinic Sponsors: Doctors Waheed Akbar and Juliette M. Perzhinsky Foundation, Orthopedics, 1983-88 and Adult Spinal Surgery, Monique S. Turner, DO (Women’s Ob-Gyn, PC) 1988-89 Specialty: Ob/Gyn (Board Certified 2018) Military: U.S. Air Force, Travis AFB, California, Staff Surgeon, Medical School: Michigan State University 1989-93 College of Osteopathic Medicine, 2012 Sponsors: Doctors Waheed Akbar and Tarek Taha Internship/Residency: Henry Ford Macomb Hospital, Ob/Gyn, 2012-16 Oveys Mansuri, MD (CMU Health - Surgery) Military: U.S. Air Force, 1996-98; Michigan Army National Guard, Specialty: Surgery – General (Board Certified 2012) 2000-present Medical School: University of Illinois College of Medicine, Sponsors: Doctors Jennifer R. Schmidt and Kristine K. Spence Chicago, IL, 2005 Lisa M. WintonLi, MD (CMU Health - Surgery) Internship/Residency: University of Illinois, Chicago, IL, Specialty: Surgery - General (Board Certified 2018), General Surgery, 2005-08 Surgery - Breast Residency: University of California, San Diego, CA, General Medical School: Ohio State University College of Surgery, 2008-10 Medicine, Columbus, OH 2012 Fellowship: Harvard Medical School, Boston, MA, Surgery, Internship/Residency: Maricopa Integrated 2010-11 Health Systems, Phoenix, AZ, General Surgery, 2012-17 Sponsors: Doctors Timothy R. Hackett and Samuel J. External Rotation: Stanford University, Breast Surgical Oncology, Shaheen 4/15 to 5/15 Omar N. Marar, MD (CMU Health - Surgery) Specialty: Surgery – General (Board Certified Fellowship: University of Texas Southwestern, Breast Surgical Oncology, 8/17 to 11/18 2018), Surgery - Colorectal Sponsors: Doctors Elizabeth A. Paulus and Samuel J. Shaheen Medical School: Royal College of Surgeons Ireland, Dublin, Ireland, 2012 Internship: Abington Memorial Hospital, Abington, PA, General Surgery, 2012-13 Residency: St. Barnabas Medical Center, Livingston, NJ, General Surgery, 2013-17 Fellowship: Thomas Jefferson University Hospital, Philadelphia, PA, Colon and Rectal Surgery, 2017-18 Sponsors: Doctors Maher Ghanem and Wael A. Solh

ADVERTISER INDEX Advanced Diagnostic Imaging, P.C. Ascension St. Mary’s Hospital Barb Smith Suicide Resource & Response Network Covenant HealthCare Covenant Diabetes Self-Management Program Jan Hauck – Century 21 HealthSource Saginaw 30

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When you have a need for a service, please consider our dedicated advertisers first! Healthway Compounding Pharmacy Horizons Conference Center/Riverview Brownstones Lori Krygier Graphic Designer Norton + Kidd Accounting & Consulting, P.C. Peak Performance PC Services Shields Chiropractic Wolgast Corporation

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Behavioral Medicine | Medical Rehabilitation | Long-Term Care

We are like no other hospital in the area. Our focus is recovery. We specialize in getting you back on your feet from surgery, debilitating illness or injury, chemical dependency or mental issues. Whether your rehabilitation journey is short or long, we’re at your side every step of the way.

3340 Hospital Road • Saginaw Township • The Bulletin | February 2019 31


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



These Area Businesses Support Saginaw County Medical Society Membership Meetings. When you have a need for a service, please consider our Key Providers. Please mark your calendar for the following meetings and events in 2019. You will receive an email meeting notice and reminder each month for SCMS events. Non-SCMS events are listed as a courtesy and you must contact the sponsor directly to register. SCMS Membership Meetings are held on the third Tuesday of January, April, May, September and October. The SCMS Board meets on the third Tuesday of every month (except July and December) at 5:30 p.m.

Saturday, March 16, 2019 Horizons Conference Center - 15th Annual Health Fair “The Doctor Is In!” from 9 a.m.-12 p.m. (see pages 12-13) Tuesday, March 19, 2019 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m. Tuesday, April 16, 2019 Horizons Conference Center - SCMS Board meets at 5:30 p.m. Membership Meeting with Social (cash bar) at 6:30 p.m. followed by dinner and program at 7 p.m. Program: “TED Talks: The Human Challenge of Healthcare.” See page 5 for more information.

Tuesday, May 21, 2019 Horizons Conference Center - SCMS Board meets at 5:30 p.m. Membership Meeting with Social (cash bar) at 6:30 p.m. followed by dinner and Annual Meeting at 7 p.m. Program: “Update on CMU College of Medicine.” Saturday, June 8, 2019 Saginaw Country Club – 10th Annual SCMS Foundation Golf Outing. Four person scramble. 12 p.m. Registration and Lunch, with 1 p.m. Shotgun Start. Tuesday, June 18, 2019 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m. Joan Cramer/SCMS | Office 790-3590 | Fax 790-3640 | Cell 284-8884 |