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The

Bulletin Saginaw County Medical Society

February/March 2018 | Volume 76 | No 5

Second Victim

Register Now for Tuesday, April 17, 2018 Membership Meeting on Second Victim Spouse/Significant Other Invited p. 4-5

Register to Sponsor and Golf! 9th Annual SCMS Foundation Golf Outing p. 10-11

January Membership Meeting p. 16-17

www.SaginawCountyMS.com


Covenant Structural Heart Disease Program

Structural Heart Disease Program Services Research shows that an estimated two million people in the U.S. are currently living with structural heart disease. While most individuals can have surgery to help improve their heart condition, some patients may be considered intermediate or high-risk. As a result, they find themselves living in constant fear and exhaustion because they’ve been told that there is nothing else they can do. Now there’s new hope for these patients. With the first and most comprehensive Structural Heart Disease Program in the Great Lakes Bay Region, Covenant Center for the Heart is leading the way with new, emerging options in minimally-invasive treatments.

The Structural Heart Disease Program offers two minimally-invasive procedures for intermediate or high-risk heart patients Transcatheter Aortic Valve Replacement (TAVR) – Individuals with aortic stenosis need an aortic valve replacement. When the aortic valve is not fully open, patients suffer a decrease in blood flow from the heart to the body. While open heart surgery is the ideal treatment for aortic stenosis, a third of these patients do not qualify for the surgery. This minimally-invasive procedure repairs the narrowing valve by wedging a replacement valve in place, which expands and pushes the old valve out of the way. Participating TAVR Physicians: Firas Alani, MD; Parthiv Amin, MD; Peter Fattal, MD; Adebambo Kadri, MD; Safwan Kassas, MD; Daniel Meldrum, MD and Manoj Sharma, MD.

Watchman – To lower stroke risks, this device is permanently implanted to close the Left Atrial Appendage (LAA), the source for a large majority

of stroke-causing blood clots in people with non-valvular atrial fibrillation. The Watchman device helps prevent the migration of blood clots from the LAA, reducing the patient’s risk of stroke. Participating Watchman Physicians: Firas Alani, MD; Safwan Kassas, MD and Asim Yunus, MD.

In addition, our extraordinary heart team also provides other structural heart disease procedures Patent Foramen Ovale (PFO) procedure – This is a catheterbased closure of atrial and ventricular wall defects, commonly known as a “hole in the heart”. Atrial Septal Defect (ASD) procedure – A catheter is threaded through a blood vessel in the body up to the heart. Then, a closure device is threaded through the catheter and placed into the ASD, an abnormal hole in the wall separating the top two chambers of the heart. Our Structural Heart Disease Program consists of an extraordinary, multidisciplinary team of experts who work together to develop a customized treatment plan for every patient. This includes cardiologists, interventionalists, cardiac surgeons, anesthetists, nurses and technicians (cath and electrophysiology lab, ECHO and surgical). Our newly emerging minimally-invasive treatment options might be just right for you, giving you an improved quality of life you didn’t think possible. Contact Covenant Structural Heart Coordinator Deb Best, MSN, RN at 989.583.7171 to learn more about the Structural Heart Disease Program at Covenant Center for the Heart. ©2018 Covenant HealthCare. All rights reserved. Bus. Dev. (AQ/RF) Rev. 2/18


The

Bulletin Saginaw County Medical Society

SAGINAW COUNTY MEDICAL SOCIETY 2017-2018 OFFICERS AND DIRECTORS President Julia M. Walter, MD President-Elect Zubeda S. Khan, MD

contents 5

8

Past President Virginia R. Dedicatoria, MD

10-11

Register Now! April Membership Meeting on “Second Victim” CMU College of Medicine “Thanks For Staying” Thursday, April 19

Secretary Sanjay J. Talati, MD Treasurer Christopher J. Allen, MD (Interim)

16-17 26-29

9th Annual SCMS Foundation Golf Outing Sponsorship and Team Registration January Membership Meeting MAPS Registration and Integration

Board of Directors B.L. Nahata, MD Mildred J. Willy, MD Gopi K. Nallani, MD Anthony M. Zacharek, MD Maliha N. Shaikh, MD Jorge M. Plasencia, MD Bulletin Editor Louis L. Constan, MD Retiree Representative Larry S. Kelly, MD Resident Representative Abhishek A. Bhandiwad, MD MSMS Delegates Elvira M. Dawis, MD B.L. Nahata, MD Zubeda S. Khan, MD Sanjay J. Talati, MD Julia M. Walter, MD Virginia R. Dedicatoria, MD Mohammad Yahya Khan, MD Mildred J. Willy, MD MSMS Alternate Delegates

4 6 7 7 8 8 9 12 13 14 15

President’s Letter From the Editor Attention Retired Members! Mark Your Calendar for 2018 Meetings Alliance News Caduceus Meeting for Recovering Health Care Professionals MCVI Cardiac Critical Care Symposium – April 14 Key Provider of the Month – Covenant HealthCare March Birthdays Covenant HealthCare

Gopi K. Nallani, MD

J. Patricia Dhar, MD Danielle C. Duncan, MD Jorge M. Plasencia, MD Christopher J. Allen, MD Jacquelyn M. Charbel, DO Peer Review Ethics Committee Waheed Akbar, MD 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

25 30 32 32

St. Mary’s of Michigan | Ascension CMU College of Medicine | CMU Health April Birthdays MSMS – A Day of Board of Medicine Renewal Requirements – April 18 BeAWARE – Reversing the Opioid Epidemic Start Talking Consent Form for Use with Minors Advertiser Index Key Providers Calendar of Events

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

Waheed Akbar, MD

Steven J. Vance, MD

24

In Memory – Richard D. Goldner, MD

Applications for Membership

Caroline G.M. Scott, MD

Anthony M. Zacharek, MD

15 18 20 21 22

EDITOR Louis L. Constan, MD

PUBLISHER Saginaw County Medical Society

EXECUTIVE DIRECTOR Joan M. Cramer

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

DESIGNER Lori Krygier

Telephone: (989) 790-3590. Fax: (989) 790-3640 E-Mail: jmcramer@sbcglobal.net

All statements or comments in the Bulletin are those of the writers, and not necessarily the opinion of the Saginaw County Medical Society. Contributions are welcome. We publish committee reports, letters to the editor, Alliance reports, public health activities of the members, and some personal items (birthdays, weddings, graduations and like events). The Editor determines which are accepted. Advertisements are accepted as space is available at our going rates. Members may advertise office information, professional services, skills, and procedures, also at our going rates. We do not accept advertisements from nonmembers, or non-Saginaw hospitals. The Bulletin is mailed free of charge to SCMS members as part of their membership. Complimentary copies are sent to various other parties. Others may subscribe at the rate of $50 per year.

The Bulletin | February/March 2018 3


PRESIDENT’S LETTER

Second Victims: How Do You Feel? Coping with Traumatic Medical Events By Julia M. Walter, MD

W

hen patients die, it’s a stark reminder that despite our advanced degrees and clinical training, physicians are human after all. Unfortunately, we can’t save everyone and things happen beyond our control. Consider these possible scenarios. • A 40-year-old woman undergoes a standard hysterectomy, but her body starts to systematically shut-down during recovery; she is put on a respirator and later dies despite multidisciplinary efforts to save her. • A 37-year-old man suffers a grand mal seizure due to an allergic reaction to anesthesia which progresses to cardiac arrest; he is saved only due to the availability of a fully prepped cardiac operating room. • A 12-year-old honor student’s parents take her to her doctor and then to the hospital due to constant vomiting and a high fever; she later dies of complications of an especially virulent form of flu. The patients and families, of course, are the first victims of any adverse event. But there are also second victims: The physicians

and other health care workers involved in the event. The Emotional Toll The term “Second Victim” was introduced by Professor Albert Wu in 2000 in a British Medical Journal study. He said, “Although patients are the first and obvious victims of medical mistakes, doctors are wounded by the same errors; they are the second victims.” Second Victim applies to any health care provider exposed to any traumatic life-and-death event. The emotional and psychological toll can be huge, even for the most experienced. Second Victims, in fact, experience many of the same emotions as first victims. These include: • Numbness and detachment • Confusion, anxiety and agitation • Withdrawal, grief and depression • Shame, guilt, anger and selfdoubt • Lack of concentration and confidence • Post- traumatic stress disorder – reliving the event through flashbacks and nightmares

Without help, some health care workers will leave their profession, and others will sadly resort to suicide. Numbing Down Unfortunately, the litigation environment has fostered a climate of fear and culture of silence which, when combined with the expectation for medical perfectionism, makes it difficult for physicians to reach out and ask for help. According to Wu, “Strangely, there is no place for mistakes in modern medicine… innovations that present tangible images of illness have in fact created an expectation of perfection. Patients, who have an understandable need to consider their doctors infallible, have colluded with doctors to deny the existence of error.” As a result, physicians are expected to distance themselves emotionally – a trend called numbing down. Unfortunately, the problem is exacerbated when you are not allowed to discuss the incident with others, and when you feel guilty continued on page 5

“Although patients are the first and obvious victims of medical mistakes, doctors are wounded by the same errors; they are the Second Victims.” Julia M. Walter, MD

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The Bulletin | February/March 2018


continued from page 4 for even thinking about yourself. Add to this the anger and distresses expressed by family members, finger-pointing (even from colleagues), possible litigation and inquisition-type atmosphere, and you get a climate where no one is talking, listening or learning constructively, nor are they healing. Peer Support and More Dealing with Second Victim Syndrome is a complex problem that requires multiple solutions. A few key solutions include: • Providing health care workers with emotional first aid • Opening the door to communications between first and second victims • Improving systems-based thinking The good news is that the industry is making progress, creating accessible “safe haven” support structures for physicians and other providers struggling to cope, whether or not they made a mistake. These structures are committed to supporting the well-being of health care providers and to building a foundation for culture transformation and communications. Effective programs are peer-supported to provide the level of understanding, credibility and empathy that only peers can provide. Peer support programs are proven to also strengthen teamwork and compassion, while eliminating the stigma of formal support services. Importantly, they provide an outlet for personal expression, giving physicians

the chance to ask difficult questions such as: Why do I feel weak? Should I even be a doctor? Why do I feel bad even if it wasn’t my fault? Hallmarks of peer-support programs include: • Staffed by peers • Confidential • Non-judgmental • Constructive feedback • Immediately available, 24/7 • Voluntary participation • Separated from the investigation process (no written documentation) • Outlet for personal expression Industry is also making progress with systemic improvements. Greater than 90 percent of the outcomes experienced in health care are a function of systems – not the individual physicians. Ergo, 90 percent of the mistakes are system-based. Initiatives like High Reliability Organizations are helping to minimize these errors while improving patient safety, patient satisfaction and efficiency. In addition, an increasing number of institutions are updating their disclosure policies to better address the emotional needs for all parties involved – patients, families and providers. Hope Team is Here For You 24 Hour Hotline|(989) 583.HOPE (4673)

Register Online Now for our April Membership Meeting on Second Victims! REGISTER ONLINE NOW! Tuesday, April 17, 2018, Membership Meeting Spouse/Significant Other Invited Register now for the Tuesday, April 17, 2018, Membership Meeting at Horizons Conference Center. Spouse/ significant other also invited to attend! PROGRAM: Second Victim – Several local healthcare providers will share their experience as a Second Victim, and how to deal with Second Victim Syndrome. Who is a Second Victim? Second Victims are “healthcare providers who are involved in an unanticipated adverse patient event, medical error and/or a patient related injury and become victimized in the sense that the provider is traumatized by the event.” The Second Victim

phenomenon can occur to any healthcare provider, in any organization. See the President’s Letter on page 4 for more information on Second Victims. Date: Time:

Tuesday, April 17, 2018 6:30 p.m. Social (cash bar), 7 p.m. dinner, brief meeting and program Place: Horizons Conference Center, 6200 State Street, Saginaw Cost: No cost for SCMS Members, Residents, Medical Students and Spouse/Significant Other Non-member physicians $100 each All others $40 each Those who make a reservation and do not attend will be charged a $25 cancellation fee. Click to make an online reservation. The Bulletin | February/March 2018 5


FROM THE EDITOR

High(er) Anxiety By Louis L. Constan, MD

Q. A.

What’s the difference between life and love?

Life is one crazy thing after another, and love is two crazy things after each other

In the January Bulletin, we talked about the high anxiety that may be associated with medical practice and how we might deal with it; this month we’ll consider what’s happening on the other side of the examining table or the hospital bed. And it’s not a pretty view. Fortytwo thousand suicides a year and rising. Eighteen percent of adults suffering disabling mental disorders sometime during any given year and rising. Antidepressants the second most commonly prescribed drugs. Doctors severely stressed; patients severely stressed. One wonders if you could re-write the above joke somehow, like, which side of the examining table is needier? If there’s a joke, I’m not laughing, because medical care is

simply too serious for levity, and the challenges ahead of us are just too daunting. After we’ve dealt with all the complexities of medical care, insurance reimbursements and government regulations; after we’ve dealt with our own anxieties, burnout, depression…we must deal with psychologically broken patients. We must, because if we don’t, our medical interventions will not succeed. Stressed-out patients don’t take their meds, don’t show up for appointments, don’t stop smoking, don’t stop opioids, don’t go back to work, don’t want to leave the hospital, come in to the office with long lists of complaints, overeat and become obese, call at night, repeatedly show up in the ER for minor problems, complain about everything and are “difficult.” Sound familiar? We can’t simply ignore them; they also may commit suicide. As always, I have some thoughts: • As someone famously said, don’t just sit there, do something! I don’t believe that we can expect someone else to help them. Not going to happen.

Every doctor, every specialist has a role to play. We are all healers. Take the unfortunate orthopedist who found out too late that his patient with the broken ankle had gotten it during a failed suicide attempt. If our orthopedist had been more perceptive, he might have been able to prevent the second successful attempt. • Keep a list of psychiatrists, psychologists, social work counsellors handy, and give them out to patients. Make an effort to talk to these professionals, who attend SCMS events. • Remember that there is such a thing as Old-Fashioned Doctoring. I don’t mean house calls…I do mean putting your hand on the patient’s shoulder, getting up close, looking him square in the eye, and telling him sincerely that you care about him. This is Primal. This is, of itself, therapeutic. Patients remember this. continued on page 7

After we’ve dealt with all the complexities of medical care, insurance reimbursements and government regulations; after we’ve dealt with our own anxieties, Louis L. Constan, MD

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The Bulletin | February/March 2018

burnout, depression…we must deal with psychologically broken patients.


Mark Your Calendar Now for our Upcoming Membership Meetings! continued from page 6 • Empower your staff. I know a doctor who found out that his patients regularly share their more intimate selves with his staff than with him. They don’t want to “bother” him. He has his staff send them cards and sometimes flowers to show their concern for life’s events. The patients love it and it may truly help. • In the hospital, the staff, of course, are not employees, but they need to know that the doctor appreciates it when they take especially good care of “his” patients. Appreciation is a powerful motivator, and going that extra mile is very important to patients’ care. • Ask your colleagues what they do about the sort of difficult patients you yourself encounter. I’m sure there are plenty of good ideas around that need to be shared, and there has never been more of a need. I daresay that practicing medicine could be more rewarding when you include these approaches. The world is a difficult place; our world is a difficult place, but we make it better, one patient at a time.

ATTENTION RETIRED MEMBERS!

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 jmcramer@sbcglobal.net.

Tuesday, May 15, 2018 Annual Membership Meeting Mark your calendar now for our Tuesday, May 15, 2018, Annual Membership Meeting. The social with cash bar starts at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Dean George E. Kikano, MD will give an update on the CMU College of Medicine and medical student and resident training in Saginaw.

There are no Membership Meetings in June, July or August

Tuesday, September 18, 2018 Membership Meeting - ETHICS Mark your calendar now for our Tuesday, September 18, 2018, Membership Meeting joint with the Saginaw County Osteopathic Society 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. Jason Wasserman, PhD, Associate Professor of Biomedical Sciences at Oakland University William Beaumont School of Medicine will present a program on Ethics. Dr. Wasserman joined the Oakland University William Beaumont School of Medicine faculty in July 2013. He directs the Medical Humanities and Clinical Bioethics courses for M1 students, as well as, serving on the Admissions, Curriculum and Student Research committees among others.

Tuesday, October 16, 2018 Membership Meeting Mark your calendar now for our Tuesday, October 16, 2018, Membership Meeting hosted at and by HealthSource Saginaw. The social starts at 6:30 p.m., followed by dinner, meeting and a Candidates’ Forum for the November election at 7 p.m. The Bulletin | February/March 2018 7


ALLIANCE NEWS The SCMS Alliance’s 14th Annual Jingle Mingle was a huge success, and raised $1,600 for CASA (Court Appointed Special Advocates) through the CAN Council Great Lakes Bay Region. Mark your calendar to attend the 15th Annual Jingle Mingle scheduled to be held on Monday, December 3, 2018, to raise money for another deserving charity!

Caduceus Meeting for Recovering Health Care Professionals Beginning April 17, 2018 Tuesday Nights 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. AA is a worldwide fellowship of men and women who help each other to stay sober. Caduceus meetings are “closed” meetings for recovering health care professionals including, but not limited to, nurses, doctors, dentists and pharmacists. (l-r) Amanda Tucker, Suzanne Greenberg of CAN Council, Randy Dee Roberts of CASA, Jennifer Rogers, Janie Gugino and Keri Benkert

8

The Bulletin | February/March 2018

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


Non-cardiogenic Shock

Samer Kais, MD Echocardiography in Shock Management

Naveed Akhtar, MD Cardiogenic Shock in Patients with ACS Parts I & II

Rao Gudipati, MD John Collins, MD Brain-Heart Connection

Faith Abbott, MD Management of BP in Stroke Patients

Iftikhar Khan, MD Acute Aortic Emergencies

Vipin Khetarpal, MD Acute Management of Arrhythmia

in ICU setting Liaqat Zaman, MD Acute Decompensated Heart Failure

Department of Cardiac Sciences

Cardiac Critical Care Symposium Saturday, April 14, 2018 St. Mary’s of Michigan Lecture Hall 5 CME Credits $25 - Residents, Students & Allied Health $35 - Physicians 7 a.m. - Registration | 8 a.m. - Program Begins 11:30 a.m. - Lunch | 3 p.m. - Adjournment FACULTY

Moderator: Naveed Akhtar, MD Dept. of Cardiac Sciences Samer Kais, MD Surgical & Trauma Intensive Care Shaffi Kanjwal, MD Pulmonary & Critical Care Medicine

PLANNING COMMITTEE

Phoo Pwint Nandar, MD—Lead Coordinator Ronak Soni, MD Rex Roda, MD Angad Parmar, MD Zhilwan Rahim, MD Chandramouli Mandalaparty, DO

Peter Fattal, MD

The Planners and Speakers have disclosed they have no relevant financial relationships with commercial interests .

Cardio-Renal Syndrome

Call or Email to Register! (989) 754-3222 or jross@mcvi.com | (989) 754-3349 or jlewis@mcvi.com

Mohammad Bashir, MD Acute Valve Diseases and Endocarditis

Rajeev Sudhakar, MD Management of Bleeding in Patients with anticoagulation

Rajeev Sudhakar, MD Acute Pulmonary Embolism

M. Shaffi Kanjwal, MD

Target Audience: The targeted audience is physicians (Hospitalists, Emergency Physicians, Intensivists, Anesthesiologists, Primary Care Physicians) and advanced clinical practitioners (NP’s, PA’s). Objectives: 1. Discuss the best practices, diagnosis, and treatment of acute cardiovascular care with topics including post cardiac arrest syndrome, cardiogenic shock in ACS, non-cardiogenic shock, role of echocardiography in shock. 2. Management of complex cardiac patients in collaboration with multispecialty departments. 3. Formulate the protocols for management of the acute cardiovascular care. 4. Be well versed with the latest guidelines in the field of cardiac critical care with an emphasis on multispecialty This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Michigan State Medical Society (MSMS) through the joint providership of Central Michigan University College of Medicine Office of Continuing Medical Education (CMED and OCME) and Michigan CardioVascular Institute. CMED and OCME is accredited by the MSMS to provide continuing medical education for physicians. CMU College of Medicine Office of Continuing Medical Education designates this live activity for a maximum of 5.0 AMA PRA Category 1 Credit(s).TM Physicians should claim only the credit commensurate with the extent of their participation in the activity.

1015 S. Washington Saginaw, MI 48601 989.754.3000 www.mcvi.com


9th Annual Golf Outing – Sponsorship Form Saturday, June 9, 2018  Saginaw Country Club 12 p.m. Registration  1 p.m. Shotgun Start The Saginaw County Medical Society (SCMS) Foundation was founded in 1968 by SCMS members, and is the charitable entity of the SCMS. The Foundation:  Provides low interest loans to medical students with ties to Saginaw;  Forgives loan interest if the recipient returns to Saginaw to practice after completion of their residency;  Forgives 25 percent or a maximum of $5,000 loan principal per year if the recipient returns to Saginaw to practice after completion of their residency and is a dues paying member;  Awards scholarships and mentors Saginaw County high school students who are interested in becoming a physician;  Provides research grants and scholarships to medical students and residents through CMU CoM; and  Assists the SCMS Alliance in awarding seven nursing scholarships each year. Proceeds from this event are used for the above initiatives to help ensure the future of medicine in Saginaw County.  Title Sponsor - $6,000 (LIMIT OF TWO)  Company name in title of Golf Outing (including banner, program, all signage, etc.)  Company choice of (1) sleeve of golf balls with your company logo provided to each golfer; (2) golf towel with your logo provided to each golfer; or (3) ditty bag with your logo provided to each golfer  A representative from your company will be allowed to address the golfers from the podium at the Award Reception  Includes 4-person team  Event Sponsor - $3,000 (LIMIT OF FIVE )  Company name in golf carts and program  Company name on sign at driving range and practice putting green  Recognized from the podium  Includes 4-person team  Golf Ball Sponsor - $1,500 (Sleeve of golf balls with your company logo provided to each golfer)  Company name listed in program  Scorecard/Scoreboard Sponsor - $1,500  Company name on scoreboard and individual scorecards  Company name listed in program

 Award Reception Sponsor - $1,000  Company name listed on sign at reception, table-tents on reception tables and in program  Putting Contest Sponsor - $750  Company name on sign at tee and in program  Company representative on site  Lunch Sponsor - $500  Company name on sign in cookout area and in program  Beverage Sponsor - $500  Company name on sign at beverage stations and in program  Team Sponsor - $600 (Payment for four person golf team of your players)  Company name listed in program  Medical Student/Resident Team Sponsor - $600 (Payment for four person golf team of medical students/residents)  Company name listed in program  Longest Drive Sponsor - $500 (Men & Women)  Company name on sign at tee and in program  Closest to the Pin Sponsor - $500 (Men & Women)  Company name on sign at tee and in program  Tee/Hole Sponsor - $500 (LIMIT OF TWO PER HOLE)  Company name on sign at tee and in program

We would like to be a sponsor for the 9th Annual SCMS Foundation Golf Outing, as follows: Company Name: __________________________________________________________________________ Contact Person: __________________________________________________________________________ Address: ________________________________________________________________________________ Phone: ____________________________Email: _______________________________________________ Sponsor Level: __________________________________________________________________________ RETURN FORM AND CHECK BY FRIDAY, MAY 25, 2018, TO: SCMS Foundation  350 St. Andrews Road  Suite 242  Saginaw, MI 48638-5988 Questions? Contact Joan M. Cramer, SCMS Executive Director, at jmcramer@sbcglobal.net or 989-790-3590 Forms are downloadable at www.SaginawCountyMS.com 3/25/18 4:06PM

NOTE: For income tax purposes, the following values are NOT tax deductible: Golf participant, $88 each. An IRS-compliant tax deduction receipt will be provided upon request.

10 The Bulletin | February/March 2018


9th Annual Golf Outing

Four Person Scramble Saturday, June 9, 2018  Saginaw Country Club 12 p.m. Registration  1 p.m. Shotgun Start TEAM REGISTRATION FORM Please sign up the following golfers to participate in the 9th Annual SCMS Foundation Golf Outing on Saturday, June 9, 2018. Golfers may sign up as an individual, or as a four-person team. Those that sign up as individuals will be assigned to a four-person team. The charge per golfer is $150, and includes green fees, cart, practice range, cookout lunch, beverages (domestic draft beer, Coke and Pepsi products, bottled water) on the course, two drink tickets (soft drinks, draft beer, house wine) and heavy hors d’oeuvres award reception with prizes. REGISTRATION PRIOR TO THE GOLF OUTING IS REQUIRED! Please sign up the following golfers: GOLFER NAME

 PLEASE PRINT!  PHONE

EMAIL

1. 2. 3. 4. If team is sponsored, please indicate name of sponsor for program_______________________________ Please return form and check by Friday, May 25, 2018 ($150 Per Golfer) to: SCMS Foundation 350 St. Andrews Rd., Suite 242 Saginaw, MI 48638-5988 Call Joan Cramer at 989-790-3590 or email jmcramer@sbcglobal.net with questions. Forms are downloadable at www.SaginawCountyMS.com If play is stopped because of inclement weather before five holes are completed, there will be no guest fee charged. If play is stopped between five and 13 holes, the guest fee will be the nine-hole rate. Playing 14 holes shall constitute the playing of 18 holes, and guests will be charged the full guest fee. Groups playing less than five holes will still be subject to and responsible for all other non-golfing products and services for which they contracted. The Saginaw Country Club is a spikeless facility and golf course. Arrangements may be made ahead of time with the Saginaw Country Club Pro Shop for guests that need to change spikes. The fee is $7 per set. NOTE: For income tax purposes, $88 of the total per golfer charge is NOT tax deductible: An IRScompliant tax deduction receipt will be provided upon request. 1/30/18 10:17AM

The Bulletin | February/March 2018 11


We lead with extraordinary care.

TH! E MON H T F O IDER ide support for SCMS er v EY PROV vid

K

ers” pro Key Pro “Key Provid ngs. Each month, a ti e ip me etin. in The Bull membersh is featured

Because our patients are at the center of everything we do.

12 The Bulletin | February/March 2018 © 2018 Covenant HealthCare. All rights reserved. PK 2/18


MARCH BIRTHDAYS Faith Abbott DO Robert P. Ainsworth MD Joseph N. Aquilina MD Edward S. Bernreuter MD Harold Blumenstein MD Bryan D. Brazeau MD Aditya D. Bulusu MD Louis F. Byrne MD Brenda M. Coughlin MD Jonathon P. Deibel MD Danielle C. Duncan MD Thomas G. Ferreri MD Maher Ghanem MD Timothy R. Hackett MD Timothy H. Kaufman MD Lauren A. Kershnar MD Asif H. Khan MD Andrew M. LaFleur MD James R. LaFleur MD James A. Letson, Jr. MD Albert G. Linden MD Veronica E. Lorenzo MD Luigi Maresca MD Michelle M. McLean MD Kurt A. Menapace MD

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

Omer S. Mirza MD James R. Mlejnek II MD Nobou Nakagawa MD Matthew C. Newman MD 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 Rex Edward B. Roda MD Jennifer R. Schmidt DO Shiraz H. Shariff MD Alexa M. Shepherd MD Michael J. Slavin MD Wael A. Solh MD Kristine K. Spence DO Robert J. Toteff MD Scott C. Woodbury MD Harvey K. Yee MD Yong C. Yoon MD Asim Yunus MD

3/28 3/17 3/8 3/10 3/24 3/3 3/31 3/27 3/20 3/27 3/4 3/20 3/9 3/17 3/3 3/2 3/7 3/19 3/29 3/7 3/11 3/20 3/12 3/5

Commercial medications not meeting the needs of your patients? We produce customized medications specially suited to meet the patient’s needs; thus, allowing limitless prescribing opportunities. • Liquid solutions • Discontinued medications • Topical medications • Human Identical Hormone Replacement for men and women • Sugar free/dye free medications • Non narcotic pain medications

Key Provider to the SCMS

Healthway Compounding Pharmacy 2544 McLeod Dr. N. | Saginaw, MI 48604 | 989.791.1691 | www.healthwayrx.com The Bulletin | February/March 2018 13


Covenant Kids Telethon is Saturday, April 14 Diagnosing sight issues early in premature infants. Easing the anxiety of a child during an MRI. Educating a preteen and her family about how to deal with diabetes. Giving a voice to adolescents with speech limitations. These moments are happening to kids across the region because of Covenant Kids and the businesses, organizations and individuals who support it. Every penny of every gift donated to the Covenant Kids Fund with the Covenant HealthCare Foundation goes directly to support medical equipment and programs for pediatric patients - no administrative costs taken out - with the money staying local. The 9th Annual Covenant Kids Telethon will air live on WNEM TV5 from noon until 6 p.m. on Saturday, April 14, 2018, from the Mid-Michigan Children’s Museum in Saginaw. The Telethon will be hosted by WNEM TV5 personalities and Covenant employees, featuring stories of local Covenant Kids (past pediatric patients) and their families. Want to participate? All you have to do is: 1) Call. Dial 1.855.475.KIDS (1.855.475.5437) during the Telethon to donate and give phone bank volunteers some work!

2) Visit. Families can stop by the Mid-Michigan Children’s Museum (515 Genesee, Saginaw, MI) between 12-6 p.m. on April 14 to make their donation (and guest appearances) in person. To get involved with Covenant Kids, contact Heather Appold at 989.583.4166. Why Covenant Kids? Covenant is the regional leader in providing health care to children with the following services: • Level III Regional Neonatal Intensive Care Unit (RNICU) offering the highest level of critical care for neonatal infants • The only Pediatric Intensive Care Unit (PICU) serving mid-Michigan and the northern lower Michigan region designed to care for critically ill infants and children through the age of 17 • ACS-Verified Pediatric Trauma Center - one of only six in Michigan verified to care for the whole family in an emergency • Community-based urgent care through MedExpress • Extensive clinical programs for children (diabetes, rehabilitation, cardiology, and more) Save the Date: Pediatric Symposium, Friday, April 20, 2018 Covenant HealthCare presents the Pediatric Symposium: Care of the Pediatric Patient on Friday, April 20 at Horizons Conference Center. Topics will include pediatric sedation, concussions, urology, neonatal abstinence syndrome, pain management, sleep studies and suicide. Presentations will take place from 8 a.m. to 2:45 p.m., followed by a meet and greet with presenters from 2:45-4 p.m. (includes wine and cheese). For additional questions, contact Brenda Fitak at 989.583.4150 or brenda.fitak@chs-mi.com.

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The Bulletin | February/March 2018

Extraordinary care for every generation.


APPLICATIONS FOR MEMBERSHIP

Below are Applications for Membership that may be recommended for acceptance at the Tuesday, April 17, 2018, Board Meeting. Please contact Joan Cramer at jmcramer@sbcglobal.net or 790-3590 if you have any questions or would like more information on the applicants. Kristi M. Murphy, MD Hassan Hussein Beiz, MD

(Advanced Diagnostic Imaging, PC) Primary: Diagnostic Radiology, Board Certified Secondary: Vascular Interventional Radiology Medical School: MSU-CHM, 2011 Sponsors: Doctors Scott E. Cheney and Kristin M. Nelsen

(CMU Health-Internal Medicine) Primary: Internal Medicine, Board Certified Medical School: Ross University, Dominica, 2008 Sponsors: Doctors J. Patricia Dhar and Juliette M. Perzhinsky

Arvind R. Patel, MD

Raya C. Beiz, MD

(Advanced Diagnostic Imaging) Primary: Radiology-Diagnostic, Board Certified Medical School: B.J. Medical College, Ahmedabad, India, 1988 Sponsors: Doctors Ramakrishnayya Gadam and Harvey K. Yee

(CMU Health-Internal Medicine) Primary: Internal Medicine, Board Certified Secondary: Infectious Disease, Board Certified Medical School: University of the Philippines, Manila, Philippines, 2003 Sponsors: Doctors Del J. DeHart and J. Patricia Dhar

Andrew H. Cohen, DPM

(Mid-Michigan Foot & Ankle Center) (Affiliate Membership) Primary: Podiatry, Board Certified Medical School: New York College of Podiatric Medicine, 1990 Sponsors: Doctors Ronald A. Bays and Colleen A. Linehan

Asim A. Kichloo, MD

(CMU Health-Internal Medicine) Primary: Internal Medicine, Board Certified Medical School: Acharya Shri Chander College of Medical Sciences, Sidhra, India, 2009 Sponsors: Doctors J. Patricia Dhar and S. Sethu K. Reddy

Jeffrey S. Milewski, DO

(Valley ENT Associates) Primary: Ear, Nose and Throat, Board Certified Secondary: Facial Plastic Surgery, Board Certified Medical School: MSU-COM, 2002 Sponsors: Doctors Brian F. Perry and Keith E. Scharf

IN MEMORY

Richard D. Goldner, MD Dr. Goldner, age 94, passed away on January 18, 2018, from complications of the flu ending in respiratory failure. Dr. Goldner was born in Decatur, Indiana and graduated from Wayne State University. He practiced psychiatry for over 50 years at Ypsilanti State Hospital, and was on staff at Saginaw General Hospital, St. Luke’s Hospital and the VA in Saginaw. He was a longtime member of the Saginaw County Medical Society, AMA, NRA, Audubon Society and Michigan Northern Nut Growers Association. Dr. Goldner loved all things nature, and was intelligent, funny and kind. Dr. Goldner was preceded in death by his wife, Elizabeth, in 2008; son, Don Henry, in1979; and daughter, Karen, in 2010. He is survived by his son, R. Dan Goldner of North Ridgeville, Ohio; daughter, Gayle Goldner White, of Saginaw County; sister, Kate Hott Adelphi, of Maryland; grandchildren, Katelyn Dykes (Zack Dykes) and Lee Daniel White; and great grandchildren, Kyland Dykes, Emeric Dykes and Tobias Dykes. Private services were held at his home on Sunday, January 21, 2018.

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The 28th Annual Joint Membership Meeting with the Saginaw County Dental Society was held on Tuesday, January 16, 2018, at Horizons Conference Center.

The next meeting will be held on Tuesday, April 18, 2018, at Horizons Conference Center. See page 5 for more details.

Julia M. Walter MD, SCMS President, called the meeting to order at 7:25 p.m. Dr. Walter welcomed Saginaw County Dental Society and Saginaw Valley District Dental Society members, Jim P. Getzinger MD (speaker), new Advanced Diagnostic Imaging Radiologist, Arvind Patel MD, residents, medical students and guests. Dr. Walter thanked the following Key Providers in attendance for their ongoing support of SCMS programs: • Bieri Hearing Specialists – Cathy Bieri-Ryan and Jerd Clayton; • Covenant Cancer Care Center – Joseph P. Contino MD, James A. Fugazzi MD and Barb Hoffman; and • St. Mary’s of Michigan Seton Cancer Institute - Cyberknife – Nicole Stewart, Kathi Smith-Nowlin, April McGinnis and Christine Bergman. Dr. Walter also noted Jill Armentrout of Great Lakes Bay Health Centers was distributing information on their services at their table tonight. Dr. Walter then conducted the following business of the SCMS: • The Minutes of the October 17, 2017, Membership Meeting were attached to the Agenda and published in the November Bulletin. MOTION: Accept the October 17, 2017, Meeting Minutes as printed. MOTION APPROVED. • Announced new members approved at tonight’s Board Meeting: 1) Joseph P. Contino MD (Covenant Cancer Care Physician Group) – General and Breast Surgery;

January 2018 Meeting Minutes Top Left to Right: Hannah Schultz, Drs. Carolyn Vert, James Fugazzi, Timothy Brown and Joseph Contino, Barb Hoffman, Jackie Tinnin

Bottom: Left to Right: Drs. Bill Lichon, Jim Getzinger, Julia Walter and Bill Mason Jerd Clayton and Cathy Bieri-Ryan of Bieri Hearing with Dr. Paul Bry

16

The Bulletin | January 2018


2) Asif H. Khan MD (CMU Health-Psychiatry) – Psychiatry; 3) Kaitlyn E. Matz Bishop DO (Covenant HealthCare Emergency Department) – Emergency Medicine; 4) S. Sethu K. Reddy MD (Chair, Discipline of Medicine-CMU College of Medicine | CMU HealthInternal Medicine) – Internal Medicine, Endocrinology, Diabetes & Metabolism; and 5) Benjamin R. Schoener MD (Covenant HealthCare Emergency Department) – Emergency Medicine. Introduced new members in attendance: 1) John Blebea MD (CMU Health-Surgery) – General and Vascular Surgery; 2) James A. Fugazzi MD (Covenant Radiation Center) – Radiation Oncology; and 3) Gregory P. Sutton MD (Covenant Cancer Care Physician Group) – Gynecologic Oncology. Invited members to sign up for the safeTALK Suicide Awareness Training on Saturday, February 24, 2018, at CMU College of Medicine in Saginaw.

ANNOUNCEMENTS: • The 14th Annual Health Fair will be held on Saturday, March 17, 2018, at Horizons Conference Center in Saginaw. SCMS Physicians are needed

to staff the SCMS booth and answer questions of those attending. • The Program Committee is looking for topics for 2018-19 Membership Meetings. • The Nominating Committee is seeking physicians to serve on the Board of Directors. • The 2018 MSMS House of Delegates will be held on Saturday-Sunday, April 28-29, 2018, at The Henry in Dearborn. Members with ideas for a resolution should contact a Delegate, Board Member or Joan. • The 9th Annual SCMS Foundation Golf Outing will be held on Saturday, June 9, 2018, at the Saginaw Country Club. Dr. Walter welcomed William E. Mason DDS to the podium. Dr. Mason introduced the evening’s speaker, Jim P. Getzinger MD, MS, FAAEM, Emergency Medicine Physician and Medical Informatics at William Beaumont Hospital. Dr. Getzinger’s CME presentation was “Head/Neck Trauma: When a Pain in the Neck is Something Else.” Dr. Walter thank everyone for attending, and reminded them to sign in at the registration table and complete the online evaluation for CME credit within 30 days. The meeting was adjourned at 8:21 p.m. Respectfully submitted, Joan M. Cramer Executive Director

Top Left to Right: Drs. Tim Brown, Millie Willy and Carolyn Dennis Vert Drs. Ron Jenson and Bill Lichon who started the joint meeting in 1989 CMU M4 Taylor Boehler-Gaudard and M2 Lindsay Murphy Bottom: Left to Right: St. Mary’s of Michigan - April McGinnis, Christine Bergman and Nicole Stewart


Raghu Sarvepalli, MD, Returns to Family Practice Effective April 1, 2018, Raghu Sarvepalli MD, will transition from the role of Vice President of Medical Affairs (VPMA) and return to family medicine practice. Clark Headrick DO, will assume the role of interim VPMA for St. Mary’s of Michigan and St. Joseph Health System. Dr. Sarvepalli has been in physician leadership roles with St. Mary’s for many years, serving as VPMA and Chief Medical Officer, as well as, medical director of St. Mary’s Physician Hospital Organization. He led the development, implementation and management of many quality, service and strategic initiatives for our hospitals and formed a multitude of relationships with physicians and providers across our region. He, along with his wife, Bhrama Sarvepalli MD, joined Heritage Family Physicians more than 20 years ago. His decision to return to medical practice is appropriate, and timely, given the need for primary care physicians. Christopher J. Oravitz, MD, Joins St. Joseph Health System Dr. Christopher Oravitz has joined St. Joseph Health System and the Women’s Center. He began seeing patients on February 1; coinciding with the retirement of Dr. Earl Elowsky who served St. Joseph Health for 24 years. Dr. Oravitz joins Dr. Chris Landrey and physician assistant, Judy Herbolsheimer, to continue to provide comprehensive obstetrics and gynecology care for those in the northern community. A Michigan native, Dr. Oravitz has more than 25 years’ experience. He most recently served as an Assistant Physician Director with the CMU-Health Division of Ob/ Gyn Specialist, which included clinic time in addition to overseeing resident physicians. Prior to joining the CMU College of Medicine team, he served the Saginaw community for 22 years in private practice as the physician and owner of Women’s Specialists. St. Mary’s Opens New Walk-in Clinic It is with great excitement to announce the opening of the St. Mary’s of Michigan Walk-in Clinic. Located at 5810 Gratiot Road in Saginaw Township, the Clinic officially opened on Monday, February 26. The Walk-In Clinic will be open seven days a week from 10 a.m. to 7 p.m. Common medical conditions treated at the Walk-In Clinic include: • Basic medical care and routine vaccinations 18

The Bulletin | February/March 2018

• Respiratory illness such as cold, flu, sinus infections, strep throat and bronchitis • Head, ear and eye conditions including headaches, Pink eye and sties • Skin conditions like rashes, allergies, insect bites and infections • Stomach, digestive and urinary conditions • Minor injuries like strains and sprains Melissa North, MSN-FNP, will serve as the primary provider at the Walk-in Clinic. She is a graduate of Walden University where she was educated as a Family Nurse Practitioner. She received her Bachelor of Science in Nursing degree from the University of Michigan. Melissa has more than 15 years of nursing care experience having worked at Genesys Regional Medical Center for 13 of those years in the emergency department, respiratory and cardiac care step down units. Most recently, Melissa has worked at an Owosso area urgent care center as the primary care provider, managing the medical needs of up to 50 patients daily. She is experienced in diagnosing and managing common illnesses and skilled at preventative and wellness care. The Walk-in Clinic offers same-day care, with convenient hours which is designed to complement – not replace – care from a primary care provider. No appointment is necessary. For more information, call (989) 790-3650. Ascension Michigan Names New Chief Medical Officer Ascension Michigan is making additions to its executive team as the organization continues to enhance and align its leadership and clinical structures across the state. Charles Husson DO, has been named as Ascension Michigan Market Chief Medical Officer. He will have accountability for physician alignment and medical staff functioning across the state. “This move is part of our effort to align our clinical structure to achieve the Quadruple Aim of high quality clinical outcomes, enhanced patient experience, enhanced provider experience and affordable cost,” said Donald D. Bignotti MD, Chief Clinical Officer, Ascension Michigan. Dr. Husson has been serving as Regional Chief Medical Officer for Ascension Mid-Michigan since 2015, and prior to that, served as Vice President for Medical Affairs at Genesys Regional Medical Center. Ascension Mid-Michigan is comprised of Genesys Regional Medical Center, St. Mary’s of Michigan in Saginaw and Standish, and St. Joseph Health System. In Michigan, Ascension operates 15 hospitals and hundreds of related healthcare facilities that together employ more than 26,000 associates.


St. Joseph

Lung C a ncer Scr eening Progr a m

Take charge of your lung health A lung screening could save your life!

Is it covered by insurance?

If you’re a long-time smoker age 55 to 80, you’re at a higher risk for developing lung cancer. National studies have shown a low-dose CT (computed tomography) lung screening can diagnose early stage lung cancer, when it can be more effectively treated. An early diagnosis could save your life.

• Medicare covers an annual low-dose CT lung cancer screening for beneficiaries who meet the criteria.

Why is a lung cancer screening important? • Can detect cancer long before symptoms are present • Identifies the cancer’s stage to help your doctor decide the best course of treatment. • Early diagnosis can reduce the risk of death by up to 20%

• Most private insurances now cover all or a majority of the screening cost. A self-pay option is also available.

What are the benefits of going to St. Mary’s of Michigan and St. Joseph Health System? • Education about the benefits and risks of a lung cancer screening to help you make an informed decision.

• Noninvasive, painless and only takes a few minutes.

• Low-dose computed tomography with expert radiological interpretation.

Who should get a lung screening?

• Interdisciplinary lung nodule review by physicians for every positive screening result.

High-risk category 1: • Age 55-80 years (77 with Medicare)

• A thorough follow-up report and recommendation is sent to your primary care physician.

• Asymptomatic (no signs or symptoms of lung cancer)

• Immediate access to experts in the treatment of lung cancer.

• Smoked at least 30 pack years (1 pack a day for 30 years OR 2 packs a day for 15 years, etc.)

• Patient Navigator to coordinate care, answer questions and provide support.

• Currently smoking or have quit smoking within the last 15 years

Where do I go for my screening?

High-risk category 2a:

St. Mary’s of Michigan & St. Joseph Health System offer two convenient locations:

Age 50 or older with a 20+ pack year history AND one additional risk factor (family history of lung cancer, emphysema, pulmonary fibrosis or exposure to certain carcinogenic substances).

• Located inside St. Mary’s of Michigan Towne Centre 4599 Towne Centre Road, Saginaw • Located inside St. Joseph Health System 200 Hemlock, Tawas City

Call now to learn about your options and to schedule your lung cancer screening. 1-866-246-4673 The Bulletin | February/March 2018

19


CMU College of Medicine Receives Accreditation for Surgical Residency in Saginaw

7,000 applied for 36 first-year positions in seven medical residency programs CMU College of Medicine recently announced the accreditation of its surgical residency program and will welcome surgical residents to Saginaw this July. The Accreditation Council for Graduate Medical Education (ACGME) approved the residency, which is supported by CMU Medical Education Partners - a collaboration among CMU, St. Mary’s of Michigan and Covenant HealthCare. With the most recent accreditation, CMU and its Saginaw-area partners will have 114 medical residents in seven programs: Surgery, Family Medicine, Internal Medicine, Emergency Medicine, Obstetrics and Gynecology, Podiatry and Psychiatry. More than 7,000 candidates applied for 36 first-year residency positions.

“The accreditation for our surgical residency is a result of the combined commitment of our faculty and overwhelming support of St. Mary’s of Michigan, Covenant HealthCare and our physician partners,” said Dr. John Blebea, chair of surgical disciplines. “ Saginaw has a long history of physician residency programs affiliated with Covenant, St. Mary’s and their predecessors. Many physicians practicing in the region today spent their residency years in Saginaw,” Blebea said. “The surgical residency is an essential asset for Central’s College of Medicine,” said Dr. Samuel Shaheen, executive director of CMU Medical Education Partners. “In addition to providing opportunities for residents to learn and practice in Saginaw, it adds mentors for medical students, augments patient care and provides resources to area hospitals.” Accreditation has been a priority for Dr. George Kikano, Dean of the College of Medicine, since he joined the university in 2015. CMU also offers graduate fellowships in Emergency Medical Services and Simulation/education.

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APRIL BIRTHDAYS Hussein J. Al Amer MD Abhishek A. Bhandiwad MD H. Joseph Blair MD Donald J. Cady MD David W.T. Chen MD Megan J. Dutcher DO Peter G. Fattal MD E. Malcolm Field MD Victoria A. Haddad MD Joy A. Hart MD Theodore B. Hennig DDS C.R. Indira MD M. Sohail Jilani MD Min H. Kim MD Narendra R. Kumar MD H.F. Labsan MD Phillip W. Lambert MD Peter A. Lassing MD Toby C.J. Long MD Bapineedu Maganti MD Khalid M. Malik MD

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A Day of Board of Medicine Renewal Requirements Let MSMS be your resource to earn the new, mandated Michigan Board of Medicine CME – all in one day. From 9 a.m. – 2:45 p.m., presenters will address Pain and Symptom Management, Medical Ethics and Human Trafficking, fulfilling these additional requirements. When: Wednesday, April 18, 2018, from 9 a.m. to 2:45 p.m. Where: MSMS Headquarters, 120 West Saginaw Street, East Lansing, MI 48823 Fees: Members: $195 | Non-members: $275 9 a.m.–12 p.m. Pain and Symptom Management • The Current Epidemic and Standards of Care Narasimha R. Gundamraj, MD, Anesthesiologist, Anesthesia and Pain Management Consultants, Lansing • Balancing Pain Treatment and Legal Responsibilities Ronald W. Chapman, II, Esquire, Chapman Law Group • The Michigan Automated Prescription System Update Kim Gaedeke, Director, Bureau of Professional Licensing 12 – 12:45 p.m. Lunch 12:45 – 1:45 p.m. Medical Ethics Lauren B. Smith, MD, Department of Pathology, University of Michigan and Chair, MSMS Committee on Bioethics 1:45 – 2:45 p.m. Human Trafficking Jane White, Executive Director and Founder, Michigan Human Trafficking Task Force

Statement of Accreditation: The Michigan State Medical Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. AMA Credit Designation Statement: The Michigan State Medical Society designates this live activity for a maximum of 5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Click HERE to register.

Reversing the Opioid Epidemic On Dec. 27, 2017, the Michigan Lieutenant Governor signed into law several new requirements aimed at combating the opioid epidemic. These new laws will have direct implications for physicians and medical practices. MSMS has continued on page 23

NEW! Physicians Home Loan We value our healthcare workers and recognize all they give to serve our community. We created a special loan for those serving in the medical field including, medical resident or fellow, nurse practitioner, physician, physician’s assistant, pharmacist, or therapist. If you work in the healthcare field* and meet certain income requirements you could enjoy, low down payments, lower initial monthly payments with no PMI, and flexible financing options. For More Information Contact: Laura Schultz, Mortgage Originator NMLS#771041 203 E. Genesee in Saginaw Office: 989.754.0388 Cell Phone: 989.397.5425 Website: isabellabank.com/lschultz Email: lschultz@isabellabank.com

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22

The Bulletin | February/March 2018


continued from page 22

created and collected many resources to help physicians and their staff understand the new requirements. READ MORE

COMPLIANCE MADE SIMPLE

HB 5517-5523 No-Fault Repeal Legislation: Bad Policy, Poorly Written The sponsors of the seven-bill package identified as HB 5517-5523 claim that these bills will repeal the Michigan NoFault Act and return Michigan to a system of pure tort law. Apart from the social irresponsibility of such legislation, is the harsh reality that these bills, as currently written, are a drafting nightmare that are virtually impossible to fully understand. READ MORE What to Expect When You Are Sued On average, each physician spends 50.7 months, or approximately 11 percent of an average 40-year career, on resolving medical malpractice cases - the vast majority ending up with no indemnity payment. That’s the conclusion of a study by the RAND Corporation based on data provided by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer. By the age of 65, more than 75 percent of physicians in low-risk specialties and 99 percent of physicians in high-risk specialties have experienced a claim. READ MORE

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The Bulletin | February/March 2018 23 HOURS: Monday–Thursday 8am–5pm • Friday 8 am–Noon


Reversing the Opioid Epidemic Other Resources Michigan Dept. of Licensing & Regulatory Affairs (LARA) - Pain Management Website Michigan Automated Prescription System (MAPS) Michigan Rx Card - Statewide Prescription Assistance Program

MSMS Resources NEW - Start Talking Consent Form NEW - Need to Know Prescribing Legislation FAQs NEW - LARA Required CME - Pain and Symptom Management On-Demand Webinars MSMS Opioid Alert

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START TALKING CONSENT FORM For Use with Minors1 Required by MCL 333.7303b(b) MUST BE INCLUDED IN THE MINOR’S MEDICAL RECORD Patient Name: Date of Birth: Controlled Substance Name: Does the Controlled Substance Contain an Opioid?

Yes

No (check one)

Number of Refills: Quantity Prescribed2: Dosage:

A controlled substance is a drug or other substance that the United States Drug Enforcement Administration has identified as having a potential for abuse. I certify that I have discussed the following with the minor patient and his/her parent or guardian or with another adult authorized to consent to the minor’s medical treatment, the following: a) The risks of addiction and overdose associated with a controlled substance. b) The increased risk of addiction to a controlled substance to an individual who is suffering from both mental and substance abuse disorders. c) The danger of taking a controlled substance containing an opioid with benzodiazepines, alcohol or another central nervous system depressant. d) Any other information in the patient counseling information section of the labeling for the controlled substance that is required under 21 CFR 201.57(c)(18).

Signature of Prescriber

Date

Signature Minor Patient

Date

Signature of Parent/Guardian

Date

Signature of Adult Authorized to Consent to Minor’s Treatment 3

Date

This form must be completed before issuing a minor the first prescription in a single course of treatment for a controlled substance containing an opioid, regardless of whether the dosage is modified during the course of treatment. 2 The prescription must be limited to not more than a single 72-hour supply if the person consenting to treatment is an adult authorized to consent to a minor’s treatment. See MCL 333.7303b(3). 3 An adult to whom a minor’s parent or guardian has given written authorization to consent to the minor’s medical treatment. 1

The Bulletin | February/March 2018 25


MAPS Registration Tips for Physicians As of April 4th, all MAPS current and future users will need to be registered with the new MAPS AWARxE. Below are some useful tips to ensure you have the information necessary to enroll.

n Know Where to Register •

For registration to PMP AWARxE, go to https://michigan.pmpaware.net/login and click on “Create Account.”

You will be prompted to enter your email and create a password. (Note: Only one user account is allowed per email address. Also, your email address will become your login ID.) Your password must be at least 8 characters with at least 1 UPPERCASE letter, 1 lowercase letter, and one symbol (e.g., HappyDay!).

• n Know your email and what password you want to use •

n Know your role • •

Physicians will select “Healthcare Professionals” and then “Physician MD, DO”. Residents will select “Healthcare Professionals” and then “Medical Residents”.

n Watch for the green banner •

You will be prompted to check the email account you provided, open the Welcome email, and click on the “Verify your email” link in that email. When you click the link, you should then see a login screen that says, “Your email has been verified.” The next step is to return to your Registry Form and finish registering.

n Know your numbers

You will be asked to enter the following numbers: • DEA Number (Note: Once you enter your DEA number, you can select “AutoFill Form” to populate the form.) • Controlled Substance ID (Note: Your Controlled Substance License is issued by the state of Michigan and is not the same as your DEA Number. If you don't know this number, go to the state’s “Verify a License” webpage at https://w2.lara.state.mi.us/VAL/License/Search, typing in your name, and selecting "Pharmacy" as your occupation.) • Professional Licensee Number (Note: This is your state-issued Permanent ID. It is the 10-digit number in the lower left corner on your license If you don’t have it readily available, you can find your Permanent ID by going to https://w2.lara.state.mi.us/VAL/License/Search, typing in your name, and selecting "Medicine" or "Osteopathic Medicine & Surgery" as your occupation.) • National Provider Identifier (NPI)

n Identify your specialty •

You will be asked to select your specialty.

Following receipt of your confirmation email, you will be able to login to MAPS AWARxE using the email address and password you created during registration In most cases, physicians will be Auto Approved with their DEA, Professional License, and Controlled Substance numbers. However, there are some specific roles that require manual review and approval by the state administrator such as Indian Health Service and VA prescribers and dispensers.

• n Check for your confirmation email •

n Know where to go for help • • •

26

Call 1-844-364-4767. Questions regarding registration are being handled directly by Appriss and technical assistance is available 24 hour day, 7 days/week, 365 days/year. Should you have any policy questions, please contact the Bureau of Professional Licensing’s MAPS support team at (517) 373-1737 Informational webinar on upgraded MAPS: https://msms.adobeconnect.com/p2xbbliddwr/.

The Bulletin | February/March 2018


Exciting Grant Opportunity for Michigan Physicians!

Integrate Your EHR«–»MAPS In April 2017, the state of Michigan updated its Michigan Automated Prescription System (MAPS) to a more userfriendly platform, powered by Appriss Health’s PMP AWARxE software. Through a combination of state and federal funding* the state will cover Appriss Health’s costs to integrate the newly-upgraded MAPS directly into physician practices’ electronic medical records and pharmacy dispensing systems across Michigan, allowing instant access for prescribers and pharmacists.

The Michigan State Medical Society and the Michigan Academy of Family Physicians have been working closely with the Department of Licensing and Regulatory Affairs to anticipate any questions or concerns physician practices may have. We have also prepared a separate FAQs document, which we encourage you to review prior to applying for this grant opportunity.

Upon reviewing the FAQs document, please visit the state of Michigan website (http://www.MSMS.org/MAPSGrant) and complete the following steps to be considered for funding support:

STEP 1: Complete the Integration Request Form Be sure to identify the primary contact person who will lead the project on your practice’s behalf, as well as your EHR vendor’s name and contact.

STEP 2: Review and sign the Terms & Conditions See the FAQs for additional information on contract terms.

Physician practices are encouraged to apply!

STEP 3: Submit your information Send the completed Integration Request Form and Terms & Conditions to MAPS at BPL–MAPS@michigan.gov.

STEP 4: Schedule a Meeting A technical assistance meeting will be scheduled between the practice’s software vendor and Appriss Health, the MAPS software vendor. *This two-year funding opportunity is scheduled to end on August 31, 2019. See FAQs for additional information.

Send the necessary information to BPL-MAPS@Michigan.gov. The Bulletin | February/March 2018 27


Frequently Asked Questions

EHR«–»MAPS Integration Q1: What is the Integration Initiative? As you may know, an updated and more user-friendly Michigan Automated Prescription System (MAPS), powered by the Appriss PMP AWARxE software platform, went live in April 2017. While this update offers many functionality and efficiency improvements, the State of Michigan also wants to increase the utilization of MAPS within the clinical workflows of prescribers and pharmacists. Therefore, the State is taking advantage of additional technology available from Appriss Health by funding the integration of MAPS data into the electronic health records (EHRs) and pharmacy dispensation systems of hospitals, medical practices, and pharmacies. This integration will enable prescribers and pharmacists to access their patients’ MAPS reports without having to log out of one system and into another. Additionally, participants in this integration initiative will receive Appriss’ NarxCare, which is a more robust analytics and prevention tool intended to help prescribers and dispensers better assess patient risk and help prevent prescription drug and opioid abuse.

Q2: How do I participate? There is a simple four-step process to participate. 1. Go to the Michigan Department of Licensing and Regulatory Affairs (LARA) webpage at http://www.MSMS.org/MAPSGrant where you can access the Integration Request Form and the Terms and Conditions document. 2. Fill out the one-page Integration Request Form. 3. Review and sign the Terms and Conditions. 4. Email the Integration Request Form and Terms and Conditions document to LARA at BPL-MAPS@michigan.gov.

Once your application is received, the State will notify Appriss Health. Appriss Health will then connect with your EHR vendor.

Q3: Is there a cost to participate? The State is fully funding the cost to integrate charges by Appriss Health, the MAPS software vendor, including licensing fees through August 31, 2019. The State will not be funding any costs that may be charged by EHR vendors. However, we are hopeful that many of the EHR vendors will be offering this capability at no additional charge to their customers. We strongly recommend that you seek clarification from Appriss Health and your EHR vendor regarding potential EHR vendor costs prior to moving forward with integration.

Q4: What if I’m not yet registered in MAPS? You and any other prescribers on your EHR must be registered in MAPS in order to take advantage of the integration. If you have not yet registered, you may do so at http://www.MSMS. org/MAPSUsers.

Q5: What do I need to know about the Terms and Conditions document? Although Appriss Health and LARA have negotiated the language in this Agreement, there are some key provisions that are important to understand. Costs – the document clearly states that the State of Michigan will cover Appriss Health’s integration and licensing costs through August 31, 2019. Any additional costs are the responsibility of the medical practice (“Subscribing Organization”). As mentioned in FAQ #3, for most users there may not be any additional costs.

(CONTINUED)

Send the necessary information to BPL-MAPS@Michigan.gov. 28

The Bulletin | February/March 2018


However, unless and until your EHR vendor commits to providing this capability free of charge, there is no guarantee that additional costs will not be incurred. The State intends that health systems, physician organizations, medical practices, and pharmacies will work directly with Appriss Health for continued licensing privileges beyond August 31, 2019. At this time, there is no commitment from the State to continue funding after August 31, 2019, for any integration or licensing costs. The State encourages participants of the statwide integration project to develop a separate Agreement with Appriss that covers continued services and support beyond this date should the participant be willing to cover these costs. Authorized Users – are validly licensed prescribers who are registered with MAPS, authorized by their Subscribing Organization (i.e., medical practice) to use MAPS data, and acting pursuant to applicable requirements and law. See Section 1.8 of the terms and conditions. Access and Use of Appriss Health’s Gateway Service – practices will need to have policies and procedures in place to ensure appropriate access, use, and security. (Note: MSMS Legal Counsel is drafting model template language for practices to use as a guide to comply with this requirement.) Unauthorized or Inappropriate Use of Gateway Service – the Subscribing Organization is compelled to investigate and report to LARA complaints of unauthorized or inappropriate use. Unauthorized Disclosures – the Subscribing Organization is required to investigate and report any known privacy or security breach incidents involving the unauthorized use or disclosure of PHI which is not in compliance with the terms of the Agreement or with applicable law.

Q6: How long will it take after I sign up to integrate my EHR with MAPS? It depends on the readiness of your EHR vendor and the timing of scheduled updates that may be required for the version of software you are currently using. If your EHR vendor is one that has the capability in place, you could be up and running in the near future. However, if your vendor still needs to develop those capabilities or is waiting to offer it in the next update release, it may take more time. Also, in order to make this integration initiative available to as many prescribers as possible, the State is prioritizing those EHR vendors that have a greater presence in Michigan.

Q7: If my EHR vendor doesn’t currently have the capability to integrate with MAPS, should I wait to submit a request? No. It is important that you get in the queue. Also, by signing up, the State and Appriss Health have more leverage when working with the EHR vendors whose customers are asking for the ability to integrate with MAPS.

Q8: Do I need to contact my EHR vendor? No, not to register to participate. However, it is important that you include the name of your EHR vendor and your contact with that vendor on the Integration Request form. Appriss Health will follow-up with your EHR vendor to coordinate the integration.

Indemnification – the Agreement indemnifies and holds harmless the State, Appriss Health, and the National Association of Boards of Pharmacy from inappropriate actions of the Subscribing Organization.

Q9: Where can I get more information?

Ownership of Information – states that PHI and any related information created or received from or on behalf of the State is the property of the State. The intention is that the information not be used for purposes other than intended.

Stacey Hettiger, MSMS: 517-336-5766 or shettiger@MSMS.org

Termination or Expiration – if the Agreement is terminated or expires, the Subscribing Organization can no longer use the Gateway Service and must destroy and certify destruction of proprietary information (i.e., Gateway Service documentation).

LARA MAPS Support Team: 517-373-1737 or BPL-MAPS@michigan.gov

Dara Barrera, MSMS: 517-336-5770 or djbarrera@MSMS.org Christin Nohner, MAFP: 517-664-9082 or cnohner@MAFP.com

Visit MSMS.org/MAPSgrant to apply for this exciting grant opportunity. The Bulletin | February/March 2018 29


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Please mark your calendar for the following meetings and events for 2018. 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. Wednesday, April 11, 2018 CMU College of Medicine, 1632 Stone Street, Saginaw - CMU College of Medicine and CMU Health Research Symposium from 12-5 p.m. Saturday, April 14, 2018 St. Mary’s of Michigan Lecture Hall – MCVI’s “Cardiac Critical Care Symposium.” See page 9 for more details. Tuesday, April 17, 2018 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: “Second Victim.” Spouse/Significant Other invited. See page 5 for more details. Thursday, April 19, 2018 CMU College of Medicine, 1632 Stone Street, Saginaw – “Thanks for Staying,” Rotary Scholarships 2018 Fundraising Event sponsored by the Rotary Clubs of Mid-Michigan from 5:30-7:30 p.m. Ticket information at www.thanksforstaying.org. See page 8 for more details.

Tuesday, May 15, 2018 Horizons Conference Center - SCMS Board meets at 5:30 p.m. Annual Membership Meeting with Social (cash bar) at 6:30 p.m. followed by dinner at 7 p.m. Program: “Update on the CMU College of Medicine,” by Dean George E. Kikano, MD. See page 7 for more details. Saturday, June 9, 2018 Saginaw Country Club - 9th Annual SCMS Foundation Golf Outing. Proceeds are used for low interest medical students loans, research grants and scholarships to medical students, residents and high school students interested in medicine. See pages 10-11. Tuesday, September 18, 2018 Horizons Conference Center - SCMS Board meets at 5:30 p.m. Membership Meeting joint with the Saginaw County Osteopathic Society with Social (cash bar) at 6:30 p.m. followed by dinner and program at 7 p.m. Program: “Ethics.” See page 7 for more details. Tuesday, October 16, 2018 HealthSource Saginaw - SCMS Board meets at 5:30 p.m. Membership Meeting with Social at 6:30 p.m. followed by dinner and program at 7 p.m. Program: “Candidates’ Forum.” Spouse/ Significant Other invited. See page 7 for more details.

Joan Cramer/SCMS | Office 790-3590 | Fax 790-3640 | Cell 284-8884 | jmcramer@sbcglobal.net

SCMS BULLETIN - February/March 2018  
SCMS BULLETIN - February/March 2018