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Bulletin Saginaw County Medical Society

January 2018 | Volume 76 | No 4

MSMS Opioid Alert p. 21

www.SaginawCountyMS.com

MAPS Registration & Grant Opportunity p. 26

Covenant Medical Group –Cardiology & Cardiothoracic Surgery Meet Our Specialists

Firas R. Alani, MD, FACC, FSCAI, RPVI Interventional Cardiology

Bashar Al Jayyousi, MD Interventional Cardiology

Parthiv Amin, MD, FACC Invasive Cardiology

Soheil Assar, DO Invasive Cardiology

Umesh Badami, MD, FACC, FSCAI Interventional Cardiology

Scott K. Huffaker, DO Invasive Cardiology

Mayar M. Jundi, MD, FACC Heart Failure Specialist

Loai F. Marouf, DO, FACC, FACOI Invasive Cardiology

Daniel Meldrum, MD, FACS, FAHA Cardiothoracic Surgery

Manoj Sharma, MD, FACC, FSCAI Interventional Cardiology

Pauline D. Watson, DO, FACC, FACP Clinical Cardiology

Covenant Medical Group – Cardiology and Cardiothoracic Surgery has exceptionally well-trained cardiologists and a cardiothoracic surgeon, offering the region’s most comprehensive heart program with the latest medical innovation in cardiac diagnosis and treatment. CONTACT: 989.583.4700 Tel 866.800.0995 Toll Free CovenantCardiology.com

The

Bulletin Saginaw County Medical Society

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

contents 5

President-Elect Zubeda S. Khan, MD

Past President Virginia R. Dedicatoria, MD Secretary Sanjay J. Talati, MD Treasurer Vacant (Interim to be named) Board of Directors B.L. Nahata, MD Mildred J. Willy, MD

4 6 7

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

10 11 12 12

From the Editor

Save the Date: 2018 Membership Meetings 14th Annual Health Fair Vendor Registration Form

Anthony M. Zacharek, MD Steven J. Vance, 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

19 19

Key Provider of the Month: Healthway Compounding Pharmacy February Birthdays

14th Annual Health Fair – Dump Your Drugs Great Lakes Bay Health Centers “Together Event”

Covenant HealthCare Nursing Scholarship Applications Available Medical Student Loan Applications Available MSMS Who Sets MSMS Policy? YOU DO!

MiHIA Focus Group

St. Mary’s of Michigan|Ascension

MAPS Registration, EHR Integration and Grant Opportunity

Applications for Membership

30 32 32

CMU College of Medicine| CMU Health Advertiser Index Key Providers Calendar of Events for 2018

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

Caroline G.M. Scott, MD Gopi K. Nallani, MD

MSMS Alternate Delegates Waheed Akbar, MD

14 18

President’s Letter

MSMS Opioid Alert – New Requirements

ON THE COVER: SCMS Alliance and CAN Council/CASA Representatives 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 | January 2018 3

PRESIDENT’S LETTER

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 201819 program year in early March. The slate will be announced in April, and elections will take place at the annual meeting in May. The 2018-19 program year begins June 1, 2018. 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 2018 MSMS HOD will be held Saturday-Sunday, April 28-29, 2018, at The Henry in Dearborn.

The 2019 MSMS HOD will be held Saturday-Sunday, May 4-5, 2019, at The Radisson Hotel and Suites in Kalamazoo. 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 790-3590 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. Julia M. Walter, MD

The Bulletin | January 2018

SUICIDE ALERTNESS TRAINING Saturday, February 24, 2018 Registration 8-8:30 a.m.Training 8:30 a.m.-12 p.m. CMU College of Medicine 1632 Stone StreetRoom 1008Saginaw, MI 48602 SPACE IS LIMITED TO 30 PARTICIPANTS SCMS Members, Residents and Medical Students are invited to participate Additional sessions may be scheduled in the future based on need/interest REGISTER ONLINE AT https://www.surveymonkey.com/r/safetalk22418 Deadline for registration is Thursday, February 15, 2018 At the request of our members following the October Membership Meeting, the Saginaw County Medical Society is hosting a FREE Suicide Alertness Training, safeTALK, to expand on the ZEROSuicide overview presented by Barb Smith SUICIDERESOURCE & Response Network (formerly known as Survivors of Suicide). safeTALK is a half-day alertness training that prepares anyone 15 or older, regardless of prior experience or training, to become a suicide-alert helper. Most people with thoughts of suicide don’t truly want to die, but are struggling with the pain in their lives. Through their words and actions, they invite help to stay alive. safeTALK-trained helpers can recognize these invitations and take action by connecting them with life-saving intervention resources. Learning goals and objectives Over the course of their training, safeTALK participants will learn to:  Notice and respond to situations where suicide thoughts might be present  Recognize that invitations for help are often overlooked  Move beyond the common tendency to miss, dismiss and avoid suicide  Apply the TALK steps: Tell, Ask, Listen, and KeepSafe  Know community resources and how to connect someone with thoughts of suicide to them for further help Up to 45% of individuals who die by suicide have visited their primary care physician within a month of their death; additional research suggests that up to 67% of those who attempt suicide receive medical attention as a result of their attempt. Given these statistics, primary care has enormous potential to prevent suicides and connect people to needed specialty care - especially when they collaborate or formally partner with behavioral healthcare providers. Jerry Reed, PhD, MSW, Director, Suicide Prevention Resource Center Funded by a generous grant from the Dow Chemical Company Foundation Donor Advised Fund

Questions? Contact Joan Cramer at the SCMS at 790-3590 or jmcramer@sbcglobal.net www.SaginawCountyMS.com Saginaw County Medical Society 350 St. Andrews Road, Suite 242Saginaw, MI 48638-5988 Office (989) 790-3590Fax (989) 790-3640Cell (989) 284-8884jmcramer@sbcglobal.net www.SaginawCountyMS.com The Bulletin | January 2018 5

FROM THE EDITOR

High Anxiety By Louis L. Constan, MD

here’s an old medical joke about the doctor attempting to resuscitate a patient suffering a cardiac arrest when it’s not going well. As the patient deteriorates, the doctor fires orders in rapid succession to his team: VASOPRESSORS! ANTIARRHYTHMICS! BICARBONATE! All intravenously, of course, because the patient is unconscious, but then: VALIUM PO! The nurse, puzzled, looks at him for a moment until he says: “It’s for me, of course.” This joke is funny because it reminds us that the doctor has needs too, and unless those needs are met, it’s not so good for the patient. Truth be told, anxiety is an alltoo-much part of medical practice these days, and not just because the holding of someone’s life in our hands is intrinsically an anxietyprovoking activity. The problem nowadays is more and more caused by powerful men and women at the local, state and national level who have little or no idea what doctors actually do, but who do not let that deter them from telling doctors how to do it. Like the staff in the cardiac arrest above, the last thing on their minds is the needs of the doctor, so it is left to the doctor, you and me

here and now, to discuss ways to deal with this situation. What not to do. It goes without saying that taking controlled substances is not a good strategy for dealing with anxiety and stress, and we all know colleagues for whom this has ended badly. Actually, the whole idea of going it alone, fixing it yourself, being your own doctor, well, there are problems with that. Every doctor tries it though. You’d think there was something in the Hippocratic Oath against asking for personal help from another physician. Many of us would rather die than ask for help. Be a dependent-patient? Admit we’re only human? Admit that we’re not superman? Admit that WE CANNOT CURE OURSELF? I see a need to get the ball rolling along these lines. Let’s assume, for the sake of argument, that I personally once had a problem with anxiety, and had to see a Psychiatrist, and had to get some advice on dealing with it. And let’s just assume, for the sake of argument (this might have happened) that the advice was helpful. You might be interested in how it went (hypothetically of course).

To start with, he put me at ease. He had seen other professional people with similar problems and knew how to handle them. Then, he just listened…a lot. After a while I felt that he understood what I was going through at a fairly deep level. It was interesting how therapeutic that was, simply to have another human being listen deeply and understand. Not something that happens in the ordinary course of one’s life. I began to relax. Then, of course, I was ready to ask for his advice. He had earned the right to give it. Here are some of his suggestions of what to do: • Put your anxiety in perspective. What exactly are you worried about? How likely is it to happen? If it’s say, 10 percent likely to happen, then resolve to spend no more than 10 percent of your time worrying about it. For example, if your income could drop if suchor-such an insurance change occurs, but you don’t know if it will or it won’t, it makes no sense to worry over much until you know for sure. continued on page 7

The problem nowadays is more and more caused by powerful men and women at the local, state and national level who have little or no idea what doctors actually do, but who do not let that deter Louis L. Constan, MD

The Bulletin | January 2018

them from telling doctors how to do it.

continued from page 6

NO STATE INCOME TAX • Find comfort in your colleagues who are all in this together. We all belong to a friendly, dynamic organization. It helps to share the burden with others who understand. It helps to know that we are not alone. • Focus on serving others. It’s hard to worry when you are serving others who are probably worse off than you are. This gives life meaning. Plus, it’s heartwarming to be appreciated. Positive feelings tend to counteract negative feelings. • If you have faith in a higher power, cultivate that faith, practice that faith. That can put our small problems in a larger perspective, again, taking the focus off ourselves, and on positive meaning in life. • Focus on the good things in your life: Family, friends and good health. Be thankful for them every day. Short of the process of seeing a Psychiatrist, the advice herein can be helpful when you have “one of those days.” And maybe the next time you think to prescribe a tranquilizer to an anxious patient, perhaps you could share some of this advice. More next month.

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Mark Your Calendar Now for our April and May Membership Meetings! Save the Date! Tuesday, April 17, 2018 Membership Meeting Mark your calendar now for our Tuesday, April 17, 2018, Membership Meeting at Horizons Conference Center. The social with cash bar starts at 6:30 p.m., followed by dinner, brief meeting, program and panel discussion at 7 p.m. The tentative program is “Second Victims.” 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.

Save The Date! 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. The Bulletin | January 2018 7

SAGINAW COUNTY MEDICAL SOCIETY  14th Annual Health Fair “The Doctor Is In!” Saturday, March 17, 2018, 9 a.m. – 1 p.m. Horizons Conference Center  6200 State Street  Saginaw, Michigan 48603 VENDOR REGISTRATION PLEASE NOTE: Registration fee prior to February 23, 2018, is $200. Registration fee after February 23, 2018, is $250. DEADLINE FOR RECEIPT OF ALL BOOTH RESERVATIONS IS WEDNESDAY, MARCH 7, 2018, 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. Participants are asked to staff their booth during the entire Health Fair. Tear down will not be allowed until 1 p.m. Anticipated attendance - 1,100. If you would like to participate in the 14th Annual Health Fair, please complete and return this form and your check in the amount of $200 per booth (before 2/23/18) or $250 per booth (after 2/23/18) BUT NO LATER THAN WEDNESDAY, MARCH 7, 2018, payable to the Saginaw County Medical Society, to 350 St. Andrews Road, Suite 242, Saginaw, Michigan 48638-5988. Please contact the SCMS – Joan at jmcramer@sbcglobal.net or Keri at keri.benkert@sbcglobal.net or 989-790-3590 with any questions (fax 989-790-3640). The Vendor Registration form can also be downloaded from our website at www.SaginawCountyMS.com under the Health Fair tab. The 14th 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

State

Office Phone

Cell Phone

What is planned for your space?

Zip Code Fax

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 CMU Health, Covenant HealthCare, Great Lakes Bay Health Centers, Michigan Cardiovascular Institute, Saginaw County Osteopathic Society and St. Mary’s of Michigan Effective 1/25/18

The Bulletin | January 2018

KEY PROVIDER OF THE MONTH! â€œKey Providersâ€? provide support for SCMS membership meetings. Each month, a Key Provider is featured in The Bulletin.

Proud to be a Key Provider to the SCMS for Six Consecutive Years!

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Healthway Compounding Pharmacy celebrating 30 years of

Better Solutions. Better Care. 2544 McLeod Dr. N. | Saginaw, MI. 48604 Ph. 989.791.1691 | Fax 989.791.4603 healthwayrx.com The Bulletin | January 2018 9

FEBRUARY BIRTHDAYS Ibrahim H. Abou Daya MD 2/4 Farhan Ansari MD 2/1 George F. Ascherl, Jr. MD 2/7 Walter C. Averill, III MD 2/8 Shafia Beg MD 2/9 Anirudha Bhandiwad MD 2/21 Peter Bistolarides MD 2/10 Dennis A. Boysen MD 2/10 Timothy K. Brown MD 2/14 Donato M. Cabrera MD 2/28 Thomas J. Campana MD 2/17 Scott E. Cheney MD 2/23 John F. Collins MD 2/23 Joseph P. Contino MD 2/10 Kathleen M. Cowling DO 2/29 Fred C. Dunham MD 2/27 Anu R. Gollapudi MD 2/13 Angela K. Gregory MD 2/4 Smitha Gudipati MD 2/27 Richard P. Heuschele MD 2/28 Johnathan Todd Howard DMD 2/4

Charles E. Jessup DO 2/11 Jose Mari G. Jurado MD 2/5 K.P. Karunakaran MD 2/15 Lawrence L. LaLonde MD 2/8 Renato S. Lee MD 2/4 Jose V.B. Mangune MD 2/16 Dale L. Moliterno DO 2/19 Fady Moustarah MD 2/26 Debasish Mridha MD 2/10 John M. O’Grady MD 2/25 James K. Putman MD 2/20 Meena Ramani MD 2/5 Minoo K. Rao MD 2/16 Arup Sarkar MD 2/17 Biren R. Shah MD 2/27 Ronak G. Soni MD 2/9 Donald L. Tuckey MD 2/1 Carolyn M. Dennis Vert DO 2/25 David A. Wiersema DO 2/28 Anthony M. Zacharek MD 2/15

VISIT OUR WEBSITE TODAY! | www.SaginawCountyMS.com

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APPLICATIONS FOR MEMBERSHIP Below are Applications for Membership that may be recommended for acceptance at the Tuesday, February 20, 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.

Kai Anderson, MD

Menelito D. Lilagan, DO

Adam Z. Cote, DO

Faiz Tuma, MD

(CMU Health-Psychiatry) Primary: Psychiatry, Board Certified 1993 Medical School: Wayne State University School of Medicine, 1986 Sponsors: Doctors Furhut R. Janssen and Sunil D. Parashar

(Covenant Medical Group Orthopaedic Surgery) Primary: Surgery-Orthopaedic, Board Certified 2013 Medical School: MSU-COM, 2004 Sponsors: Doctors Colleen A. Linehan and Michael J. Tucker, Jr.

(Covenant Digestive Care Center) Primary: Internal Medicine, Board Certified Secondary: Gastroenterology, Board Certified Medical School: Touro University Nevada College of Osteopathic Medicine, Henderson, Nevada Sponsors: Doctors Asad I. Mehboob and Mark S. Pankonin

(CMU Health-Surgery) Primary: Surgery â€“ General, Board Certified Medical School: Saddam University, Saddam College of Medicine, Iraq, 1994 Sponsors: Doctors John Blebea and Timothy R. Hackett

Victor H.L. Gordon, MD

(Covenant Pulmonary and Critical Care Associates) Primary: Internal Medicine, Board Certified Secondary: Pulmonary and Sleep Medicine, Board Certified Medical School: St. Georgeâ€™s University, Grenada, 2010 Sponsors: Doctors Ibrahim H. Abou Daya and Farhan Ansari

Below are Applications for Membership that may be recommended for acceptance at the Tuesday, March 20, 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.

Hassan H. Beiz, MD

Jeffrey S. Milewski, DO

Asim A. Kichloo, MD

Arvind R. Patel, MD

(CMU Health-Internal Medicine) Primary: Internal Medicine, Board Certified Medical School: Ross University, Dominica, 2008 Sponsors: Doctors J. Patricia Dhar and S. Sethu K. Reddy

(CMU Health-Internal Medicine) Primary: Internal Medicine, Board Certified Medical School: Acharya Shri Chander College of Medicine, 2009 Sponsors: Doctors J. Patricia Dhar and Juliette M. Perzhinsky

(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

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

The Bulletin | January 2018 11

St. Mary’s Medical Oncologist Receives National Award CyberKnife for Treatment of Inoperable Cancer and Recognizing Excellence in Clinical Trial Participation Tumors The National Cancer Institute (NCI) Community Oncology Did you know St. Mary’s is one of only three sites in Research Program (NCORP) is a nationally supported Michigan to offer the CyberKnife Robotic Radiosurgery network that brings cancer treatment and prevention clinical System – advanced technology for treatment of inoperable trials to people in their communities. There are only 34 cancer and tumors anywhere in the body – including the funded NCORP programs in the United States. St. Mary’s prostate, lung, brain, spine, pancreas and kidney? of Michigan is a member of the Michigan Cancer Research Though its name may imply surgery, the CyberKnife Consortium, one of the largest and most successful programs treatment involves no cutting. In fact, the CyberKnife System in the country. is designed to treat tumors non-invasively through beams of There is a total of 3,500 physician investigators involved high dose radiation, with extreme accuracy and little to no side in these programs and this year, the NCORP presented effects or recovery time. 358 physician investigators with special awards recognizing For more information about CyberKnife or to refer a excellence in clinical trial participation. patient, call (989) 907-8115. Ernie P. Balcueva, MD is one of the recipients of these prestigious awards which are based on the number of patients the physician treated on clinical trials over the last three-year period. DECEMBER 2017 Clinical trials are part of clinical research and at the heart of all medical advances. Patient participation is essential for moving new methods of preventing, diagnosing and treating cancer from the laboratory to physicians' offices and other clinical settings. Clinical trials offer hope for patients, and a chance to help researchers “Together Event” “Together Event” find more effective treatments for others in the future. Great Lakes Bay Health Centers invite Congratulations, Dr. Balcueva! Great Lakes Bay Health Centers invite SCMS Members, Residents, Medical Students and SCMS Members, Residents, and Community healthcare professionals to a “Together Event” atMedical the JanesStudents Street Academic healthcare professionals Health Center, 1522 Janes Street in Saginaw.to a “Together Event” at the Janes Street Academic Community Health Center, Thursday, January 25|Thursday, February 22|Thursday, March 22 1522 Janes Street in Saginaw. Meet and Greet with registration and light refreshments at 5:15 p.m. Tour from 5:30-6:30 p.m.

14th Annual FREE Health Fair “The Doctor Is In!” www.SaginawCountyMS.com

Saturday, March 17, 2018

Thursday, February 22 | Thursday, March 22 Tours include personal Meet stories and from staff, patients volunteers who Greet withand registration andillustrate the mission of nonprofit community-based Great Lakes Bay Health Centers. light refreshments at 5:15 p.m. Tour from 5:30-6:30 p.m. TO REGISTER FOR ANY OF THE EVENTS: Call Jill Armentrout, GLBHC Fund Development Coordinator, at Tours personal stories from staff, patients and (989)include 751-8866 or email jarmentrout@glbhealth.org.

9 a.m. to 1 p.m. Horizons Conference Center • 6200 State Street, Saginaw

The Saginaw County Health Department and Saginaw County Sheriff’s Department will collect your unused, unwanted and expired medications at this year’s Health Fair. Medicines play an important role in treating many conditions and diseases, but when they are no longer needed, it’s important to dispose of them properly to avoid harm to others.

DUMP YOUR DRUGS AT THIS YEAR’S HEALTH FAIR! 12 The Bulletin | January 2018

volunteers who illustrate the mission of nonprofit

Private group tours are also available at other the Health BaysideCenters. Health and Dental Center in community-based Greattimes LakesatBay Bay City and the David R. Gamez Community Health Center in Downtown Saginaw.

TO Lives|Healing REGISTER FOR ANYBuilding OF THE EVENTS: Touching People| Community Together

Call Jill Armentrout, GLBHC Fund Development Coordinator, at (989) 751-8866 or email jarmentrout@glbhealth.org Private group tours are also available at other times at the Bayside Health and Dental Center in Bay City and the David R. Gamez Community Health Center in Downtown Saginaw Touching Lives | Healing People | Building Community Together

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 The Bulletin | January 2018 lung cancer screening. 1-866-246-4673

Covenant HealthCare and Mary Free Bed Forge Partnership to Expand Inpatient Rehabilitation Care

In December, leaders from Covenant HealthCare and Mary Free Bed signed a partnership agreement to form a 50-50 joint venture. Working together, Covenant and Mary Free Bed will bring advanced rehabilitation care to Saginaw and the Great Lakes Bay Region. Located in Saginaw, Covenant HealthCare is a 642-bed health care system. Providing quality inpatient rehabilitation has long been part of the care delivered to patients.

The team believed the time was right to expand and enhance these services, looked extensively at options and ultimately selected Mary Free Bed as a rehabilitation partner. Nationally recognized for excellent patient satisfaction and rehabilitation outcomes, specialists from Mary Free Bed will share expertise, educational programs and research opportunities to expand and enhance services. The organizations are also exploring plans to design and construct a new freestanding center in Saginaw. In the meantime, the current inpatient rehabilitation area will be updated. “This partnership underscores Covenant’s focus on our patients’ needs and the needs of their families,” notes Ed Bruff, Covenant President and CEO. “Patients and their families travel across the state to receive the advanced inpatient rehabilitation care that Mary Free Bed so wonderfully delivers. We are excited to see what this partnership will bring to patients in our community.” “Covenant is an organization with parallel values and a reputation for providing outstanding care,” said Mary Free Bed CEO Kent Riddle. “We’re thrilled to expand our services to Saginaw through this partnering.”

continued on page 15

diabetes Self Management Program

In the United States,

30.3 million

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

The Bulletin | January 2018

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

continued from page 14 Covenant is the newest member of the Mary Free Bed Rehabilitation Network, an alliance of 32 hospitals with 369 inpatient rehabilitation beds and more than 2,000 rehabilitation specialists across Michigan.

About Mary Free Bed Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital in Grand Rapids. For more than 125 years, Mary Free Bed has restored hope and freedom through rehabilitation for children and adults who have experienced brain injuries, strokes, spinal cord injuries, multiple traumas, amputations, cancer and other diagnoses. The combination of 110-plus specialized medical and sports rehabilitation programs and an exclusive focus on rehabilitation, enables our specialty physicians and staff to help patients achieve extraordinary clinical results. For additional information, visit maryfreebed.com. Covenant HealthCare Awarded the Healthcare Facilities Accreditation Program (HFAP) Reaccreditation as a Primary Stroke Center Covenant HealthCare was awarded reaccreditation as a Primary Stroke Center from the Healthcare Facilities Accreditation Program (HFAP), an independent, accreditation organization recognized by the Centers for Medicare and Medicaid Services (CMS). Accreditation confirms that Covenant is providing high quality care as determined by an independent, external process of evaluation. “Covenant clearly demonstrates a commitment to quality patient care,” said Lawrence Haspel, DO Chairman of the Bureau of Healthcare Facilities Accreditation for the HFAP. “We base our decision on the findings of an extensive and thorough on-site review of Covenant against recognized national standards for patient safety, quality improvement, and environmental safety. Covenant earned the distinction of HFAP accreditation through its performance in successfully meeting those standards.” About HFAP: HFAP is a nationally recognized not-for-profit accreditation organization with deeming authority from the Centers for Medicare and Medicaid Services. Originally created in 1945, HFAP is the original healthcare accrediting body in the United States. HFAP accreditation is recognized by the federal government, state governments, managed care organizations and insurance companies. In 2015, the Accreditation Association for Hospitals/Health Systems (AAHHS), acquired and assumed management of HFAP’s range of accreditation and specialty certification programs. For more information about these programs, visit www.hfap.org.

Jennifer Behm, BSN, RN, Joins Physician Relations Team Jennifer Behm, BSN, RN, has joined the Office of Physician Relations & Regional Outreach as a Physician Liaison. Jen assumes the duties of Kelly DeBolt, who resigned her position at Covenant earlier this year. Jen has 25 years professional nursing experience, including 21 years at Covenant in CCU and OR/POHA/PACU. Most recently, Jen worked at Mackinaw Surgery Center, serving as a circulating nurse in the OR and POHA/PACU. Jen can be reached at 989.583.4051 (office) or 989.239.4451 (mobile). Retirements & Reintroductions We’d like to express our thanks to John M. Kosanovich, MD and Michael L. Schultz, MD who recently celebrated their retirements. Over the years, they showcased a lasting dedication to patients, the medical community and the medical staff they served. While they will be missed, the foundation they left for the future is appreciated. In December 2017, Iris A. Marteja MD, FACP assumed the role of CEO of Covenant Medical Group. Following the completion of her Internal Medicine residency at CMU Partners in 2003, she became one of Covenant’s first Hospital Medicine physicians. In 2012, Iris took on the role of Medical Director for Covenant Hospital Medicine. With her leadership, the group achieved new levels of growth, quality and operational performance. Dr. Marteja is a member of many hospital and medical staff committees, including the Medical Executive Committee (MEC), Quality Improvement Committee and Credentials Committee. She also chairs the Inpatient Advisory Council for Information Technology. Iris is an Associate Clinical Professor at Central Michigan University’s College of Medicine, serving as a Clinical Preceptor and Community Faculty member. Dr. Marteja is currently completing her Masters of Science in Health Administration and Leadership at Saginaw Valley State University. With the retirement of Dr. Michael Schultz from the Vice President of Medical Affairs position, Covenant has decided to combine the duties of that position with those of the Chief Transformational Officer role. Michael W. Sullivan, MD, MBA will move into the new combined role as the Vice President of Performance Improvement and Chief Medical Officer. The Bulletin | January 2018 15

14th Annual Jingle Mingle Benefits CASA A huge success, with nearly $2,000 raised for CASA (Court Appointed Special Advocates)

The SCMS Allianceâ€™s 14th Annual Jingle Mingle was a huge success, with nearly $2,000 raised for CASA (Court Appointed Special Advocates) through the CAN Council Great Lakes Bay Region. Many thanks to the vendors (the most there has ever been), table sponsors, participants and the Saginaw Country Club. Special thanks to the speakers, Suzanne Greenberg of CAN Council and Randy Dee Roberts of CASA. Everyone enjoyed Christmas piano music by Norma Roenicke, and shopping for those special and unique gifts. A delicious luncheon was provided by the Saginaw Country Club and vendor gifts, along with pixie Poinsettias, were given away in prize drawings. Mark your calendar NOW to attend the 15th Annual Jingle Mingle on Monday, December 3, 2018!

Highlights from the th 14 Annual Jingle Mingle Top Left to Right: Randy Dee Roberts of CASA and Jennifer Rogers Norma Roenicke Bottom: Left to Right: Amanda Tucker, Jennifer Rogers, Donna Campana, Keri Benkert and Janie Gugino

Jennifer Rogers and Donna Campana Childhood friends reunited - Jill Loth, Denise Stenger and Joan Cramer Janie Gugino, Jamie Chamberlin and Cathleen Veverka

The Bulletin | January 2018

SCMS-A Planning Committee Jennifer Rogers – President Tina LaFleur – Past President Colleen Cheney – Treasurer Anne deBari – Secretary Janie Gugino – Board Member Amanda Tucker – Board Member Donna Campana – Committee Member Shannon Thurin – Committee Member Keri Benkert – SCMS Table Sponsors Dr. Ronald C. Barry Dr. Louis F. Byrne Dr. Scott & Colleen Cheney Dr. John F. Collins & Family Dr. George & Janie Gugino Dr. Andrew & Tina LaFleur Saginaw County Medical Society

Vendors ACT (Another Chance Tourniquet) – Alice Brown Creations by Jeanne – Jeanne Hammond Custom Caramel Corn – Denise Siler Discovery Toys – Shirley Bitters Gift of Hope Boutique – Marci Thurlow Glass and Glitz – Dana Borenitsch LimeLight by Alcone – Justine Marlette LuLaRoe – Rachelle Bryant Omoni Boutique– Jessica Hill Outsider Art Jewelry – Cherie Davila Puppy Paw Creations – Shirley Mercer Pure Barre – Anne Marie Goidosik Purple Frog – Trish Boersma Saginaw Art Museum – Jenn Gray Timeless Treasures – Connie Glasslee Touchstone Crystals – Ann Marie Pieschke Usborne Books – Sonja Cissell Whimsical Garden Art, Inc. – Nancy Slebodnik “Wool-agins” - Judith Niederstadt & Lana Wenzel WW Farms – Trish Wesener

Just a few of our many great vendors!

MARK YOUR CALENDAR NOW to attend the 15th Annual Jingle Mingle on Monday, December 3, 2018!

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 www.SaginawCountyMS.com under the “Alliance” tab. Deadline for applications is March 31, 2018.

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 www.SaginawCountyMS.com under the “Foundation” tab. Deadline for applications is March 31, 2018.

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The Bulletin | January 2018

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CMS Data Submission System for Clinicians in the Quality Payment Program is Now Available The Centers for Medicare & Medicaid Services launched a new data submission system for clinicians participating in the Quality Payment Program. Clinicians can now submit all of their 2017 Merit-based Incentive Payment System data through one platform on the qpp.cms.gov website. Data can be submitted and updated any time from January 2, 2018, to March 31, 2018, with the exception of CMS Web Interface users who will have a different timeframe to report quality data from January 22, 2018, to March 16, 2018. READ MORE Is Your Practice Ready for the New Medicare Beneficiary Identifier? 1st Healthcare Compliance Preventing identity theft continues to be a major focus of the Social Security Administration and the Center of Medicare and Medicaid Services. Beginning in April 2018, Medicare cards will no longer contain Social Security Numbers as part of the Social Security Number Initiative and Medicare Access and CHIP Reauthorization Act. Instead, Medicare beneficiaries will be assigned a new randomly generated individually identifiable number — the Medicare Beneficiary Identifier. Accordingly, your practice management systems must be updated to accept and protect the confidentiality of these new MBI numbers. READ MORE

Focus Group Pharmacists and Barriers to Patient Care Wednesday, March 21, 2018 7-8 a.m. (EDT) Location to be announced If SCMS members or other healthcare providers would like to participate in this Focus Group (or learn about additional ways to share input), please contact Katie Trotter at ktrotter0102@gmail.com or (989) 600-0963.

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.

Focusing our practice on the needs of our community, we provide the following services for both individuals and businesses: n Monthly Accounting n Tax Planning n Financial and Business Consulting Service n Payroll Service n Tax Preparation Service n Retirement Planning Contact us for a complimentary visit at 989-791-1040. Three convenient locations to serve you in: Saginaw | Vassar | Frankenmuth

“Attention to detail since 1980.” The Bulletin | January 2018 19

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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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20 The Bulletin | January 2018

OPIOID Alert OPIOID

MICHIGAN OSTEOPATHIC ASSOCIATION

JANUARY 2018 MICHIGAN OSTEOPATHIC ASSOCIATION

Alert

On December 27, 2017, the Lieutenant Governor signed into law several new requirements aimed at combating the opioid epidemic. Following is an objective analysis of the

JANUARY 2018

On December 27, 2017, the Lieutenant Governor signed into law several new requirements On Decemberand 27, 2017, the Lieutenant Governor signed into law several new requirements new laws that could have direct implications for physicians medical practices.

PRESCRIBING OPIOIDS TO A MINOR – REQUIREMENT FORpages INFORMED CONSENT aimed at combating the opioid epidemic. On the following is an objective analysis of the new laws that could have direct implications for physicians and medical practices. aimed at combating the opioid epidemic. On the following pages is an objective analysis of the

PRESCRIBING OPIOIDS TO A MINOR – REQUIREMENT FOR INFORMED CONSENT

(House Bill 4408, Public Act 246 of 2017) new (House laws that have direct for physicians and medical practices. Bill could 4408, Public Act 246implications of 2017)

Effective June 1, 2018, before issuing an initial prescription for Exceptions to the informed consent include: an opioid in a June single1,course of treatment minor,prescription a prescriberfor • If the Effective 2018, before issuingtoana initial Exceptions to the informed consent include: minor’s treatment is associated with or incident to a mustan discuss following with the minor the minor’s opioidallinofa the single course of treatment to and a minor, a prescriber medical • If theemergency minor’s treatment is associated with or incident to a parent or guardian: must discuss all of the following with the minor and the minor’s • If themedical minor’semergency treatment is associated with or incident to parent or addiction guardian: and overdose • The risks of a surgery, regardless of whether the surgery is performed • If the minor’s treatment is associated with or incident to • The risks of addiction and overdose on an inpatient or outpatient basis a surgery, regardless of whether the surgery is performed • The increased risks of addiction for patients with underlying inpatient or outpatientjudgment, basis mental or existing disorderswith underlying• If, in on thean prescriber’s professional fulfilling • Thehealth increased risks ofsubstance addiction use for patients

PRESCRIBING OPIOIDS TO A MINOR – REQUIREMENT FOR INFORMED CONSENT the• requirements of the bill would be detrimental to the mental health or existing substance use disorders If, in the prescriber’s professional judgment, fulfilling • The danger of taking an opioid along with a

(House 4408, Public Act 246 of 2017) benzodiazepine, alcohol or central • TheBill danger of taking another opioid along with a system (House Bill 4408, Public Act 246 of nervous 2017)

minor’s or safetyof the bill would be detrimental to the the health requirements minor’s health or safety is rendered in a hospice or oncology depressant benzodiazepine, alcohol or other central nervous system • If the minor’s treatment department of a hospital thatisisrendered licensed in byathe state or oncology • If theto minor’s treatment hospice depressant Effective June 1, issuing an initial for • Any other in the patient information Exceptions the informed consent include: Effective Juneinformation 1, 2018, 2018, before before issuing an counseling initial prescription prescription for Exceptions to the informed consent include: ofissuing a hospital is licensedfor bythe theminor state at thedepartment prescriber is thethat prescription an opioid aathe single course of treatment to aa counseling minor, prescriber ofother label for the substance is • Anyin information in the patient information ansection opioid in single course of controlled treatment to minor, aathat prescriber ••• IfIfIf the minor’s treatment is with the minor’s treatment is associated associated with or or incident incident to to aa the time of discharge from hospice required under federal law (21 CFR 201.57(c) (18)) • If the prescriber is issuing the prescription for the minor at must discuss all of the following with the minor and the minor’s section of the label for the controlled substance that is medical must discuss all of the following with the minor and the minor’s medical emergency emergency the time of discharge from hospice required under federal law (21 CFR 201.57(c) (18)) parent or guardian: the consent of the minor’s parent or guardian is not • The prescriber must document the informed consent on a parent or guardian: ••• IfIfIf the treatment is with or the minor’s minor’s treatment is associated associated with or incident incident to to legally required forof the minor to obtain treatment • If the consent the minor’s parent or guardian is not “Start Talking Consent Form,” which must contain: • The prescriber must document the informed consent on a •• The The risks risks of of addiction addiction and and overdose overdose aa surgery, regardless of whether the surgery is surgery, regardless of whether the surgery is performed performed legally required for the minor to obtain treatment “Start Talking Consent which must contain: on » The name and quantity ofForm,” the controlled substance being •• The on an an inpatient inpatient or or outpatient outpatient basis basis The increased increased risks risks of of addiction addiction for for patients patients with with underlying underlying prescribed for the minor and of thethe amount of the initial dose » The name and quantity controlled substance being mental health or existing substance use disorders • If, in the prescriber’s professional mental health or existing substance use disorders • If, in the prescriber’s professional judgment, judgment, fulfilling fulfilling ENFORCEMENT prescribed for the minor and the amount of the initial dose the requirements of the bill would be detrimental to »TheAdanger statement indicating that a controlled substance is •• The of taking an opioid along with a the requirements of the bill would be detrimental to the the danger of taking an opioid along with a ENFORCEMENT Failure to comply with this section could result in the minor’s health health or or safety safety a drug or other substance that the United States Drug benzodiazepine, alcohol or other central nervous system » A statement indicating that a controlled substance is minor’s benzodiazepine, alcohol or other central nervous system following disciplinary against a physician’s license: Failure totreatment comply actions with this section result in the Enforcement has identified as having a •• IfIf the minor’s is rendered in aa could hospice or oncology depressant a drug orAdministration other substance that the United States Drug the minor’s treatment is rendered in hospice or oncology depressant probation, limitation, denial, fine, suspension, revocation or following disciplinary actions against a physician’s license: potential for abuseAdministration has identified as having a Enforcement department department of of aa hospital hospital that that is is licensed licensed by by the the state state •• Any Any other other information information in in the the patient patient counseling counseling information information permanent revocation. probation, limitation, denial, fine, suspension, revocation or potential forfor abusethat •• IfIf the prescriber is » A statement certifying the prescriber discussed section of substance that is thepermanent prescriber revocation. is issuing issuing the the prescription prescription for for the the minor minor at at section of the the label label for the the controlled controlled substance that with is the minor, and with the minor’s parent or guardian or with with the the required federal law CFR 201.57(c) (18)) » Aunder statement certifying prescriber discussed the time time of of discharge discharge from from hospice hospice required under federal law (21 (21that CFRthe 201.57(c) (18)) another adult authorized to consent to the minor’s medical minor, and with the minor’s parent or guardian or with • If the consent of the minor’s The prescriber prescriber must must document document the the informed informed consent consent on on aa • If the consent of the minor’s parent parent or or guardian guardian is is not not •• The treatment, the topics outlined in the bill another adult authorized to consent to the minor’s medical legally required for the minor to obtain treatment “Start Talking Consent Form,” which must contain: legally required for the minor to obtain treatment “Start Talking Consent Form,” which must contain: treatment, the topics outlined the bill The number of refills, if any, that areinauthorized by the »»» The name and quantity of the controlled substance The name and quantity of the controlled substance being being prescription » The number of refills, if any, that are authorized by the prescribed prescribed for for the the minor minor and and the the amount amount of of the the initial initial dose dose prescription ENFORCEMENT »» A A space for the signature of the minor’s parent or guardian ENFORCEMENT statement indicating that a controlled substance is » A statement indicating that a controlled substance is or» theA signature of another adult authorized to consent to Failure space for the signature of the minor’s parent or guardian Failure to to comply comply with with this this section section could could result result in in the the a drug or substance that United States Drug a drug or other other substance that the the United States Drug the the minor’s medical treatment, and a space to indicate following disciplinary actions against a physician’s license: or the signature of another adult authorized to consent to following disciplinary actions against a physician’s license: Enforcement Administration has identified as having a Enforcement Administration has identified as having a date the thatminor’s the minor’s parent or guardian orspace another adult the probation, limitation, denial, fine, suspension, revocation or medical treatment, and a to indicate probation, limitation, denial, fine, suspension, revocation or potential for abuse potential fortoabuse authorized consent to the minor’s medical treatment date that the minor’s parent or guardian or another adult permanent revocation. permanent revocation. »» A statement certifying that the prescriber discussed with A statement certifying that to thethe prescriber discussedtreatment with the the signed the form authorized to consent minor’s medical minor, and the minor, and with with the minor’s minor’s parent parent or or guardian guardian or or with with signed the form The Bulletin | January 2018 21 another adult authorized to consent to the minor’s another adult authorized to consent to the minor’s medical medical treatment, treatment, the the topics topics outlined outlined in in the the bill bill

PATIENT PATIENT INFORMATION INFORMATION ON ON OPIOID OPIOID RISKS RISKS –– REQUIREMENT REQUIREMENT FOR FOR INFORMED INFORMED CONSENT CONSENT (House (House Bill Bill 4408, 4408, Public Public Act Act 246 246 of of 2017) 2017)

Effective June 1, 2018, before an opioid is prescribed to a Effective June 1, 2018, before an opioid is prescribed to a patient by a physician (and/or any other prescribers licensed patient by a physician (and/or any other prescribers licensed with the state), the physician will be required to obtain the with the state), the physician will be required to obtain the patient's informed consent on a form prescribed by the patient's informed consent on a form prescribed by the Michigan Department of Health and Human Services that they Michigan Department of Health and Human Services that they have received from the physician, the following information: have received from the physician, the following information: •• The danger of opioid addiction The danger of opioid addiction •• How to properly dispose of an expired, unused or unwanted How to properly dispose of an expired, unused or unwanted controlled substance controlled substance •• That the delivery of a controlled substance is a felony under That the delivery of a controlled substance is a felony under Michigan law Michigan law •• IfIf the patient is pregnant or is a female of reproductive age, the patient is pregnant or is a female of reproductive age, the short- and long-term effects of exposing a fetus to a the short- and long-term effects of exposing a fetus to a controlled substance, including neonatal abstinence controlled substance, including neonatal abstinence syndrome syndrome

ENFORCEMENT ENFORCEMENT

Failure to comply with this section could result in Failure to comply with this section could result in disciplinary action by the Michigan Board of Medicine. disciplinary action by the Michigan Board of Medicine.

Exception: Exception:

If the opioid is prescribed for inpatient use. If the opioid is prescribed for inpatient use.

MANDATORY MANDATORY MICHIGAN MICHIGAN AUTOMATED AUTOMATED PRESCRIPTION PRESCRIPTION SYSTEM SYSTEM (MAPS) (MAPS) CHECKS CHECKS (Senate (Senate Bills Bills 166 166 & & 167, 167, Public Public Act Act (PA) (PA) 248 248 of of 2017, 2017, and and PA PA 249 249 of of 2017) 2017) Effective June 1, 2018, all licensed prescribers in Michigan will Effective June 1, 2018, all licensed prescribers in Michigan will be required to query the Michigan Automated Prescription be required to query the Michigan Automated Prescription System (MAPS) when prescribing controlled substances to System (MAPS) when prescribing controlled substances to any patient. any patient.

Exceptions Exceptions include include the the following: following:

•• Prescriptions written for quantities less than or equal to a Prescriptions written for quantities less than or equal to a •• •• ••

3-day supply 3-day supply If dispensing occurs in hospital or surgical freestanding If dispensing occurs in hospital or surgical freestanding outpatient facility and is administered in the facility outpatient facility and is administered in the facility If the patient is an animal and the controlled substance is If the patient is an animal and the controlled substance is administered in a veterinary hospital or clinic administered in a veterinary hospital or clinic If the controlled substance is prescribed by a veterinarian If the controlled substance is prescribed by a veterinarian and dispensed by a pharmacist and dispensed by a pharmacist

Beginning June 1, 2018, all licensed prescribers in Michigan Beginning June 1, 2018, all licensed prescribers in Michigan must be registered with MAPS before prescribing or must be registered with MAPS before prescribing or dispensing a controlled substance to a patient. dispensing a controlled substance to a patient.

The Bulletin | January 2018

ENFORCEMENT ENFORCEMENT Prescribing or dispensing a controlled substance on or Prescribing or dispensing a controlled substance on or after June 1, 2018, without first registering with MAPS after June 1, 2018, without first registering with MAPS could result in the following disciplinary actions against a could result in the following disciplinary actions against a physician’s license: denial, fine, reprimand, probation, physician’s license: denial, fine, reprimand, probation, limitation, suspension, revocation, or permanent limitation, suspension, revocation, or permanent revocation. revocation. Failure to query MAPS when prescribing controlled Failure to query MAPS when prescribing controlled substances to any patient, starting June 1, 2018, could substances to any patient, starting June 1, 2018, could result in the following disciplinary actions against a result in the following disciplinary actions against a physician’s license: denial, fine, reprimand, probation, physician’s license: denial, fine, reprimand, probation, limitation, suspension, revocation, or permanent limitation, suspension, revocation, or permanent revocation. revocation. If a physician has violated the requirement to check or If a physician has violated the requirement to check or register with MAPS, the Department of Licensing and register with MAPS, the Department of Licensing and Regulatory Affairs may issue a letter to the licensee Regulatory Affairs may issue a letter to the licensee notifying the licensee that he or she may be in violation. A notifying the licensee that he or she may be in violation. A letter would not be considered discipline. letter would not be considered discipline.

LIMITATION ON OPIOID PRESCRIBING: 7-DAYS FOR ACUTE PAIN (Senate Bill 274, Public Act 251 of 2017) Beginning July 1, 2018¸ if a licensed prescriber is treating a patient for acute pain, the prescriber shall not prescribe the patient more than a 7-day supply of an opioid within a 7-day period.

ENFORCEMENT Non-compliance could result in disciplinary action by the Michigan Board of Medicine.

“Acute pain” is defined as pain that is the normal, predicted physiological response to a noxious chemical or thermal or mechanical stimulus and is typically associated with invasive procedures, trauma, and disease and usually lasts for a limited amount of time.

BONA FIDE PRESCRIBER-PATIENT RELATIONSHIP (Senate Bill 270, Public Act 247 of 2017) Beginning March 31, 2018, a licensed prescriber shall not prescribe a controlled substance listed in schedules 2 to 5 unless the prescriber is in a “bona fide prescriber-patient relationship.” If a licensed prescriber prescribes a controlled substance, he or she must provide follow-up care to the patient to monitor the efficacy of the use of the controlled substance. If a licensed prescriber is not able to provide follow-up care, the prescriber shall refer the patient to the patient’s primary care provider for follow-up care or, if the patient does not have a primary care provider, the physician must refer the patient to another geographically accessible primary care provider.

ENFORCEMENT Failure to comply with this section could result in the following disciplinary actions against a physician’s license: probation, limitation, denial, fine, suspension, revocation, or permanent revocation.

“Bona fide prescriber-patient relationship” is defined as treatment or counseling relationship between a prescriber and a patient in which both of the following are present:

• The prescriber has reviewed the patient’s relevant medical or clinical records and completed a full assessment of the patient’s medical history and current medical conditions, including a relevant medical evaluation of the patient conducted in person or via telehealth

• The prescriber has created and maintained records of the patient’s condition in accordance with medically accepted standards

The Bulletin | January 2018 23

PHYSICIAN REFERRAL FOR SUBSTANCE USE DISORDER (Senate Bill 273, Public Act 250 of 2017) Effective March 27, 2018, a physician who treats a patient for an opioid-related overdose is required to provide information to the patient on “substance use disorder services.” “Substance use disorder treatment and rehabilitative services” is defined under the Michigan Mental Health Code as including:

• Early intervention and crisis intervention counseling services for individuals who are current or former individuals with substance use disorder

• Referral services for individuals with substance use disorder, their families, and the general public • Planned treatment services, including chemotherapy, counseling, or rehabilitation for individuals physiologically or psychologically dependent upon or abusing alcohol or drugs

DIRECT ADMINISTRATION OF A CONTROLLED SUBSTANCE & MEDICATION ASSISTED TREATMENT (Senate Bill 47, Public Act 252 of 2017) Effective March 27, 2018, even when administering a controlled substance directly to a patient, a physician or a licensed prescriber will be required to report the dispensing of the controlled substance to MAPS. Moreover, physician offices that prescribe buprenorphine or methadone as part of an approved substance use disorder program, must query MAPS prior to prescribing. Physicians who dispense buprenorphine or methadone on premises, as part of an approved substance use disorder program, are required to query and report data associated with the encounter to MAPS so long as federal law does not prohibit the reporting of data concerning the patient.

Exceptions to the MAPS reporting requirement when dispensing a controlled substance include the following circumstances: • A hospital that is licensed under article 17 that administers the controlled substance to an individual who is an inpatient.

• A health facility or agency licensed under article 17 if the controlled substance is dispensed by a dispensing prescriber in a quantity adequate to treat the patient for not more than 48 hours. • A veterinary hospital or clinic that administers the controlled substance to an animal that is an inpatient.

The Bulletin | January 2018

Saginaw Campus and meet other current students here at the school,” said Emilee Khair, a second-year student at the Central Michigan University College of Medicine.

Adam, Jess, Dr. Reddy, Mike

Mike, Ray, Kevin, Larry, Dean Kikano, Brian

Business in Medicine Networking Night Our Business in Medicine Student Interest Group recently held its annual Networking Night in Saginaw. “This was a special night, as we were really able to bring together students from each campus and introduce them to residents, attending physicians and local leaders within the community,” said Business in Medicine President, Mike Aljadah. The event took place at the College of Medicine’s Student Education Building where individuals who attended the event could take tours of the building, including the state-of-the-art and newly renamed Covenant HealthCare Simulation Center. The event was sponsored by prominent organizations within the Saginaw and Mount Pleasant communities including Tri-Star Trust Bank, Covenant HealthCare, MidMichigan Health, and the Michigan Area Health Education Center. Students from each four years of the medical school were in attendance, along with representatives of sponsors and other various leaders within the community. “This was really an astounding event. It was such a great opportunity to see the

Medical School and Residency Applications – 7,000+ As of mid-November, 7,370 medical students applied to the CMU Medical Education Partners’ Emergency Medicine, Internal Medicine, Family Medicine, OB/GYN, Podiatric Medicine and Surgery, Psychiatry and General Surgery programs of CMU Medical Education Partners. Interviews are being conducted daily, and it is not uncommon to see groups of students led by residents touring the Saginaw campuses. Additionally, the CMU College of Medicine closed out its application season with more than 7,200 applications for only 104 positions. Congratulations! Survivors of Suicide (SOS) Receives Funding From Dow Chemical Michigan-based Survivors of Suicide (SOS), in partnership with Central Michigan University has been awarded a $50,000 grant from the Dow Chemical Company Foundation. The grant will be used to present safeTALK to students at the CMU College of Medicine. “Building on the existing collaboration between the CMU College of Medicine, SOS will provide evidence-based educational programs to health-professional students and residents-in-training to increase awareness about mental health and provide skills for early intervention to identify signs of suicide and better manage patients and families affected,” said Dr. George Kikano, Dean of the College of Medicine. We congratulate safeTALK and ASIST trainer, Barb Smith, the founder of SOS. Her efforts are building visibility and engagement across Michigan - and helping thousands of people find ways of contributing to suicide safety.

The Bulletin | January 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 • • •

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 | January 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 | January 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 | January 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 | January 2018 29

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The Bulletin | January 2018

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HOURS: Monday–Thursday 8am–5pm • Friday 8 am–Noon The Bulletin | January 2018 31

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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. Tuesday, February 20, 2018 SCMS Board meets at 5:30 p.m. at CMU College of Medicine, 1632 Stone Street, Saginaw in Room 1016. There is no membership meeting in February. Saturday, March 17, 2018 14th Annual Health Fair “The Doctor Is In,” at Horizons Conference Center, 9 a.m. to 1 p.m. See page 8 for Vendor Registration Form. Tuesday, March 20, 2018 SCMS Board meets at 5:30 p.m. at CMU College of Medicine, 1632 Stone Street, Saginaw in Room 1016. There is no membership meeting in March. 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. 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. Tentative Program: “Second Victim.” See page 7 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 25 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.

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