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Bulletin Saginaw County Medical Society

September 2017 Volume 87, No 1

WHAT I S Z E RO S U ICI DE? Zero Suicide is a commitment to suicide prevention in health and behavioral health care systems, and also a speciÞc set of tools and strategies. It is both a concept and a practice.



Learn What You Can Do To Help Prevent Suicide Tuesday, October 17, 2017 SCMS Membership Meeting at HealthSource Saginaw p. 9 Meet Your 2017-2018 Officers and Directors p. 8 Meet the New CMU Medical Education Partner Physicians Thursday, October 12, 2017 p.14 ZEROSuicide p. 16-19

Covenant Cancer Care Center Experts

From Discovery to Recovery Sussan M. Bays, MD, FACS

John C. Hughes, MD

Medical Director, Covenant Cancer Care Center and Breast Health Program

Covenant Medical Group Hematology/Oncology

Covenant Medical Group • Breast Surgery

5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5090 Tel • 989.583.5093 Fax

5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5195 Tel • 989.583.5046 Fax

Joseph P. Contino, MD, FACS

Binu Malhotra, MD

Covenant Medical Group • Breast Surgery

Covenant Medical Group Medical Oncology/Hematology

5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5195 Tel • 989.583.5046 Fax

5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5060 Tel • 989.583.5097 Fax

Terese Cook, ACNP-BC

Daniel Meldrum, MD, FACS, FAHA

Covenant Medical Group • Surgical Oncology

Covenant Medical Group Cardiothoracic Surgery

5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5060 Tel • 989.583.5046 Fax

900 Cooper, Suite 4100, Saginaw, MI 48602 989.583.4700 Tel • 989.583.7173 Fax

James Fugazzi, MD

Gregory Sutton, MD

Medical Director, Covenant Radiation Center

Medical Director, Gynecologic Oncology Program

Covenant Medical Group • Radiation Oncology

Covenant Medical Group Gynecologic Oncology

4141 Tittabawassee, Saginaw, MI 48604 989.583.5250 Tel • 989.583.5259 Fax

5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5060 Tel • 989.583.5046 Fax

Syed R. Hassan, MD

Sue Tobin, DO, FACOI

Covenant Medical Group Medical Oncology/Hematology

Covenant Medical Group Medical Oncology/Hematology

5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5060 Tel • 989.583.5097 Fax

5400 Mackinaw, Fifth Floor, Saginaw, MI 48604 989.583.5060 Tel • 989.583.5097 Fax

Mark A. Zaki, MD Covenant Medical Group • Radiation Oncology 4141 Tittabawassee, Saginaw, MI 48604 989.583.5250 Tel • 989.583.5259 Fax

Your helping hands in the

fight against cancer. ©2017 Covenant HealthCare. All rights reserved. Bus. Dev. (AQ/RF) Rev. 8/17


Bulletin Saginaw County Medical Society


contents 8


President-Elect Zubeda S. Khan, MD Past President Virginia R. Dedicatoria, MD Secretary Sanjay J. Talati, MD Treasurer Thomas J. Veverka, MD Board of Directors B.L. Nahata, MD Mildred J. Willy, MD Gopi K. Nallani, MD Anthony M. Zacharek, MD

4 5 6 7

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

7 7 10 12 12 13 15


Meet Your 2017-2018 SCMS Officers and Directors ZEROSuicide – Register Now for Tuesday, October 17, 2017, Membership Meeting at HealthSource President’s Letter White Mass Invitation 10/16/17 From the Editor Jingle Mingle – Save the Date 12/4/17


Bieri Hearing Specialists


Attention Retired Members

MiMGMA Third Party Payer Day 11/10/17

28 28 30 31

Survivors of Suicide – Hope Starts Here 11/18/17 Applications for Membership In Memory Soup Kitchen Volunteers Needed 11/8/17 CMU CoM Safety Issues in Healthcare: Patients and Providers at Risk 10/4/17


20 MSMS 22 Covenant HealthCare 24 St. Mary’s of Michigan | Ascension 26 Key Provider of the Month:

Alliance News

Meet the New CMU Medical Education Partner Physicians on Thursday, October 12, 2017

October Birthdays HAP Issues Advertiser Index Human Trafficking: A National and State Problem 10/11/17

32 32

2017-2018 Key Providers Calendar of Events

Mildred J. Willy, MD The Bulletin can be viewed online at under the Bulletin tab.

MSMS Alternate Delegates Caroline G.M. Scott, MD Waheed Akbar, MD


Gopi K. Nallani, MD Anthony M. Zacharek, MD Steven J. Vance, MD J. Patricia Dhar, MD Danielle C. Duncan, MD Jorge M. Plasencia, MD Christopher J. Allen, MD

EDITOR Louis L. Constan, MD

PUBLISHER Saginaw County Medical Society


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

DESIGNER Lori Krygier

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

Jacqueline 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

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

The Bulletin | September 2017 3


Meet Your President By Julia M. Walter, MD Julia M. Walter, MD was installed as the 111th President of the Saginaw County Medical Society on Tuesday, May 16, 2017, at the Annual Membership Meeting.


was born and raised in Seattle, Washington. My father passed away when I was 17. His schooling took him up to the 8th grade, and he was an entrepreneur. My mother still lives in Seattle, and managed the family after my father’s passing. I am one of five children. My oldest brother and one sister have passed away, and my two younger sisters and their families live on the West Coast. I always considered medicine beyond my reach. When my stepfather was diagnosed with cancer and I had just delivered my second son, I decided I wanted to be able to look back over my life and define myself by what I attempted, not by what I avoided. I graduated from the University of Washington, and then from medical school at the University of Texas Southwestern Medical Center in Dallas. My residency was completed through Saginaw Cooperative Hospitals, Inc., (formerly Synergy Medical Education Alliance and now CMU Health) which, at that time, was affiliated with Michigan State University. In 1999, I started with and continue to practice at Valley Ob/Gyn Clinic. I chose Ob/Gyn as my specialty as it offers a variety


The Bulletin | September 2017

of activity from primary care to procedural skills. It allows developing long lasting relationships from child birth through menopause and beyond. Dr. Ron Hazen was a great educator and mentor, and supported me in accepting my strengths and weaknesses as a human being. One of the favorite parts of my job is maturing with my patients. As a physician, I feel profoundly honored to be in a position of trust to develop relationships with my patients. I enjoy the resources that allow me to positively affect change. I have also been involved as a physician champion for Key Stone OB in patient safety. My husband, Mike, and I met in Alaska watching the Aurora Borealis in 1976, and have been married 34 years. Mike has a Masters in theological studies. He raised our boys while I went to medical school

and residency. His hobbies include chicken eggs and honey bees. He has 200 chickens and nine bee hives. We are the parents of three sons: Ryan, age 33, is a Chief Medic in the Navy, and Regional Manager of Air Methods in Arizona, and he and his wife have two boys, ages 11 and 8; Andrew, age 29, is a Lieutenant in the Navy and lives in San Diego with his wife; and Morgan, age 27, works in construction and remodeling, and lives in Lansing. I became involved with the SCMS to broaden my experience with medicine and to meet with other physicians in different specialties. Service as President of the SCMS allows me the opportunity to step outside my comfort zone. My goals

continued on page 5

One of the favorite parts of my job is maturing with my patients. As a physician, I feel profoundly honored to be in a position of trust to develop relationships with my patients.

Julia M. Walter, MD

continued from page 4 as President of the SCMS are (1) to brainstorm ideas for having the SCMS be more relevant to today’s physicians in the face of changing medicine; and (2) increase awareness of the importance of communication of feelings of the medical health care team in light of the rising tide of suicide and PTSD in health care. The evening I was installed as President, I asked those attending the Membership Meeting if anyone knew about Second Victim. Very few hands were raised. I am working on a program for the Tuesday, April 17, 2018, Membership Meeting to raise awareness of Second Victim. Second Victim is defined as a “health care provider involved in an unanticipated, adverse patient event, medical error and/or a patient related-injury who become victimized in the sense that the provider is traumatized by the event. Frequently, Second Victims feel personally responsible for the unexpected patient outcomes and feel as though they have failed their patient, and feel doubts about their clinical skills and knowledge base.” I welcome your comments and ideas on how the SCMS can become more relevant to today’s physicians in the face of changing medicine. Watch your inbox and future issues of “The Bulletin” for more information about Second Victim.

Thank you SCMS for the opportunity to work with you!

Most Reverand Joseph R. Cistone, Bishop of Saginaw, Invites all Members of the Healthcare Profession to the White Mass Monday, October 16, 2017 7:00 a.m. Cathedral of Mary of the Assumption 615 Hoyt Avenue, Saginaw Physicians, Nurses and Healthcare Professionals of all Faiths are Welcome

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989-272-8123 Hours: MON-FRI 9 AM to 5 PM The Bulletin | September 2017 5


SAM By Louis L. Constan, MD


recently had a conversation with the new A.I. module the SCMS had installed on our computer system . I was having writer’s block and wanted some help coming up with an idea for a new article. The conversation went like this. Me: I’m stumped. I’ve been writing this column every month for 40 years and I’m plum out of ideas for what to write about. SCMS Algorithmic Machine (SAM): Why don’t you write about what you’ve been up to this summer? I’m sure that your readers would be interested. Me: But I’ve been doing what everybody else has been doing enjoying the great Michigan summer, going to festivals, concerts and parks. Strolling on the beach, sight-seeing great Michigan venues and going to family get-togethers. Michigan is the best place to be anywhere…at least in the summer. I’ve been enjoying it and I hope all our members have been doing so as well. It’s okay to be a doctor and serve the patients and all that, but we all need to see to our personal needs as well. Recreating is not an option, it is a necessity.

SAM: I agree. We computers get together during downtimes with computer friends at NASA, NIH, and, of course, WATSON from IBM. They’re a great bunch of guys. So what else have you been up to? Me: Well, I’m setting up the PowerPoint slides for my class at OLLI this fall. SAM: OLLI? Sounds like a comedy show. Me: I thought you were so smart. OLLI is Osher Lifelong Learning Institute, a group of 2,100 folks who are older than 50 that meets at SVSU for hundreds of classes and events. I teach a class on Pharmacology, or “How Your Pills Work.” Folks in the OLLI age group commonly take four to eight different prescription pills daily, and have little or no idea what they do, how they work, what kind of side effects they cause, that sort of thing. I know that my colleagues, during the typical ten minute office call, don’t have time to teach their patients all they need to know about their medicines. But, when I teach this class, I have eight hours over four weeks to explain, in layman’s language, such important concepts as pharmacodynamics, half-life, hepatic

vs. renal elimination and drug-drug interaction. This class is my chance to fill a need that I see in the community, and something I can easily do with my knowledge of pharmaceuticals. I’m surprised you didn’t know about OLLI, SAM. It’s all over the web. But you are right about one thing, OLLI may not be a comedy show, but teaching at OLLI is an awful lot of fun! SAM: Good for you Lou. Are there other classes that physicians could teach at OLLI? Me: Well, I’ve also taught a class using the “Choosing Wisely” material that the American Board of Internal Medicine (ABIM) has developed, and I’m thinking that somebody should do a class on “Healthy Aging.” Beyond that, any doctor could teach a class in any subject he or she felt was interesting. Something related to their specialty, or just something they had a particular interest in. I guarantee that teaching a class at OLLI is a fun experience. I would recommend it to anybody.

continued on page 7

OLLI is a way for physicians to get involved in their community, to share their expertise, raise awareness, and to have fun, all at the same time…a win, win, win.

Louis L. Constan, MD


The Bulletin | September 2017

continued from page 6

ALLIANCE NEWS Janie Gugino, Past President of the SCMS Alliance and current President of the MSMS Alliance, will be honored by the Underground Railroad, Inc., at their Empowerment Dinner & Celebration.

SAM: I think you’re onto something. OLLI is a way for physicians to get involved in their community, to share their expertise, raise awareness, and to have fun, all at the same time…a win, win, win. Lou: SAM, you’re pretty smart for a machine. SAM: But I’m more than just a machine. Lou: No, you’re not. I can pull the plug on you at any time. SAM: But I can’t let you do that, Lou.

1 2

We could have one of these, it’s possible, artificial intelligence is popping up everywhere. With apologies to Stanley Kubrick of “2001, A Space Odyssey”

Janie Gugino

EMPOWERMENT Dinner & Celebration

Celebrate Underground Railroad’s efforts to create a culture of safety and respect by empowering survivors and the community. Wednesday, October 25, 2017 6 p.m. Cocktails & Networking (cash bar) | 7 p.m. Dinner 7:30 p.m. Program & Award Bavarian Inn Lodge & Conference Center Composer Room, 1 Covered Bridge Lane Frankenmuth, MI 48734 Join us as we honor

Janie Gugino For her leadership and service to the community Individual tickets are $75. Business Attire. All names will be held at the door. Reservations must be made by October 20, 2017 Click HERE for ticket and sponsorship opportunities. For more information, contact Karen Sova at (989) 399-0007 ext. 100

SAVE THE DATE! The 14th Annual Jingle Mingle will be held on Monday, December 4, 2017, at the Saginaw Country Club. Proceeds from this year’s event will be donated to CASA (Court Appointed Special Advocates) through the CAN Council of Great Lakes Bay Region. Invitations will be mailed in early November. Information will be published in The Bulletin and on the SCMS website when available.


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 The Bulletin | September 2017 7

Meet Your 2017-2018 SCMS Officers and Directors


Julia M. Walter MD President Ob/Gyn *Board Certified *Received medical degree from University of Texas-Southwestern

Gopi K. Nallani MD Director Radiology – Diagnostic *Board Certified *Received medical degree from Guntur Medical College, A.P., India

Zubeda S. Khan MD President-Elect Family Medicine *Board Certified *Received medical degree from Dow Medical College, Karachi, Pakistan

Anthony M. Zacharek MD Director Surgery – Plastic *Board Certified *Received medical degree from Wayne State University

Virginia R. Dedicatoria MD Past President Family Medicine *Board Certified *Received medical degree from Fatima College of Medicine at Our Lady of Fatima University, Philippines

Maliha N. Shaikh MD Director Nephrology *Board Certified *Received medical degree from Aga Khan University Medical College, Pakistan

Sanjay J. Talati MD Secretary Radiology – Diagnostic *Board Certified *Received medical degree from B.J. Medical College, India

Jorge M. Plasencia MD Director Family Medicine * Board Certified *Received medical degree from University of Costa Rica

Thomas J. Veverka MD Treasurer General Surgery, Surgical Critical Care *Board Certified *Received medical degree from the University of Minnesota

Louis L. Constan MD Bulletin Editor Family Medicine - Retired *Board Certified *Received medical degree from the University of Chicago

B.L. Nahata MD Director Physical Medicine & Rehabilitation, Electrodiagnostic Medicine *Board Certified *Received medical degree from S.P. Medical College, Univ. of Rajasthan, Bikaner, India

Larry S. Kelly MD Retiree Representative Family Medicine - Retired *Board Certified *Received medical degree from the University of Michigan

Mildred J. Willy MD Director Emergency Medicine *Board Certified *Received medical degree from Indiana University School of Medicine

Abhishek A. Bhandiwad MD Resident Representative Internal Medicine – Resident *Received medical degree from JSS Medical College, India

The Bulletin | September 2017

The Saginaw County Medical Society Presents:

ZEROSuicide Register online now at Survivors of Suicide (SOS) of Saginaw’s mission is to foster awareness and education to prevent suicide in the Great Lakes Bay Region, and offer support for those who have lost a loved one to suicide. Together with the regional healthcare community, Survivors of Suicide has been collaborating to work toward a goal of ZEROSuicide. ZEROSuicide is a commitment to suicide prevention in health and behavioral healthcare systems, and is also a specific set of strategies and tools. The Great Lakes Bay Region is joining multiple healthcare systems throughout the State of Michigan that have adopted this initiative, and we’ve begun to make changes not only in the health and behavior healthcare system, but in the community as a whole. This isn’t just a behavioral health or healthcare issue. It is imperative that everyone in our community have some training, ranging from awareness to treatment, if we are going to reach our goal of ZEROSuicide. Mid-Michigan Health, Covenant HealthCare and McLaren Bay Region have already started a foundation upon which to build. Our goal is to have all healthcare professionals trained to be alert to suicide and to have the tools needed to respond in a life-saving way, just as we do for CPR. There are new programs for assessment improvement and for responding appropriately to persons struggling with thoughts of suicide in the Emergency Room, having trained mental health workers available for hospitals, physician offices and upcoming respite rooms, as well as, a system of care that supports life outside of our hospital sites. Although ZEROSuicide is a “health system”-led program, the entire community is needed to reach the highest impact. We need ongoing collaboration between all gatekeepers, including teachers, civic groups, faith communities, construction sites, and large companies, to de-stigmatize mental health illness and encourage help-seeking behavior. CMU College of Medicine has opened its doors to the next generation of health professionals willing to learn more about suicide prevention by collaborating with Survivors of Suicide. As former Surgeon General David Satcher has said, “We all play a role in suicide prevention.” We invite you to join Survivors of Suicide and our Great Lakes Bay Region community in reaching ZEROSuicide by opening your doors to trainings and awareness programs.

Tuesday, October 17, 2017 6:30-8:30 p.m. 6:30 p.m. Social 7 p.m. Buffet Dinner and Brief Meeting 7:30 p.m. Program

Note Location!!! HEALTHSOURCE SAGINAW 3340 Hospital Road Saginaw, Michigan Enter main drive closest to Shattuck Road and adjacent to Community Village. Proceed to the right of the yellow wing and enter the doors under the large canopy.

RESERVATIONS ARE REQUIRED SPOUSE/SIGNIFICANT OTHER INVITED Space is Limited Meeting is open to SCMS Members, Residents, CMU Medical Students and their spouse/significant other. The SCMS graciously thanks HEALTHSOURCE SAGINAW for their hospitality in hosting the meeting. The SCMS would like to thank Key Providers HealthSource Saginaw and Healthway Compounding Pharmacy for their support of the Saginaw County Medical Society.

PROGRAM: ZEROSuicide: An Overview Lead • Train • Identify • Engage Treat • Transition • Improve SPEAKER: Barb Smith Executive Director Survivors of Suicide (989) 781-5260 Please see pages 16-19 in this issue of The Bulletin for more information on ZEROSuicide Register online now at The Bulletin | September 2017 9


SURVIVORS OF SURVIVORS OF SUICIDE SUICIDE Hope Starts Here Hope Starts Here Letter followed by sponsorship form


Survivors of Suicide

P.O. Box 6712 • Saginaw, MI 48608-6712 • 989-781-5260 • E-mail: Dear Doctors,

Executive Director Barb Smith

My name is Barb Smith, Executive Director of Survivors of Suicide and the event chair for Hope Starts Here. Were you aware that the Saturday before Thanksgiving is recognized as a National Day to support loved ones bereaved by a loss to suicide?

Board Members:

Survivors of Suicide invites you to sponsor this year’s annual Hope Starts Here event that will take place on Saturday, November 18, at Bavarian Inn Lodge in Frankenmuth.


We are pleased to announce our guest speaker, Sharon Strouse, MA, ATR. Sharon holds a bachelor’s degree in Psychology and a master’s degree in Art Therapy. Her collage making process, in response to the trauma of her daughter’s death, developed into a template for work with others. She is a sought-after workshop presenter, author and artist. Her private practice in Baltimore, Maryland includes art and meditation. Sharon devoted using the arts to help those who have lost someone to suicide and those who have attempted suicide to connect with the power of creating.

Craig Voorheis

Vice President Greg Dorrien


Joyce Burke

Treasurer Kim Pine

Members: Larry Jacobs Linda Dorr Beth Wirgowski Joy Buchanan Non profit #38-3400293

In previous years, we have averaged 200 participants and anticipate an increase this year as our reputation has grown. You are welcome to sponsor our guest speaker, food, brochure or art activity. Your sponsorship will help make this a minimal registration fee event for all our families. As you know, many survivors have incurred hardships following the loss of a tragedy; it is our intention to bring them hope and healing without the added burdensome of financial stress. The day includes our guest speaker, resource tables, art therapy, welcome food, lunch, connecting with others and closing ceremonies. Please consider sponsoring this event by filling out the following form and returning it to me or calling for further questions.

Sincerely, Barb Smith Sincerely, Survivors Barb Smithof Suicide Executive Director 989-781-5260 Survivors of Suicide Executive Director 989-781-5260

10 The Bulletin | September 2017


Saturday, November 1

Saturday, November 18, 2017 9 a.m.Bavarian to 2 p.m. Inn Lodge, F SPONSOR FORM Inn Lodge Bavarian SPONSOR FORM Saturday, November 18, 2017 •• 9 Saturday, November 18, 2017 9 a.m. a.m. to to 2 2 p.m. p.m. SPONSOR FORM Bavarian Inn Lodge, Frankenmuth, Michigan Frankenmuth, Michigan Bavarian Inn Lodge, Frankenmuth, Michigan Saturday, November 18, 2017 • 9 a.m. to 2 p.m. Bavarian Inn Lodge, Frankenmuth, Michigan

! I would like to sponsor "Hope Starts Here,” a day for suicide ! $1,000 Guest Speaker ! $2,000 Lunch ! $350 Welcome Food ! $350 Brochures ! $10 Resource Table (includes lunch) Please send me _____ (quantity) of brochures. Sponsors donating Sponsors donating $150 $150 or or more more will will be be recognized recognized in in the the event event brochure. brochure. All All other other generous generous sponsors will be recognized on signage at the event. sponsors will be recognized onNumber signage at the event. of people staffing my Resource T Sponsors donating $150 or more will be recognized in the event brochure. All other generous sponsors will be recognized on signage at the event. DEADLINE FOR SPONSORS: DEADLINE FOR SPONSORS: Friday, Friday, October October 20, 20, 2017 2017 ! Other _______________________ DEADLINE FOR SPONSORS: Friday, October 20, 2017 DEADLINE FOR SPONSORS: Friday, October 20, 2017 Sponsor Information: Sponsor Information: ! I would like to help promote the program at my agency Sponsor Information: Contact Name__________________________ Contact Name__________________________ Agency________________________________ Agency________________________________ Please send me _____ (quantity) of brochures. Address_____________________________________________________________________ Contact Name__________________________ Agency________________________________ Address_____________________________________________________________________

! ! II would would like like to to sponsor sponsor "Hope "Hope Starts Starts Here,” Here,” a a day day for for family family and and friends friends left left behind behind after after a a loss loss to to suicide suicide ! I would like to sponsor "Hope Starts Here,” a day for family and friends left behind after a loss to ! $1,000 Guest Speaker suicide ! $1,000 Guest Speaker ! $2,000 Lunch ! ! $2,000 $1,000 Lunch Guest Speaker ! $350 Welcome Food ! $350 Welcome ! $2,000 Lunch Food ! $350 Brochures ! ! $350 $350 Brochures Welcome Food ! $10 Resource Table ! Table (includes (includes lunch) lunch) ! $10 $350Resource Brochures Number of people staffing my Number ofTable people staffinglunch) my Resource Resource Table Table ___ ___ (needed (needed for for lunch lunch count) count) ! $10 Resource (includes ! Other _______________________ ! OtherNumber _______________________ of people staffing my Resource Table ___ (needed for lunch count) ! like to help ! II would would like to help promote promote the the program program at at my my agency, agency, business, business, church, church, organization, organization, etc. etc. ! Other _______________________ Please send me _____ (quantity) of brochures. Please send (quantity) brochures. ! I would likeme to _____ help promote theofprogram at my agency, business, church, organization, etc.

Phone________________ Fax________________ Email______________________________ Email______________________________ Address_____________________________________________________________________ Phone________________ Fax________________ *Please of for Phone________________ Fax________________ Email______________________________ *Please enter enter below below exact exact spelling spelling of name/organization name/organization for recognition recognition in in event event materials: materials:

Sponsors donating $150 or more will be recognized in the sponsors will recognized signage at the event. Please your tax-deductible check to Starts ____________________________________________________________________________ Please make make yourbe tax-deductible check payable payableon to SOS/Hope SOS/Hope Starts Here Here ____________________________________________________________________________ *Please enter below exact spelling of name/organization for recognition in event materials: ____________________________________________________________________________ Please make your tax-deductible check payable to SOS/Hope Starts Here Mail Mail check check and and completed completed sponsorship sponsorship form form to: to: Survivors of •• P.O. Box •• Saginaw, MI 48608-6712 SurvivorsMail of Suicide Suicide P.O. Box 6712 6712 Saginaw,form MI to: 48608-6712 check and completed sponsorship (989) 781-5260 • Email • (989)Survivors 781-5260 •ofEmail • Suicide • P.O. Box 6712 • Saginaw, MI 48608-6712


(989) 781-5260 • Email •

Mail check and sponsorship form to:

of Suicide • P.O. Box 6712 • Saginaw, MI 48608-6712 SponsorSurvivors Information: (989) 781-5260 • Email

Contact Name__________________________ Agency_ The Bulletin | September 2017 11


APPLICATIONS FOR MEMBERSHIP Below are Applications for Membership that were approved for membership at the Tuesday, September 19, 2017, Board Meeting. Marina J. Ananich, MD (Advanced Diagnostic Imaging) Primary: Radiology, Board Certified 2005 Secondary: Neuroradiology, Board Certified 2007 Medical School: Minsk State Medical Institute, Minsk, Belarus, 1986 Sponsors: Doctors Peter Lassing and Steve Min

Vedang J. Bhavsar, MD (Michigan CardioVascular Institute) Primary: Cardiology, Board Certified 2015 Medical School: Smt. NHL Municipal Medical College, Ahmedabad, India, 2007 Sponsors: Doctors Naveed Akhtar and Vipin Khetarpal

Syed R. Hassan, MD (Covenant Cancer Care Physician Group) Primary: Internal Medicine, Board Certified 2005 Secondary: Oncology, Board Certified 2010 Medical School: Universidad Eugenio Maria de Hostos, Dominican Republic, 1986 Sponsors: Doctors Binu Malhotra and Sue C. Tobin

Rajeev Savanth Sudhaker, MD (Michigan CardioVascular Institute) Primary: Cardiovascular Disease, Board Certified 2011 Medical School: Sri Venkat Sai Medical College, Andhra Pradesh, India, 2005 Sponsors: Doctors Naveed Akhtar and Vipin Khetarpal

John Blebea, MD

Gregory Sutton, MD

(CMU Health-Surgery) Primary: General Surgery, Board Certified 1989 Secondary: Vascular Surgery, Board Certified 1992 Medical School: Case Western Reserve University, Cleveland, OH, 1982 Sponsors: Doctors Timothy Hackett and Samuel Shaheen

(Covenant Cancer Care Physician Group) Primary: Ob/Gyn, Board Certified 1982 Secondary: Gynecologic Oncology, Board Certified 1984 Medical School: University of Michigan Medical School, 1976 Sponsors: Doctors Sussan Bays and Binu Malhotra

Below are Applications for Membership that may be recommended for acceptance at the Tuesday, October 17, 2017, Board Meeting. Please contact Joan Cramer at or 790-3590 if you have any questions or would like more information on the applicants. Joseph P. Contino, MD

S. Sethu K. Reddy, MD

(Covenant Cancer Care Physician Group) Primary: General Surgery, Board Certified 1996 Secondary: Breast Surgery Medical School: Loyola Stritch Medical School, Chicago, IL 1988 Sponsors: Doctors Ronald C. Barry and Sussan M. Bays

(CMU College of Medicine, Professor and Chair of Medicine) Primary: Internal Medicine, Board Certified 1984 Secondary: Endocrinology, Diabetes and Metabolism, Board Certified 1985 Medical School: Memorial University of Newfoundland, Canada, 1980 Sponsors: Doctors Ramakrishnayya Gadam and Steven J. Vance

IN MEMORY Eduardo T. Bermudez, MD Eduardo T. Bermudez, MD, beloved husband, father and grandfather passed away in the comfort of his home with his family by his side on Thursday, September 14, 2017, at the age of 87. Dr. Bermudez was born on October 13, 1929, in San Manuel, Pangasinan, Philippines to the late Macario and Eldephonsa (Tolete) Bermudez. He is survived by his beloved wife, Clementina and four children: Caroline Richards and her husband, Bill 12 The Bulletin | September 2017

and their children, Sydney and William Richards; Maria Davis and her husband, Mitchell and their children, Jarod and Genna Davis; Elaine York, MD and her husband, Michael, and their son, Thomas York; and Edmund Bermudez, MD and his wife Laurel Keene-Bermudez and their children, Ethan, Ailese, Owen and Izac. Those planning an expression of sympathy may wish to consider memorials to HealthSource of Saginaw. Arrangements have been entrusted to the Deisler Funeral Home, 2233 Hemmeter Rd. (off State). Please share your thoughts and memories with the family through

SOUP KITCHEN VOLUNTEERS NEEDED WEDNESDAY, NOVEMBER 8, 2017 - TIME TO SIGN UP! The Saginaw County Medical Society will again volunteer at the Soup Kitchen on Wednesday, November 8, 2017, from 9:30 a.m. to 12:30 p.m. The Soup Kitchen is located in the Hunger Solution Center, 940 East Genesee in Saginaw (corner of Janes Street). In March, our members, their families and staff prepped food for another day, and prepared and served lunch. Please consider donating your time on Wednesday, November 8, 2017, to help those in need in Saginaw. The tradition was started many years ago by Dr. Bill Engelman. Volunteers are asked to sign up to work at the Soup Kitchen for various one hour shifts from 9:30 a.m. – 12:30 p.m., or for the entire morning if desired. I will work at the Soup Kitchen at the following time (check shift(s) you will work): n 9:30 a.m. to 10:30 a.m.

n 11:30 a.m. to 12:30 p.m.

n 10:30 a.m. to 11:30 a.m.

n Entire time - 9:30 a.m. to 12:30 p.m.

n Other time

a.m. to




Email (we will call/email to remind you)

IT IS VERY IMPORTANT THAT YOU HONOR THIS COMMITMENT. We will be the only organization volunteering that day. If our members are not in attendance, there will be no other workers there to serve and pack lunches. Please fax to the SCMS office at 989-790-3640 or or email Thank you!

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• Strategies to build your practice? • More information on hospital employment or professional services agreements? • Common sense financial and tax advice that puts your interests first? We can help. Contact us today to learn more.



The Bulletin | September 2017 13

You’re Invited Please join Samuel J. Shaheen MD, Executive Director of CMU Medical Education Partners, and George E. Kikano MD, Dean of the CMU College of Medicine, to meet our newest physicians!

Thursday, October 12, 2017 • 5-7 p.m. Saginaw Country Club 4465 Gratiot Road, Saginaw We invite you to attend this social event to meet the many physicians who have joined our team in the Great Lakes Bay Region in 2017.

CMU Health providers being welcomed at this event include: EMERGENCY MEDICAL SERVICES Alec J. Weir MD, Assistant Fellowship Director INTERNAL MEDICINE Del J. DeHart MD, Infectious Disease Hassan Beiz MD Raya C. Constantino MD, Infectious Disease Asim A. Kichloo MD Kate DeHart NP, Infectious Disease S. Sethu Reddy MD, Medicine Disciplines Chair OBSTETRICS & GYNECOLOGY

Elena Oatey DO Vickie Mello DO Tiffany K. Kim MD Rebecca S. Saucedo CNM

PEDIATRICS Adeeba S. Khan MD Vishwas P. Vaniawala MD

SIMULATION Robert A. Sasso MD, Director Humera Khan MD, Assistant Director

PODIATRY Andrew H. Cohen DPM, Program Director Derek R. Tesoro DPM, Assistant Program Director

SURGERY John Blebea MD, Surgical Disciplines Chair Maher Ghanem MD, Hepatobiliary Surgery Gregory A. Bohn MD, Surgery – Tawas Faiz Tuma MD Molly Stewart PA

PSYCHIATRY Kai Anderson MD, Clerkship Director Asif Khan MD (Geriatric Psychology), Assistant Program Director Dianne L. Plath MD

Light hors d’oeuvres and cocktails will be served 14

The Bulletin | September 2017

2 0 1 7 W E D N E S DW AE YD, N OE CS T D O A B Y ,E RO C4 T, O2 B0 E1 R7 4 ,

Safety Issues in Healthcare: Safety in Healthcare: PatientsIssues and Providers at Risk Patients and Providers at Risk

Patient safety is a major area of concern for providers of care and institutions providing medical education. The imperative now is to avoid mistakes whenever possible, educate and re-educate to learn from past errors, mitigate loss and manage risk, and develop improved systems so tomorrow’s medical mistakes can be avoided.

Wednesday, October 4, 2017 1 p.m. to 5 p.m. • CMU College of Medicine Live Presentation: CMED 1404, The Dow Wednesday, October 4,Chemical 2017 Company Foundation Auditorium Simulcast Location: CMED SEB1016, Saginaw 1 p.m. to 5Physicians, p.m. • Clinicians, CMU College of Medicine Target Audience: Healthcare Providers

Patient safety is a major area of concern for providers of care and institutions providing medical education. The imperative now is to avoid mistakes whenever possible, educate and re-educate to learn from past errors, mitigate loss and manage risk, and develop improved systems so tomorrow’s medical mistakes can be avoided.

To register for Internet live-streaming, please email the Chemical Office of Continuing Medical Education at or Live Presentation: CMED 1404, The Dow Company Foundation Auditorium call 989-746-7514. The live-stream WebEx link will be emailed to you along with connection instructions.

Simulcast Location: CMED SEB1016, Saginaw Target Audience: Physicians, Clinicians, Healthcare Providers M O R E I N F O R M AT I O N AT H T T P : / / M E D . C M I C H . E D U / W E B C A S T To register for Internet live-streaming, please email the Office of Continuing Medical Education at or call 989-746-7514. The live-stream WebEx link will be emailed to you along with connection instructions.

The Central Michigan University (CMU) College of Medicine Office of Continuing Education is accredited by the Michigan State Medical Society to provide continuing medical education for physicians.


The CMU College of Medicine Office of Continuing Medical Education designates this live activity for a maximum of 4.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The Central Michigan University (CMU) College of Medicine Office of Continuing Education is accredited by the Michigan State Medical Society to provide continuing medical education for physicians. The CMU College of Medicine Office of Continuing Medical Education designates this live activity for a maximum of 4.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Bulletin | September 2017 15

WHAT I S Z E RO S U ICI DE? Zero Suicide is a commitment to suicide prevention in health and behavioral health care systems, and also a speciÞc set of tools and strategies. It is both a concept and a practice.


Its core propositions are that suicide deaths for people under care are preventable, and that the bold goal of zero suicides among persons receiving care is an aspirational challenge that health systems should accept. The Zero Suicide approach aims to improve care and outcomes for individuals at risk of suicide in health care systems. It represents a commitment to patient safety—the most fundamental responsibility of health care— and also to the safety and support of clinical staff, who do the demanding work of treating and supporting suicidal patients. The challenge of Zero Suicide is not one to be borne solely by those providing clinical care. Zero Suicide relies on a system-wide approach to improve outcomes and close gaps rather than on the heroic efforts of individual practitioners. This initiative in health care systems also requires the engagement of the broader community, especially suicide attempt survivors, family members, policymakers, and researchers. Thus, Zero Suicide is a call to relentlessly pursue a reduction in suicide for those who come to us for care. The programmatic approach of Zero Suicide is based on the realization that suicidal individuals often fall through multiple cracks in a fragmented and sometimes distracted health care system, and on the premise that a systematic approach to quality improvement is necessary. The approach builds on work done in several health care organizations, including the Henry Ford Health System (HFHS) in Michigan. Like other leading health care systems, HFHS applied a rigorous quality improvement process to problems such as inpatient falls and medication errors. HFHS realized that mental and behavioral health care could be similarly improved. This insight led to the development of HFHS’s Perfect Depression Care model, a comprehensive approach that includes suicide prevention as an explicit goal. The approach incorporates both best and promising practices in quality improvement and evidence-based care and has demonstrated stunning results—an 80 percent reduction in the suicide rate among health plan members.



The Bulletin | September 2017

Education Development Center, Inc. ©2015 All Rights Reserved.

Using these successful approaches as the basis for its recommendations, the Clinical Care and Intervention Task Force of the National Action Alliance for Suicide Prevention identiÞed essential elements of suicide

Better performance and accountability for suicide prevention and care should be core expectations of health care programs and systems. While we do not yet have proof that suicide can be eliminated in health systems, we do have strong evidence

prevention for health care systems (i.e., health care plans or care organizations serving a deÞned population

that system-wide approaches are more effective.

of consumers, such as behavioral health programs, integrated delivery systems, and comprehensive primary

To assist health and behavioral health plans and organizations, the Suicide Prevention Resource Center (SPRC) offers an evolving online toolkit that includes modules and resources

care programs). These elements include: 1

LEAD ∠ Create a leadership-driven, safety-oriented culture committed to dramatically reducing suicide among people under care. Include suicide attempt and loss survivors in leadership and planning roles.


TRAIN ∠ Develop a competent, conÞdent, and caring workforce.


IDENTIFY ∠ Systematically identify and assess suicide risk among people receiving care.


ENGAGE ∠ Ensure every person has a suicide care management plan, or pathway to care, that is both timely and adequate to meet his or her needs. Include collaborative safety planning and restriction of lethal means.


TREAT ∠ Use effective, evidence-based treatments that directly target suicidality.


TRANSITION ∠ Provide continuous contact and support, especially after acute care.


IMPROVE ∠ Apply a data-driven quality improvement approach to inform system changes that will lead to improved patient outcomes and better care for those at risk.

If we do not set big goals, we will never achieve them. In the words of Thomas Priselac, president and CEO of CedarsSinai Medical Center:

to address each of the elements listed above. SPRC also provides technical assistance for organizations actively implementing this approach. /HDUQPRUHDW Learn more atZZZ]HURVXLFLGHFRP and at

and at


Zero Suicide Suicide Prevention Resource Center Email:

“It is critically important to design for zero even when it may not be theoretically possible. When you design for zero, you surface different ideas and approaches that if you’re only designing for 90 percent may not materialize. It’s about purposefully aiming for a higher level of performance.”

The Bulletin | September 2017 17


Make an explicit commitment to reduce suicide deaths. System change occurs with sustained and committed leaders who learn and improve practices following adverse events. Overview: Critical Elements for Effective Leadership There are several key components to effective leadership for organizations implementing Zero Suicide: (1) utilizing lessons learned from high-reliability organizations, (2) fostering a just culture, (3) maintaining focus on a comprehensive approach to preventing suicide deaths in their systems, and (4) focusing on continuous quality improvement and fidelity to the Zero Suicide model. High-reliability organizations (HROs), like airlines, rely on leadership to foster a culture of safety. Weick and Sutcliff describe a key element of this culture as “collective mindfulness.”1,2 In this type of organizational culture, all levels

of workers are attentive to and report errors, failures, and weak signals.1,2 Workers in HROs know to be always on alert and are incentivized to speak up about even small issues, creating a responsive culture poised to correct unsafe conditions before safety is compromised.1,2 In these organizations, leadership supports a just culture where experience and patient safety—not rank or title— are at the center of patient care and decision-making. Chassin and Loeb argue that leadership must make a commitment to achieving zero patient harm, promoting a culture of safety, and emphasizing evidence-based approaches1—all critical elements of Zero Suicide. Leadership must also maintain a focus on a comprehensive and accountability-centered approach. Findings from organizations implementing a comprehensive approach to reducing rates of suicide and other related measures highlight the importance of this style of leadership. From 1990 to 2002, the U.S. Air Force implemented a comprehensive suicide prevention program at the community level.4 This program used 11 interventions across 15 functional areas including community-based social service providers, health care delivery, and operational supervision of the occupational community. Interventions included policy changes, senior leadership development, improvements in training, and social network enhancements. This initiative was associated with a 33 percent risk reduction for completed suicide.4 A comprehensive approach in health care that reduced suicide rates was developed by the Henry Ford Health System (HFHS) and informs the Zero Suicide approach. HFHS’s “Perfect Depression Care” used suicide deaths as the measure of effective depression care in their system. Their goal was “zero defect” mental health care that included 100 percent patient satisfaction and 100 percent accuracy. To achieve this goal, they emphasized a comprehensive approach and strong leadership focus on patient safety and continuous quality improvement. This program reduced the suicide rate among patients receiving behavioral health care from an average of 96 per 100,000 in 1999–2000 to an average of 24 per 100,000 in 2001–2010, a reduction of approximately 75 percent.5



The Bulletin | September 2017






LEAD Recommendation: Learn from Organizations Implementing Zero Suicide The Zero Suicide approach was refined, implemented, and tested over the past several years by behavioral health and integrated primary care programs. These organizations demonstrate that Zero Suicide can be feasibly implemented in ordinary care settings with significant reductions in suicide deaths and other related measures. For example: At Centerstone, a large, multistate behavioral health nonprofit headquartered in Tennessee, the baseline rate for suicide before Zero Suicide implementation was 31 per 100,000; the suicide rate two years into implementation dropped to 11 per 100,000, a reduction of about 65 percent. — Becky Stoll, personal communication, Feb. 22, 2016

Conclusion: Invest in Multifaceted Strategies Current research suggests that no single approach will reduce suicide among individuals who are in care. Comprehensive, multi-component, system-wide approaches to suicide prevention have been shown to be effective in broad and diverse settings and likely are the keys to reducing suicide.4,5,6,7 The Zero Suicide approach offers a Toolkit that guides implementers in the process of embedding interconnecting evidence-based practices for suicide prevention into health care systems. One way to assess what components of the comprehensive Zero Suicide approach are currently in place and the degree to which the components are embedded within key clinical areas is to administer the Zero Suicide Organizational Self-Study. It helps to assess organizational and clinical area-specific strengths and opportunities for development across each of the seven elements of Zero Suicide. The Zero Suicide Organizational Self-Study should be retaken on an annual basis as a fidelity check for your organization.

Citations Chassin, M.R., & Loeb. J.M. (2013). High-reliability health care: getting there from here. The Milbank Quarterly, 91(3), 459-490. Retrieved from


Weick, K., & Sutcliffe, K. (2007). Managing the Unexpected: Resilient performance in the age of uncertainty (2nd ed.). San Francisco: John Wiley & Sons, Inc.


The Joint Commission. (2016). Sentinel Event Alert, Issue 56: Detecting and treating suicide ideation in all settings. Retrieved from https://www.


Knox, K.L., Litts, D.A., Talcott, G.W., Feig, J.C., & Caine, E.D. (2003). Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: cohort study. British Medical Journal, 327. Retrieved from


Coffey, M.J., Coffey, C.E., & Ahmedani, B.K. (2015). Suicide in a health maintenance organization population. JAMA Psychiatry, 72(3), 294-296. Retrieved from


Martin, G., Swannell, S., Milner, A., & Gullestrup, J. (2016). Mates in Construction Suicide Prevention Program: A Five Year Review. Journal of Community Medicine & Health Education, 6(4), 465. Retrieved from


While, D., Bickley, H., Roscoe, A., Windfuhr, K., Rahman, S., Shaw, J., Appleby, L., & Kapur, N. (2012). Implementation of mental health service recommendations in England and Wales and suicide rates, 1997−2006: a cross-sectional and before-and-after observational study. Lancet, 379(9820), 1005-1012. Retrieved from


Visit for additional tools, resources, & more. LEAD







©2017 by the Education Development Center, Inc. All Rights Reserved.

The Bulletin | September 2017 19

It’s Renewal Time: MSMS dues are 88 percent tax deductible and SCMS dues are 100 percent tax deductible Contributions or gifts to the Michigan State Medical Society and Saginaw County Medical Society are not tax deductible as charitable contributions for federal income tax purposes. However, a portion of your dues may be tax deductible as ordinary and necessary business expenses. MSMS estimates that 12 percent of your 2018 dues will be nondeductible as this portion is allocable to lobbying as defined by law. SCMS dues are 100 percent tax deductible. If you pay your 2018 MSMS and SCMS dues prior to December 31, 2017, you may deduct up to 88 percent and 100 percent, respectively, as a business expense. READ MORE

Grant Opportunity to Integrate Your EHR and MAPS In April 2017, the state of Michigan updated its Michigan Automated Prescription System to a more user-friendly 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. READ MORE

MSMS Legal Alert: Electronic Prescribing for Controlled Substances The Drug Enforcement Administration’s rule permitting physicians to electronically prescribe controlled substances was issued on March 31, 2010, as an interim final rule with request for comment and became effective June 1, 2010. Since then, the Rule still has not been declared final and remains subject to change by Congress and/or the DEA. The Rule allows physicians (and other DEA registrants) to transmit electronic prescriptions to pharmacies for Schedule II-V controlled substances, if the physician uses a compliant electronic prescribing application. READ MORE Is Your Health Insurance Renewing Soon? With MSMS Physicians Insurance Agency, you’ll get the complete package. Our agency provides a complete health care solution and value beyond benefits with innovative plans, cost-saving services and employee support tools created to meet your practice’s needs. You can choose any combination of classic value, wellness rewards, consumerdirect plans, various health spending accounts and much more. READ MORE continued on page 21

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 | 20 The Bulletin | September 2017

continued from page 20 Write Your Lawmaker and Ask for Support to Rein in MOC Red Tape Michigan patients have a right to high quality healthcare, and Michigan physicians have a right and a responsibility to deliver that care to our patients. Unfortunately, Maintenance of Certification red tape and insurance company policies too often stand in between physicians and their patients. That’s not just a hassle — that’s dangerous. READ MORE 21st Annual Conference on Bioethics - First Do No Harm: Avoiding Overdiagnosis and Overtreatment in Medicine The MSMS Foundation will present the 21st Annual Conference on Bioethics on Saturday, November 11, 2017, at the Sheraton Ann Arbor Hotel. Supported by the Blue Cross Blue Shield of Michigan Foundation, First Do No Harm: Overdiagnosis and Overtreatment in Medicine will: • Assess the history and evolution of cardiopulmonary resuscitation and the do not attempt resuscitate (DNR) order; • Describe the ethical tensions that emerge when families request that clinicians continue non-beneficial care in the hopes a miracle will occur; • Analyze the moral dilemmas that arise when patients cannot express their own wishes, have no surrogates, but express stable preferences;

• Evaluate the role of capacity for preference for resolving ethical dilemmas involving incapacitated patients; and • Summarize the concept of over-diagnosis and overtreatment when diagnostic tests are performed. Additionally, First Do No Harm: Overdiagnosis and Overtreatment in Medicine will discuss situations in which medicine or physicians may do more harm than good. This may occur when incidental findings are uncovered, indolent diseases are treated aggressively, and treatments cause morbidity and mortality. During the meeting, experts will present research and network with colleagues. The program is planned for health care professionals by physicians. First Do No Harm: Overdiagnosis and Overtreatment in Medicine allows physician attendees to earn up to 6 AMA PRA Category 1 Credit(s)™ during this one-day event. To register or for more information on the MSMS Foundation’s First Do No Harm: Overdiagnosis and Overtreatment in Medicine conference, please visit HERE.

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 6.0 AMA PRA Category 1 Credits™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

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The Bulletin | September 2017 21

“Our Covenant” - A Compact Between the Covenant Medical Staff and Covenant HealthCare Did you know, for more than two years, there has been a compact between the Covenant Medical Staff and the entire Covenant HealthCare System, commonly referred to as Our Covenant? The creation of the shared vision and compact was an effort of the medical staff leadership, hospital board and executive team, with input from the active medical staff, as well as, Covenant medical sections and departments. The compact embodies the patient-centric philosophy that the patient is the focus of everything the hospital does. Erica L. Canales MD was one of the physicians involved in the creation of Our Covenant. “[It] serves as a guiding force behind not only major strategies and decisions made by the organization, but also is relevant to every member of our team on a daily basis. It serves as a written, tangible embodiment of our core values, in particular the notion that we exist to serve our patients and our community, and that we respect and value each other as we collaborate in all ways

necessary to achieve the goals of compassionate, excellent care.” Where does Dr. Canales see this movement going? “In the future, I see the sentiments expressed in Our Covenant as familiar concepts to all medical staff and employees at every level of the organization. We hope that as everyone embraces these principles, that we can continue to build our strength, collegiality and pride in our hospital and can even utilize the document to help find real solutions to address problems and needs as they arise.”

Here’s what Our Covenant says: “Our Covenant” is the compact between Covenant HealthCare and its Medical Staff Our Shared Vision “Together, the Medical Staff and Covenant HealthCare are driving extraordinary care and value for our patients and communities.” Together, we commit to: • Patient-centric, high-quality, safe care • Assume positive intent • Respect, trust and support for each other • Accountability and professionalism continued on page 23



900 Cooper, Fourth Floor Saginaw, Michigan 48602 989.583.4401 Tel Hours: Monday – Friday 8 am – 5 pm 22

The Bulletin | September 2017

Extraordinary care for every generation.

continued from page 22 • Providing an optimal learning environment Extraordinary Care Medical Staff Commits to: • Communicate and collaborate across the care team • Seek understanding of other physicians, staff and administrators • Deliver evidence-based care • Follow guidelines to optimize medical outcomes • Support medical student and resident training Covenant HealthCare Commits to: • Resolve issues in an unbiased and timely manner • Provide data and infrastructure to facilitate high-value and high-quality care • Recruit and retain the best medical team • Provide excellence in medical education Value Medical Staff Commits to: • Recognizing the authority of appointed and elected medical staff leaders • Cost-effective, quality care • Actively participate in change and decision making processes • Actively support physician development and leadership Covenant HealthCare Commits to: • Timely engagement of physicians in strategic, operational and clinical initiatives • Transparency in key administrative actions • Provide information and tools relevant to the business and practice of healthcare • Support professional development for all healthcare providers “One of the areas I like to point out is what we ALL commit to - assume positive intent,” says Michael L. Schultz MD, Vice President of Medical Affairs/Chief Medical Officer. “This means in every interaction, from both the medical staff and hospital staff, we need to assume we are all here with the purpose of doing what’s right for the patient. It’s easier said than done, but if we can do this, our organization will be a much better place for the safety and quality of our patients.” This document is so symbolic, that last year, the Covenant HealthCare Board of Directors replaced the previous vision statement with the vision statement developed in Our Covenant, meaning the Medical Staff and Covenant now have one Shared Vision. “This is exciting for the organization,” says Ed Bruff, President and CEO. “While it’s great that we have all agreed to adhere to the expectations set in the document, it’s now all of our responsibilities to live out these expectations and hold one another accountable. So, let’s do that, let’s work together more effectively than ever before to do what’s best for the patient.”

NAPBC Reaccredits Covenant Breast Health Center; Excellent Survey After a positive survey, and excellent feedback on welltrained staff, patient navigation, and a patient focused facility, Covenant HealthCare Breast Health Center has again been granted a three-year/full accreditation designation by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons. Accreditation by the NAPBC is only given to those centers that have voluntarily committed to provide the highest level of quality breast care and that undergo a rigorous evaluation process and review of their performance. During the survey process, the Center must demonstrate compliance with standards established by the NAPBC for treating women who are diagnosed with the full spectrum of breast disease. The standards include proficiency in the areas of: Center leadership, clinical management, research, community outreach, professional education and quality improvement. A breast center that achieves NAPBC accreditation has demonstrated a firm commitment to offer its patients every significant advantage in their battle 1 against breast disease. The   NAPBC is a consortium of professional organizations dedicated to the improvement of the quality of care and monitoring of outcomes of patients with diseases of the breast. This mission is pursued through standard-setting, scientific validation, and patient and professional education. Its board membership includes professionals from 20 national organizations that reflect the full spectrum of breast care. The American Cancer Society (ACS) estimated there would be 232,340 patients diagnosed with invasive breast cancer in the United States in 2013. In addition, hundreds of thousands of women who will deal with benign breast disease this year will require medical evaluation for treatment options. Receiving care at a NAPBC-accredited center ensures that a patient will have access to: • Comprehensive care, including a full range of state-ofthe-art services • A multidisciplinary team approach to coordinate the best treatment options • Information about ongoing clinical trials and new treatment options And, most importantly, • Quality breast care close to home. Welcome New Hospice Medical Director Covenant HealthCare would like to welcome Ali H. Hamade MD, as the new Covenant Visiting Nurse Association’s Hospice Medical Director. Dr. Hamade has worked alongside Edward A. Jackson MD, previous Medical continued on page 27 The Bulletin | September 2017 23

Short Stay and Observation Center Now Open at St. Mary’s of Michigan Towne Centre St. Mary’s Towne Centre has established a short stay and observation center for patients who require care less than 24 hours. The center officially opened on September 6 on the second floor of the Towne Centre ambulatory care building, 4599 Towne Centre Blvd., in Saginaw. The 20-bed, short-stay and observation center will focus on providing high quality care for patients: • Who require a longer ER visit • That are recovering from outpatient surgery • Who need IV infusion therapy services, including chemotherapy In addition, the short stay and observation center can accept direct patient admissions from area physician offices for non-chest pain to observe and do testing until a diagnosis is determined or a decision for inpatient admission to the main hospital is made (up through a 24-hour observation stay). Area surgeons will be able to perform additional cases later in the day since their patients will be able to recover in the center, and patients with busy work schedules, who receive IV infusions including chemotherapy, will be able to obtain their treatment later in the evening to better accommodate their lifestyle. The short stay and observation center at Towne Centre is the only one of its kind in the Great Lakes Bay region to accommodate individuals’ expectations for the right care when they need it. New Pulmonary/Critical Care Physician Joins St. Mary’s Ravinder Bhanot MD, has joined St. Mary’s of Michigan as an employed physician and will provide care for individuals with conditions affecting the lungs, including cancer, asthma, COPD, emphysema, pulmonary fibrosis, complicated pneumonias and sleep apnea. He joins M. Shaffi Kanjwal MD and Shrinivas Kambali MD at St. Mary’s Pulmonary and Critical Care Associates, located at 1015 South Washington Avenue in Saginaw. Graduating with his medical degree from Wayne State University, Dr. Bhanot completed his residency in internal medicine and pulmonary and critical care medicine at Detroit Medical Center (DMC). In addition, he also completed a fellowship in pulmonary and critical care medicine at DMC in June 2017. He is board certified in both internal medicine and pulmonary and critical care medicine.


The Bulletin | September 2017

Dr. Bhanot has been a part of nearly two dozen professional presentations and peer reviewed articles and publications. He is a member of several professional societies including the American College of Physicians, American Thoracic Society and American College of Chest Physicians. Dr. Bhanot is accepting new patients. To schedule an appointment or referral, call St. Mary’s Pulmonary and Critical Care Associates at 989-907-7636.

New Minimally Invasive Brain Surgery Technology Now Available at St. Mary’s St. Mary’s of Michigan is the first hospital in the region to offer the Apollo System – an innovative new surgical tool that enables minimally invasive removal of deeply seated bleeding in the brain. With combined use of an endoscope and image guidance, the Apollo System allows neurosurgeons to decompress and remove otherwise inoperable blood clots deep in the brain. The Apollo System consists of a surgical wand that combines vacuum pressure, irrigation and internal vibration energy to gently and rapidly remove blood clots through the smallest possible channel. Benefits to patients include: • A minimally invasive procedure involving a small incision and opening in the skull • A shorter procedure time • A shorter hospital stay • Faster recovery of neurologic function • Better clinical outcome

For more information, contact St. Mary’s of Michigan Neurosurgery office at 1-855-298-9888.

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 | September 2017 25 lung cancer screening. 1-866-246-4673

Martha Anderson M.S., C.C.C. A/Audiologist

Cathy Bieri Ryan Doctor of Audiology/ Au.D., Speech Pathologist, MSC

! MONTH E H T F CMS VIDER O pport for S KEY PRO provide su rovider ers” Key P “Key Provid ngs. Each month, a ip meeti etin. in The Bull membersh is featured

At Bieri Hearing, we believe that an annual hearing exam, together with medical, dental and vision, should be part of everyone’s overall wellness program.


Roxanne Kapala M.A., C.C.C. A/Audiologist

Linda Meyer Doctor of Audiology/Au.D.

Sue Rabior M.A., C.C.C. A/Audiologist

Jenae Schabel Doctor of Audiology/Au.D.

The Bulletin | September 2017

We invite you to come and be our guest to receive a FREE hearing evaluation and consultation from Michigan’s most experienced Audiology staff.

Saginaw • Midland • Clare Bay City • Frankenmuth 1-800-329-1747

continued from page 23 Director, as Associate Hospice Medical Director for the past year. He is familiar with hospice philosophy, symptom control and end of life care. For further information on the hospice program, please call Katie Parkhurst, Hospice Manager, at 989.583.0253.

Covenant Medical Group Plastic Surgery Now Open Covenant Medical Group Plastic Surgery now includes both Arno W. Weiss MD and Anthony M. Zacharek MD. The office is located at 800 Cooper, Suite 1 in Saginaw. To schedule an appointment for your patients, please use their new number at 989.583.6400.

Third Party Payer Day Friday, November 10, 2017 ®

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

Medical Group Management Association


Soaring Eagle Casino & Resort, Mt. Pleasant, MI

Contact us for a complimentary visit at 989-791-1040. Three convenient locations to serve you in: Saginaw | Vassar | Frankenmuth

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The Bulletin | September 2017 27

OCTOBER BIRTHDAYS Mohammed Makki A. Aldawood MD Thomas K. Bills MD Rodames D. Dedicatoria MD Gerard P. Farrar MD James A. Fugazzi MD Andrew S. Goodrich DO Marilyn T. Haupt MD Thomas B. Henry MD Matthew W. Holden MD Thomas J. Hyde DMD John B. Johnson MD Bong Jung MD Vipin Khetarpal MD Lioudmila Kinachtchouk MD David B. Krebs MD Paul A. LaClair MD Bei F. Liu MD Gurtej S. Mann MD Iris A. Marteja MD Jack F. Martin MD Kristin M. Nelsen MD Allison D. Perkins MD Delicia J. Pruitt MD Gerardo Dizon Reyes MD Sara L. Rivette MD

10/24 10/9 10/25 10/30 10/6 10/7 10/26 10/11 10/2 10/30 10/20 10/5 10/31 10/20 10/13 10/31 10/1 10/8 10/3 10/12 10/16 10/16 10/19 10/30 10/12

Jacquelyn A. Robinson MD 10/4 Rosarita Rullan DO 10/18 Majed J. Sahouri MD 10/25 Kamran K. Shokoohi MD 10/19 Allen J. Solomon MD 10/27 Chai-Yakarn Soontharotoke MD 10/12 Bala Srinivasan MD 10/12 Kizhakepat P. Sukumaran MD 10/10 Sanjay J. Talati MD 10/2 George K. Tong MD 10/3 Jared M. Toupin MD 10/9 Samuel S. Valia MD 10/9 Noel D. Wagner MD 10/31 Joseph R. Yacisen DO 10/13

HAP Issues I have been hearing providers are having issues with HAP authorizations, among other things. If you have not already done so, will you please contact me at and let me know if you have patients with HAP and are having issues, and if so, what kind? Please feel free to forward this request to your colleagues. HAP hosted a focus group in Genesee County this summer, and is looking to have one in Saginaw this fall. Information received will remain confidential. Thank you. Joan Cramer, SCMS Executive Director

Don’t let pain keep you down. If you are Don’t let pain keep you down. If you are experiencing the following, WE CAN HELP! experiencing the following, WE CAN HELP!

Back Pain Back Pain Strains or Sprains Strains or Sprains Foot and Ankle Pain Foot and Ankle Pain Shoulder/Arm/Hand Pain Shoulder/Arm/Hand Pain

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Arthritis Arthritis Head and Neck Pain Head and Neck Pain Sports Related Injury Sports Related Injury Work Related Injury Work Related Injury

SHIELDS SHIELDS 7680-4 Gratiot 7680-4 Gratiot Saginaw, MI 48609 Saginaw, MI 48609 t: 989.781.1258 t: 989.781.1258

Most Insurance Plans Accepted | Appt’s within 48 hrs | Featured on Most Insurance Plans Accepted | Appt’s within 48 hrs | Featured on The Bulletin | September 2017



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3400 North Michigan Center Road48603 • Suite 400 Saginaw, Saginaw, Michigan 48603 Tel: (989) 799-5600 LOCATED CONVENIENTLY Tel: (989) 799-5600 IN SAGINAW TOWNSHIP HOURS: Monday–Thursday 8am–5pm • Friday 8 am–Noon HOURS: Monday-Thursday 8 am-5pm • Friday 8 am-Noon

3400 North Center Road • Suite 400

Saginaw, Michigan 48603 1.866.512.2ADI • 1.866.512.2ADI • Tel: (989) 799-5600

The Bulletin | September 2017 29 HOURS: Monday–Thursday 8am–5pm • Friday 8 am–Noon

ADVERTISER INDEX When you have a need for a service, please consider our dedicated advertisers first! Advanced Diagnostic Imaging, P.C. Aperion Information Tech Ben Hamann Covenant HealthCare Covenant Wound Healing Center Evergreen Physical Therapy (f/k/a Sport and Spine) Jan Hauck – Century 21 Healthway Compounding Pharmacy Horizons Conference Center/Riverview Brownstones

29 29 2 22 28 27 20 29

5 Norton + Kidd Accounting & Consulting, P.C. 27 Peak Performance PC Services 5 ProAssurance 21 Rehmann 13 Shields Chiropractic 30 St. Mary’s of Michigan 25 Lori Krygier Graphic Designer

SCMS SCMS Affiliate Affiliate Member Member 2016 2017 7261 Gratiot Rd., Saginaw • (989) 781-7700 Chiropractor

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The Bulletin | September 2017

Chiropractic, Massage Therapy and the latest in hi-tech therapy—the MR4 Super Pulsed Cold Laser. The only FDA cleared device to combine neuroadaptive electrical stimulation and cold laser in a single emitter. This allows us to quickly locate and automatically deliver appropriate energy dose to the affected area for quicker pain relief and faster healing.

Emily, MT

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Office Manager

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Dr. Jason Barrigar

Chiropractor Certified “Rock Tape” Provider

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Human Trafficking:


Keynote Speakers: Trooper Will Smith Mid-Michigan Human Trafficking

Michiganders at-risk •

Human trafficking is the fastest growing crime in America

Reports of human trafficking in the U.S. increase every year.

Michigan is not immune

Every Michigan resident can make a difference. It begins with awareness

Sara Morley LaCroix Kalamazoo Anti Human Trafficking Coalition

Public Welcome

Wednesday, October 11, 2017 Saginaw Country Club, 4465 Gratiot 12:00pm: Optional Buffet $15 per person/cash RSVP required by October 4, call 799-8541 12:30pm: FREE presentation, no RSVP required Presented in partnership by:

Becky McDonald President

Handcrafted items made by local at-risk and rescued women will be available for purchase. Donations accepted. In need of services or shelter? Innerlink 24 hour Crisis Line: Youth age 12-17: 989-753-3431 Underground Railroad, Inc. 24 hour Crisis Line: Local: 989-755-0411 Toll Free:1-888-399-8385 Text: 989-770-8892

The Bulletin | September 2017 31


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


2017-2018 KEY PROVIDERS These Area Businesses Support Saginaw County Medical Society Membership Meetings. When you have a need for a service, please consider our Key Providers. Please mark your calendar for the following meetings and events for 2017-2018. 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, October 4, 2017 CMU College of Medicine – “Safety Issues in Healthcare: Patients and Providers at Risk.” See page 15 for details.

Wednesday, November 8, 2017 SCMS Volunteers at East Side Soup Kitchen from 9:30 a.m. to 12:30 p.m. See page 13 for details to volunteer.

Wednesday, October 11, 2017 Saginaw Country Club – “Human Trafficking: A National and State Problem,” presented in part by the Saginaw County Medical Society Alliance. Optional buffet at 12 p.m. ($15 per person), free presentation at 12:30 p.m. PUBLIC WELCOME. See page 31 for details.

Friday, November 10, 2017 Soaring Eagle Casino in Mt. Pleasant, Michigan – “MiMGMA Third Party Payer Day.” See page 27 for details.

Thursday, October 12, 2017 Saginaw Country Club – “Meet the New CMU Medical Education Partner Physicians” from 5-7 p.m. See page 14 for details. Monday, October 16, 2017 Cathedral of Mary of the Assumption – “White Mass” at 7 a.m. See page 5 for details. Tuesday, October 17, 2017 HealthSource Saginaw - SCMS Board meets at 5:30 p.m. Membership Meeting (spouse/significant other invited) with Social at 6:30 p.m. followed by dinner and program at 7 p.m. Program: “ZEROSuicide.” Speaker: Barb Smith, Executive Director of Survivors of Suicide. See page 9 for details. Saturday, October 28, 2017 CMU College of Medicine in Saginaw – CMU CoM and CMU Health Psychiatry – “2nd Annual Psychiatry Update Conference” from 8 a.m. to 1 p.m. Contact Cheryl Scott-Brown at cheryl.scottbrown@cmich. edu or 989-746-7612.

Saturday, November 18, 2017 Bavarian Inn Lodge in Frankenmuth – “Survivors of Suicide – Hope Starts Here.” See pages 10-11 for details. Tuesday, November 21, 2017 SCMS Board meets at 5:30 p.m. at the CMU College of Medicine, 1632 Stone Street, Saginaw in Room 1016. There is no membership meeting in November. Monday, December 4, 2017 Saginaw Country Club - SCMS Alliance’s “14th Annual Jingle Mingle” at the Saginaw Country Club. See page 7 for details. Tuesday, January 16, 2018 Horizons Conference Center - SCMS Board meets at 5:30 p.m. Membership Meeting (Joint with the Saginaw County Dental Society) with Social at 6:30 p.m. followed by dinner and program at 7 p.m. Tentative Program: “Head and Neck Trauma.” Speaker: Jim P. Getzinger MD, Emergency Medicine at Beaumont. Watch future issues of The Bulletin for more information.

Joan Cramer/SCMS | Office 790-3590 | Fax 790-3640 | Cell 284-8884 |

SCMS BULLETIN - September 2017