SCMS BULLETIN - January 2019

The

Bulletin Saginaw County Medical Society

January 2019 | Volume 77 | No 5

Physician Well-Being p. 18-20

The Passage of Maintenance of Certification Legislation: Final Report p. 8

15th Annual Jingle Mingle Raises over $1,500 for Suicide Awareness Programs p. 16-17

www.SaginawCountyMS.com

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The

Bulletin Saginaw County Medical Society

contents 8

SAGINAW COUNTY MEDICAL SOCIETY 2018-2019 OFFICERS AND DIRECTORS

9

Call for Resolutions: Who Sets MSMS Policy? You Do!

14

President Julia M. Walter, MD

16-17

Secretary Caroline G.M. Scott, MD Treasurer Mohammad Yahya Khan, MD Board of Directors Mildred S. Willy, MD Anthony M. Zacharek, MD Jorge M. Plasencia, MD Kala K. Ramasamy, MD Tiffany K. Kim, MD Mark G. Greenwell, MD Bulletin Editor Louis L. Constan, MD Retiree Representative Rustico B. Ortiz, MD Resident Representative Mary J. McKuen, MD MSMS Delegates Elvira M. Dawis, MD Zubeda S. Khan, MD Julia M. Walter, MD Virginia R. Dedicatoria, MD Mildred J. Willy, MD Anthony M. Zacharek, MD Jorge M. Plasencia, MD Christopher J. Allen, MD MSMS Alternate Delegates Caroline G.M. Scott, MD Waheed Akbar, MD Mohammad Yahya Khan, MD Danielle C. Duncan, MD Steven J. Vance, MD Amandeep S. Dhaliwal, MD Miriam T. Schteingart, MD Peer Review Ethics Committee Waheed Akbar, MD, Chair Caroline G.M. Scott, MD James R. Hines, MD MSMS District 8 Director Thomas J. Veverka, MD EXECUTIVE DIRECTOR Joan M. Cramer ADMINISTRATIVE ASSISTANT Keri Benkert

4 5 5 5 6 7

7 10 11 12 13 15

• Your Family Feels the Fallout of Physician Burnout Too

15th Annual SCMS Alliance Jingle Mingle Benefits Barb Smith SR&RN

20

President’s Letter

Save the Dates – 2019 Membership Meetings

22 23 24 25

Thank you CMU! Caduceus Meeting From the Editor A Guide to 2019 Physician License Renewal Requirements Attention Retired Members! Barb Smith SR&RN CME Update Extortion Scam Targeting DEA Registrants Key Provider of the Month Healthway Compounding Pharmacy SCMS Volunteers at Soup Kitchen

PHYSICIAN WELL-BEING • How to Recognize and Respond to Burnout in a Fellow Physician • Burned Out? You’re Not Alone. Here’s How Two Doctors Overcame It

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

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

18-20

The Passage of Maintenance of Certification Legislation: Final Report

26 27 28 30 31 31 32 32

Medical Student Loan & Nursing Scholarship Applications Available CMU College of Medicine | CMU Health February Birthdays MSMS | MSMS Login Information Applications for Membership | Reactivated Member Covenant HealthCare MiHIA Conferences – Register Now! Ascension St. Mary’s Hospital Member News Golf Outing – Save the Date! Advertiser Index Key Providers Calendar of Events

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

ON THE COVER: 15th Annual SCMS Alliance Jingle Mingle Benefits Barb Smith Suicide Resource & Response Network (l-r) Donna Campana, Barb Smith, Anne de Bari, Colleen Cheney, Janie Gugino, Tina LaFleur and Jennifer Rogers 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 2019 3

PRESIDENT’S LETTER

Do Politics Really Matter in Medicine? By Julia M. Walter, MD

I

t would seem that you cannot access any type of media these days without being drawn into a political argument. Are you on this side or that side? How strongly do you feel about the side you are on? How did you come to choose that side? Where does a side play into an oath - to do no harm? Humanity, humankind, mankind, man, people. Is humanity part of the conversation? Are we losing our ability to consider humanity as our central theme of which to set our moral code? Can we see the humanity in the person with whom we disagree? As we look at politics, a mirror image of our culture, we are drawn to play by the rules of which we know. For some, rules can determine the difference

between life and death. We are fallible to becoming so focused on our culture that we lose the ability to see the validity in the “other side’s” arguments and stories. At some point, it becomes distilled to a focus on winning. As healers, we bring the very best of our culture forward - our knowledge, skills and attitude. We are vetted through an intense academic process, ensuring that we can practice with the bandwidth needed to care for the masses. Our skills are further shaped through the unique experiences that only a person can bring to an interaction with another person. As clinicians, we are the best that “we” have to offer. Lastly, our attitude; we know that our attitudes must be

aligned with an open mindedness needed to see through the “sides.” Our attitudes must be consistent with a certain level of compassion for the people in our care. I will leave you with this. In thinking about whether or not politics really matter in medicine, think about the objective and subjective matter needed to provide good care. Challenge yourself to ensure that you are aligned with humanity as your priority. Honor your obligations as much as you fight for your rights. I am proud to have the opportunity to care for others, and I will not let policy or sides deter that passion or vision.

Are we losing our ability to consider humanity as our central theme of which to set our moral code?

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The Bulletin | January 2019

Save The Dates For Our Upcoming Membership Meetings!

College of

Medicine

Tuesday, April 16, 2019, Membership Meeting Mark your calendar now for our Tuesday, April 16, 2019, Membership Meeting at Horizons Conference Center. The social with cash bar starts at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Topic: “TED Talks* - The Human Challenge of Healthcare” Speakers: To be determined *So what is a TED Talk? A TED Talk is about ideas. It is about real people making connections with other real people. These talks are concise, every word counts, lasting from 5-18 minutes. Generally these talks are delivered without notes, from memory, conveying passion and possibilities. A speaker need not be an educated professional. They can be illiterate. Their experience is what matters. The audience plays a role in that they need to encourage if they feel the speaker is nervous. As a speaker, be real and kind. This is an opportunity to promote great ideas by working together to open each other’s eyes.

Thank you! The SCMS would like to thank CMU Health for encouraging and facilitating the membership of all Residents in the SCMS. Welcome to Saginaw, Residents! We would also like to thank Dean Kikano, all Program Directors and the College of Medicine for encouraging and facilitating the membership of CMU physicians and faculty!

The theme of the evening will be The Human Challenge of Healthcare. So bring excitement, energy and focus on your idea and its application to the lives of others. To join the list of guest TED Talkers to be considered for the meeting, please contact Joan Cramer at jmcramer@sbcglobal. net with a brief synopsis of your proposed TED Talk. All ideas will be submitted to the SCMS Board for review and consideration to present at the April Membership Meeting.

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

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

Caduceus meetings are available to health care industry professionals, and have adopted many of the principles of 12-Step programs. Caduceus meetings are “closed” meetings for recovering health care professionals including, but not limited to, nurses, doctors, dentists and pharmacists. We engage in group discussions where members may want to speak up, ask questions or share thoughts with fellow members. The Bulletin | January 2019 5

FROM THE EDITOR

Has My Life Been Worth It? By Louis L. Constan, MD

T

hat is the question George Bailey asks himself as he stands on the edge of a bridge over a raging river. Yes, the muchloved Christmas classic, “It’s a Wonderful Life,” actually begins with a suicide scene, in which the star of the film, after financial reverses, questions the value of his life, planning on ending it so his family can have his life insurance money. Fortunately, and miraculously (this is a Christmas story after all) his hand gets stopped by a loveable angel named Clarence whose job is to show him that he is, indeed, a worthwhile human being. Helped by the Man Upstairs, Clarence conjures up scenes from George Bailey’s past where he makes a difference in the lives of the people around him, rescuing them from drowning, getting them loans to buy homes, helping them to go to college, often sacrificing his own wellbeing for the good of others, a modernday saint if there ever was one. In the end, everyone gathers around the Christmas tree, singing carols, celebrating George Bailey’s “wonderful life,” and their part in it. For 72 years, this film has been played and re-played, usually at Christmastime; at the Temple Theatre, at the Court

Theater and free on Amazon Video. The ultimate feel-good movie, it has colorful characters, miracles, Hollywood stars, small-town values, and a happy ending, enticing many families to make it a Christmas-time tradition, perhaps naively so, possibly promoting the false impression that suicide could be a solution to life’s troubles, because, as you know, in real life, a Clarence would never show up and George Bailey would end up as just another grim statistic. My point here is that being as we are in the midst of a suicide epidemic, it would be wise to look at the messages we present to our fellow human “sufferers” on this bumpy road of life, making darn sure we do not inadvertently advance the notion that suicide is something to be considered as a valid solution to life’s troubles. This is not a trivial exercise. Our society has long glamorized the suicides of certain well-known persons: Cleopatra, Marilyn Monroe, Vincent Van Gogh, Ernest Hemingway, Alan Turing and Virginia Wolf. “Assisted Suicide” is an ever-popular topic. The 2006 Super-hero movie, “Suicide Squad,” was a blockbuster, with a sequel planned, and action figures in toy stores and in children’s play

rooms. Suicides and murder-suicides are common themes in crime shows and prime-time dramas. Is it not out of the realm of possibility that this attention to the subject of suicide keeps it foremost in the minds of those who are vulnerable for whatever reason, be it depression or financial reversal, suggesting an easy solution to their problems, a solution that they might not otherwise think of so readily? Why then, watch this movie? You should because, though this 72-year-old classic revolves around a depressed man contemplating suicide, it’s what happens next that’s important. The real miracle in the movie is not that the angel came down from on high and played touching scenes from George’s life…the real miracle is, in fact, all the selfless action that George took throughout his life to benefit others. The movie teaches us, again and again, as we watch it through the years, of what happens every time we selflessly give of ourselves to another person; and it is worth reminding us of this on Christmas, or any time of year, especially when we’re feeling stressed, unappreciated, or even perhaps, burned out. continued on page 7

My point here is that being as we are in the midst of a suicide epidemic, it would be wise to look at the messages we present to our fellow human “sufferers” on this bumpy road of life, making darn sure we do not inadvertently advance the notion Louis L. Constan, MD

6

The Bulletin | January 2019

that suicide is something to be considered as a valid solution to life’s troubles.

READY TO RENEW?

continued from page 6

In fact, I contend that you, doctor friend, are more George Bailey than George Bailey. Where George made someone a loan so they could buy a house, which undoubtedly was helpful to them, you saved someone’s life (or contributed in some way to that end), which was undoubtedly hugely helpful to them as well. Oh, and you say you’ve done this more than once? Even Better! Where George shelved his vacation plans to help the bank’s patrons during a run on the bank, you were late to, or missed entirely, family events because you were attending to patients. Oh, and you did it more than once? Really? Guessed it! So, George, if I may call you George, should you ever, and I mean ever, find yourself standing at the edge of a bridge (figuratively or literally), asking yourself if your life has been worth it, looking for an answer to depression, family troubles, financial worries, addiction, whatever, and feeling hopeless and helpless; please remember what you have meant to your patients, and even what you might not fully understand that you have meant to your patients because these people likely have seen tougher times than you, and are painfully aware, more than anyone, that you have truly, for them, led a marvelous, wonderful life.

A Guide to 2019 Physician License Renewal Requirements

150 HOURS Physicians must complete 150 hours of Continuing Medical Education Credits during a three year period prior to requesting renewal. Of these 150 hours, a minimum of 75 must come from Category 1 Credits. Category 1 Credits include live in person programs, as well as, web-based programs

3 HOURS

Pain and Symptom Management

Of the 150 hours, a minimum of three hours must be in the area of Pain and Symptom Management. Examples Include: • Michigan Pain and Controlled Substance Laws • Opioid Management • Pain Definitions • Specific Pain Conditions • Ensuring Quality Pain Care • Public Health Burden of Pain • Michigan Programs and Resources Relevant to Pain

1 HOUR ATTENTION RETIRED MEMBERS!

Medical Ethics

Of the 150 hours, a minimum of one hour must be in the area of Medical Ethics.

Human Trafficking Victim Identification Training Retired physicians meet for lunch every Wednesday at 12 noon at IHOP, 2255 Tittabawassee Road in Saginaw. Those attending are responsible for their own lunch, and the informal gathering lasts about an hour. Join your retired colleagues whenever you like! If you have any questions, please contact Joan Cramer at the SCMS office at 790-3590 or by email at jmcramer@sbcglobal.net.

A one-time training that is separate from continuing education. Licensees renewing for 2019 must complete training by renewal in 2022. Beginning in 2021, a completion of the training is a requirement for initial licensure.

Need all three requirements? Visit MSMS.org for On-Demand Webinars (under the Education tab) The Bulletin | January 2019 7

The Passage of Maintenance of Certification Legislation: Final Report MSMS and the SCMS, along with other county medical societies, kept the pressure on every step of the way. The Grassroots Origin. It was at the MSMS House of Delegates that the topic of the underlying burdens associated with Maintenance of Certification (MOC) bubbled to the surface and prompted action. In 2013, MSMS passed a resolution to address concerns surrounding MOC, and more than a dozen resolutions dealing with the perceived abuses of the MOC process preceded it. Of note is Resolution 73-15, which reads as follows: MSMS supports MOC only under all of the following circumstances: • MOC must be voluntary. • MOC must not be a condition of licensure, hospital privileges, health plan participation or any other function unrelated to the specialty board requiring MOC. • MOC should not be the monopoly of any single entity. Physicians should be able to access a range of alternatives from different entities. • The status of MOC should be revisited by MSMS if it is identified that the continuous review of physician competency is objectively determined to be a benefit for patients. If that benefit is determined to be present by objective data regarding value and efficacy, then MSMS should support the adoption of an evidencebased process that serves only to improve patient care. Ultimately, it was these actions, taken by the House of Delegates, that help set off the ensuing chain of events in Lansing. Legislative History. Beginning in 2014, MSMS teamed up with lawmakers to draft legislation that would have precluded hospitals and health plans from utilizing maintenance of certification as the sole basis for privileges or panel participation. Those efforts materialized in the form of Senate Bills 608-609 and House Bills 5090-5091, introduced by Senator Peter MacGregor (R-Rockford) and Representative Ned Canfield, DO (R-Sebewaing), respectively. House Bills 5090-5091 were the subject of hearings featuring a significant amount of testimony from physicians and the bills’ physician sponsor, Representative Canfield. Unfortunately, the bills failed to advance in either chamber prior to adjournment of the 2015-2016 legislative session. In early 2017, Representative Canfield introduced House Bills 4134 and 4135, which would preempt any future effort to tie MOC to state licensure, and prohibit insurance companies in the state from requiring MOC as a condition of reimbursement. Those bills saw a hearing in the House Health Policy Committee on May 24, 2017, and MSMS was instrumental in organizing several physicians to attend and testify. While the bills were out rightly opposed by Blue Cross Blue Shield of Michigan (BCSBM), 8

The Bulletin | January 2019

what became particularly devastating to their potential fate was the lack of unification within the physician community. At the time of the hearing, the opposing physician groups included the Michigan Section of the American Congress of Obstetricians and Gynecologists, Michigan Orthopedic Society, the Michigan College of Emergency Physicians and the Michigan Board of Emergency Medicine. While acknowledging some of the pitfalls around MOC, particularly for their primary care colleagues, most physicians represented by these groups expressed contentment with their existing MOC requirements and did not generally agree there was a need for a legislative remedy. The lack of unification and BCBSM opposition was more than enough to convince Representative Hank Vaupel (R-Fowlerville), the Chairman of the House Health Policy Committee, to hold the bills and they stalled out for over a year. During that time, MSMS successfully worked with the respective specialty groups to assuage concerns and by the summer of 2018, the groups had moved to either a neutral position or no position. With no physician opposition, the Chairman promised to hold a hearing and a vote in the fall so long as MSMS was able to align the votes in the Health Policy Committee necessary to move the legislation forward. In response, the MSMS government affairs team met with each member of the House Health Policy Committee and/ or their staff in the weeks following the summer legislative recess. Concurrently, MSMS partnered with county medical societies, including Wayne, Washtenaw, Oakland and Saginaw to successfully host roundtable discussions to generate further energy at the grassroots level. All indications from those meetings pointed to broad support for the bills. Despite this and ongoing pressure from Representative Canfield, the Chairman remained reticent to take up the bills, likely due to BCBSM’s continued opposition. Representative Canfield and MSMS continued to put pressure on and, in a surprising turn of events, during the flurry of the lame duck session, MSMS and BCBSM were able to negotiate changes that moved BCBSM to neutral. Under the changes, the thrust of the legislation would focus on the primary care specialties of family medicine, internal medicine and pediatrics. Although not everything MSMS wanted, given these specialties face the most onerous MOC requirements and are the specialties where the state faces the most acute physician shortages, the changes still go a long way toward achieving the original objectives of the legislation. Despite opposition from the Michigan Association of Health Plans (who had previously taken a neutral position), the American Board of Emergency Medicine and the American Board of Medical Specialties, House Bills 4134 and 4135 were considered and voted out of the House Health Policy Committee on December 4, and were subsequently approved continued on page 9

continued from page 8

by the full House of Representatives that day by a vote of 95 to 13 and 89 to 19, respectively. The following week, they were taken up and passed unanimously out of the Senate Health Policy Committee on December 12, and unanimously approved by the full Senate on the evening of December 18. Not only was the 2018 lame duck session perceived by many to be the busiest and most fraught with controversy in years, the high level of horse trading that is typical of lame duck threatened to tie up the bills at almost every turn. With the pathway to passage unclear, MSMS kept the pressure on every step of the way, engaging when necessary and staying laser focused on moving the bills through the legislature. On December 27, 2018, Gov. Snyder signed HBs 4134-4135 into law. They are now Public Acts 486 and 487. The Saginaw County Medical Society would like to offer their sincere thanks and appreciation to 32nd District State Senator, Ken Horn (R), and 95th District State Representative, Vanessa Guerra (D), for their participation in our MOC Round Table and Candidates Forum in October, and especially for their support in voting to approve HB 4134 and 4135.

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.”

Call for Resolutions: Who Sets MSMS Policy? You Do! The Michigan State Medical Society (MSMS) House of Delegates (HOD), comprised of 319 elected delegates, is the official legislative and policy-making body of MSMS and its component societies, including the Saginaw County Medical Society (SCMS). Resolutions debated during the annual MSMS HOD are the vehicles by which MSMS policies, priorities and directives are determined. Deadline for resolutions is March 1 at 5 p.m. Resolutions must be submitted via the online submission form. If you have any questions, contact Stacey Hettiger at (517) 336-5766. The best way to get your idea or recommendation adopted as MSMS policy or directive is at the grassroots level. As a member in good standing of MSMS/SCMS, you have the right to bring your ideas to the annual HOD for consideration by MSMS’ "legislators." To do so, present your suggestion and rationale at the SCMS meeting. If the SCMS agrees, the SCMS will work with you to draft a resolution to be presented at the next HOD meeting. The resolution should specify the desired MSMS policy or directive for MSMS action. If the SCMS does not agree with your idea, you may ask another delegate to submit a resolution on your behalf as an individual delegate. It is also prudent to check MSMS’ current Policy Manual and, if relevant, the AMA Policy Finder to determine if policy on the issue already exists. The Bulletin | January 2019 9

Because there has been no improvement in suicide rates in the U.S., and since suicide is the 10th leading cause of death in the country, The Joint Commission re-evaluated the NPSG in light of current practices relative to suicide prevention. The Joint Commission has issued new National Patient Safety Goal requirements to improve the quality and safety of suicide care in health care settings. It has also released a selection of resources to support their implementation, which includes the Zero Suicide Toolkit and the National Action Alliance for Suicide Prevention’s (Action Alliance) Recommended Standard Care Report. National Patient Safety Goal for Suicide Prevention Effective July 1, 2019, seven new and revised elements of performance (EPs) will be applicable to all Joint Commissionaccredited hospitals and behavioral health care organizations. These new requirements are at National Patient Safety Goal (NPSG) 15.01.01, and are designed to improve the quality and safety of care for those who are being treated for behavioral health conditions and those who are identified as high risk for suicide. Engagement with Stakeholders, Customers and Experts In addition to an extensive literature review and public field review, The Joint Commission held five technical expert panel meetings between June 2017 and March 2018. The results of the first four meetings were published in the November 2017, January 2018 and February 2018 editions of The Joint Commission Perspectives. The revisions have been posted on the Prepublication Standards page of The Joint Commission website, and will be available online until the end of June 2019. The new and revised EPs also will be published online in the spring 2019 E-dition update of the behavioral health care (BHC) and hospital (HAP) accreditation programs, and in print in the 2019 Update 1 to the Comprehensive Accreditation Manuals for the BHC and HAP accreditation programs. After July 1, 2019, please access the new requirement in the E-dition or standards manual.

Upcoming ASIST Trainings MIDLAND | Tuesday-Wednesday, January 29-30, 2019 8 a.m. to 4:30 p.m | Fee $50 Midland Evangelical Free Church | 7221 N. Jefferson Avenue Midland, MI 48642 Register at give.classy.org/asistmidland SAGINAW | Tuesday-Wednesday, February 19-20, 2019 8 a.m. to 4:30 p.m. | Fee $50 Diocese of Saginaw | 5800 Weiss Street | Saginaw, MI 48603 Register at give.classy.org/asistsaginaw 10 The Bulletin | January 2019

Special Note from Joan Cramer, SCMS Executive Director: I participated in the two-day ASIST Training in September, and can truly say it was one of the best things I have ever done in my career. The skills learned can be used in day-to-day interactions with patients, colleagues, family and friends. One of our surgeon members who took the ASIST training said it helped her better understand her patients, and how she talks to them about an illness or condition they may have that can cause depression or suicidal ideation. I highly recommend the training to physicians and health care providers.

About this Training Applied Suicide Intervention Skills Training (ASIST) is a two-day interactive workshop in suicide first aid. ASIST teaches participants to recognize when someone may have thoughts of suicide and work with them to create a plan that will support their immediate safety. The ASIST method helps reduce suicidal feelings in those at risk, and is a cost effective way to help address the problem of suicide. ASIST helps to build regional networks of trained caregivers who can support each other, and use common terminology to approach suicide and safety. Due to the content of the training, you are required to attend two full days (no exceptions). Class size is limited to 45.

Who Should Attend Anyone can experience thoughts of suicide. By giving participants the skills to help friends, family members, colleagues and clients stay alive, ASIST supports suicide-safer communities. Although ASIST is widely used by healthcare providers, no formal training is needed to attend the workshop. Anyone 16 or older can learn and use the ASIST model.

Learning Goals & Objectives Over the course of the two-day workshop, ASIST participants learn to: • Understand the ways that personal and societal attitudes affect views on suicide and interventions • Provide guidance and suicide first aid to a person at risk in ways that meet their individual safety need • Identify the key elements of an effective suicide safety plan and the actions required to implement it • Appreciate the value of improving and integrating suicide prevention resources in the community at large • Recognize other important aspects of suicide prevention including life-promotion and self-care Questions? Contact Barb Smith at sosbarb@gmail.com or (989) 781-5260

ASIST is sponsored in part by the Alden & Vada Dow Family Foundation ASIST is a program offered through:

LivingWorks Education is a suicide intervention training company that trains community helpers of all kinds to work in this intervention context. Operating as a private social enterprise corporation, it employs all of the financial discipline, innovation and determination of any private sector business to achieve its mission

CME Update College of

Medicine Central Michigan University Office of Continuing Medical Education (OCME) is pleased to announce changes in CME course accreditations available for physicians and the interdisciplinary healthcare team. New features include the: • Ability to offer AOA Category 1-A, Social Work CE and other credit (i.e., physical therapy). • Selection of Continued Certification or Maintenance of Certification (MOC) with several American Boards of Medical Specialties (ABMS) currently collaborating with the Accreditation Council for Continuing Medical Education (ACCME), including the: o American Board of Anesthesiology (ABA) o American Board of Internal Medicine (ABIM) o American Board of Otolaryngology – Head & Neck Surgery (ABOHNS) o American Board of Pathology (ABPath) o American Board of Pediatrics (ABP) • Additional ABMS boards will be added periodically • All courses certified for MOC or CE will be listed on the ACCME CME Finder

ADVANCED DIAGNOSTIC IMAGING is proud to be part

of mid-Michigan’s well-established medical community. Our highlyexperienced, sub-specialized radiologists are the region’s trusted leaders for professional diagnostic and interventional services.

• Courses certified for ABIM MOC can use their logo in promotional materials: The OCME is focusing on the following major categories required for Commendation in accredited CME: • Public health priorities • Enhancing skills • Demonstrating educational leadership • Promoting team-based education • Achieving outcomes For further information about CME or to apply for CME credits, please check out our website where you can find the latest CME application documents; claim CME credit; print a CME certificate or transcript; find the latest CME activities; review the monthly Calendar of Events; locate Category 2 Credit Forms for teaching residents and medical students; utilize Physician Resources … and more! For any questions, comments or suggestions about CME, please contact us at: CMUCME@cmich.edu or call us at 989-746-7555 or 989-746-7602.

THE RIGHT TESTS…THE RIGHT READS…RIGHT AWAY!

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The Bulletin | January 2019 11

Extortion Scam Targeting DEA Registrants The Drug Enforcement Administration (DEA) Diversion Control Division is aware that registrants are continuing to receive telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel. The issue was first brought to our attention in the spring, and in April, we notified physicians of the scam which unfortunately continues. The criminals have masked their telephone number on caller ID by showing the DEA Registration Support 800 number. Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant’s DEA registration. If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through “Extortion Scam Online Reporting” posted on the DEA Diversion Control Division’s website, www.DEADiversion.usdoj.gov . EXTORTION SCAM ONLINE REPORTING For more information contact: Detroit Division Office | 431 Howard Street | Detroit, MI 48226 Phone: (313) 234-4187 | (313) 234-4028 | (313) 234-4202 Fax: (313) 234-4017 | (313) 234-4057 Registration Service Center: 1-800-882-9539 Email: DETROIT.DIVERSION.REGISTRATION@USDOJ.GOV Email: DEA.Registration.Help@usdoj.gov

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Save the Date! How Can You Help? Do you want to raise awareness, volunteer or participate in an upcoming event? Contact Barb Smith at sosbarb@gmail.com or 989-781-5260 and schedule a training or educational event or get more information.

9 a.m. to 12 p.m. (note new end time) Horizons Conference Center

Barb Smith Suicide Resource & Response Network is supported solely by donations and grants. To make a donation, please make your check payable to Barb Smith SR&RN and mail to: Barb Smith Suicide Resource & Response Network PO Box 6712, Saginaw, MI 48608-6712

Click HERE for Vendor Registration form.

The organization is a 501(c)(3) nonprofit, and your donation is tax deductible (EIN 38-3400293).

15th Annual Health Fair “The Doctor Is In” Saturday, March 16, 2019

12 The Bulletin | January 2019

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

PLEASE PRINT Name of Organization Contact Person Address City

State

Office Phone

Fax

What is planned for your space?

Zip Code Cell/Mobile

Email Number of people working your booth

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

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

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

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

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The Bulletin | January 2019

SCMS Volunteers at Soup Kitchen Twice each year, in March to celebrate Doctors’ Day and again in November, SCMS members, their families, friends and office staff volunteer at the East Side Soup Kitchen. On November 7, we were fortunate to have a group of volunteers from CMU College of Medicine join us. Volunteers clean and prepare vegetables for future use in soups and gravies, and help prepare and serve lunch to 250+ people. The SCMS also donates $600 for the food consumed the days we volunteer. The tradition was started many years ago by Dr. Bill Engelman who passed away on May 11, 2018, and the SCMS continues to serve in his honor. The SCMS would like to thank the following who volunteered to serve at the Soup Kitchen in November (if we’ve missed anyone, please contact the SCMS): Angie Appold Ben and Keri Benkert Sharon Coenis Dr. Ron Jenson John Jervinsky Dr. Jose Jurado Dr. Mena Khan

Juliet Nicholls Dr. Meena Ramani Michele Reynolds Tara Schultz Dr. Mary Jo Wagner Alyce Wechter

The SCMS would also like to acknowledge and thank SCMS members who staff the clinic at the Soup Kitchen on a regular basis.

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www.wolgast.com/blog/topic/medical-office-construction The Bulletin | January 2019 15

15th Annual Jingle Mingle Benefits Barb Smith Suicide Resource & Response Network

A huge success, with $1,550 raised for the Barb Smith Suicide Resource & Response Network!

The SCMS Alliance’s 15th Annual Jingle Mingle was a success again in 2018, with $1,550 raised for suicide education and awareness programs through the Barb Smith Suicide Resource & Response Network . Many thanks to the vendors, table sponsors, participants and the Saginaw Country Club. The Alliance would also like to thank Norma Roenicke who once again this year entertained guests with Christmas piano music. Vendor gifts, along with pixie Poinsettias, were given away in prize drawings to those attending. Barb Smith gave a moving presentation during the luncheon, and spoke about how her Network offers group support and understanding for those who have lost a loved one to suicide, and provides suicide awareness and education in the community so future acts may be prevented.

SCMS-A Planning Committee Colleen Cheney – Board Member Anne deBari – Board Member Janie Gugino – Board Member Tina LaFleur – Board Member Jennifer Rogers – Board Member

Amanda Tucker – Board Member Donna Campana – Committee Member Shannon Thurin – Committee Member Keri Benkert – SCMS

Highlights from th 15 Annual Jingle Mingle Top Left to Right: Barb Smith Gift of Hope Boutique Bottom Left to Right: Debi Gamache D & D Creations

Table Sponsors Dr. Ronald C. Barry Dr. Scott Cheney & Advanced Diagnostic Imaging, P.C. Dr. George & Janie Gugino Kent County Medical Society Alliance Dr. Andrew & Tina LaFleur Diane Matekel – Survivors of Suicide Michigan State Medical Society Alliance Saginaw County Medical Society

Vendors Angel of Grace – Linda Plumhoff CMU Health – Samantha Strieter Creations by Jeanne’ – Jeanie Hammond D & D Creations – Dana Borenitsch Debi Gamache Discovery Toys – Shirley Bitters enLightenment by Paul – Paul Rytlewski Gift of Hope Boutique – Marci Thurlow Matilda Jane Clothing – Jamie Montei Whalen Outsider Art Jewelry – Cherie Davila Paul’s Gourmet Jerky – David Gamache Puppy Paw Creations – Jim & Shirley Mercer Purple Frog – Jim & Trish Boersma Saginaw Art Museum/Temple Theatre – Ashley Stoddard Tastefully Simple – Melinda Dager Touchstone Crystals by Swarovski – Allie Pieschke Trish McEvoy – Shuston Vincent Usborne Books – Sonja Cissell Whimsical Garden Art, Inc. – Nancy Slebodnik

The Barb Smith Suicide Resource & Response Network offers group support and understanding for those who have lost a loved one to suicide, and provides suicide awareness and education in the community so future acts may be prevented.

Top Left to Right: Matilda Jane Clothing Puppy Paw Creations Bottom Left to Right: Tastefully Simple Usborne Books - Sonja Cissell

Physician Well-Being How to Recognize and Respond to Burnout in a Fellow Physician Sara Berg, Senior Staff Writer - AMA Wire® Physician burnout is distressingly common, yet when you see a colleague struggling you might not be sure what to say or do. Knowing what to look for and how to respond can make a huge difference to a struggling colleague. Whether you are in a small practice, hospital or health system, here is how to recognize and how to respond to physician burnout in a colleague.

Pay attention to those around you When physicians are burned out, they noticeably go from happy and inquisitive to rushed and indifferent. As a result, both the patient and physician suffer. “It’s a tough job. It’s hard work. Everybody is going to be down at some point in time and it will often feel like you’re barely keeping your head above water,” AMA member Kevin Hopkins MD, said in an interview with AMA Wire®. “When you’re struggling to keep your head above water, make sure you are looking for people around you, because you will notice co-workers - and even partners and physicians - who are drowning.” Look to others around you. Changes in personality, such as making less eye contact or asking fewer questions, are often signs of depersonalization and fatigue. If left unaddressed, they can lead to inattentiveness and indifference - neither of which improve patient care or physicians’ experience. “If you are only concerned about keeping your own head above water, you’re never going to throw them a line to help them when they’re drowning,” said Dr. Hopkins, a family physician and medical director at the Cleveland Clinic Strongsville Family Health and Ambulatory Surgery Center in Strongsville, Ohio. “Be aware of your surroundings, be aware of the mood, the level of burnout of the people with whom you work most closely,” he added. “And when you see someone is in trouble, do something about it.”

Watch out for cynicism The strongest sign of burnout is when a physician feels that nothing she does will make a difference. Watch out for physicians who might display an increase in biased comments about patients and the ineffectiveness of treating them. Physician burnout comes with a sense of despair, hopelessness and isolation. While that can be intimidating 18 The Bulletin | January 2019

when you spot it in a colleague, the first response can be basic. “It is amazing what a difference just being kind and treating people with respect makes,” Dr. Hopkins said. “Treat other people the way you would want your mom treated.” Approach a fellow physician with empathy and let them know you care about them or have noticed they are struggling.

Exhausted by their profession No one is expected to be upbeat all the time, but there is a big difference between being tired at work and being exhausted by your profession. Too often, Dr. Hopkins hears from patients who have gone to see another physician and report, “He has no personality,” or “He didn’t answer any questions.” Those can be signs of burnout. Physician burnout might begin with exhaustion, but it can lead to something worse if not identified. Unfortunately, early in training, physicians often learn that seeking help is a sign of weakness - it is not. Reassure your colleague that asking for help is a sign of health and recommend they speak with their family, other physicians or even seek professional help. The AMA offers online CME on physician burnout that helps doctors redesign their medical practices to minimize stress and improve job satisfaction. AMA’s STEPS Forward™ is an open-access platform featuring more than 50 modules that offer actionable, expert-driven strategies and insights supported by practical resources and tools. Based on best practices from the field, STEPS Forward modules empower practices to identify areas or opportunities for improvement, set meaningful and achievable goals, and implement transformative changes designed to increase operational efficiencies, elevate clinical team engagement and improve patient care.

Burned Out? You’re Not Alone. Here’s How Two Doctors Overcame It. Sara Berg, Senior Staff Writer - AMA Wire® Health care is experiencing a physician burnout epidemic. And with 42 percent of physicians reporting burnout in one online survey, it is important to know you’re not alone. Physicians face a unique set of problems that can often lead to burnout, including external forces beyond your control such as regulatory and administrative burdens. Fortunately, though, there are ways to recover from physician burnout. To help you avoid, navigate and survive physician burnout, two physicians share their stories on how they overcame the struggle. continued on page 19

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Team-based care lessens the EHR burden “It took some time to fully realize how difficult - if not impossible - it had become to function effectively as a physician,” said James Jerzak, MD, AMA member and family physician at Bellin Health in Green Bay. “I thought I was pretty efficient working on the computer in the room with the patient. In retrospect, trying to document the visit, enter the orders, renew medications, all while trying to function as an effective primary care physician - in a 15-minute appointment was overwhelming,” he added. When the EHR problem was brought to the attention of Bellin’s physicians and administration in early 2014, it led to their team-based care transformation. By allowing the staff to perform most of the EHR work, it lessened Dr. Jerzak’s workload and allowed him to focus completely on the patient. For more details, visit the AMA STEPS Forward™ module, “EHR In-Basket Restructuring for Improved Efficiency.” “Patients notice the difference,” he said. “I cannot imagine working in what for us now is the ‘old world.’ I feel for the doctors that remain in that situation.” The other contributing factor to physician burnout was the overwhelming demands of complex and high-risk patients. To help Dr. Jerzak and his physician colleagues, Bellin created an extended care team consisting of case managers, clinical pharmacists, diabetes services and care coordinators. This allowed them to work together to get patients the help they need. “Discussing these patients with the extended care team members drives home the point that practicing medicine can no longer be an individual responsibility,” he said.

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Take a break from your daily routine “Before the phenomenon of burnout was generally recognized, I now realize that I experienced periods of burnout. At those times, I benefitted the most from a complete break from my daily routine,” said AMA member and Yale Medicine Chief Medical Officer Ronald Vender, MD. He is also the associate dean for clinical affairs and a professor of medicine in digestive diseases at Yale. Dr. Vender has always enjoyed traveling and family vacations. His favorite memories included exploring cities in Europe. However, he found that a quiet vacation on the beach was better for overcoming burnout. “The opportunity to sleep late, live without a schedule, be surrounded by natural beauty, eat a leisurely breakfast and completely disconnect was restorative,” he said. “However, that has become more difficult in our connected world, so at least once or twice a year I now force myself to fully disconnect.”

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continued on page 20

The Bulletin | January 2019 19

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Your Family Feels the Fallout of Physician Burnout Too AMA Wire® In recent years, increasing attention has been focused on the crisis of physician burnout - the damage to doctors, risk to patients and strain on the health system. What’s largely left out of the discussion is the effect of burnout on physician families. About half of physicians report at least one symptom of burnout - about twice the rate of other American workers - and that proportion has been rising in recent years. In many physician households, both spouses are doctors, thus heightening the risk that one or both will be burned out. Physicians have high-stress jobs, vanishing control over their workdays and report being burdened by EHR clerical tasks. Add to that years of repaying debt and a schedule of long and uncertain hours that practically guarantee missed family, social and school events. New research shows that the majority of issues that cause physician burnout can be attributed to the environment in which physicians practice. Properly addressing burnout is about making system-level changes to improve workplace conditions. Yet when work factors catch up with physicians, the result can be articulated by the three elements of the Maslach Burnout Inventory - emotional exhaustion, depersonalization and a lost sense of personal accomplishment. Even when a physician thinks he or she is suffering in silence, the problems on that list alone run the risk of having a negative impact on a spouse or children. While physicians of either gender are at substantial risk of burnout, it is more common among female physicians. They also show higher rates of depression, even suicide, than their male colleagues. Female physicians, in addition to their professional lives, also are likelier to take on household and childrearing responsibilities, which can affect work-life balance. The AMA Alliance , through its magazine Physician Family, devoted a theme issue to physician burnout. The stories featured offer insights into the strain on relationships, the help that can come from a supportive spouse, and reminds readers that marriage and family counseling are options if the household stress gets to be too much to handle. In her story for the magazine, “How Physician Burnout Affects Relationships,” licensed clinical social worker Jordyn Paradis

Hagar notes that “when a physician is experiencing a state of burnout, the relationship or marriage can start to suffer.” The spouses of physicians experiencing burnout symptoms may notice: • Increased isolation • Greater irritability • More time away from home • Less communication within the relationship • Less time spent together • Drop in physical intimacy • More emotional separation This can drive the couple apart, leading “to two partners who are functioning much more as individuals than as a unified team. Each starts to take care of his or her own needs, and spirals of misunderstanding and miscommunication can begin to occur, leading to further disconnection and isolation,” writes Hagar, author of the 2012 book, At Least You’ll Be Married to a Doctor. One small upside is that “this process takes time to unfold” and timely intervention is possible, she writes. The first step is to recognize that the physician is experiencing burnout. Once both partners agree the issue should be addressed, Hagar recommends forming a plan to address the burnout’s family impact. That plan can include agreements to: • Engage in enjoyable activities together. • Engage in health and wellness activities together, or at least plan together how to implement vital elements such as sleep, exercise, healthy eating and time outdoors. • Spend time together as a family. • Disengage from work: Take a vacation, even a short one. • Set limits for daily work engagements. • Create mandatory non-work commitments, including family, friends and hobbies. • Dream and plan for future endeavors together. • Increase intimacy, even if this needs to be scheduled. No matter how supportive spouses and families are, physician burnout is a problem that fundamentally must be addressed by changing the work factors that contribute to the problem.

Medical Student Loan Applications Available Nursing Scholarship Applications Available www.SaginawCountyMS.com 20 The Bulletin | January 2019

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21

College of

Medicine Training to Fight Opioid Addiction College of Medicine faculty member leads effort to equip medical, physician assistant students Every day, more than 115 people in the United States die from an opioid overdose. In Michigan alone, there were 18.5 opioid-related deaths per 100,000 in 2016, compared with the national rate of 13.3 deaths. That was up from 7.1 in Michigan in 2012. Central Michigan University’s Juliette M. Perzhinsky MD MSc, Associate Professor of Medicine in the College of Medicine, wants to help change those statistics by training CMU medical and physician assistant students effectively on the treatment of pain and possibility of addiction. She aims to do that as project leader on a $433,500 three-year grant recently received from the U.S. Substance Abuse and Mental Health Services Administration to expand access to medication-assisted treatment, or MAT, for patients with opioid use disorders. Dr. Perzhinsky has several objectives: • Help health providers earn the required MAT Drug Addiction Treatment Act waiver to prescribe the most common anti-withdrawal medication used for outpatient treatment, buprenorphine. Just 2.2 percent of physicians in

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The Bulletin | January 2019

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Data Breach Insurance MSMS is constantly evaluating new products and services that help physicians address emerging issues in their practices. A data breach is a sudden event which occurs when personally identifiable information is compromised, and they occur every day. Even though hacking incidents receive the most attention, it isn’t the most common. Three out of four incidents result from human error. • 40% of the data breach cases are from people making mistakes, such as losing laptops and flash drives. • 36% are system glitches, such as software updates, which inadvertently expose confidential information. • 24% are malicious and criminal attacks. A data breach can be devastating to a practice. The practice must offer credit monitoring to patients, analyze how the data breach occurred and develop steps to avoid another breach. This can be costly and time consuming. The estimated remediation cost is $73 per record, which becomes expensive without an appropriate insurance policy. For example, if a software update inadvertently exposes confidential information for 4,000 records, the remediation costs would be $292,000.

MSMS Physicians Insurance Agency sells a comprehensive data breach policy that helps cover these costs. This policy offers: • Various liability limits and retention values • Full limit for breach notification costs • Full limit for computer forensics • A duty to defend policy • Coverage for breach contract claims • Coverage that incorporates wording from HIPAA HITECH to help ensure coverage triggers properly • Coverage for regulatory actions, including state attorney general investigations • Coverage for civil penalties and compensatory awards If you would like to learn more about a data breach policy, or know anyone who would qualify, please contact Gin Gibson at 517-336-5730 or at vgibson@msms.org.

MSMS is constantly evaluating new products and services that help physicians address emerging issues in their practices.

MSMS LOGIN INFORMATION As a member benefit of MSMS/SCMS, you can access “Members Only” resources at www.MSMS.org. Information available ONLY TO MEMBERS includes: Health Law Library; Ask Our Lawyer; Contract Review; Alerts, Guides and Checklists; On Demand Webinars and MORE! If you have not yet registered as a user, it is simple and quick! 1) Start at this page: https://www.msms.org/ Register, enter your email address twice on that page, and hit the blue “Continue” button. 2) The next screen should prefill with all the information MSMS already has on file for you. The only information you should need to enter is in the two places for “Password” and “Confirm Password” in the middle of the pre-filled form. 3) Passwords need to be at least seven characters long, and have at least one UPPER case letter and one lower case letter. Numbers and special characters such as #$%& are allowed but not required.

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The Bulletin | January 2019

4) When done choosing and confirming the password, click the blue button that says “Create Profile” at the bottom. If you enter your email address and your prefilled member profile does NOT appear, please contact Joan at the SCMS at jmcramer@sbcglobal.net. Since most people have more than one email address, it could be that the address you are trying to register under is not the email MSMS has on file for you. Joan can let you know the email address MSMS has for you. If you prefer to use a different email address to register, Joan can help you with that or you can contact MSMS directly at (517) 336-5762 and request the change.

APPLICATIONS FOR MEMBERSHIP | REACTIVATED MEMBER FIRST READING: Applications for membership that may be recommended for acceptance at the February 19, 2019, Board Meeting: Kevin J. Lawson, MD (Ascension St. Mary’s Orthopedics) Specialty: Surgery – Orthopedic (Board Certified 1991) Surgery – Spine (Board Certified 2009) Pain Management Medical School: University of Michigan Medical School, 1983 Internship/Residency/Fellowship: Cleveland Clinic Foundation, Orthopedics, 1983-88 and Adult Spinal Surgery, 1988-89 Military: U.S. Air Force, Travis AFB, California, Staff Surgeon, 1989-93 Sponsors: Doctors Waheed Akbar and Tarek Taha Oveys Mansuri, MD (CMU Health - Surgery) Specialty: Surgery – General (Board Certified 2012) Medical School: University of Illinois College of Medicine, Chicago, IL, 2005 Internship/Residency: University of Illinois, Chicago, IL, General Surgery, 2005-08 Residency: University of California, San Diego, CA, General Surgery, 2008-10 Fellowship: Harvard Medical School, Boston, MA, Surgery, 2010-11 Sponsors: Doctors Timothy R. Hackett and Samuel J. Shaheen Omar N. Marar, MD (CMU Health - Surgery) Specialty: Surgery – General (Board Certified 2018), Surgery - Colorectal Medical School: Royal College of Surgeons Ireland, Dublin, Ireland, 2012 Internship: Abington Memorial Hospital, Abington, PA, General Surgery, 2012-13 Residency: St. Barnabas Medical Center, Livingston, NJ, General Surgery, 2013-17 Fellowship: Thomas Jefferson University Hospital, Philadelphia, PA, Colon and Rectal Surgery, 2017-18 Sponsors: Doctors Maher Ghanem and Wael A. Solh Najibah K. Rehman, MD (Saginaw County Health Department – Medical Director, and CMU College of Medicine, Assistant Professor, General Preventive Medicine & Public Health) Specialty: General Preventive Medicine and Public Health Medical School: Wayne State University School of Medicine, 2014 Residency: Detroit Medical Center, Wayne State University, Detroit, Internal Medicine, 07/14 to 12/15 Residency: University of Michigan, General Preventive Medicine and Public Health, 7/16 to 6/18 Sponsors: Doctors Waheed Akbar and Juliette M. Perzhinsky

Monique S. Turner, DO (Women’s Ob-Gyn, PC) Specialty: Ob/Gyn (Board Certified 2018) Medical School: Michigan State University College of Osteopathic Medicine, 2012 Internship/Residency: Henry Ford Macomb Hospital, Ob/Gyn, 2012-16 Military: U.S. Air Force, 1996-98; Michigan Army National Guard, 2000-present Sponsors: Doctors Jennifer R. Schmidt and Kristine K. Spence Lisa M. WintonLi, MD (CMU Health - Surgery) Specialty: Surgery - General (Board Certified 2018), Surgery - Breast Medical School: Ohio State University College of Medicine, Columbus, OH 2012 Internship/Residency: Maricopa Integrated Health Systems, Phoenix, AZ, General Surgery, 2012-17 External Rotation: Stanford University, Breast Surgical Oncology, 4/15 to 5/15 Fellowship: University of Texas Southwestern, Breast Surgical Oncology, 8/17 to 11/18 Sponsors: Doctors Elizabeth A. Paulus and Samuel J. Shaheen SECOND READING: Applications for membership that may be recommended for acceptance at the January 15, 2019, Board Meeting: Judy S. Blebea, MD (CMU College of Medicine – Associate Dean, Faculty Affairs, Faculty Development) Specialty: Radiology – Diagnostic (Board Certified 1989) Medical School: State University of New York Health Science Center, Brooklyn, NY, 1983 Internship: George Washington University Medical Center, Washington, DC, Internal Medicine, 1983-84 Residency: Columbia – New York Presbyterian University Medical Center, New York, NY, Diagnostic Radiology, 1985-89 Fellowship: University of Rochester Medical Center, Rochester, NY, Body Imaging and MSK Radiology, 1989-90 Sponsors: Doctors John Blebea and Mildred J. Willy Mark J. Hass, MD (Advanced Diagnostic Imaging, PC) Specialty: Radiology – Diagnostic (Board Certified 2006), Breast Imaging Medical School: Spartan Health Sciences University, St. Lucia, West Indies, 1999 Internship/Residency: Oakwood Hospital & Medical Center, Dearborn, MI, Diagnostic Radiology, 2000-05 Fellowship: University of Virginia Health System, Charlottesville, VA, Breast Imaging, 7/16-6/17 Sponsors: Doctors Mark R. Ludka and Harvey K. Yee REACTIVATED MEMBER Brian C. deBeaubien, MD Covenant Orthopaedics 900 Cooper, Suite 3100 | Saginaw, MI 48602-5182 Office (989)-583-7450 www.covenanthealthcare.com Surgery – Orthopaedic The Bulletin | January 2019 25

New Year, Healthy Habits: Free Seminars to Help Patients Quit Smoking

Please consider this opportunity to generate a difference by offering your insights to us.

We can help your patients, or you, become a quitter! Sure, it can be difficult to quit smoking. That’s why Covenant HealthCare is here to help, and offers free informational seminars to the public. At the seminars, attendees will: • Gather information on ways to successfully quit smoking • Check lung health status with on-site respiratory screening tools • Learn from the Covenant Respiratory Therapy staff the importance of a tobacco-free life • Sign up for free Smoking Cessation Classes or a more personal plan • All seminars are open to the public

The PFACs are comprised of former patients, family members and caregivers of former patients, Covenant HealthCare leadership and staff. Together, we can positively impact care for generations to come.

Have a patient who needs support? Covenant HealthCare has informational classes three times each year that are free to the community from 6-8 p.m. at Covenant HealthCare, 5400 Mackinaw Road, Third Floor Conference Room A in Saginaw. Upcoming classes: • Thursday, April 25 • Thursday, September 19 Register at 1.866.Covenant (1.866.268.3626).

Covenant Seeks Members for Patient and Family Advisory Councils We extend an invitation to our former patients and their family members/ caregivers to join one of the Covenant HealthCare Patient and Family Advisory Councils (PFAC). Our vision for the PFACs is for the voice of the patient and family to be heard across the continuum in all decisions made about patient care. To support our mission of “Extraordinary Care for Every Generation,” we commit to partnering with our patients and families by empowering those we serve to: • Identify opportunities for improvement • Enhance patient and family centered care • Help us pursue clinical excellence and value of care • Help us see all patients as people The rewards of participating are many – from developing new friendships to making an impact on Covenant patient care. 26

The Bulletin | January 2019

About the Council: • Two-hour, monthly dinner meetings • Provide feedback on Covenant projects • Work on program development and implementation • Share experiences and offer opportunities for improvement Other opportunities include: • Facility design planning • E-Advisor (online focus groups) • Committee membership • Special projects of interest Applications for the Executive PFAC, Cancer Care Center PFAC, Physician Office PFAC and the Women’s and Children’s Advisory Council are available online at www. covenanthealthcare.com/ch/pfac. For questions, contact Christin Tenbusch, Patient Experience Administrator at 989.583.7491 or pfac@chs-mi.com.

Scholarship Applications Now Available Covenant HealthCare Foundation takes great pride in offering students the opportunity to apply for scholarships to further their education. Over the past 10 years, the Foundation has granted more than $225,000 in scholarship money through the High School Scholarships program, Nursing scholarships and the Zeile awards. A formal presentation of the scholarships are made at the Foundation’s Spring Second Century Reception in May of each year. High School Scholarships We offer scholarships for high school seniors who are a dependent of a Covenant HealthCare employee, as well as, seniors attending a Saginaw, Bay, Tuscola, Arenac, Huron, Sanilac or Midland county high schools (further details in the application). Nursing Scholarships To be eligible to apply, potential applicants must be a current Covenant HealthCare employee who is enrolled in the clinical phase of instruction, and intending to pursue an undergraduate or graduate degree in Nursing. Visit www.covenanthealthcarefoundation.com for applications.

MiHIA Conferences – Register Now! 10th Annual “The Region’s Health and Health Care Systems: Communities Achieving Excellence and Accountability” Conference Achieving population health in an efficient and sustainable manner calls for innovative and transformative actions. It requires outstanding vision to achieve better system performance, improve care coordination and reduce cost simultaneously. This can all be accomplished by building on ideas and models developed and catalyzed by national and regional thought leaders. Conference speakers will provide conceptual framework and case examples that will enable participants to continue examining and enhancing their efforts toward population health outcomes while improving quality and patient care experiences in the region. Date: Friday, January 25, 2019 Time: 8:15 a.m. - 12:30 p.m. ET Location: Saginaw Valley State University, University Center, MI Simulcast: Central Michigan University (Mt. Pleasant, MI) and Kirtland Community College (Grayling, MI) Keynote Speakers: Keynote speakers will be Karen Timberlake,

Principal of Michael Best Strategies and Vondie Woodbury, Principal Consultant of The Woodbury Group. Who Should Attend: Hospital board members, health care executives, physicians, other health care providers/professionals and community health leaders. Cost: $75 per person ($25 for students) CLICK HERE TO VIEW CONFERENCE BROCHURE CLICK HERE TO REGISTER

Community Coalition Accelerator Workshops Uniting Communities to Address the Opioid Crisis MiHIA Community Coalition Accelerator Program: Workshop III Wednesday, February 27, 2019 | 1-4 p.m. ET | Saginaw, MI In follow up to the highly successful Workshops I & II, MiHIA is pleased to host the 3rd and final MiHIA Community Coalition Accelerator Program: Workshop III. The workshop will highlight successes from 2018, connection to ongoing regional work, overview of the 2019 Action Plan and outline progress made and opportunities to collaborate. Additionally, a special presentation will be delivered by David R. Neff, DO, Chief Medical Director, Office of Medical Affairs, Michigan Department of Health and Human Services (MDHHS). CLICK HERE TO LEARN MORE CLICK HERE TO REGISTER For any questions, please contact MiHIA Quadruple Aim Leader, Katie Trotter, at populationhealth@mihia.org.

PROVIDING NEW

COVENANT REGIONAL WOUND HEALING & HypERbARIC MEDICINE CENTER

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

www.covenanthealthcare.com

Extraordinary care for every generation. The Bulletin | January 2019 27

St. Mary’s Performs First Robotic Major Liver Removal Dr. Ghanem removed a basketball-sized growth of the liver with minimally invasive robotic procedure Maher Ghanem MD and Samuel Shaheen MD were the first surgeons in the state of Michigan to remove 80 percent of a liver through a roboticassisted procedure. Liver surgery can be extremely challenging given its position located under the rib cage and vascular complexity. Dr. Ghanem, boardcertified surgeon with CMU Health Department of Surgery, removed the right side of the liver consumed by a basketball-sized hemangioma through a 12-millimeter incision using the da Vinci robotic surgical system. A traditional procedure requires a large incision and a longer hospital stay; however, the robotic procedure involves only a few small incisions and a shorter hospital stay. The robot-assisted approach alleviates some of the complexity by giving the surgeon a magnified 3-D view of the surgical site and by improving dexterity and ability to manipulate instruments safely within the body. With the robotic arms, a surgeon can perform delicate operations through tiny incisions. Robotic surgery offers many advantages including smaller incisions, less post-operative pain, less blood loss, shorter hospital stays, quicker recovery and a faster return to normal daily activities. Dr. Ghanem completed a fellowship in endocrine and oncologic surgery at Johns Hopkins University School of Medicine under worldwide distinguished surgeons John L. Cameron MD and Martha Zeiger MD. Dr. Ghanem’s passion for improving the care of patients with liver, pancreas and bile duct cancers led him to complete a second fellowship in HepatoPancreatoBiliary Surgery at the University of Pittsburgh Medical Center Thomas E. Starzl Institute. It was here that both liver transplantation and minimally invasive liver resection were pioneered in the United States and in the world. He is one of very few surgeons in the country to offer minimally invasive robotic liver resection to treat cancer and noncancerous tumors. After extensive training at the University of Pittsburgh Medical Center, home of the nation’s premier liver center, 28

The Bulletin | January 2019

Dr. Ghanem came to Saginaw to develop Michigan’s first and only minimally invasive robotic liver surgery program. He says patients are already reaping the benefits. Earlier this year, Dr. Ghanem performed the first robotic Whipple in the state, and was also the first surgeon north of Detroit to perform a robot-assisted distal pancreatectomy and splenectomy at St. Mary’s in 2015. The da Vinci robotic surgical system can be used for a range of surgeries. Ascension St. Mary’s robotic surgery team currently uses the da Vinci for colorectal, general, gynecological, thoracic and urological procedures.

Iftikhar A. Khan MD Joins Ascension St. Mary’s Ascension Medical Group and Ascension St. Mary’s are proud to welcome Iftikhar A. Khan MD, neurologist, as an employed physician. On January 2, Dr. I. Khan, who has had a local neurology practice for over 20 years, officially transitioned to Ascension Medical Group. Dr. I. Khan’s office and phone number will remain the same. His office is located at 4705 Towne Centre Road, Suite 302, Saginaw, MI 48604, and his phone number is (989) 799-2640. Dr. I. Khan will continue to offer patients options for an array of neurological issues such as Alzheimer’s Disease, epilepsy, headaches, migraines and stroke. The addition of Dr. I. Khan complements the Ascension St. Mary’s neurosciences team to provide compassionate, personalized care. Welcome Dr. Iftikhar A. Khan!

Welcome New Breast Surgeon Welcome to Lisa WintonLi MD, who has joined the Ascension St. Mary’s medical staff. She will collaborate with Ascension St. Mary’s cancer care team, and work closely with Ernie Balcueva MD, Asma Taj MD and Roma Srivastava MD at Ascension St. Mary’s Towne Centre medical oncology. As a member of the multi-specialist surgical team at Central Michigan University (CMU) Health Department of Surgery, Dr. WintonLi is the first fellowshiptrained breast surgeon in our community. Her areas of medical expertise and interest include breast cancer, benign breast disease, hereditary cancer syndromes, nipple-sparing mastectomies and oncoplastic breast-conserving surgery. Dr. WintonLi earned her medical degree from The Ohio State University College of Medicine, and was board-certified in General Surgery in 2018. She completed a General Surgery residency at Maricopa Integrated Health Systems in Phoenix, Arizona and a fellowship in Breast Surgical Oncology at the University of Texas Southwestern in Dallas. Dr. WintonLi is accepting new patients and referrals. Call 989-790-1001 for more information.

Welcome New Physicians

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

Welcome

Eric Bialaski, DO Neurosurgery

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

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

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

Rachael Kasperowicz, MD Primary Care

Kevin Lawson, MD Orthopedics

Laura Reitz, DPM Podiatrist/Foot and Ankle Surgery

Roma Srivastava, MD Hematology/Oncology

All are accepting new patients. The Bulletin | January 2019 29

MEMBER NEWS

Allen J. Solomon, MD – Wayne State University Member since 1974

50th Anniversary of Medical School Graduation The SCMS would like to honor and congratulate the following members on the 50th anniversary of their graduation from medical school:

All four longtime SCMS members graduated in 1968, and were honored at the MSMS Annual Scientific Meeting in October. Congratulations, Doctors!

Ronald L. Jenson, MD – University of Kansas School of Medicine Member since 1972

Ryan Walter Elected President of IAFCCP Phillip W. Lambert, MD – University of Cincinnati Member since 1985

Jose V.B. Mangune, MD – University of the East, Philippines Member since 1979

Ryan Walter, FP-C, Air Methods Corporation, U.S. Navy, son of SCMS President, Julia M. Walter MD and Michael A. Walter, was recently elected President of the International Association of Flight & Critical Care Paramedics (IAFCCP). Founded in 1986, the National Flight Paramedic Association, currently known as the IAFCCP, is the largest independent paramedic association in the world. Their focus is the professional paramedic, and their purpose is to serve as advocates to the profession on an international basis. IAFCCP continued on page 31

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

Key Provider to the SCMS

Healthway Compounding Pharmacy 2544 McLeod Dr. N. | Saginaw, MI 48604 | 989.791.1691 | www.healthwayrx.com 30

The Bulletin | January 2019

continued from page 30

members are involved in transporting critical care patients by airplane, helicopter and ground ambulance. “Good thoughts, good words, good deeds.” A behavior of mine is always looking for patterns and correlations. Sometimes I like to amuse myself and look for these correlations in the most unpronounced locations - for instance, the movie Bohemian Rhapsody. Bohemian Rhapsody is a biopic about the late lead singer of the band Queen, Freddy Mercury. I enjoyed the film, but I don’t imagine you were looking for my expertise as a movie critic. I love EMS. I love the business, patients, medicine, innovation, but most importantly, I love the crews. Nowhere else have I seen a group of people so selfless that sacrifice is not considered sacrifice. A group of people, driven by passion, in an uncontrolled environment, critically thinking nonstop, to not just kind of save, but really save some of our sickest and most injured members of the community. I love the people who are willing and driven to do this job, who truly espouse the values of readiness, expertise and professionalism. Good thoughts, good words, good deeds; an interesting line in Bohemian Rhapsody that caught my attention. From Zarathustra, meaning that we can make this world heaven or hell

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Barb Smith Suicide Resource & Response Network Bieri Hearing Specialists Covenant HealthCare Covenant Wound Healing Center Jan Hauck – Century 21 Healthway Compounding Pharmacy Horizons Conference Center/Riverview Brownstones Lori Krygier Graphic Designer Norton + Kidd Accounting & Consulting, P.C. Peak Performance PC Services Shields Chiropractic Wolgast Corporation

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depending on how we think, speak and act. Having served on this Association’s board for the past three years, I have no doubt this Association is aligned with positive change. I am excited to work with the IAFCCP and its leadership board to represent the voice of specialty care paramedics throughout the globe. Our new board is excited and hungry to drive value to our members, drive influence to our industry and drive excellence to our patients.” Ryan Walter Congratulations, Ryan! Please contact Joan Cramer at jmcramer@sbcglobal.net with newsworthy information on SCMS physician members or families. Publication is subject to available space and the discretion of the Editor. Advertisements for physician practices, procedures, etc., will not be considered for publication as Member News. Display ads may be purchased for those purposes.

www.SaginawCountyMS.com

GOLF OUTING SAVE THE DATE!

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

Saturday, June 8, 2019

Saginaw Country Club Four Person Scramble 12 p.m. Registration - 1 p.m. Shotgun Start Watch upcoming issues of The Bulletin for information and sponsorship opportunities! The Bulletin | January 2019 31

PRSRT STD U.S. POSTAGE PAID Saginaw, MI 48605 PERMIT #228

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

ADDRESS SERVICE REQUESTED

2018-2019 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 in 2019. You will receive an email meeting notice and reminder each month for SCMS events. Non-SCMS events are listed as a courtesy and you must contact the sponsor directly to register. Tuesday, February 19, 2019 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m. Saturday, March 16, 2019 Horizons Conference Center - 15th Annual Health Fair “The Doctor Is In!” from 9 a.m.-12 p.m. Tuesday, March 19, 2019 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m.

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

Tuesday, April 16, 2019 Horizons Conference Center - SCMS Board meets at 5:30 p.m. Membership Meeting with Social (cash bar) at 6:30 p.m. followed by dinner and program at 7 p.m. Program: “TED Talks.” See page 5 for more information.

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