SCMS BULLETIN-January 2017

The

Bulletin Saginaw County Medical Society January 2017 Volume 82, No 5

MACRA: REGISTER NOW! January 17, 2017 Meeting p. 5 SCMS/MSMS Advocates for ALL Physicians & Their Patients p. 8

www.SaginawCountyMS.com

DEA Reverses Announced Change to Registration Renewal Process p. 25

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The

Bulletin Saginaw County Medical Society

SAGINAW COUNTY MEDICAL SOCIETY 2016-2017 OFFICERS AND DIRECTORS PRESIDENT Virginia R. Dedicatoria, MD PRESIDENT-ELECT Julia M. Walter, MD PAST PRESIDENT Danielle C. Duncan, MD SECRETARY Maliha N. Shaikh, MD TREASURER Thomas J. Veverka, MD BOARD OF DIRECTORS

B.L. Nahata, MD Zubeda S. Khan, MD

contents 5 5 4 6 7 8 9

Sanjay J. Talati, MD Anthony M. Zacharek, MD Mildred J. Willy, MD BULLETIN EDITOR Louis L. Constan, MD

10

RETIREE REPRESENTATIVE Larry S. Kelly, MD RESIDENT REPRESENTATIVE Rahul Jacob, MD PEER REVIEW ETHICS COMMITTEE Waheed Akbar, MD Caroline G.M. Scott, MD James R. Hines, MD MSMS DELEGATES Elvira M. Dawis, MD B.L. Nahata, MD Zubeda S. Khan, MD Sanjay J. Talati, MD

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MiHIN Overview: Save The Date! April 18, 2017, Meeting

MACRA: Register Now! January 17, 2017, Meeting President’s Letter From The Editor Golf Outing - Save The Date! SCMS/MSMS Advocates for YOU and YOUR PATIENTS! The Power of MSMS/SCMS Looking Back to the Defeat of the 2009 Proposed Physician Tax

Mildred J. Willy, MD MSMS ALTERNATE DELEGATES Caroline G.M. Scott, MD Vijay K. Chaku, MD Waheed Akbar, MD Gopi K. Nallani, MD Anthony M. Zacharek, MD Dennis A. Boysen, MD Steven J. Vance, MD Daniel J. Wechter, MD J. Patricia Dhar, MD MSMS DISTRICT 8 DIRECTOR Thomas J. Veverka, MD EXECUTIVE DIRECTOR Joan M. Cramer

26 27 28

Key Provider of the Month Covenant Healthcare

29 30 30

Covenant HealthCare St. Mary’s of Michigan Attention Retired Members! Cleveland Clinic’s Approach to Burnout Focuses on Relationships February Birthdays Soup Kitchen Volunteers Needed

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SCMS Foundation Tax-Deductible Donation MSMS

CMU CME Calendar & Survey Member News DEA Reverses Announced Change to Registration Renewal Process HPRP Helps Impaired Health Care Professionals Peer Review Ethics Committee Applications For Membership Five Ways to Recognize Patient Cues, Understand Needs 2017 Physician Directory Advertiser Index How to Write Resolutions to the MSMS House of Delegates SCMS FOUNDATION Make a Tax Deductible Gift Today! 2016-2017 Key Providers Calendar of Events for 2017

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

Virginia R. Dedicatoria, MD Mohammad Yahya Khan, MD

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SCMS Members Needed to Staff SCMS Booth at the 13th Annual Health Fair

Julia M. Walter, MD

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Annual Jingle Mingle Benefits The Mustard Seed Shelter

ON THE COVER: (l-r) Jennifer Rogers, Meg Cappelli, Tina LaFleur, Janie Gugino, Amanda Tucker, Colleen Cheney and Anne deBari with Amy Bartels-Roe and Sr. Leona Sullivan of The Mustard Seed Shelter 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: Joan@SaginawCountyMS.com 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 2017 3

PRESIDENT’S LETTER

U.S. Healthcare Reform By Virginia R. Dedicatoria, MD

T

he Affordable Care Act, or Obamacare, was enacted near Christmas 2010. The signature health law entered its presence in U.S. history. How meaningful are all of the proposed articles in the 2,700+ pages? President-Elect Donald Trump will be inaugurated as the 45th President of the United States on January 20, 2017. Will it be a repeal, replace or delay? Healthcare advocates and leaders stick to an all-hands-on-deck answer to the nation’s healthcare issues. However, answers remain to be seen. The best solutions to healthcare are always difficult to come by in this country. There are many possible ways to accomplish the goals we want, but all have a subjection to financial cost. Cost controls are hoisted on us by federal or state governments which pay 64 percent of healthcare

costs in the country. We can agree that the steep rise in healthcare costs is unsustainable. No physicians became wealthy from the increase. We physicians always struggle on this regard: Providing better outcomes at a lower cost. Is it really a matter of quality than anything else? The final assessment remains undetermined with MACRA, something that emphasizes quality beginning January 1, 2017. What do you think are answers to healthcare reform? Is collaboration a possibility? This opens another question and presents endless challenges and changes. Physicians and patients demand reforms on health insurance, government entitlement programs and subsidies, tort malpractice liability, billing scams, pharma brand pricing, revolution of technologies,

physician/patient relationships and so on. An article from Bernard Tyson, CEO of Kaiser Permanente, discusses why the human touch will be at the center of healthcare even with the revolution of technology in patient care. The piece serves as a guiding principle to uplift morale for better days ahead. Do you think we are deeply into technology that will enable us to do a better job in taking care of each patient? Will it come at the expense of the human touch? The human touch will always be the deciding factor on people’s opinions about their care. Physicians are here to provide high quality and affordable care to millions of people. We will take care of the health of our communities. To balance the equation, I feel the patient and third-party payer should be held responsible too. That is my opinion.

The best solutions to healthcare are always difficult to come by in this country. There are many possible ways to accomplish the goals we want, but all have a subjection to financial cost.

Virginia R. Dedicatoria, MD

6 4

The 6 Bulletin | January 2017

SAVE THE DATE! April Membership Meeting Mark your calendar now for our Tuesday, April 18, 2017, Membership Meeting at Horizons Conference Center. Rick Wilkening, Director of Major Accounts and Emerging Solutions of MiHIN, will present Michigan Health Information Network Shared Services (MiHIN) Overview. A growing number of health care providers in Michigan have started storing patient data in electronic health records as the first step in moving away from traditional, paper-based files. These records create instant increase in efficiency within each provider’s practice, but more work needs to be done to ensure timely and relevant patient information can be shared among providers and other health care stakeholders. This sharing of patient information between legally authorized health care providers is known as health information exchange. In Michigan, a health information network has been created to coordinate and facilitate building a statewide capability to securely, electronically exchange health information. MiHIN is Michigan’s initiative to continuously improve health care quality, efficiency, and patient safety by promoting secure,

electronic exchange of health information through the MiHIN Health Information Services Cloud™ (HISC). MiHIN represents a growing network of public and private organizations working to overcome data sharing barriers, reduce costs, and ultimately advance the health of Michigan’s population.

Date: Time:

Tuesday, April 18, 2017 6:30 p.m. social (cash bar), 7 p.m. dinner, brief meeting and program Program: “MiHIN Overview” Speaker: Rick Wilkening, Director of Major Accounts and Emerging Solutions of MiHIN Place: Horizons Conference Center 6200 State Street, Saginaw Cost: No cost - SCMS members and medical students Non-member physicians - $100 each All others - $60 each

RESERVATIONS ARE REQUIRED. Those who make a reservation and do not attend will be charged a $40 cancellation fee. Invitations will be mailed and emailed in late March, but please mark your calendar now to attend.

January Membership Meeting

Tuesday, January 17, 2017

REGISTER NOW! MACRA: The Big Picture

Register now for the SCMS Membership Meeting on Tuesday, January 17, 2017, at Horizons Conference Center. Stacey Hettiger, Director, Medical and Regulatory Policy of MSMS, will present a CME accredited program, “MACRA: The Big Picture.” MACRA is the Medicare Access & CHIP Reauthorization Act of 2015. MACRA makes three important changes to how Medicare pays those who give care to Medicare beneficiaries. One staff person from each members’ office is invited to attend the meeting at no charge. Additional staff that would like to attend will be responsible for their dinner – reservations and prior payment required. Please click here to register now. Space is limited. The SCMS thanks Key Providers Barton Woods Assisted Living, Bieri Hearing Specialists and Caretel Inns of Tri-Cities for sponsorship of this meeting.

Date:

Tuesday, January 17, 2017

Time:

6:30 p.m. social (cash bar), 7 p.m. dinner, brief meeting and program

Program:

“MACRA: The Big Picture”

Speaker: Stacey Hettiger, Director, Medical and Regulatory Policy of MSMS Place:

Horizons Conference Center 6200 State Street, Saginaw

Cost: No cost - SCMS members, medical students and ONE staff person per member Additional staff personnel - $40 each

Non-member physicians - $100 each All others - $60 each

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

The Bulletin | January 2017 5

FROM THE EDITOR

The Secret Life of Patients By Louis L. Constan, MD

Y

ou’re getting ready to visit your doctor when you chance to see, on TV, an ad for a wonderful new drug for your very own disease that’s been making you so sick. “Wow” you say to yourself, “I’d better tell him about this drug.” But, what’s that they say? “Tell your doctor if you’ve had an organ transplant.” Hmm. You’ve never told your doctor about the kidney transplant you had when you were young. It didn’t seem any business of his, and there were embarrassing elements to the story that you didn’t want him to know about. It’s a good thing that they reminded you that it might be important for him to know this before you start this new drug... And although you feel a little guilty about withholding information from (OK, lying to) your doctor, you rationalize it by reasoning that “everybody lies.” In fact, just today you: • Received a letter from your insurance company, that “cares about you as a name-not a number”

containing a health checklist created “especially for you” that suggests you have a blood pressure check “If you haven’t had it done.” They haven’t noticed that your doctor has been billing them for blood pressure visits for years, and they have been paying a pharmacist all that time for blood pressure meds! Why bother actually trying to get to know you as an individual when it’s easier to simply “say” that they care when they really don’t? • Listened to a politician lying about what he’ll do when he gets elected. You like what he has to say, but realize, based on experience, that what he says and what he eventually does are two different things. • Watched a TV ad proclaiming that “no analgesic is better than our analgesic,” when they know that no one has ever shown a bit of difference between the two products. Or the ad proclaiming that “90 percent of doctors use their product for headache” when this is only because they’ve been giving doctors free samples for years.

• Viewed a television drama or comedy whose plot involves someone lying to someone else. Could there even be any drama or comedy if everyone told the truth? You’ve found that, for you, lying helps. Who wants their friends and co-workers to know their real age, their weight, how much they drink, their infidelities, how they spend their money, how fast they drive, where they were last night, who made that mistake at work, what he said, what she said? With this enormous mass of lies all around you, lying is a habit. You cannot help yourself. Hence, from time to time you need to be reminded that, with your doctor, you must be brutally honest. Thou shalt never lie…to your doctor! And yet, you reason, if it’s so important that you don’t lie to your doctor, why should he be allowed to lie to you? Honesty should cut both ways. And you suspect that your doctor has been less than honest with you. continued on page 7

Hence, from time to time you need to be reminded that, with your doctor, you must be brutally honest.

Louis L. Constan, MD

6

The Bulletin | January 2017

continued from page 6 You know, for instance, that he was required to purchase a computer system, and may be up-coding in order to pay for it. You know that he has purchased a piece of expensive diagnostic equipment, and he is ordering this test much more often than he did when he didn’t own the equipment. You know that your insurance company rewards him or penalizes him for doing or not doing certain tests and procedures. You would like to know what they are. You know, as well, that your physician is an employee of a health system, and that they require him to use certain consultants, even when he knows that these consultants are not the best ones for you. You might know that MACRA is coming and that he will be paid for what he does for his population of patients, and that you are just one of the crowd. Your fervent wish is that he feels the same need to be honest with you as you feel the need to know how and why he makes the decisions he does about your health. Honesty should apply to both of you equally. So, my physician colleague, it seems to me that we need to see these issues from the perspective of the patients. We need to take a brutally honest look at what we do, everything that we do, and ask if it is honestly the best for our patient. It is not easy to take the time to be completely straightforward and direct with patients about why we do what we do. Nevertheless, we must make the attempt. Our

patients expect no less. We may not always know when patients are withholding the truth, but we’re the professionals here, and we realize that healthcare works best with honesty and it is up to us to show a good example, to demonstrate that we believe, always, that honesty is the best policy.

GOLF OUTING - SAVE THE DATE! June 10, 2017 The SCMS Foundation will host its 8th annual golf outing on Saturday, June 10, 2017, 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 10, 2017 • Saginaw Country Club Four Person Scramble 12 p.m. Registration • 1 p.m. Shotgun Start Watch upcoming issues of The Bulletin for information and sponsorship opportunities!

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SAGINAW SAGINAWCOUNTY COUNTYMEDICAL MEDICALSOCIETY SOCIETY&&MICHIGAN MICHIGANSTATE STATEMEDICAL MEDICALSOCIETY: SOCIETY:

The ONLY organizations advocating for ALL physicians and their patients. Advocating for your patients and their rights, including access to care and public health initiatives. Working with elected officials to pass common-sense legislation which support the physician and their patients. Aligning quality initiatives and appropriate reimbursement to better care for patients. From employment terms to independent privileges, we are your voice in a hospital setting. Working with regulators to lessen administrative hassles.

The Saginaw County Medical Society and the Michigan State Medical Society, for more than 150 years, has had a leadership role in Michigan. From standing up for patients’ rights to working with lawmakers for sensible legislation to advocating insurance companies to negotiating with hospitals to lessening administrative hassles, SCMS and MSMS are the ONLY organizations advocating for ALL Michigan physicians.

To To join join the the movement, movement, please please call call 800/352-1351; 800/352-1351; email msms@msms.org; email msms@msms.org; or, or, visit visit us us online online at at www.joinmsms.org www.joinmsms.org 8

The Bulletin | January 2017

The Power of MSMS/SCMS Looking Back to the Defeat of the 2009 Proposed Physician Tax In 2009, the Michigan House of Representatives passed the Quality Assurance Assessment Program (QAAP), otherwise known as the Physician Tax, by a tight margin. It passed along party lines, after heavy internal pressure from within the Democratic Party. The Michigan State Medical Society (MSMS) and its partners in organized medicine, acted swiftly to rally efforts opposing this legislation through its Action Center and a successful march on the Michigan Capitol. The march, which was held on October 20, 2009, was attended by nearly 1,200 physicians, fellows, residents, medical students, office staff and many others. This tremendous effort demonstrated the power, impact, and necessity of organized medicine. The result of this swift action led to the Michigan Senate voting the bill down, saving each physician up to an estimated three percent of their gross revenues. If you ever wonder why you should join MSMS and SCMS, please think of your patients, your colleagues, your practice, your staff and yourself. The defeat of the

physician tax in Michigan is an example of MSMS/SCMS’s importance. MSMS/SCMS are your voice. If your practice grosses $1 million per year, three percent would equal $30,000 per year. In seven years since the bill was voted down, MSMS/SCMS has saved you and your practice a significant amount which more than covers your annual membership dues. MSMS is the most regarded physician advocacy group in Michigan, both in size and effectiveness. MSMS/SCMS are the voice of YOU, THE PHYSICIAN, and YOUR PATIENTS. Become a member, become involved.

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The Bulletin | January 2017 9

SCMS Members Needed To Staff SCMS Booth At the 13th Annual Health Fair “The Doctor Is In!”

Saturday, March 18, 2017 • 9 a.m. to 1 p.m. • Horizons Conference Center SCMS members of all specialties are needed to staff the SCMS Booth and interact with patrons, answer their questions and distribute the 2017 Public Membership Directory and other information. Members will be scheduled in one hour shifts from 9 a.m. to 12 p.m. Please contact Joan Cramer at 790-3590 or jmcramer@ sbcglobal.net if you can help! If you or your group is interested in purchasing a booth to promote your practice, please contact Joan as well. Booths are available on a first come, first served basis. This is your chance to get in front of 1,100+ Saginaw County residents in one convenient location! Visit www.SaginawCountyMS.com under the Health Fair tab or click HERE to reserve a booth!

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The Bulletin | January 2017 11

NUTRITION • EXERCISE • SUPPORT • FOR LIFE!

Covenant HealthCare Awarded the Healthcare Facilities Accreditation Program (HFAP) Accreditation Covenant HealthCare was awarded reaccreditation from the Healthcare Facilities Accreditation Program (HFAP), an independent, accreditation organization recognized by the Centers for Medicare and Medicaid Services (CMS). It earned this distinction after HFAP conducted an extensive and objective review of the quality and safety Standards of Covenant. “Covenant clearly demonstrates a commitment to quality patient care,” said Lawrence Haspel, DO Chairman of the Bureau of Healthcare Facilities Accreditation for HFAP. “We base our decision on federal standards, as well as, recognized national standards for patient safety, quality improvement and environmental safety. Covenant met or exceeded the standards in every case.” “It is a significant achievement that recognizes our commitment to providing extraordinary care to our patients and our community. Providing quality care is what drives us every day, and we keep it at the forefront of our work,” said Covenant Chief Transformation Officer, Michael W. Sullivan, MD MBA. “We are proud HFAP has validated the care our team provides.” New Year, Fresh Start: Free Seminars to Help Patients Quit Smoking. Quitting smoking is tough. Not quitting smoking is tougher! According to the American Cancer Society, smoking is by far the most significant causative factor for lung cancer. Smoking causes 87 percent of all lung cancer deaths among men and 70 percent of lung cancer deaths in women. The risk of developing lung cancer increases with quantity of cigarettes smoked and years of smoking. The CDC states, “Smoking is a major cause of cardiovascular disease and causes one of every three deaths from cardiovascular disease.” Smoking can also raise triglycerides, lower good cholesterol, increase plaque in blood vessels and cause them to thicken and narrow. In addition, secondhand smoke causes 34,000 early deaths among nonsmokers from coronary heart disease in the U.S. each year. 12 The Bulletin | January 2017

Quitting smoking can improve a person’s chances of survival immensely. According to the American Cancer Society (ACS), within 20 minutes of smoking that last cigarette, the body begins a series of changes that go on for years. Two weeks to three months after quitting, circulation improves and lung function increases. One year after quitting, the excess risk of heart disease is half of someone who still smokes. Five years after quitting, the risk of cancer of the mouth, throat, esophagus and bladder is cut in half. Cervical cancer risk falls to that of a nonsmoker. Stroke risk also diminishes within the first two to five years. After fifteen years, the risk of heart disease is that of nonsmokers. Have a patient who needs some support? Covenant HealthCare has informational classes three times each year that are free to the community. We can help patients make a Fresh Start! We can help set a quit date and increase a patient’s success at stopping smoking. The next classes are January 12, 2017, April 20, and September 14 from 6-8 p.m. at Covenant HealthCare, 5400 Mackinaw Road in Saginaw. For more information, call 1.866. Covenant (1.866.268.3626).

Covenant HealthCare Receives High Marks for Practices in Infant Nutrition and Care Hospital routines can help or hinder new mothers and babies while they’re learning to breastfeed. The CDC’s national survey of Maternity Practices in Infant Nutrition and Care (mPINC) is administered every two years to monitor and examine changes in practices over time at all hospitals and birth centers with registered maternity beds in the United States and Territories. Covenant HealthCare is delighted that our facility received an mPINC Total Score* of 96 out of 100. Across Michigan, the average score was 78, and the national average mPINC score was 79. continued on page 13

continued from page 12

Connie Downing, Director for Women’s & Children’s Services says, “I am incredibly proud of the team who has been working on important steps like rooming in and breastfeeding support groups for more than two decades.” In 2015, Covenant received international recognition as a Baby-Friendly Designated birth facility. Baby-Friendly USA, Inc., is the U.S. authority for the implementation of the Baby-Friendly Hospital Initiative (“BFHI”), a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). Each year, more than 3,000 babies are born at Covenant HealthCare. More than 2,000 hours of breastfeeding support training have been completed by frontline staff. Downing says, “This is yet another recognition of Covenant’s mission to provide extraordinary care to all generations. We are the only birthing facility in Saginaw County and serve as the regional center for mothers and babies in our immediate region and for some as far away as Sault St. Marie. I feel great pride and affection for the team who worked so diligently to ensure our moms and babies are supported and educated in their health care.”

*About mPINC: In October 2003, the CDC convened an expert panel of researchers with specific experience in surveillance and monitoring of hospital practices related to breastfeeding. At the time, no system in the U.S. collected nationally representative data on these practices. The Expert Panel’s recommendation was to establish an ongoing, national system to monitor and evaluate hospital practices related to breastfeeding among all facilities that routinely provide intrapartum care in the U.S. In 2007, the CDC administered the first national survey of maternity practices related to breastfeeding, known as the mPINC survey. It is administered every two years to every facility in the U.S. that routinely provides maternity care services, and is completed by a key informant on behalf of his or her institution in their capacity as the person most knowledgeable about the relevant practices. Details about the mPINC survey methodology, scoring, and history are at https://www.cdc.gov/breastfeeding/data/ mpinc/index.htm

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Extraordinary care for every generation. The Bulletin | January 2017 13

Pink Wave with SVSU to Honor Breast Cancer Survivors St. Mary’s of Michigan and Saginaw Valley State University Athletics are teaming up to host the 9th annual breast cancer survivor reception and recognition event on February 18, 2017, in coordination with a home basketball double header contest during the Great Lakes Intercollegiate Athletic Conference's Pink Wave week. Each year, more than 50 breast cancer survivors from the Great Lakes Bay Region attend this event on the campus of SVSU to be recognized and celebrate their journey of courage, hope and faith. Funds are raised by selling commemorative t-shirts and other promotional items with proceeds benefitting the St. Mary's of Michigan Seton Cancer Institute Breast Care Fund. The St. Mary’s of Michigan Breast Care Fund provides mammograms and follow-up ultrasounds for qualified uninsured and underinsured patients. To date, the Pink Wave event has raised more than $27,000 for hundreds of local community members in need of breast care services. For more information, contact the SVSU Athletics Department Community Engagement programs at 989-9642565. Gastric Cancer Symposium - January 14 “Updates in multidisciplinary management of gastroesophageal cancer patients” will be held Saturday, January 14, 2017, from 7 a.m. to 4 p.m. at the Somerset Inn in Troy. This symposium, presented by the Jerome F. Williams Gastric Cancer program of St. John Providence, is for physicians, clinicians and other healthcare providers who care for patients with gastroesophageal cancers. Check out the brochure for detailed information and the registration form. Deadline to register is January 6. You can register by mail or fax (see brochure) or call 1-866-501- DOCS (3627) and dial option 3. Cost is $75 and includes breakfast, lunch and registration materials.

Foundation’s Light Up A Life Raises Over $13,500 Each holiday season, St. Mary’s of Michigan Foundation’s Light Up A Life campaign gives individuals the opportunity to make a gift in memory of a loved one or in honor of a special person by purchasing a lighted tree, ornament or white light. This year, the Foundation had 122 individuals and eight corporate sponsors participate in the program, grossing $13,560 in proceeds. Proceeds from the 2016 Light Up A Life campaign will be used to support the purchase of a new digital breast tomosynthesis mammography system. The annual Light Up A Life Remembrance Reception was held on December 13 in the hospital’s Health Education Center lobby. Guests enjoyed a short remembrance service, refreshments and holiday entertainment. The light display is also part of the City of Saginaw’s light tour. Special Thanks to the 2016 Light Up A Life Corporate Sponsors: Kelly & James Fabiano, II Glastender, Inc. The Iles Group - Merrill Lynch Looby Baumgarten, P.C. Michigan Blood Primary Home Care Remer Plumbing, Heating & Air Conditioning SignTec

ATTENTION RETIRED MEMBERS! Retired physicians meet for lunch every Wednesday at 12 noon at IHOP, 2255 Tittabawassee Road in Saginaw. Those attending are responsible for their own lunch, and the informal gathering lasts about an hour. Join your retired colleagues whenever you like! If you have any questions, please contact Joan Cramer at the SCMS office at 790-3590 or by email at jmcramer@sbcglobal.net. 14

The Bulletin | January 2017

St. Joseph

Lung C a ncer Scr eening Progr a m

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

Is it covered by insurance?

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

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

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

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

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

• Noninvasive, painless and only takes a few minutes.

• Low-dose computed tomography with expert radiological interpretation.

Who should get a lung screening?

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

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

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

• Asymptomatic (no signs or symptoms of lung cancer)

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

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

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

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

Where do I go for my screening?

High-risk category 2a:

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

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

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

Call now to learn about your options and to schedule your lung cancer screening. 1-866-246-4673 The Bulletin | January 2017

15

13th Annual Jingle Mingle Benefits The Mustard Seed Shelter

A huge success, with over $2,000 raised for The Mustard Seed Shelter!

The SCMS Alliance’s 13th Annual Jingle Mingle was a huge success, with over $2,000 raised for The Mustard Seed Shelter (MSS)! Many thanks to the vendors (the most there has ever been), table sponsors, participants and the Saginaw Country Club. Everyone enjoyed Christmas piano music by Norma Roenicke, and shopping for those special and unique gifts. A delicious luncheon was provided by the Saginaw Country Club and vendor gifts, along with Poinsettias, were given away in prize drawings. Special thanks to Amy Bartels-Roe, Director of MSS, who spoke on the services they offer, their success stories, and the need for financial support to continue their mission. MSS is a homeless shelter for single women and women with children. Founded in 1995 by Sr. Leona Sullivan, MSS is open 24 hours a day, seven days a week, and is funded solely by individual donors, businesses, churches and foundation grants. Women stay at MSS from three to six months on average. During their time at MSS, staff and volunteers assist them with

Highlights from th 13 Annual Jingle Mingle Top Right to Left: Sr. Leona Sullivan and Amy Bartels-Roe of The Mustard Seed Shelter Mustard Seed Shelter information display Bottom: Just a few of our many great vendors!

putting together the pieces from their lives that have fallen apart. MSS begins with the basics such as helping them obtain all their identification, then work with each woman to set goals that will help her get out of the crisis situation. Some services include: • Recovery support groups • Individual counseling sessions • Random drug screening • Life skills support group • Parenting skills • Safe, supportive home environment MSS is the perfect place for you to support a woman with children, as she works to move from homelessness to self-sufficiency. Here is what you can do: • Pray for an end to homelessness and violence • Donate money • Volunteer • Donate a vehicle to be used by the shelter (they are in need of vehicles at this time) • Donate used or new computers so residents can attend college online Please visit MSS if you would like to donate or volunteer your time.

MARK YOUR CALENDAR NOW to attend the 14th Annual Jingle Mingle on Monday, December 4, 2017!

continued on page 18

Top: MSMSA and SCMSA officers Right: Anne deBari visits a vendor Left: President Tina LaFleur welcomes all

The Bulletin | January 2017 17

continued from page 17

Great displays from our many vendors!

The SCMS would like to give special thanks to the following: Table Sponsors Ronald C. Barry, MD Dr. George & Janie Gugino Dr. Andrew & Tina LaFleur Dr. James & Debra LaFleur Dr. Mark & Suzette Ludka Vendors Airbeads – Sharon Wright Andrea’s Closet – Andrea Ferris Bear Grass Leather – Vicky Barckholtz Creations by Jeanne – Jeanne Hammond Custom Caramel Corn – Denise Siler Discovery Toys – Shirley Bitters LuLaRoe – Rachel Connolly Matilda Jane Clothing – Jamie Montei-Whalen Omani – Jessica Hill Outsider Art Jewelry – Cherie Davila Puppy Paw Creations – Jim Mercer Purple Frog – Trish Boersma Saginaw Art Museum – Emily Korn Sweet Peach Baby Boutique – Katy Bauer Timeless Treasure Flatware – Connie Glasslee Touchstone Crystal – Ann Pieschke Trades of Hope – Justine Marlette Usborne Books – Sonja Cissell “Wool-agins” - Judith Neiderstadt & Lana Wenzel WW Farms – Trish Wesener Alliance Board Members Tina LaFleur – President Colleen Cheney – Treasurer Janie Gugino – Past President Amanda Tucker – Secretary Jennifer Rogers – Board Member Anne deBari – Board Member

18 The Bulletin | December 2016

Cleveland Clinic’s Approach to Burnout Focuses on Relationships You can try, but it’s not easy to find a physician who wants to add another commitment to an already busy schedule. At the Cleveland Clinic, a one-time training session in relationship-centered communication skills improved patient satisfaction scores, physician empathy and self-efficacy, and reduced physician burnout through three simple phases. The training, “Relationship: Establishment, Development and Engagement” (REDE), took place over one eight-hour session, comprised of interactive didactics, live or video skill demonstrations and group practice sessions. More than 1,500 of the 3,220 physicians at the Cleveland Clinic participated in REDE, offered by the health system’s Center for Excellence in Healthcare Communication. Before taking the course, only 20 percent of physicians “strongly agreed” that it would be a valuable use of their time. But after completing the course, 58 percent “strongly agreed” that it was valuable to their daily practice. Read more at AMA Wire®.

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The Bulletin | January 2017 19

FEBRUARY BIRTHDAYS Ibrahim H. Abou Daya MD 2/4 Farhan Ansari MD 2/1 George F. Ascherl, Jr. MD 2/7 Walter C. Averill, III MD 2/8 Shafia Beg MD 2/9 Anirudha Bhandiwad MD 2/21 Peter Bistolarides MD 2/10 Dennis A. Boysen MD 2/10 Timothy K. Brown MD 2/14 Donato M. Cabrera MD 2/28 Thomas J. Campana MD 2/17 Scott E. Cheney MD 2/23 John F. Collins MD 2/23 Kathleen M. Cowling DO 2/29 Fred C. Dunham MD 2/27 Jack J. Ferlinz MD 2/18 Anu R. Gollapudi MD 2/13 Angela K. Gregory MD 2/4 Smitha Gudipati MD 2/27 Richard P. Heuschele MD 2/28 Johnathan Todd Howard DMD 2/4

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

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Healthway Compounding Pharmacy 2544 McLeod Dr. N. | Saginaw, MI 48604 | 989.791.1691 | www.healthwayrx.com 20 The Bulletin | January 2017

SOUP KITCHEN VOLUNTEERS NEEDED THURSDAY, MARCH 30, 2017 - TIME TO SIGN UP! The Saginaw County Medical Society will again volunteer at the Soup Kitchen on Thursday, March 30, 2017, from 9:30 a.m. to 12:30 p.m. in celebration of Doctors’ Day. The Soup Kitchen is located in the Hunger Solution Center, 940 East Genesee in Saginaw (corner of Janes Street). In November, our members, their families and staff prepped food for another day, and prepared and served lunch to 236 people. Please consider donating your time on Thursday, March 30, 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 Other time

a.m. to

a.m./p.m.

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

Name Phone Email PLEASE PRINT

(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 mail to 350 St. Andrews Road, Suite 242, Saginaw, Michigan 48638. Thank you!

www.evergreenpt.org www.evergreenpt.org

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

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The Bulletin | January 2017 21

Michigan Legislature's Lame Duck Session Ends The Michigan Legislature's lame duck session ended December 14, and the Michigan State Medical Society (MSMS) is still analyzing the effects over the past three weeks. More details will be shared over the next few days, please watch MSMS.org and your email for further information and updates. There are, however, some immediate highlights we wanted to share with you: 1. SB 1019: Your calls, emails and social media posts to your lawmakers worked! Senate Bill 1019, a bill that would remove the state's common sense requirement that a physician supervise anesthesia procedures in Michigan, has been stopped. MSMS strongly opposed and never deviated from its integrity and commitment to medicine. 2. HB 1104: MSMS supported legislation that addressed the Court of Appeals decision that allowed the collection of windfall payments stemming from awarding the plaintiff the amount charged by the hospital, as opposed to, the amount required to settle the debt to the hospital paid by the insurer. House Bill 1104 passed and will now head to the Governor’s desk to be signed into law.

3. Auto No-Fault: For a detailed report on this please reference Gongwer's article, titled Hospitals Pull Stunner On Auto Insurance; Energy In Doubt. MSMS will continue to work with lawmakers to ensure that we help pass sound health policy for patients and the medical profession based on goals outlined in the MSMS Legislative Agenda. For more information about MSMS legislative advocacy efforts, contact Colin Ford cford@msms.org at (517) 336-5737 or visit MSMS Engage.

MSMS's Legislative Priorities 1. Insurance and Regulatory Advocacy o Support mental health parity o Advocate for adequately sized physician networks o Regulate narrow networks o Appropriate access to telemedicine o Advocate regulation of silent PPO/rental networks o Reduce unnecessary administrative costs: i. Streamlined credentialing ii. Streamlined claims processing iii. Reducing benefit variability

continued on page 23

• Professional liability • Employment practices liability • Directors & officers liability • Contingency excess liability • Own occupation disability • Group health benefits • Key person life • Umbrella policies business | benefits | home & auto | sbuins.com 22

The Bulletin | January 2017

continued from page 22

o

2. 3. 4. 5.

Oppose attempts to legislatively mandate pay-for-performance o Oppose legislative attempts to weaken Michigan’s automobile no-fault insurance laws o Seek repeal of the Certificate of Need o Oppose ownership of medical practices by non-physician corporate interests o Ensure regulatory changes to individual health insurance markets are appropriate and fair to physicians and consumers o Support policies to minimize "bad debt" to physician practices Public Health and Prevention o Restore Michigan's helmet law o Support vaccine availability o Support wellness incentives o Appropriate access to pain medication/ reduce prescription drug diversion o Reduce childhood environmental hazards o Support efforts to reduce unintended pregnancies o Support school-based nutrition and exercise standards Professional Liability o Preserve existing tort reforms o Advocate for higher negligence thresholds in medical liability cases o Eliminate the lost opportunity doctrine o Restore legislative intent of tort reforms related to meaningful caps on non-economic damages o Restore legislative intent of tort reforms related to court rules and procedures to level the playing field for physicians o Seek pilot projects of medical courts and other non-judicial alternatives to the tort system o Advocate liability relief for legislatively mandated standards of practice Physician Supply and Training o Increase Graduate Medical Education funding at state level o Minimize burden of medical school debt o Support for a Physician Primary Care Scholarship program Medicaid o Seek funding parity with Medicare o Oppose taxes that are limited only to physicians o Seek funding sources that are fair and sustainable

o o

Support Medicaid Expansion Tax credits for physicians to encourage participation with Medicaid o Ensure access to primary care physicians and sub-specialty physicians 6. Insurance Contracting Reform o Limit retroactive audit timeframes o Support adequate disclosure of fee screens o Limit extrapolation of penalties during audits o Reform copay requirements o Support "for-cause" termination o Support non-discrimination of qualified physicians o Prohibit "all products" clauses o Create a reasonable definition of "covered services" o Advocate standards for amending contracts o Support payment accountability 7. Scope of Practice o Support education over legislation as the means of increasing scope of practice o Oppose independent prescriptive authority by non-physicians o Oppose surgical privileges for non-physicians o Oppose direct access to physical therapy o Support the physician-led team based approach to health care o Support patient right-to-know/health professional credentials disclosure For more information about MSMS legislative advocacy, contact Colin Ford cford@msms.org.

Michigan State Loan Repayment Program Application Period Starts February 1 The Michigan State Loan Repayment Program assists employers in the recruitment and retention of medical, dental and mental healthcare providers who continue to demonstrate their commitment to building long-term primary care practices in underserved communities designated as Health Professional Shortage Areas. MSLRP will assist those selected by providing up to $200,000 in tax-free funds to repay their educational debt over a period of up to eight years. READ MORE Watch for the Signs: Screen All Patients for Suicidal Thoughts Suicide is now the 10th leading cause of death in the United States. Most people who commit suicide received healthcare services in the year prior to death, usually for reasons other than mental health issues or suicidal thoughts. It’s a strong reminder that any patient can be at risk for suicide. A consistent and formal screening process, plus a response plan, will protect both the patient and the physician. READ MORE The Bulletin | January 2017 23

MEMBER NEWS Covenant HealthCare Honors Physicians

The following SCMS members are serving as Covenant Medical Staff Officers for 2017-18: Chief of Staff: Michael L. Fiore MD Vice Chief of Staff: Sarosh Anwar MD Secretary/Treasurer: Kathleen M. Cowling DO Past Chief of Staff: James R. Hines MD

John B. Johnson MD

Caroline G.M. Scott MD

Manuel M. Perea MD

John B. Johnson MD, retired Family Physician, was awarded the honor of Distinguished Physician of the Year by Covenant HealthCare during the December Active Staff Annual Dinner Meeting. Michael J. Slavin, MD spoke regarding Dr. Johnson’s 36 years of dedication, service and contribution in the medical profession, and presented him with his award. In addition, Caroline G.M. Scott MD, retired Family Physician and Manuel M. Perea MD, retired General Surgeon, were presented with Emeritus recognition. Congratulations, Drs. Johnson, Scott and Perea! SCMS Members Serve as Covenant HealthCare Medical Staff Officers

Michael L. Fiore MD

Sarosh Anwar MD

Kathleen M. Cowling DO

Member-At-Large: Manoj Sharma MD Maternal/Family Care Department Chairman: John B. Llewelyn MD Family Medicine Section Chief: Jorge M. Plasencia MD Pediatrics Section Chief: Thomas M. Burkey MD OB/GYN Section Chief: John B. Llewelyn MD Medicine Department Cardiology Section Chief: Vipin Khetarpal MD Surgery Department Chairman: Todd G. Richardson MD Orthopaedic Section Chief: Colleen A. Linehan MD General Surgery Section Chief: Elizabeth A. Paulus MD Clinical Services Department Chairman: Iris A. Marteja MD Emergency Medicine Section Chief: Matthew D. Deibel MD Radiology Section Chief: Sanjay J. Talati, MD Hospital Medicine Section Chief: Iris A. Marteja MD

James R. Hines MD

Office of Continuing Medical Education

Semi-Annual Survey of CME Program The Office of Continuing Medical Education (OCME) conducts an annual (or semi-annual) survey seeking input and feedback from learners who have attended accredited CME activities over the past year. The survey linked below consists of three questions and should only take a few minutes. We respectfully request and invite your participation in our 2016 survey as your suggestions, opinions and feedback provide invaluable information and data to assist us in analyzing the effectiveness of our overall continuing medical education program and to better meet your needs. All responses are completely anonymous. Please click the link below to start the survey. Thank you. https://www.surveymonkey.com/r/CMUCOM2016

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The Bulletin | January 2017

Office of Continuing Medical Education To view the January CME Calendar, visit www.SaginawCountyMS.com and click on the CMU College of Medicine – CME tab or click HERE. Please follow the CME “live calendar” located on the CMU website for the most current up-to-date event information (cancellations, rescheduling, etc.). Automated CME Evaluation and Certificate now available. Click HERE for information.

DEA Reverses Announced Change to Registration Renewal Process We recently alerted the Federation to a notice from the Drug Enforcement Administration (DEA) that effective January 1, 2017, the DEA was changing its long-standing policy of allowing a grace period for registrants who failed to file a timely renewal application. On December 20, 2016, the DEA reversed its decision and posted a notice that it is retaining its current policy and procedures, with one minor change, regarding registration renewals. REVISED ANNOUNCEMENT REGARDING RENEWAL APPLICATIONS Starting January 2017, DEA will no longer send its second renewal notification by mail. Instead, an electronic reminder to renew will be sent to the email address associated with the DEA registration. At this time, DEA will otherwise retain its current policy and procedures with respect to renewal and reinstatement of registration. This policy is as follows: • If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application. • DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. If the registration is not renewed within that calendar month, an application for a new DEA registration will be required. • Regardless of whether a registration is reinstated within the calendar month after expiration, federal law prohibits the handling of controlled substances or List 1 chemicals for any period of time under an expired registration. So, the good news is that registration numbers will not automatically be retired if renewal applications are filed within the one-month grace period after the expiration date.

However, there are a few issues that need clarification from the DEA, including whether the filing of a renewal application during the one-month grace period automatically reinstates the registration number or whether DEA must adjudicate the renewal application before the number becomes valid. It also is not clear whether a registration number remains valid if the registrant files a renewal application during the grace period and DEA fails to adjudicate the application before the end of the month. The AMA will be following up with DEA staff on these issues and will update the Federation accordingly. If you want to check your registration expiration date, please contact the DEA Registration Service Center at 1-800882-9539 or email DEA.Registration.Help@usdoj.gov and include your DEA Registration number in your email. For questions about this alert, please contact Debra Cohn, Senior Washington Counsel, at (202) 789-7423 or debra.cohn@amaassn.org. Terri Marchiori, Director, Federation Relations

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

“Attention to detail since 1980.” The Bulletin | January 2017 25

Peer Review Ethics Committee The Saginaw County Medical Society has a Peer Review Ethics Committee (“Committee”) which is comprised of Waheed Akbar, MD – Chair, Caroline G.M. Scott, MD and James R. Hines, MD. Members of the Committee are elected by the membership. The following is the definition of the Committee pursuant to Chapter IX Conduct and Discipline of Members of the SCMS Bylaws: Section 5. PEER REVIEW ETHICS COMMITTEE. This Society shall have a standing committee designated the Peer Review Ethics Committee, charged with duties and powers concerning the maintenance of standards of conduct

and discipline of members including the duties and powers specifically set forth in this chapter. Whenever any matter of alleged misconduct is referred to the Peer Review Ethics Committee, such Committee shall have the right to conduct investigations and hearings thereon, both informal and formal, and to make findings of fact and recommendations for discipline. If you need to refer a matter to the Committee, please contact Drs. Akbar, Scott or Hines, or Joan Cramer at the Saginaw County Medical Society office. All matters are confidential and are not to be disclosed to the Board or membership.

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

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

TO MAKE A REFERRAL OR SELF REPORT, CALL 1-800-453-3784 SCMS Physician Health & Well-Being Committee Confidential assistance to physician members with personal issues affecting their private and professional lives The SCMS Physician Health & Well-Being Committee is a CONFIDENTIAL resource for SCMS members who have issues affecting their private and/or professional lives. The Committee acts totally independently, and NO INFORMATION is shared with the SCMS Board, members or staff. If you are in need of confidential assistance, or know of another member who is having a difficult time, please contact Dr. Kaushik Raval, Chair of the Committee, at (989) 790-7742. If he is not available, leave a message and he will return your call.

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The Bulletin | January 2017

APPLICATIONS FOR MEMBERSHIP Below are Applications for Membership that may be recommended for acceptance at the Tuesday, January 17, 2017, Board Meeting. Please contact Joan Cramer at jmcramer@sbcglobal.net or 790-3590 if you have any questions or would like more information on the applicants. Syed K. Alam, MD (Covenant HealthCare) Primary: Anesthesiology, Board Certified 2008 Dow Medical College, University of Karachi, Pakistan, 1991 Sponsored by Drs. Waheed Akbar and Danielle C. Duncan

Joy A. Hart, MD (Valley Ob-Gyn Clinic, PC) Primary: Ob/Gyn, Board Certified 1997 Ohio State University School of Medicine, 1989 Sponsored by Drs. James R. Hines and Julia M. Walter

Sue C. Tobin, DO (Covenant Cancer Care Physician Group) Primary: Internal Medicine, Board Certified 2012 Secondary: Medical Oncology, Board Certified 2014 Michigan State University College of Osteopathic Medicine, 1998 Sponsored by Drs. Binu Malhotra and Carlotta M. Maresca Joseph R. Yacisen, DO (Sports Orthopedic Specialist) Primary: Surgery – Orthopaedic, Board Certified Secondary: Surgery - Sports Medicine Nova Southeastern University, Davie, FL, 1994 Sponsored by Drs. Kenneth W. Distler and Michael J. Tucker, Jr.

UPDATE YOUR INFORMATION FOR THE 2017 DIRECTORY If you have had a change in group, office address, phone, fax or email in the past year, please contact Joan at the SCMS at jmcramer@sbcglobal.net so your updated information can be included in the 2017 Membership Directory.

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The Bulletin | January 2017 27

Five Ways to Recognize Patient Cues, Understand Needs AMA Wire® 9/18/2016 When physicians show true empathy while listening to their patients in the exam room, patients and their families are often more satisfied and more open to adopting their advice—and it builds a much stronger patient-physician relationship. Though it seems simple, empathetic listening requires understanding how to recognize the cues that patients offer. Practicing empathy can save time and help physicians navigate difficult situations that arise in practice. It can also forge deeper connections with patients that lead to greater professional satisfaction and joy in work for physicians. Listening with empathy, recognizing cues Highly charged situations may arise in practice, and those are the ideal times to use empathetic listening. A new module from the AMA’s STEPS Forward™ collection of practice improvement strategies can help you become a better listener and get to the heart of your patients’ needs. Once you have decided that connecting with empathy is the best way to approach the patient, follow these steps to improve that skill: • Honor the first “golden moments.” The first few minutes of a clinical encounter are precious. There are many tasks that need to be completed during the visit—questions to ask, problems to analyze and solve— and you may feel pressured to dive right in. But if you leap into these tasks without listening first, you may miss key information. Set aside charts, computers, phones, alarms and pagers that may be distractions so that you can give your full attention to the patient and find the golden moments that reveal the patients true concerns or symptoms. Use subtle body language cues to convey that you are listening intently. You can start by sitting so that you are near to and facing the patient. Lean toward them and make eye contact. It is important to make sure your arms are not crossed—this can signal to the patient that you are closed off and not really listening. • Listen for underlying feelings. Sometimes a patient’s feelings are on the surface, but other times they are hidden. A patient may bring up an emotional situation briefly and wait for the physician’s cue that it is okay to continue. Watch for feelings hidden in body language, facial expressions or other non-verbal cues and allow the patient to elaborate. • Listen for underlying needs or values. Deep empathetic listening means being attuned to the underlying value or need that the emotion the patient

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The Bulletin | January 2017

is expressing is pointing to—for example, safety or security, honesty or integrity, autonomy or control, meaning or purpose, among many others. • Remain present. Become comfortable with silence. Non-verbal body language such as an open and comfortable stance, eye contact, nodding your head or murmuring simple responses like “uh huh” or “oh” can show that you are listening without interjecting. Give the patient an opportunity to express feelings to completion. Their feelings and values will surface if they are given ample time to express themselves in a welcoming environment. Focus on the moments when the patient seems to display the most energy— more rapid speech, a change in facial expressions or more pronounced gestures. These signs can provide the clues to what the patient values most. • Look for cues that the patient has finished. These cues might be a decrease in emotional intensity, a deep sigh or a shift in the focus of the conversation. At this point, it is natural to move to another stage of the communication process—either expressing yourself, attempting to solve a problem together or attending to the medical care needed. No one expects that you listen in this manner to all of your patients or coworkers all of the time. If you are new to empathetic listening, make it a goal to apply it with one person a day to learn how the process works best for you. Increasing administrative responsibilities due to regulatory pressures and evolving payment and care delivery models reduce the amount of time physicians spend delivering direct patient care. Training yourself to recognize emotional and body-language cues can help you defuse situations where a patient is dissatisfied or struggling to express themselves in a clear way. Check out the module for a more in-depth look at how the process of empathetic listening can improve your relationships with patients. There are seven new modules now available from the AMA’s STEPS Forward collection, bringing the total number of practice improvement strategies to 42, thanks to a grant from and collaboration with the Transforming Clinical Practices Initiative. By AMA staff writer Troy Parks

E N I L D A E D D! E D EN T X E

2017 Saginaw County Medical Society Physician Directory

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The 2017 Physician Directory is produced by the Saginaw County Medical Society To reserve a page for your company or physician, please call Joan Cramer at 989.790.3590 or email jmcramer@sbcglobal.net Space and Copy Deadline is Monday, January 23, at 5 p.m. To submit fully finished ads, please provide press quality pdf files with all fonts embedded. All ads submitted should be 300 dpi at 100% for best printing. All files should be CMYK color. If you need your ad designed, please provide ad copy in Word or Text format and art and logos as jpeg or eps files.

Attention all Physicians, Group Practices and Medical Partners Promote your company, office and/or group practice with an advertisement in the 2017 Saginaw County Medical Society Physician Directory. Join the many other medical suppliers and vendors and take advantage of this unique opportunity to promote your practice, group or medical company in this widely used, easy reference resource. There will be two separate versions of this conveniently sized Directory distributed in early 2017. The Private Physician version will be distributed to members’ offices, and the Public Directory will be marketed and delivered directly into the hands of the public at the Annual Health Fair, events and expos throughout the year. A limited number of additional copies will be available at the Saginaw County Medical Society office and available electronically for download at www.SaginawCountyMS.com under the Pictorial Membership Directory tab. Ad Position Back Page Inside Front/Pg. 2 Page 3 Inside Back Page 4, 5 or 7 Center Spread Full Page Half Page Quarter Page

Full Color $1,800 $1,700 $1,700 $1,700 $1,700 $2,900 $1,600 $905 $490

Actual Size 6.25” wide x 9.62” high 6.25” wide x 9.62” high 6.25” wide x 9.62” high 6.25” wide x 9.62” high 6.25” wide x 9.62” high 2 center pgs - 13” wide x 9.62” high 6.25” wide x 9.62” high 6.25” wide x 4.75” high or 3” wide x 9.625” high 6.25” wide x 2.37” high or 3” wide x 4.75” high

Price includes both Physician and Public versions. All ad design services are at no additional cost.

The Bulletin | January 2017 29

How to Write Resolutions to the MSMS House of Delegates Do you have an issue you would like considered by the Michigan State Medical Society at the 152nd Annual House of Delegates in 2017? The House of Delegates (HOD) is the official policymaking body of the Michigan State Medical Society (MSMS). Resolutions and Board Action Reports are the vehicles used to debate and determine the policies, priorities and direction of MSMS during the ensuing 12 months and beyond. Therefore, a well-crafted resolution is essential in order to present the most effective case for those issues that are of importance and concern to you. Resolutions are presented to the MSMS HOD by voting delegates on behalf of their county delegation, specialty society, ethnic medical society, MSMS membership section or as individual delegates. In order to be considered as regular business of the House of Delegates, resolutions must be submitted to the SCMS by 5 p.m. on Monday, February 20, 2017. Once received, SCMS staff will put the resolution in the proper format and submit to MSMS for review and comparison to existing MSMS and AMA policy, legal considerations and appropriate editing. Resolutions are then assigned numbers and referred to one of the six House reference committees or placed on the “Reaffirmation Calendar.”

Note: Pursuant to adopted HOD Resolution 65-14, any resolutions “submitted to the MSMS House of Delegates that require action by the AMA may only be submitted by MSMS members that are also members of the AMA.” Please contact Joan Cramer at jmcramer@sbcglobal.net or 790-3590 for more information.

ADVERTISER INDEX When you have a need for a service, please consider our dedicated advertisers first! Advanced Diagnostic Imaging, P.C. Covenant HealthCare Covenant Wound Healing Center Evergreen Physical Therapy Jan Hauck – Century 21 Healthway Compounding Pharmacy Heiden Technology Solutions 30

The Bulletin | January 2017

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SCMS FOUNDATION Make a Tax Deductible SCMS FOUNDATION GiftMake Today! a Tax Deductible* Gift Today!

The Saginaw County Medical Society Foundation provides funding through low interest loans, grants and scholarships to medical students with ties to the Saginaw community, in anticipation these new physicians will stay in Saginaw to practice medicine once they complete their training. The Foundation also assists the SCMS Alliance in providing scholarships to nursing students from Saginaw County. The annual Golf Outing raises approximately $20,000 per year for these programs, but the Foundation also relies on donations to continue and increase funding programs in order to assist as many students as possible.

! If you would like to honor a colleague who is living or deceased, please make a contribution to the SCMS Foundation ! Please remember the SCMS Foundation in your Will *The Saginaw County Medical Society Foundation is a 501(c)(3) nonprofit. Gifts have charitable tax benefits so please consult with your tax advisor for specifics. A tax receipt will be provided. PLEASE COMPLETE AND RETURN THE FOLLOWING WITH YOUR CHECK (We are unable to accept credit card payments) ! ------------------------------------------------------------------------------------------------------------------------! Enclosed is my contribution made payable to the SCMS Foundation (please designate amount): " $1,000

" $500

" $250

" $100

" $50

" Other __________

Donor’s Name ______________________________________________________________ Mailing Address _____________________________________________________________ City, State, Zip ______________________________________________________________ Daytime Phone (_____) ________________ Email _________________________________ #### If you wish to make your gift as a memorial or tribute, please provide the following: My gift is:

" in honor of

" in memory of

Occasion/Person to be honored: _________________________________________ " Please send notice of my gift (without specifying amount) to: Name _____________________________________________________________________ Address ___________________________________________________________________ City, State, Zip ______________________________________________________________ Checks should be made payable to the SCMS Foundation and sent to the SCMS office at 350 St. Andrews Road, Suite 242, Saginaw, Michigan 48638-5988. Thank you! The Bulletin | January 2017 31

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

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

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2016-2017 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.

SCMS CALENDAR OF EVENTS FOR 2017 Please mark your calendar for the following meetings and events for 2017. You will receive an email meeting notice and reminder each month. Tuesday, January 17, 2017 Horizons Conference Center – SCMS Board meets at 5:30 p.m. Membership Meeting follows at 6:30 p.m. (cash bar), with dinner and program at 7 p.m. Program: “MACRA: The Big Picture.” Speaker: Stacey Hettiger, Director, Medical and Regulatory Policy of MSMS. Cost: Members, one staff person from members’ office and medical students – no cost. Additional member office staff - $40 per person. Non-member physicians - $100. All others - $60 per person. RESERVATIONS ARE REQUIRED. Those who make a reservation and do not attend will be charged a $40 cancellation fee. See p. 5 to register. Statement of Accreditation: The Michigan State Medical Society (MSMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. AMA Credit Designation Statement: The Michigan State Medical Society designates this live activity for a maximum of 1 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Tuesday, March 21, 2017 SCMS Board meets at 5:30 p.m. at the CMU College of Medicine Education Building, 1632 Stone Street, Saginaw in Room 1016. There is no membership meeting in March. Thursday, March 30, 2017 SCMS serves at the East Side Soup Kitchen in honor of Doctors’ Day from 9:30 a.m. to 12:30 p.m. See p. 21 to sign up. Tuesday, April 18, 2017 Horizons Conference Center - SCMS Board meets at 5:30 p.m. Membership Meeting follows with Social at 6:30 p.m. (cash bar), followed by dinner and program at 7 p.m. Program: Michigan Health Information Network Shared Services MiHIN Overview Speaker: Rick Wilkening, Director of Major Accounts and Emerging Solutions. Non-member physicians - $100. All others - $60 per person. RESERVATIONS ARE REQUIRED. Those who make a reservation and do not attend will be charged a $40 cancellation fee. Saturday-Sunday, May 6-7, 2017 152nd Annual MSMS House of Delegates at the Amway Grand Plaza in Grand Rapids, Michigan. Delegates and Alternates, please mark your calendar now to attend.

Tuesday, February 21, 2017 SCMS Board meets at 5:30 p.m. at the CMU College of Medicine Education Building, 1632 Stone Street, Saginaw in Room 1016. There is no membership meeting in February.

Tuesday, May 16, 2017 Horizons Conference Center - SCMS Board meets at 5:30 p.m. prior to the Annual Membership Meeting with Social at 6:30 p.m. (cash bar), followed by meeting and program at 7 p.m. Program: TBD.

Saturday, March 18, 2017 13th Annual SCMS Health Fair “The Doctor Is In!” at Horizons Conference Center from 9 a.m. to 1 p.m.

Saturday, June 10, 2017 8th Annual SCMS Foundation Golf Outing at the Saginaw Country Club.

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