Bulletin Saginaw County Medical Society
April 2019 | Volume 77 | No 8
Tuesday, May 21, 2019 SCMS and SCMS Foundation
Annual Meetings featuring: “Update on the CMU College of Medicine” p. 5
10th Annual SCMS Foundation Golf Outing p. 10-11
15th Annual Health Fair p. 16-21
HEART CARE The Covenant Center for the Heart is the regional leader with the most comprehensive structural heart disease program in the Great Lakes Bay Region, with breakthrough cardiovascular diagnostics and treatment. That is one reason we have been the area’s heart care leader for over a decade. Our board-certified cardiologists and heart surgeons offer world-class capabilities in: • Transcatheter aortic valve replacement (TAVR) • Transcatheter mitral valve-in-valve implantation (TMViV) • Watchman procedure • Percutaneous aortic and mitral valvuloplasty • Heart valve repair/replacement surgery • Patent foramen oval (PFO) closure procedure • Atrial septal defect (ASD) closure procedure We offer hope for heart patients, close to home.
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For a convenient appointment for your patient, please call 989.583.4700. 2019 Covenant HealthCare. All rights reserved. PK 4/19 11933
Bulletin Saginaw County Medical Society
SAGINAW COUNTY MEDICAL SOCIETY 2018-2019 OFFICERS AND DIRECTORS
President Julia M. Walter, MD President-Elect Zubeda S. Khan, MD
REGISTER NOW! Tuesday, May 21 SCMS and SCMS Foundation Annual Membership Meetings including an Update on the CMU College of Medicine 5 Slate of Nominees for 2019-20 8 Proposed Bylaws Amendment
10th Annual SCMS Foundation Golf Outing – Sponsor and Register
Jorge M. Plasencia, MD
From the Editor
Kala K. Ramasamy, MD
Attention Retired Members
Mark G. Greenwell, MD
Bulletin Editor Louis L. Constan, MD
Past President Virginia R. Dedicatoria, MD Secretary Caroline G.M. Scott, MD Treasurer Mohammad Yahya Khan, MD
Wednesday, May 15, 2019 CMU College of Medicine “Thanks for Staying” Rotary Scholarships 2019 Celebration 15th Annual Health Fair SCHD Measles Outbreak Information
Board of Directors Mildred S. Willy, MD Anthony M. Zacharek, MD
Tiffany K. Kim, 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
Barb Smith SR&RN safeTALK Suicide Training
12 THRIVE 14 15
Key Provider of the Month – Ascension St. Mary’s
MSMS – Health Can’t Wait! Prior Authorization Crisis
Applications for Membership
May Birthdays CMU College of Medicine CMU Health Ascension St. Mary’s
Caduceus Meeting for Recovering Health Care Professionals
Calendar of Events
Anthony M. Zacharek, MD Jorge M. Plasencia, MD
The Bulletin can be viewed online at www.SaginawCountyMS.com under the Bulletin tab.
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
ON THE COVER: Dr. Julia Walter, Jamie Cramer Franz, Dr. Elvira Dawis and Sarah Cramer 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: firstname.lastname@example.org
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 | April 2019 3
The 2019 Health Fair By Julia M. Walter, MD
he 15th Annual SCMS Health Fair was held on Saturday, March 16, 2019. The Health Fair started in 2004 when Dr. Su Gudipati was presidentelect, and was originally held at MCVI with 24 vendors and 250 attending. When we outgrew MCVI, the Health Fair was moved to the Germania Towne and Country Club, and grew to 50 vendors and 500 attending. When the Germania closed at the end of 2010, the Health Fair was moved in 2011 to Horizons Conference Center, and has grown to 80 vendors and 900-1,000 attending. The Health Fair is provided as a service to the community, and is not intended to be a money maker, instead trying to break even. This year, as with others, the lines started about 30-60 minutes prior to the doors opening. Once the doors opened, the attendees signed in and received bags for collectibles. Many were in wheelchairs, and they all flowed smoothly in and out through the various booths. There were many collectibles, information packets, cups, drinks, snacks and the coveted SCMS
Public Membership Directory to be had throughout. While it appeared all the space was occupied from corner to corner, there was not a claustrophobic feel, but instead an openness with plenty of room to breathe. Popular screenings included cholesterol, blood pressure, glucose and depression. Mini seminars were held on Advanced Directives. Again this year, those attending were asked to consider donating non-perishable food items to benefit the East Side Soup Kitchen. The Health Department and Sheriffâ€™s Department collected unused and expired medication. Vendors also had opportunities to peruse the booths, connecting with colleagues, developing new contacts and collecting information and brochures to pass on to their patients. CMU College of Medicine/ CMU Health medical students and residents were invaluable providing blood pressure, depression and diabetic foot screenings. Delta College Nursing students and faculty helped vendors set up and tear down, staffed the registration desk and performed exit surveys. They also assisted MCVI,
Saginaw County Family Physicians and Great Lakes Bay Health with cholesterol and glucose screenings. All vendors, students, residents and volunteers were given breakfast coffee, tea and juice just off the beaten path, funded in part by Saginaw Medical Federal Credit Union. Patients had their stories to tell and enjoyed having an opportunity to share what medical conditions they were dealing with and what they had been through. Some were experiencing symptoms and wanted medical advice. Others enjoyed making the personal connections of having a conversation with their physician outside the office, sharing their genuine appreciation and fondness. Others welcomed the human touch and information of having their blood pressure, glucose and cholesterol checked. At the depression screening, one vendor commented that it was not so much the depression screening that they wanted, but the companionship of talking with someone who was interested in them and what they had to say.
There were many collectibles, information packets, cups, drinks, snacks and the coveted SCMS Public Membership Directory to be had throughout.
The Bulletin | April 2019
SCMS SLATE OF NOMINEES FOR 2019-20 The following Slate of Nominees for 2019-20 was approved by the SCMS Board of Directors on Tuesday, April 16, 2019. The Slate will be voted on by the membership at the Annual Membership Meeting on Tuesday, May 21, 2019. President
Mildred J. Willy MD
Anthony M. Zacharek MD (President in 2020-21)
Julia M. Walter MD
Caroline G.M. Scott MD
Treasurer Miriam T. Schteingart MD Board of Directors (Three year in line for presidency) Jorge M. Plasencia MD Tiffany K. Kim MD Mark G. Greenwell MD Board of Directors
(One year) Harvey K. Yee MD Elizabeth A. Paulus MD Furhut R. Janssen DO
REGISTER NOW! Tuesday, May 21, 2019 SCMS and SCMS Foundation Annual Membership Meetings
MSMS Delegates Elvira M. Dawis MD Julia M. Walter MD Mildred J. Willy MD Anthony M. Zacharek MD MSMS Alternate Delegates Caroline G.M. Scott MD Waheed Akbar MD Mohammad Yahya Khan MD Virginia R. Dedicatoria MD Steven J. Vance MD
Jorge M. Plasencia MD Christopher J. Allen MD Miriam T. Schteingart MD
Joseph P. Contino MD Kristine K. Spence DO Karensa L. Franklin MD Scott E. Cheney MD Michael W. Warren MD
Peer Review Ethics Committee James R. Hines MD Waheed Akbar MD, Chair Caroline G.M. Scott MD
NO STATE INCOME TAX
Register now for the Tuesday, May 21, 2019, SCMS and SCMS Foundation Annual Membership Meetings DATE: TIME:
Tuesday, May 21, 2019 6:30 p.m. Social (cash bar) | 7 p.m. Dinner, Annual Meetings and Program PROGRAM: Update on CMU College of Medicine SPEAKERS: Dean George E. Kikano MD Steven J. Vance MD | Mary Jo Wagner MD Samuel J. Shaheen MD PLACE: Horizons Conference Center 6200 State Street, Saginaw COST: • SCMS Members, CMU Residents and Medical Students – no cost • Physicians who are not members of the SCMS - $100 payable in advance • All others - $40 payable in advance
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The Bulletin | April 2019 5
FROM THE EDITOR
Monitor(ing) By Louis L. Constan, MD
here are days we will all remember for the rest of our lives: The day Kennedy was shot, the day men landed on the moon, the day the twin towers went down…and for physicians, the day we started using Electronic Health Records. That last one is not remembered fondly. Doctors have described EHR adoption day as being like the five stages of grief. Some doctors were sad, some angry, some tried bargaining themselves out of it, some became depressed, most finally accepted it; and unfortunately, some avoided everything by retiring prematurely. It is not overstating the situation at all to call that thing a soul-sucking screen. Patients, it now appears, did not take it all that much better. In a meta-analysis of studies of EHR use, Wei Wei Lee from the University of Chicago found that doctors spend about a third of their time in the exam room looking at the computer, instead of at the patients. It is likely the patients noticed this. Already highly sensitive to the declining time they receive from their doctors (the number one complaint of the modern patient), this sudden loss of another third dealt a body blow to the patient-physician relationship. The repercussions reverberate.
Much as we would like it to, this scourge is unlikely to go away, although there are a few things that can be done to ameliorate the situation. The best thing, for those doctors who have the resources, is to hire a scribe to handle the computer so that the physician never has to look at it or touch it. Put it in the corner and don’t go near it. I don’t know very many physicians who have the resources to do this. For most of the rest of us, here are some suggestions, some from my personal experience, and some from suggestions made in the literature that sounded good to me. Perhaps they may be helpful to you. First, consider the so-called “triangle of trust” where the physician, computer and patient make a triangle. The patient can see the computer screen and observe, at least a little bit, what the physician is doing on it. The physician, for his part, can type on the computer and still look towards or at least in the direction of the patient, maintaining a modicum of eye contact. This is preferable to turning your back completely to the patient while you look at the computer screen. Second, it’s good if the physician knows enough about the patient that he doesn’t have to look at the computer
screen immediately upon entering the exam room. He might review the record before he walks into the room, or view some sort of a printed patient summary. He can then take a ‘golden minute’ to establish rapport before starting to click away. Third, doctors should remember that, for all their mixed feelings about the computer, patients are intensely interested in what is on or in it and what the physician is doing on it. It doesn’t hurt for the physician to chat a bit about what he is entering. Further, any visuals, such as X-rays, are endlessly fascinating to patients, even though they haven’t the faintest idea what they are looking at. Think about those fetal ultrasounds that get endlessly shared on Facebook. And when patients know exactly what you are entering, they may be able to see the value of that information being readily available to another physician, such as an ED physician who may be seeing the patient later outside your office. Likewise, when you show them how their lab values can be charted by the computer over the years and trends established, they may see the value of you spending time entering that information. continued on page 7
I am told that in countries with single payors or other forms of simplified coding and reimbursement, the EHRs are much easier to handle. That may be coming. If it does, we may be ‘out of the frying pan and into the fire,’ or maybe not. It’s something to think about as we debate healthcare reform. 6
The Bulletin | April 2019
continued from page 6
We all know, of course, that one reason EHRs are so difficult is that they are built around the Byzantine reimbursement system under which we labor. I am told that in countries with single payors or other forms of simplified coding and reimbursement, the EHRs are much easier to handle. That may be coming. If it does, we may be ‘out of the frying pan and into the fire,’ or maybe not. It’s something to think about as we debate healthcare reform. For now, keep your eyes on that patient!
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 email@example.com.
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The Bulletin | April 2019 7
PROPOSED BYLAWS AMENDMENT RESIDENT REPRESENTATIVE(S) AND MEDICAL STUDENT(S) APPOINTED TO SERVE ON THE BOARD OF DIRECTORS At the Tuesday, April 16, 2019, Meeting, the SCMS Board approved the following amendment to the SCMS Bylaws in regards to appointing resident representative(s) and medical student(s) to serve on the Board of Directors. Below is Section 1 of Chapter XIV Board of Directors of the Bylaws with the amended language that was approved by the Board. These Bylaws may be amended by the affirmative vote of two-thirds of the members entitled to vote and present at any regular meeting, provided that any proposed amendment shall have been presented in writing and read at the regular meeting next preceding. The proposed amendment is being published in the April 2019 issue of The Bulletin, and will be presented to the membership for a vote at the May 21, 2019, Annual Membership Meeting. (Note: Wording to be added is shaded, and wording to be deleted appears as red strikethrough): CHAPTER XIV BOARD OF DIRECTORS Section 1. The Board of Directors shall consist of the president, president-elect, the immediate past president, the secretary, the treasurer, the editor of the Bulletin, six directors to be elected from among the membership, and three members which shall be elected from the pool of MSMS Delegates. The current president shall act as chair of the Board. The secretary of this Society shall act as secretary of the Board. The Past President will remain on the SCMS Board whether s/he retires or remains in active practice. The Board will appoint a retiree representative and a resident representative to the Board, each to serve for a one (1) year term. The Board of Directors shall have the power to appoint resident representative(s) and medical student(s) for terms to be determined at their discretion to serve on the Board. The resident representative(s) and medical student(s) shall not be subject to Section 2 of Chapter XIV herein requiring attendance at fifty percent (50%) of Board meetings, but the resident representative(s) and medical student(s) shall make every effort to attend as many meetings as possible so as to effectively represent their peers. The retiree representative, and the resident representative(s) and medical student(s) will be nonvoting members of the Board.
The Bulletin | April 2019
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Recognize that invitations for help are often overlooked
Move beyond the common tendency to miss, dismiss, and avoid suicide Apply the TALK steps: Tell, Ask, Listen, and KeepSafe
Know community resources and how to connect someone with thoughts of suicide to them for further help
Suicide Alertness For Everyone Wednesday, May 22, 2019 9:00am to 12:30pm 1632 Stone St, Saginaw 48602 Room #1008 (main floor) Questions/Concerns? Rachel Studebaker firstname.lastname@example.org Facilitated by Barb Smith, Executive Director of Suicide Resource & Response Network and certified LivingWorks instructor. 989.781.5260 Credits Available: 3.5 Social Work and 3 SCECH CEU's
Participants will receive a certificate of completion The Barb Smith Suicide Resource & Response Network would like to provide you with the opportunity to take this evidence based training at $15 per person. LivingWorks is a company specializing in suicide intervention training.
Training made possible through a grant from the Dow Charitable Foundation
Register at: give.classy.org/safeTALK The Bulletin | April 2019 9
10th Annual Golf Outing – Sponsorship Form Saturday, June 8, 2019 Saginaw Country Club 12 p.m. Registration 1 p.m. Shotgun Start The Saginaw County Medical Society (SCMS) Foundation was founded in 1968 by SCMS members, and is the charitable entity of the SCMS. The Foundation: Provides low interest loans to medical students with ties to Saginaw; Forgives loan interest if the recipient returns to Saginaw to practice after completion of their residency; Forgives 25 percent or a maximum of $5,000 loan principal per year if the recipient returns to Saginaw to practice after completion of their residency and is a dues paying member; Awards scholarships and mentors Saginaw County high school students who are interested in becoming a physician; Provides research grants and scholarships to medical students and residents through CMU CoM; and Assists the SCMS Alliance in awarding seven nursing scholarships each year. Proceeds from this event are used for the above initiatives to help ensure the future of medicine in Saginaw County. Title Sponsor - $6,000 (LIMIT OF TWO) Company name in title of Golf Outing (including banner, program, all signage, etc.) Company choice of (1) sleeve of golf balls with your company logo provided to each golfer; (2) golf towel with your logo provided to each golfer; or (3) ditty bag with your logo provided to each golfer A representative from your company will be allowed to address the golfers from the podium at the Award Reception Includes 4-person team Event Sponsor - $3,000 (LIMIT OF FIVE ) Company name in golf carts and program Company name on sign at driving range and practice putting green Recognized from the podium Includes 4-person team Golf Ball Sponsor - $1,500 (Sleeve of golf balls with your company logo provided to each golfer) Company name listed in program Scorecard/Scoreboard Sponsor - $1,500 Company name on scoreboard and individual scorecards Company name listed in program
Award Reception Sponsor - $1,000 Company name listed on sign at reception, table-tents on reception tables and in program Putting Contest Sponsor - $750 Company name on sign at tee and in program Company representative on site Lunch Sponsor - $500 Company name on sign in cookout area and in program Beverage Sponsor - $500 Company name on sign at beverage stations and in program Team Sponsor - $600 (Payment for four person golf team of your players) Company name listed in program Medical Student/Resident Team Sponsor - $600 (Payment for four person golf team of medical students/residents) Company name listed in program Longest Drive Sponsor - $500 (Men & Women) Company name on sign at tee and in program Closest to the Pin Sponsor - $500 (Men & Women) Company name on sign at tee and in program Tee/Hole Sponsor - $500 (LIMIT OF TWO PER HOLE) Company name on sign at tee and in program
We would like to be a sponsor for the 10th Annual SCMS Foundation Golf Outing, as follows: Company Name: __________________________________________________________________________ Contact Person: __________________________________________________________________________ Address: ________________________________________________________________________________ Phone: ____________________________Email: _______________________________________________ Sponsor Level: __________________________________________________________________________ RETURN FORM AND CHECK BY FRIDAY, MAY 24, 2019, TO: SCMS Foundation 350 St. Andrews Road Suite 242 Saginaw, MI 48638-5988 Questions? Contact Joan M. Cramer, SCMS Executive Director, at email@example.com or 989-790-3590 Forms are downloadable at www.SaginawCountyMS.com under the Golf Outing tab 3/24/19 6:33PM
NOTE: For income tax purposes, the following values are NOT tax deductible: Golf participant, $88 each. An IRS-compliant tax deduction receipt will be provided upon request.
10 The Bulletin | April 2019
10th Annual Golf Outing
Four Person Scramble Saturday, June 8, 2019 Saginaw Country Club 12 p.m. Registration 1 p.m. Shotgun Start
TEAM REGISTRATION FORM Please sign up the following golfers to participate in the 10th Annual SCMS Foundation Golf Outing on Saturday, June 8, 2019. Golfers may sign up as an individual, or as a four-person team. Those that sign up as individuals will be assigned to a four-person team. The charge per golfer is $150, and includes green fees, cart, practice range, cookout lunch, beverages (domestic draft beer, Coke and Pepsi products, bottled water) on the course, two drink tickets (soft drinks, draft beer, house wine) and heavy hors d’oeuvres award reception with prizes. Cash contests include 50/50 and Hit the Green. Mulligans available for purchase. REGISTRATION PRIOR TO THE GOLF OUTING IS REQUIRED! Please sign up the following golfers: GOLFER NAME
PLEASE PRINT! PHONE
1. 2. 3. 4. If team is sponsored, please indicate name of sponsor for program_______________________________ Please return form and check by Friday, May 24, 2019 ($150 Per Golfer) to: SCMS Foundation 350 St. Andrews Rd., Suite 242 Saginaw, MI 48638-5988 Call Joan Cramer at 989-790-3590 or email firstname.lastname@example.org with questions. Forms are downloadable at www.SaginawCountyMS.com under the Golf Outing tab If play is stopped because of inclement weather before five holes are completed, there will be no guest fee charged. If play is stopped between five and 13 holes, the guest fee will be the nine-hole rate. Playing 14 holes shall constitute the playing of 18 holes, and guests will be charged the full guest fee. Groups playing less than five holes will still be subject to and responsible for all other non-golfing products and services for which they contracted. The Saginaw Country Club is a spikeless facility and golf course. NOTE: For income tax purposes, $88 of the total per golfer charge is NOT tax deductible: An IRScompliant tax deduction receipt will be provided upon request. 3/24/18 6:45PM
The Bulletin | April 2019 11
The Secret Sauce By Louis L. Constan, MD
Why is it that we often overstate the disadvantages of the place where we live and understate the advantages of the places we visit? The grass is always greener. We stand in awe of Silicon Valley, the “Sunshine State,” the “Great Southwest.” Wouldn’t it be great to live there? They’ve ‘got it all’ where we’ve got ‘nothing but trouble.’ Of course, since we’re just visiting those places, we’re only seeing the good sides; living here full-time, we’re all too aware of our bad sides. Now let’s be practical. We love our town, our neighbors, our community, and surely wish it the best, especially economically. But wishing and hoping will not get us where we want to go. What will? Consider two unlikely organizations that became wildly successful without anything special in the way of location or resources. First, the New England Patriots. When Bill Belichick took over as coach, he realized that his boys could never run faster, block harder, or throw further than other teams, their egos aside. So, if he were to have a winning team, he would have to be a superb leader and organizer. This insight led him to become the most successful coach in modern football history.
Second, Henry Ford. When he decided to build cars, he realized that other manufacturers had just as skilled workers and just as modern tools so, if he were to excel, he would have to optimize the assembly line to perfection and pay his workers enough that they would accept the changes. This insight led to the biggest revolution in manufacturing the world had seen, and unprecedented prosperity for our state. Now, Bill Belichick and Henry Ford were no Harvard certified geniuses, they didn’t live in the Sunshine State or the Great Southwest, but they had insight and drive, and used these to become fantastically successful. Now, THRIVE’s insight, as mentioned last month, is that our economic progress goes hand-in-hand with the health of our communities and that BOTH need to be worked on simultaneously to assure the prosperity of our region. The only differences: The success of cities is ever so much more complicated than the success of factories and football teams, and the leadership of THRIVE is essentially spread out over dozens of different people and coordinated by a multitude of continued on page 13
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continued from page 12
entities. Now, and this is an important concept for physicians who don’t always work in large groups to get things done - large groups are actually BETTER at creating solutions to large complex problems than individuals are because of two important factors: • Groups are better at putting good ideas on the table simply because there are different people in the group from diverse backgrounds; progress depends on good ideas, and • Groups are better at ferreting out problems that might arise from erroneous concepts…bad ideas. They help the group avoid costly mistakes. And that, my friends, is the secret sauce to our success. Leaders in the medical community and the business community, the best minds in our area, by using ‘big data,’ computer algorithms, visionary planning meetings, and input from every conceivable community group, identify our five most critical priorities coupled with 34 interventions, a detailed portfolio to lead us to success. Health. A healthier
economy. Voila! Success, I can see it! Yes, it’s real. Yes, it’s happening. And we, as a Medical Society, are part of it. And we, as a Medical Society, will step up and do our part. But in contrast to previous community improvement efforts, we will not do it alone. We will contribute as part of a larger effort. This column, by myself and other writers, will keep us up-to-date on that effort in the months and years to come. The Michigan Health Improvement Alliance, Inc. (MiHIA) and the Great Lakes Bay Regional Alliance (GLBRA) are collaborating to co-lead the THRIVE initiative to bring high-value impact and benefit to our community citizens, and other regional organizations and institutions. Due to the unique work and transformative nature of our mission, and the full engagement of sectors for support, THRIVE has caught the attention of national and state thought leaders, and established foundations as we build our region into one of health excellence and sustained economic growth.
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The Bulletin | April 2019 13
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The Bulletin | April 2019
The Prior Authorization Crisis by the Numbers
“Thanks For Staying”
Rotary Scholarships 2019 Celebration Event Sponsored by the Rotary Clubs of Mid-Michigan
According to the most recent data: • 73 percent of Michigan physicians report that prior authorization requirements force their patients to wait at least one business day before getting the treatment they need. • 38 percent of Michigan physicians report that prior authorization red tape forces patients to wait three or more days before getting the medicine or treatment they need. • 94 percent of Michigan physicians report that prior authorization red tape causes delays in care for their patients. • 97.5 percent of all first-time prior authorization requests are eventually approved. In other words, insurers are delaying patients’ access to care for essentially no reason. • Prior authorization red tape is part of a staggering 92 percent of all care delays.
Wednesday, May 15, 2019 5:30 p.m. to 7:30 p.m. CMU College of Medicine, 1632 Stone St, Saginaw, Michigan Tickets available at the door for $25
www.thanksforstaying.org For questions contact Carolyn Yordy at firstname.lastname@example.org or 989-774-7871
• 78 percent of physicians trace prescription and treatment non-adherence to prior authorization delays. Health Can’t Wait. Fix Prior Authorization and Step Therapy. The SCMS and MSMS will be hosting a round table for area lawmakers this summer. Please contact the SCMS at jmcramer@ sbcglobal.net if you would like to be included in the round table.
P 989.755.2116 F 989.755.2120 Let us build a relationship with you. Please call Dornbos for your printing needs!
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15th Annual Health Fair “The Doctor Is In!”
MARK YOUR CALENDAR NOW! The 16th Annual FREE Health Fair will be held on Saturday, March 14, 2020, at Horizons Conference Center from 9 a.m. to 12 p.m.!
The 15th Annual FREE Saginaw County Medical Society Health Fair “The Doctor Is In,” held on Saturday, March 16, 2019, at Horizons Conference Center in Saginaw was another success! The SCMS planned this great event in cooperation with Ascension St. Mary’s Hospital, CMU Health, Covenant HealthCare, Great Lakes Bay Health Centers, Michigan CardioVascular Institute and the Saginaw Valley Osteopathic Society. Nearly 1,000 people attended this year’s event and visited 80 vendor booths. Numerous SCMS physicians, residents and medical students participated in the event as well. During the Health Fair, vendors performed screenings for blood pressure, body mass index, cholesterol, diabetic foot exams, glaucoma, glucose, hearing, neuro assessment, spine and vision. Information was available on services ranging from allergy/asthma to wound care. The SCMS had very positive comments from vendors and participants on everything from location to the numerous screenings that were available. Many SCMS members attended the event and either answered questions at the SCMS booth, or just made themselves available for questions during the Health Fair. Both the vendors and participants commented how nice it was to have doctors available for questions. Nonperishable food items for the East Side Soup Kitchen were also collected from those attending. The Saginaw County Health Department and Sheriff’s Department collected old, unused or unwanted medications. The SCMS would like to thank CMU Health medical students and residents for their overwhelming support and assistance. In addition to diabetic foot exams and blood pressure screenings, Psychiatry students and residents offered those attending a chance to sit down and talk about how things were going in their lives and any concerns they may have. We are also thankful to the students and residents for suggestions of how we can engage more patrons in conversation next year. Dr. Bernard Noveloso and third-year family medicine resident, Dr. Preeti Gudimella offered two mini-seminars on Advanced Directives which were very popular.
SCMS 15th Annual Health
Above, Left to Right: Dr. Caroline Scott with Sara Simnitch on WNEM TV5; Drs. Mark Greenwell, Jorge Plasencia, Julia Walter, Iris Marteja and Miriam Schteingart; Delta College Nursing Student and Faculty volunteers Bottom: Angie Appold and Rachel Burk
Comments from CMU students and residents included: Preeti Gudimella MD, PGY 3 Family Medicine “The Fair provided me a unique opportunity to discuss Advanced Directives with patients and their families. I was thrilled that so many were taking a proactive interest in their health.” Sonia S. Dhaliwal MD, PGY 1 Psychiatry “At the Health Fair, CMU psychiatry residents and medical students explored preventative mental health care. We overcame taboos to provide mood disorder screening and supportive therapy. It was a unique opportunity to have meaningful conversations with people from all over central Michigan, and I had a great time getting to know my community better!” Emmanuel Avelino, M3 “A number of colleagues and I helped with the blood pressure screening table, and personally found it incredibly rewarding. Not only were we able to practice and refine our blood pressure taking skills, we were able to build such a good rapport with the members of our own community. Some came from afar, such as a number of cities and towns from the Thumb and Central/Northern Michigan. You can tell they really appreciated the time we took to hear their stories and even educate them on continuing to follow up with their primary care physicians for the betterment of their health. It’s always a pleasure to serve the needs of this community and to always uphold CMED’s mission.”
Andrew Caminata, M3 “My experience at the Health Fair was both rewarding and enlightening. I signed up to perform depression screenings for the event. When my fellow volunteers and I were asking people walking by if they would like to have a seat, we found firsthand how the stigma of mental health was a common notion. At first look of the sign ‘Depression Screening,’ many of the visitors commented phrases like, ‘Depression... oh no, not me’ and ‘Ah, I am fine.’ Though this may be true for a lot of people, it was interesting to see them write it off so quickly. In response, we took down the sign and started to ask them if they were willing to take mood surveys. This modification in approach seemed to work as we were able to screen many people from there on out. It proved to be a wonderful experience as we were able to sit down with guests of the Health Fair, learn a bit about them, and form a bond of trust even though it was a brief period of time. I would recommend the event for any student or resident in the future as it allows a closer connection with the community.” Marcello Caso, M3 “Working at the Health Fair was a rewarding experience. There was quite a crowd - I must have checked blood pressure for at least 40 or 50 people! We hope that, in some small way, we helped raise awareness about regular blood pressure checks and keeping hypertension under control.”
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Above, Left to Right: CMU medical students and residents; Drs. David Gustavison and Tony deBari of Covenant Wound Healing Center; CMU Podiatry residents and Dr. Andrew Cohen Bottom Left: MCVI Cholesterol screening
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Daniel Y. Kalabat, M3 “The Saginaw County Medical Society Health Fair was the perfect opportunity for me to engage with community members and use my education and training to give back. The people I met during the Fair made me feel great about being a medical student in the Saginaw Community. Thanks again for all your hard work!” Ashley Stantz, M3 “I greatly appreciated the opportunity to volunteer for my community and be involved in the Health Fair. Helping with the depression screenings enabled me to have many meaningful and insightful conversations with people from different backgrounds, and truly reminded me why I want to serve this type of community as a future physician. The Fair showed me how crucial such services are to the underserved, regardless of their walks of life. Thank you for giving me this opportunity!” Vendor feedback: The public was very appreciative and thanking us for our services. Nothing but positivity, happy smiling faces from vendors and the community. I think the public was genuinely appreciative of the Health Fair. Many folks stopped by the exhibit and were unaware of our locations and the services we provide. Many stopped just to say they had gone to one of our clinics and received great care.
Above, left to right: MCVI Cholesterol screening by Delta College nursing student; Drs. Julia Walter and Danielle Duncan Bottom: Guests enjoy the 2019 Health Fair
All feedback was positive and enthusiastic. Most people I spoke with were very happy to be able to attend, and felt that they were able to get a good bit of information about medical/medically related services available to them in their community.
The SCMS would like to give special thanks to the following: Thank you to the following for helping us advertise the Health Fair: Ascension St. Mary’s Towne Centre Robert L. Borenitsch DO Doris D. Cataquiz MD Douglas Family Vision E. George Galsterer DO Great Lakes Family Health Center Jeff’s Barber Shop, St. Charles Junction Valley Railroad/Stenger Family Karu Medical Associates Michigan CardioVascular Institute WNEM-TV5 Morning Show
Event Sponsors & Donors - We couldn’t have done it without you! Ascension St. Mary’s Hospital Ben Benkert | Peak Performance PC Services, LLC CMU Health Covenant HealthCare D&M Marketing and Publishing, Inc. | Word Up Community Magazine Delta College Nursing Students and Faculty Great Lakes Bay Health Centers. Kiron Choudhri | Horizons Conference Center (discounted rental space) Stephanie Krieger | s7 Consulting Lori Krygier | Graphic Designer Michigan CardioVascular Institute Russ’ Sign Rental, LLC (discounted rates) Saginaw Valley Osteopathic Society Saginaw Medical Federal Credit Union Ron Weighman and Staff | Dornbos Printing Impressions (in-kind donation) Thank you to all of the vendors who donated raffle prizes.
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SCMS Members Who Participated (please contact the SCMS if we missed anyone):
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Finally, thank you to our vendors and members who performed screenings, gave information and helped nearly 1,000 Saginaw County residents better their health! ADIO Chiropractic Aerus (American Vacuum, LLC) Airway Oxygen, Inc. Allergy & Asthma Network American Cancer Society American Medical Equipment Americans Home Health & Hospice Care, Inc. Ascension St. Mary’s Hospital Medical Group Ascension St. Mary’s Hospital Neuroscience & Stroke Ascension St. Mary’s Hospital Seton Cancer Institute Ascension St. Mary’s Hospital Wound Care & Hyperbaric Center Barb Smith Suicide Resource & Response Network Barton Woods Assisted Living Bay County Health Department Bieri Hearing Specialists CapTel Outreach Caretel Inns of Tri-Cities Child & Family Services ClearCaptions CMU College of Medicine | CMU Health CMU Health Advanced Directives CMU Health Primary Care Comfort Keepers Compassionate Care Home Health Services, Inc. Covenant Advance Care Planning Covenant Bariatric & Metabolic Center Covenant Breast Health Center Covenant Diabetes Self Management Covenant Lung Program/Smoking Cessation Covenant Mary Free Bed Covenant Physical Medicine & Rehabilitation Covenant Stroke Covenant Trauma Program Covenant Visiting Nurse Association Covenant Wound Center Envision Eye Care Families Against Narcotics/Hope Not Handcuffs First State Home & Hospice Care Food Addicts in Recovery Anonymous
Gift of Life Michigan Great Lakes Bay Health Centers Great Lakes Eye Institute HealthSource Saginaw Hear Michigan Hear USA Hospital Hospitality House Humana, Inc. Impact Medical Supply Kehres Health & Chiropractic Mannor Financial Group Medallion Village Michigan CardioVascular Institute Miracle-Ear My Community Dental Centers Novo Nordisk Pearle Vision Physicians Hearing & Balance Center Pro-Air Medical Supply & Equipment Ray’s Physical Therapy/Rehab Movement Wellness Region VII Area Agency on Aging Renue Physical Therapy Right at Home – Northern Michigan Rodnick Chiropractic Clinic Saginaw Academy of Family Physicians Saginaw County Commission on Aging Saginaw County Health Dept. & Sheriff’s Dept. Saginaw County Medical Society Saginaw Valley Osteopathic Society Scott Medical Equipment Select Specialty Hospital Shields Chiropractic Sleep Number Saginaw SVSU Occupational Therapy Students Swanhaven Manor Retirement Community Thomas Orthodontics Underground Railroad UnitedHealthcare Community Plan Visiting Angels Wescourt Retirement Community
Matthew Abrell DPM Wendy S. Biggs MD Judy V. Blebea MD Andrew M. Cohen DPM Louis L. Constan MD Elvira M. Dawis MD Anthony deBari MD Michael J. Dense DC Sonia S. Dhaliwal MD Danielle C. Duncan MD Austin G. Friswold DPM Mark G. Greenwell MD Preeti Gudimella MD Carlyn M. Hinish DPM Daniel B. Kehres DC Larry S. Kelly MD David B. Krebs MD Kevin J. Lawson MD Iris A. Marteja MD Owen C. Morris DPM Bernard D. Noveloso MD Jorge M. Plasencia MD Mindy L. Prows DO Miriam T. Schteingart MD Caroline G.M. Scott MD Julia M. Walter MD
CMU Medical Students Emmanuel L. Avelino Andrew Caminata Marcello L. Caso Rebecca A. Groch Daniel Y. Kalabat
Jason T. LaFave Lindsay E. Murphy Kathrin M. Parisi Rebecca L. Russell Ashley M. Stantz
Delta College Nursing Faculty Students: Meredith Bladecki MSN RN CNE Cassaundra Heiler Katrina Alcock Shawn Hengehold Daleigh Bissett Kayla Hero Becky Clark Courtney Johnson Gabe Feather David Ross Haley Giltrop Mike Spaulding Renee Guza Bill Voss Katlyn Hardt Angie Appold | Ben Benkert Rachel Burk | Riley Cho Jamie Cramer Franz | Sarah Cramer Stephanie Krieger
The Bulletin | April 2019 19
2019 Annual Health Fair Highlights! From top, left to right: CMU Health BP check; GLBH Glucose screening; Ascension St. Mary’s Christine Bergman, Dr. Kevin Lawson and Adam Tompa; Dr. David Krebs of Envision Eye; Dr. Mark Greenwell and Summer Bates FNP; Drs. Bernard Noveloso and Preeti Gudimella lead Advanced Directives mini-seminar; Dr. Miriam Schteingart and Michele Krebs; Covenant Breast Health Center
Visit our website www.SaginawCountyMS.com for more event pictures
APPLICATIONS FOR MEMBERSHIP FIRST READING: Applications for membership that may be recommended for acceptance at the Tuesday, June 18, 2019, Board Meeting: Clark J. Headrick, DO (Chief Medical Officer Ascension St. Mary’s, Standish and St. Joseph; and Chief Medical Information Officer - Ascension Health Mid-Michigan) Specialty: Internal Medicine (Board Certified 1992), Pulmonary Medicine (Board Certified 2014), Critical Care (Board Certified 2005) and Sleep Medicine Medical School: Western University College of Osteopathic Medicine of the Pacific, Pomona, CA, 1988 Internship/Residency: Genesys Regional Medical Center, Internal Medicine, Pulmonary, Critical Care, Grand Blanc, MI, 1988-95 Prior Practice: (1) Genesys Health Systems Sleep Lab, Grand Blanc, Practicing Physician, 1995-04 and Medical Director, 2001-04 and 2009-11; (2) Genesys Health Systems, Medical Director of Clinical Excellence, 2007-10, and Ascension System Office Projects, 2008-present; (3) Reverence (Genesys) Home and Hospice Care Medical Director, 2005-14; (4) St. Mary’s of Michigan-Saginaw, Standish and St. Joseph’s Regional Medical Center (numerous positions), 7/14-8/15; and (5) Genesys Health Systems, Medical Director of Clinical Informatics, 2005-15. Sponsors: Doctors Waheed Akbar and Stephanie J. Duggan Ganesh D. Kini, MD (Medical Director - Covenant Hospital Medicine Program) Specialty: Internal Medicine (Board Certified 2005) Medical School: St. George’s University School of Medicine, Grenada, West Indies, 2002 Internship/Residency: University of Virginia Roanoke-Salem Program, Roanoke, VA, Internal Medicine, 7/026/05 Prior Practice: (1) The Moses Cone Hospital System, Greensboro, NC, Hospitalist, 9/05-9/06; (2) James Madison University, Harrisonburg, VA, Adjunct Clinical Assistant Professor, PA Program, 11/06-01/17; (3) Sentara Rockingham Memorial Hospital Medical Center, Harrisonburg, VA, various positions, 3/08-1/17; and (4) Bay Area Hospital, Coos Bay, Oregon, Hospitalist and South West Oregon IPA, Western Oregon Advanced Health, Medical Director, 02/17-04/18. Sponsors: Doctors Anu R. Gollapudi and Iris A. Marteja SECOND READING: Applications for membership that may be recommended for acceptance at the May 21, 2019, Board Meeting: Chris Paul Liakonis, DO (St. Mary’s Riverfront Cardiology) Specialty: Surgery - Cardiothoracic (Board Certified 2013) Medical School: Des Moines University College of Osteopathic Medicine, Des Moines, IA, 1993 continued on page 21
2019 Annual Health Fair Highlights!
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Internship/Residency: MSU Oakland General Hospital, Madison Heights and Mt. Clemens, MI, Surgery-General, 199398 Fellowship: Deborah Heart & Lung Center, Browns Mills, NJ, Thoracic Cardiovascular Surgery, 1998-01 Prior Practice: (1) St. Clair Cardiovascular Surgeons, Roseville, MI, 8/01-9/02; (2) Greater Michigan Cardiovascular Surgeons, Dearborn, MI, 9/02-7/11; (3) Oakwood Cardiovascular & Thoracic Surgeons, Dearborn, MI, 7/11-7/17; and (4) Beaumont Cardiovascular & Thoracic Surgeons, Dearborn, MI 7/17-1/19. Sponsors: Doctors Adebambo Kadri and Vipin Khetarpal Mark A. Zaki, MD (Covenant Radiation Center) Specialty: Oncology â€“ Radiation (Board Certified 2018) Medical School: Wayne State University School of Medicine, 2012 Internship/Residency: Wayne State University School of Medicine/Detroit Medical Center, Radiation Oncology, 2012-17 Sponsors: Doctors James A. Fugazzi and Gregory P. Sutton
MAY BIRTHDAYS Joseph G. Adel MD Michael S. Albosta (student) Fares Alghanem (student) Marina I. Ananich MD Elizabeth M. Barron (student) Kailtyn Bates (student) Eventure D. Bernardino MD Sultan M. Bhimani MD Adam Z. Cote DO Ryan L. Cox MD Del J. DeHart MD Kenneth W. Distler MD Daniel J. Dymek MD Thomas A. Egleston MD Happy Special Birthday! Douglas B. Forsyth MD Suhasini Gudipati MD George J. Gugino MD Enam B. Hanna MD Mark J. Hass MD Mayar M. Jundi MD Sai Sriker Kilaru (student) Ryan J. Kim MD Stephanie P. Mager MD Michael T. McAvoy MD Igor D. Middlebrook DO Jeffrey S. Milewski DO Thomas M. Minnec MD Rajesh Mithalal MD
Henry W. Moon MD Brent A. Oldham (student) Alexandra E. Ortiz (student) Yvonne V. Pacquing MD Dhara D. Patel MD Trusha Patel (student) Jill M. Paveglio MD Olivia A. Phifer-Combs MD Gregory A. Pinnell MD J. M. Prasad MD Kala K. Ramasamy MD Chalichama A. Rao MD K. K. Ravindran MD Thomas M. Raymond MD Stuart J. Rupke MD Triptpal S. Sanghera MD Samuel J. Shaheen MD Sukhmanpreet Singh MD Jonathon G. Skurya (student) William T. Starbird (student) Lauren Stull (student) Sarine Trochakerian MD Faiz Tuma MD Vivek Variar MD Lester E. Webb MD Thomas G. Weiss (student) Derek Wolfe (student) Hani H. Zreik MD
From top, left to right: CMU Health Residents and Medical Students; Barb Smith and Stacey Urbani of Barb Smith SR&RN; Drs. Larry Kelly, Caroline Scott and Lou Constan at Saginaw Family Physicians cholesterol screening booth; Dr. Wendy Biggs and MS Daniel Kalabat; Drs. Julia Walter, Caroline Scott, Elvira Dawis and Manuel Perea; Vendors and guests
Visit our website www.SaginawCountyMS.com for more event pictures
April 4, 2019 Dear Saginaw County Community, Considering the emerging measles outbreaks across the U.S., and more recently, in Southeast Michigan, the Saginaw County Health Department (SCHD) would like to inform citizens and healthcare providers that we are following the outbreak closely. Looking back at the past 5 years—we have seen ZERO cases of measles in Saginaw County. Therefore, it is important that we maintain a high level of suspicion in our differential diagnosis to protect the public’s health as it can mimic many viral illnesses. As of April 2nd, 2019, there have been 34 confirmed cases of measles in Michigan, ranging in age from 8 months to 63 years (33 in Oakland County, 1 in Wayne County). Measles was eradicated in the U.S. in 2000, but we have seen a reemergence linked to travel-related cases. There were 372 confirmed cases of Measles in the U.S. in 2018. In just the first third of 2019, we have surpassed those numbers at 387. Measles is an airborne disease that is spread from human to human. The virus can survive for up to 2 hours outside the human body. 90% of susceptible individuals that come into contact with an infected person will become ill—it is HIGHLY transmissible. Symptoms develop around 10-12 days after exposure—including a fever of 101 degrees or higher, cough, runny nose, conjunctivitis and Koplik spots (clustered white spots on oral mucosa). Rash will develop in ~14 days, starting from the head outward toward the torso and limbs. Individuals are most infectious 4 days before and 4 days after rash onset. Complications include diarrhea, middle ear infections, pneumonia, encephalitis (rare but high death rate), seizures and panencephalitis that can emerge years later. Measles continues to be a fatal disease worldwide, with a likely underestimated 145,000 deaths in 2013. The measles vaccine is recommended in a 2-dose series. The first dose at age 12-15 months, and the second between 4-6 years. A catch-up dose is recommended at 11-12 years, and if a second dose is needed, one should wait for 4 weeks. The vaccine provides 95% protection at 12 months and 98% by 15 months, with 99% achieving lifelong immunity. Those born before 1957 may also require a second dose. College students, healthcare workers and international travelers are considered high risk and should be assessed for immunity. Special circumstances will follow different recommendations, so it is important to contact your health care provider or SCHD if you need clarification. In cases of an outbreak, Post-Exposure Prophylaxis for susceptible individuals include MMR vaccination that should be administered within 72 hours—otherwise immune globulin can be given to high risk individuals within 6 days (i.e., unvaccinated or unsure of vaccination history, pregnant women, weakened immune systems).
The Bulletin | April 2019
If you have any questions or concerns, please do not hesitate to contact our Communicable Disease If you at have any questions or concerns, please do not hesitate to contact and our click Communicable Team 989-758-3880 or visit our website www.saginawpublichealth.org on MeaslesDisease under Team at 989-758-3880 or visit our website www.saginawpublichealth.org and click on Measles under the Hot Topics section of the homepage. the Hot Topics section of the homepage. FOR PROVIDERS: FOR PROVIDERS: IMMEDIATELY contact the Saginaw County Health Department if you have any suspected cases. We will IMMEDIATELY contact theinvestigation. Saginaw County Health Department if you have any suspected cases. We will assist in a thorough case Ensure droplet precautions and isolation of the individual(s), i.e. assist in a thorough case investigation. Ensure droplet precautions and isolation of the individual(s), i.e. isolate them from the waiting room, etc. isolate them from the waiting room, etc. The Clinical Case Definition to aid in diagnosis: The Clinical Case Definition to aid in diagnosis: 1) A generalized rash lasting at least three days AND 1) lasting at least three days AND AND 2) A A generalized temperaturerash of 101 degrees Fahrenheit or higher 2) A temperature of 101 degrees Fahrenheit or higher AND 3) Cough OR Runny Nose OR Conjunctivitis 3) Cough OR Runny Nose OR Conjunctivitis Laboratory Testing: COLLECT SERUM AND VIRAL SPECIMENS Laboratory Testing: COLLECT SERUM AND VIRAL SPECIMENS 1) SEROLOGY: Looks for measles-specific antibody 1) SEROLOGY: Looks antibody a. Collect 5mLforofmeasles-specific serum a. 5mLfor of measles serum and rubella (most preferred) OR b. Collect Order IgM b. Order IgM for measles and rubella ORtime) c. IgG at onset and 10 days later (run (most testingpreferred) at the same c. IgG at onset and days later (run testing at the same time) 2) VIROLOGY: Specimen for10 PCR/viral isolation to assess geographic origin of virus 2) VIROLOGY: Specimen for PCR/viral isolation to assess geographic origin virus a. Respiratory Specimen: Throat swab or nasopharyngeal within 10ofdays a. Throat swab or specimen nasopharyngeal 10 days b. Respiratory Urine: Ideal Specimen: to obtain with respiratory (50-100within mL) within 7 days b. Urine: Ideal to obtain with respiratory specimen (50-100 mL) within 7 days Cases are classified as Suspect, Probable or Confirmedâ€”please contact us if you need any clarification: Cases are classified as Suspect, Probable or Confirmedâ€”please contact us if you need any clarification: 1) Suspect: Rash with fever 1) Suspect: fever met without testing OR epidemiologic linkage to confirmed case 2) Probable:Rash Casewith Definition 2) Probable: Case Definition met without OR epidemiologic linkageAND to confirmed case 3) Confirmed: Laboratory confirmed case testing OR meeting the Case Definition 3) Confirmed: Laboratory case OR meeting the Case Definition AND epidemiologically linkedconfirmed to a confirmed case epidemiologically linked to a confirmed case Post-Exposure Prophylaxis for Susceptible Individuals: Post-Exposure Prophylaxis for Susceptible Individuals: 1) MMR Vaccination within 72 hours 1) MMR Vaccination within hours 2) Immune Globulin (Ig) for 72 high risk individuals (unvaccinated, unsure of vaccination, 2) Immune Globulin (Ig) for high risk pregnant, immune compromised). individuals (unvaccinated, unsure of vaccination, pregnant, immune compromised).
Christina Harrington, MPH Christina Harrington, MPH Health Officer Health Officer
Najibah Rehman, MD, MPH Najibah Medical Rehman, Director MD, MPH Medical Director
The Bulletin | April 2019 23
Medicine Match Day Aligns with CMU Mission Seven in 10 medical students chose primary care for residency; 45 percent will serve in Michigan Cheers, hugs and sighs of relief erupted on March 15 as students in the Class of 2019 from Central Michigan University’s College of Medicine discovered where they “matched” into residency programs across the nation. Seventyone percent of the class matched into primary care residencies, and 45 percent matched to programs in Michigan. Three of those students matched into military residencies, two in the Army and one in the Navy. “To have such high percentages of our students match into Michigan residencies is evidence that we are staying true to our mission of preparing physicians to serve in rural and medically underserved regions of Michigan,” said George Kikano MD, Dean of the CMU College of Medicine. Match Day is the conclusion of four days of emotional buildup at medical schools across the country, when graduates open sealed envelopes at noon EST to find out where they will do their residencies. The matches are determined by a computerized mathematical algorithm used by the National Resident Matching Program to align the specialty and location requests of students with the preferences of program directors at U.S. teaching hospitals. The organization expected the 2019 match to be the largest ever, exceeding the more than 43,000 applicants who registered for the 2018 match, and the more than 33,000 residency positions. Making up those numbers are medical students right here at CMU. Among them at Match Day were Bradley Demijohn of Saginaw and Jisselly McGregor, originally from the Dominican Republic, both of whom matched into their first choices for Psychiatry - Demijohn at Pine Rest Christian Mental Health Services in Grand Rapids, and McGregor at CMU’s residency program in Saginaw. While they share a similar course now in residency, their paths began very differently. A Young Father’s Dream Demijohn, a lifelong Saginaw native, started his first career here. When he was struggling to decide on a college major, a youth minister at his church told him that he had a heart for people and guided him toward nursing. He wasn’t so sure when as a student he almost passed out while watching a classroom video of a cesarean section, but he was encouraged to continue and became a first-generation college graduate. His first job after graduation from nursing school was in the intensive care unit of Covenant HealthCare. Working in the ICU as a new graduate, he knew he needed to broaden is knowledge to give his patients the best care, and he decided to return to school to earn his Bachelor’s in Nursing. It was during
Above: Bradley Demijohn matched into his first choice for a psychiatry residency. Below: Demijohn, posing with his family, will serve at Pine Rest Christian Mental Health Services in Grand Rapids.
this process that he really found a desire to lead in healthcare, and as graduation approached, he and his wife began to talk about a career in medicine. With CMU establishing a medical school in Saginaw, the choice of schools was obvious. He recalls working a shift in Covenant’s SICU and watching them break ground for the new medical school. “As I was looking out a window at that, I felt in my heart that was where I would go to school, and CMU gave me a chance.” He discovered it was a huge challenge to take on medical school while being a young father of two. However, he hadn’t expected that upon entering CMU’s medical school, he would become part of a new family. “There were times when I had a family emergency, and I had to duck and run,” he said, “but my classmates covered for me, and the faculty were really supportive of me. During my third year, my clerkship director worked with me to make sure I could be home for my son’s birth.” With his first career in nursing, he had a lot of ideas as to what area of medicine he would like to practice. However, late in his 3rd year of medical school, he had his first experience in a field that was mostly new to him - Psychiatry. “I always hoped that my background in nursing would make me a great physician, and that I would be able to bring the close relational side of nursing into medicine. Psychiatry was the perfect fit for that relational piece that I wanted to bring.” continued on page 25
The Bulletin | April 2019
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Demijohn recently found out that he will be doing his residency training in Grand Rapids at Pine Rest Christian Mental Health Services. “It’s bittersweet,” he says of his next endeavor. “It’s a great place to train and a great place to raise a family, but I will be moving from not just friends and family but also from the amazing medical community in Saginaw that has supported me from day one.” He hopes to complete his residency training along with a Child and Adolescent Fellowship and return to Saginaw. From a Pretend Doctor to a Real One McGregor loved to pretend to be a doctor. When she was eight, her father gave her a medical book and every Christmas, her grandmother gave her a plastic stethoscope. McGregor put the stethoscope into her “medical bag” of bandages and tape and took it to school. “Whenever someone would fall or cut themselves, I would run and take care of them,” she said. “Every little girl wants to be a little princess, but I wanted to be a doctor. I just couldn’t wait to grow up.” But first, she had to overcome some hurdles. Her father, a surgeon, and her mother had separated when she was very young. She was raised by her grandmother and then moved to New York at age 14 to be with her mother when her grandmother became ill. High school in Queens, New York was exceedingly difficult, she said, because she was learning the English language at the same time. But she never lost sight of her goal of becoming a doctor, but she didn’t know in what specialty. It was her father’s death from an opioid overdose when she was 16 that helped her decide on Psychiatry. She chose CMU’s medical school because I “felt a great sense of family” during her interview and identified with the mission of ministering to the underserved. She also liked the team-learning philosophy. Her goal is to continue to practice in Mid-Michigan, “and be an inspiration to people from underserved and minority backgrounds. I want to make a difference.” According to her classmates, she already is making a difference in the community. They backed up their support by submitting
Above: Jisselly McGregor matched into her first choice for a psychiatry residency. McGregor, originally from the Dominican Republic, will serve at CMU’s program in Saginaw.
a winning nomination of her to the Gold Humanism Honor Society , which is “dedicated to keeping health care human.” After Match Day, she said she is excited to be able to stay and work with the underserved population in the region. “My grandmother is very proud of me, not just that I am going to be a physician, but that I will be helping people in need like we were in need in the Dominican Republic.” Mildred J. Willy MD, Associate Dean for Student Affairs, looked over the students at Match Day and mulled that it was the culmination of four hard years for the students. “It is a very stressful yet gratifying time for them, but now they are taking the next step in developing as physicians. We are very proud of all of them.”
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www.wolgast.com/blog/topic/medical-office-construction The Bulletin | April 2019 25
Ascension St. Mary’s Launches Healthy Heart Project “Nearly half of all U.S. adults have some type of cardiovascular disease,” according to the American Heart Association. That’s why Ascension St. Mary’s is offering a new, free event called the Healthy Heart Project. The Ascension St. Mary’s Healthy Heart Project is a day devoted to heart disease screening and prevention. Attendees will receive free heart and stroke screenings with on-the-spot results and a one-on-one conversation with a doctor to review their individual situation. The Healthy Heart Project will take place on Saturday, May 4 at Michigan CardioVascular Institute. Free screenings include electrocardiogram, blood pressure, body mass index, blood glucose and cholesterol test and a heart risk assessment. Appointments are not required. The Healthy Heart Project starts at 7 a.m. and the intake of participants ends at approximately 10 a.m. All people in line at that time will be screened.
Restoring Mobility and Improving Lives with Mako Innovative Robotic Technology to Personalize Total Knee and Total Hip Replacement Procedures to Each Patient Robotic-arm assisted surgery with the Mako System is a new approach to joint replacement that offers the potential for a higher level of patient-specific implant alignment and positioning. The technology allows surgeons to create a patient-specific 3D plan and perform joint replacement surgery using a surgeon controlled robotic arm that helps the surgeon execute the procedure with a high degree of accuracy. “With the Mako robot, we can provide each patient with a personalized surgical experience based on their specific diagnosis and anatomy,” said Tarek Taha MD PhD, Ascension St. Mary’s orthopedic trauma and total joint surgeon. Watch as he explains how Mako helped a severe arthritic patient here. For more information or to see if Mako is right for your patient, call Ascension St. Mary’s Orthopedics at (989) 790-6719.
Ascension St. Mary’s & Michigan CardioVascular Institute Interventional Cardiologist Published in Journal of the American College of Cardiology Safwan Kassas MD has recently published the results of the first pilot blinded study to compare the feasibility and safety of implanting the Watchman device and assessing the PASS criteria using angiography guidance alone versus the gold standard transesophageal echocardiography (TEE). The purpose of the study was to determine if the procedure can be performed without the need to administer general anesthesia in a minimalist approach. To read the article, access this link at the Journal of the American College of Cardiology. Currently, Dr. Kassas is the National Principal Investigator of a new study, the “Watchman Minimalist Approach” study which he initiated at Ascension St. Mary’s. This trial is being conducted at multiple sites throughout the country where the Watchman device is being implanted under conscious sedation and without subjecting the patient to general anesthesia. Dr. Kassas currently leads the valve and structural heart program at Ascension St. Mary’s where he performs TAVR and Watchman procedures.
Make Plans to Attend! Annual Charity Golf Classic is May 22 at Apple Mountain Golf Club Enjoy a day on the course, while feeling good about supporting the hospital’s mission to provide the latest health care technology and treatments to everyone, every day. Foursomes will enjoy 18 holes of golf with cart, a complimentary gift package, course contests, raffles, and refreshments on the course, grilled lunch and dinner. Registration opens at 9 a.m., with the outing starting at 10 a.m. For more information about the region’s largest charity golf outing, call the Foundation at 989-907-8875 or e-mail Tamera. Weighman@Ascension.org.
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. 26
The Bulletin | April 2019
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
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 | April 2019 27
Welcome Dr. Ganesh Kini, Medical Director of Hospital Medicine Ganesh D. Kini MD has been announced Medical Director for the Covenant Hospital Medicine Program. Dr. Kini is a graduate of St. George’s University School of Medicine in Grenada, West Indies and completed his residency training at the University of Virginia. He is Board Certified in Internal Medicine. About the Covenant Hospital Medicine Program The Covenant Hospital Medicine Program has 30 hospitalists. Hospital medicine is a specialty in which physicians focus on caring for patients in the hospital setting. Hospitalists work closely with the patient, family members, primary care physicians, specialists and other departments of the hospital to provide high quality and effective inpatient care. Covenant hospitalists are highly trained internal medicine and family practice physicians. Covenant HealthCare, like many medical centers throughout the country, gives physicians on the medical staff the option of referring patients to a hospital medicine specialist when their patients require hospitalization. The hospitalist manages the inpatient care while staying in close communication with the patient’s primary care physician. The hospitalist also acts as a liaison with other required specialists. Because the hospitalist works solely within the hospital, he or she is very familiar with the hospital’s treatment and diagnostic departments, and is readily available to see the patient whenever needed during the day or night. A hospitalist is available in the hospital 24 hours a day and is able to keep a close eye on patients and readily communicate with the nursing staff, other required specialists and your primary care physician. Patients will see their primary care physician soon after leaving the hospital. Complete records and reports will be forwarded to the primary care physician from the hospital. Covenant HealthCare and Mary Free Bed to Partner on $40 Million Rehabilitation Hospital By now you have heard the news about Covenant HealthCare, Mary Free Bed Rehabilitation and a plan to locate a $40.7 million rehabilitation hospital on the Covenant main campus. Here’s everything you need to know about the project. The new building will include 48 inpatient 28
The Bulletin | April 2019
beds (with shelled space for 12 beds for future use) and a stateof-the-art outpatient therapy facility. By investing in this expansion, Covenant HealthCare and Mary Free Bed Rehabilitation Hospital are developing a Rehabilitation Center of Excellence that will serve patients and families from a broad region of eastern Michigan. In addition to the new services and technology that will be housed in the building, the creation of Mary Free Bed at Covenant HealthCare will expand the opportunity for patients to participate in national stroke rehabilitation research. In November 2017, the two organizations signed a partnership agreement creating a 50-50 joint venture that brought advanced rehabilitation care to Saginaw and the Great Lakes Bay Region. “One of our goals when we began the partnership was to study the need for a separate rehabilitation hospital,” said Mary Free Bed CEO Kent Riddle. “Our analysis shows it’s time to move ahead with construction of a new building that will be designed specifically for rehabilitation services.” “The building will provide more private space for patients and enable our teams to be more efficient as they care for patients,” says Ed Bruff, Covenant HealthCare President and CEO. “In partnership with Mary Free Bed, we believe our Rehabilitation Center of Excellence will better serve Great Lakes Bay Region residents, and be a world-class destination for patients from across the east side of the state.” The joint venture for inpatient rehabilitation became operational in March of 2018. Since then, patient rehabilitation results have consistently exceeded national benchmarks. The project completion is projected to be in late 2020 to mid-2021. We are in the early stages of development, but initial plans call for the building to: • Have 48 private inpatient rehabilitation rooms (with space for 12 beds for future use). • Accommodate leading-edge technology such as ceilingmounted ambulation systems. • Be located on the main campus of Covenant HealthCare in Saginaw. • When fully operational, the new rehabilitation hospital is also estimated to bring 25-30 additional jobs to Saginaw. Learn more about Mary Free Bed at www.maryfreebed.com. Six Hospitals Announce Formation of Covenant Regional Thumb Network (CRTN) The Covenant Regional Thumb Network (CRTN), a network of six independent hospitals, is pleased to announce its formation. The network is composed of Covenant HealthCare, located in Saginaw, and five critical access hospitals located throughout Michigan’s Thumb area including Deckerville Community continued on page 29
continued from page 28
Hospital, Harbor Beach Community Hospital, Hills & Dales General Hospital, Marlette Regional Hospital and Scheurer Hospital. While CRTN formed in late 2018, these hospitals have been working together for more than a decade to ensure quality healthcare is available to patients in the Thumb. Having an independent relationship with Covenant allows for a streamlined flow of resources and services that might not be available outside of a major metropolitan area. The partnership enables patients to choose a hospital close to home that best fits their needs while utilizing the capabilities and strengths of
diabetes Self Management Program
In the United States,
people are living with diabetes – 84 million are living with prediabetes.
CRTN. Instead of losing their local hospital to an acquisition by a large hospital conglomerate, the Thumb communities have strengthened local hospitals. The relationship among the Covenant Regional Thumb Network ensures that Thumb communities have an independent hospital close to home they can continue to depend on for quality care. It provides the assurance that if there is a need for more advanced procedures, the appropriate care is delivered through the coordinated relationship the Thumb hospitals have with Covenant.
GOLF OUTING -SAVE THE DATE! The SCMS Foundation will host its 10th Annual Golf Outing on Saturday, June 8, 2019 Saginaw Country Club Four Person Scramble 12 p.m. Registration 1 p.m. Shotgun Start
See pages 10-11 for information and sponsorship opportunities!
We are the region’s most experienced diabetes management team. Our program is certified by the American Association of Diabetes Educators (AADE) through the Michigan Department Health and Human Service (MDHHS). We are certified to provide education for patients of all ages and diabetes diagnoses, including pregnant women. Put your trust in the region’s most experienced diabetes management team . . . your PatientCentered Medical Home partner. We also have a Diabetes Prevention Program to help prevent or delay Type 2 diabetes. To refer a patient or for more information call 989.583.5193
©2018 Covenant HealthCare. All rights reserved.PK 1/18 10448
The Bulletin | April 2019 29
ADVERTISER INDEX When you have a need for a service, please consider our dedicated advertisers first! Advanced Diagnostic Imaging, P.C. Ascension St. Mary’s Hospital Barb Smith Suicide Resource & Response Network Covenant HealthCare Covenant Diabetes Self-Management Program Dornbos Printing Impressions 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 Print Express ProAssurance Shields Chiropractic Wolgast Corporation
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The Bulletin | April 2019
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Key Provider to the SCMS
Healthway Compounding Pharmacy 2544 McLeod Dr. N. | Saginaw, MI 48604 | 989.791.1691 | www.healthwayrx.com The Bulletin | April 2019 31
PRSRT STD U.S. POSTAGE PAID Saginaw, MI 48605 PERMIT #189
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. SCMS Membership Meetings are held on the third Tuesday of January, April, May, September and October. The SCMS Board meets on the third Tuesday of every month (except July and December) at 5:30 p.m. Wednesday, May 15, 2019 CMU College of Medicine, 1632 Stone Street, Saginaw – “Thanks for Staying” Rotary Scholarships 2019 Celebration Event (see page 15 for more information) Wednesday, May 22, 2019 CMU College of Medicine, 1632 Stone Street, Saginaw – safeTALK Suicide Alertness Training (see page 9 for more information) Thursday, May 30-Sunday, June 2, 2019 Crystal Mountain Resort – Restorative Retreat for Physicians (family friendly). Click HERE for more information. 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. See pages 10-11 for sponsorship opportunities and team registration. Tuesday, June 18, 2019 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m.
There are no Board or Membership Meetings in July or August. Tuesday, September 17, 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: TBD. Tuesday, October 15, 2019 HealthSource Saginaw - SCMS Board meets at 5:30 p.m. Membership Meeting – SPOUSE/SIGNIFICAN T OTHER INVITED with Social at 6:30 p.m. followed by dinner and program at 7 p.m. Program: TBD. Tuesday, November 19, 2019 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m. Saturday, November 23, 2019 Saginaw County Club – 16th Annual Jingle Mingle benefitting the Pregnancy Care Center in Saginaw from 10:30 a.m. to 2:30 p.m. Visit www.SaginawCountyMS.com and click on Jingle Mingle under the Alliance tab.
www.SaginawCountyMS.com Joan Cramer/SCMS | Office 790-3590 | Fax 790-3640 | Cell 284-8884 | email@example.com