Issuu

The

Bulletin Saginaw County Medical Society

November 2019 | Volume 78 | No 3

SAVE THE DATE!

Free 8-Hour MAT DATA Waiver Training Through ASAM | April 25, 2020 p. 10-11

PRIOR AUTHORIZATION AND OUT-OF-NETWORK

“Surprise Billing” Legislation p. 18

WORKPLACE VIOLENCE p. 4-5, 16-17 www.SaginawCountyMS.com

stroke care

that saves lives and wins awards.

The American Heart Association has given Covenant HealthCare their highest award for stroke care, given only to hospitals consistently providing prompt, effective care to stroke patients. Only 12 hospitals in the state have been awarded this honor. Covenant has also been named a Primary Stroke Center by the Health Facilities Accreditation Program. But most importantly, our superior stroke care leads to improved outcomes and healthier lives for our stroke patients. To learn more, visit CovenantStroke.com

The

Bulletin Saginaw County Medical Society

2019-2020 OFFICERS AND DIRECTORS President Mildred J. Willy MD President-Elect Anthony M. Zacharek MD Past President Julia M. Walter MD Secretary Caroline G.M. Scott MD Treasurer Miriam T. Schteingart MD Board of Directors Jorge M. Plasencia MD Tiffany K. Kim MD

contents 4-5 & 16-17 10-11

Mark G. Greenwell MD

Workplace Violence

SAVE THE DATE! Free 8-Hour MAT DATA Waiver Training Through ASAM | April 25, 2020

A Key to Successful Diabetes Management

SCMS, MSMS and AMA Present To M1 and M2 Students & You Can Mentor a Student! SCMS Membership Meetings – Save the Date!

From the Editor

Furhut R. Janssen DO

Medical Mission Articles Needed!

Bulletin Editor Louis L. Constan, MD

Harvey K. Yee MD Elizabeth A. Paulus MD

Retiree Representative Rustico B. Ortiz, MD Resident Representatives Mary J. McKuen, MD Anushka N. Magal MD

Prior Authorization and Out-of-Network “Surprise Billing” Legislation

Barb Smith SR&RN Achieves Two Milestones Key Provider of the Month Healthway Compounding Pharmacy

December Birthdays

Attention Retired Members

THRIVE

In Memory – Drs. Allport and Toteff

Caduceus Meeting

Advertiser Index

SCMS Foundation – Make a Tax Deductible Gift Today!

MSMS Delegates

Ascension St. Mary’s

Elvira M. Dawis MD

Directory Update

Key Providers

Julia M. Walter MD

20 24

Covenant HealthCare

Calendar of Events

Mildred J. Willy MD Anthony M. Zacharek MD Jorge M. Plasencia MD Christopher J. Allen MD Miriam T. Schteingart MD MSMS Alternate Delegates

CMU College of Medicine | CMU Health The Bulletin can be viewed online at www.SaginawCountyMS.com under the Bulletin tab.

ON THE COVER: (l-r) Drs. Marie Daly, Jorge Plasencia and Jennifer Romeu

Caroline G.M. Scott MD Waheed Akbar MD Mohammad Yahya Khan MD Virginia R. Dedicatoria MD Steven J. Vance MD Joseph P. Contino MD Kristine K. Spence DO Karensa L. Franklin MD

EDITOR Louis L. Constan, MD

PUBLISHER Saginaw County Medical Society

EXECUTIVE DIRECTOR Joan M. Cramer

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

DESIGNER Lori Krygier

Telephone: (989) 790-3590. Fax: (989) 790-3640 E-Mail: jmcramer@sbcglobal.net

Scott E. Cheney MD Michael W. Warren MD Peer Review Ethics Committee Waheed Akbar, MD, Chair Caroline G.M. Scott, MD James R. Hines, MD MSMS Region 7 Director Thomas J. Veverka, MD Executive Director Joan M. Cramer Administrative Assistant Keri Benkert

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

The Bulletin | November 2019 3

PRESIDENT’S LETTER

Workplace Violence By Mildred J. Willy, MD

t the Tuesday, October 15th Membership Meeting at HealthSource Saginaw, guest speakers, Drs. Howie Mell and Brad Walters, shared the following information on workplace violence. Without question, violent acts in our society have increased in frequency and severity. Mass shootings and terrorist incidents are extreme examples. However, there are lower levels of violence that take place in general society, and in the work environment that attract less attention and fewer headlines. It is surprising to physicians that the healthcare environment is a place where workplace violence is not just common, but more common than in most other settings. A research study1 conducted to assess violence in the ED in 2005 presented the following: • Workplace violence was a common experience for most emergency physicians. • Verbal threat was the most common form followed by physical assault. • Such incidents were equally prevalent in suburban and rural

EDs compared to urban ones. In fact, all cases of stalking occurred in rural ED’s. • Many physicians obtained forms of protection including firearms, knives and clubs. • Hospital and legal support were sparse and infrequently sought to the point where some physicians considered leaving the practice of emergency medicine. The workplace violence study was repeated in 2018, and found the following: • Workplace violence not only is prevalent, but increased in the 13year period. • Verbal threat is still the most prevalent, but physical assault does occur. • Despite more press about workplace violence and security in the ED (locked units, metal detectors, security personnel), emergency physicians continue to feel unsafe in the ED, but fewer contemplated leaving the practice. • Few physicians bothered to report incidents; there is a lack of support for healthcare workers at all levels – supervisors, hospital and legal.

Some people think this is just an ED problem and a risk you take by choosing to work in the ED. Let's look at the statistics. Per the Bureau of Labor Statistics and/or OSHA: • 117 fatal workplace injuries were reported in a healthcare setting in 2016. • For nurses, healthcare setting violence is 5-12x higher than for the average U.S. worker. • OSHA reports that 75 percent of all workplace assaults occur in a healthcare setting. • Statistics from 2014 for injuries from workplace violence: Healthcare setting – 8.2/100,000 workers overall, 34.9/100,000 workers in psychiatric hospitals, 109.4/100,000 workers in substance abuse hospitals, and 0.4/100,000 workers in a medical office setting. This data compares to the average injury rate in the U.S. for workplace from violence = 1.7/100,000 workers. Injuries in the healthcare setting have happened to patients, prisoners (the highest risk patients), family 1 Kowalenko T., Walters B.L., Khare R.K., Compton S. Workplace Violence: A Survey of Emergency Physicians in the State of Michigan. Ann Emerg Med 2005;46:142-147.

continued on page 5

It is surprising to physicians that the healthcare environment is a place where workplace violence is not just common, but more common, than in most other settings.

The Bulletin | November 2019

continued from page 4

members of patients and employees of the hospital. Most hospitals go on lock down for gunshot wounds, however, these are not the highest risk patients. We need to look at the data and risk factors differently than our current methods. We need to take more seriously the risk when caring for prisoners. In fact, none of the most recent deaths mentioned by the speakers occurred in an ED. The death from violence of an ED physician by her ex-fiancé earlier this year occurred outside the hospital setting. There are no statistics on office setting threats or assaults on physicians, both in the private practice setting or hospital clinic setting, but anecdotally there are such incidents. What should you do and why? Most physicians will do nothing if the risk is not felt to be significant enough to them. Many physicians have limited ability to alter the physical environment of their office or want to spend the money to do so. The potential consequences of doing nothing include loss of nursing/office personnel due to a single violent confrontation in your office; employees may start looking for another job; multiple phone calls with threats without follow-up or PPO can mean you have little grounds for prosecution and can lead to escalation or injury to yourself and or staff; deterioration of the patient/physician relationship; and potential increased liability for you if someone is injured while working for you or defends another healthcare worker during an attack. Reporting does not usually cause escalation of the perpetrator. If an incident occurs, you will be shocked at the sanguine and lack of response from police and the courts. Many prosecutors have said they will not prosecute a violent act in the ED, except in the most extreme circumstances, including cases where nurses in the ED have suffered a fractured hand and an orbital fracture.

Recommendations from the experts: • Have an alternative means to exit your office – a back door. • Have a locked door between your waiting room and the examination area. • Consider alert buttons in the exam rooms. • Try to keep your wait times as short as possible. • Telephone answering as quickly as possible (call your own office every once in a while, and see how your receptionist(s) answer the phone). • Meet with your staff regarding a response to a threatening patient or family member, including evacuation of the office, calling police, etc. • Run shooter drills – run, hide, fight. • Develop quality measures around workplace violence • Consider a zero-tolerance policy for workplace violence including threats in your hospital and/or office. • Advocate for a safe healthcare workplace - consider meeting with police and prosecutors at the county and local level. • Support state initiatives to protect physicians – MSMS, MCEP. Expectations for working in the healthcare environment must change to zero tolerance for threat or violence, including calling the police, immediately severing ties with the patient, even court restriction of the patient on the premises. An example was made of Dr. Cornbleet who was telephoned by his murderer over 500 times and never once notified the police. Do not make excuses for the patient. Advocate for a safe workplace in the healthcare environment. Please see pages 16-17 for more information from the October Meeting on "Workplace Violence."

SCMS MEMBERSHIP MEETINGS - SAVE THE DATE! Tuesday, January 21, 2020, Membership Meeting Save the date for our Tuesday, January 21, 2020, Membership Meeting at Horizons Conference Center. The social with cash bar starts at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Joint with the Saginaw County Dental Society. Program: "Oral Health and Overall Health: 2020 and Beyond" Speaker: Darnell Kaigler, Jr., DDS, PhD from the University of Michigan Dental School Email meeting notices will be sent in early January. Online reservations are required.

Tuesday, April 21, 2020, Membership Meeting Save the date for our Tuesday, April 21, 2020, Membership Meeting at Horizons Conference Center. The social with cash bar starts at 6:30 p.m., followed by dinner, meeting and program at 7 p.m. Program: “Physician Compassion Fatigue/Burnout” Speaker: Molly E. Gabriel-Champine, PhD, LP, Director of Behavioral Science, Family Medicine Residency at McLaren Bay Email meeting notices will be sent in early April. Online reservations are required. The Bulletin | November 2019 5

FROM THE EDITOR

When Values Collide By Louis L. Constan, MD

n interesting exhibit at the Smithsonian Museum of American History, albeit an unflattering one for our profession, highlights how, between 1935 and 1953, tobacco companies advertised extensively in leading American medical Journals (Our Journals), and used physicians (Our People) to help promote their products. “20,679 physicians recommend Lucky Strikes,” “More doctors smoke Camels,” and on and on. The exhibit showcases efforts by cigarette companies to minimize the harmful effects of smoking and to persuade physicians to actually promote smoking to their patients for a purported health benefit. The brazen lying it took to advance this narrative is quite impressive, as is the fact that many doctors fell for it and actually directly helped the cigarette companies, while others chose to keep quiet, indirectly facilitating a colossal social evil. All the while the truth was there for all to see, for anyone who cared to look. Some 7,000 peer-reviewed articles in respected journals. The evidence of their own eyes. Their smoking patients got sick…a great deal. They themselves, the ones who smoked, got sick as well. So, why didn’t they speak up? I suspect that some were hesitant in part because cigarette advertising helped support the

mission of the medical societies to further scientific research and education. That, plus a massive amount of disinformation, was enough to silence opposition to cigarette smoking and to prolong the influence of the tobacco companies. It took a very public report by the U.S. Surgeon General, a political appointee not charged to be the arbiter of knotty questions, to break through, and the rest was history. Of course, we’re too smart these days to let ourselves be manipulated by commercial interests. Or maybe not. Consider the mess our healthcare system is in, a mess which is largely related to our inability to rationally allocate financial resources towards taking care of patients. The truth is there for all to see, if we care to look. Our healthcare system is awash with money. Our economy spends two or three times as much on healthcare as any other advanced economy on the planet, and experiences, if anything, worse health outcomes. We do not need an infusion of additional money. Not from the federal government, not from employers and certainly not from patients. We do not need more control of physicians. We certainly do not need to ask physicians to take a pay cut. That makes no sense. We are the final step in patient care, where the ‘rubber hits the road.’ You do not want

to put the brakes on care at that step. The financing and organization of this mess is about to burst onto the public debate stage, once more, over the next months and years. This same debate that has been going on since the early 1960’s when the very first reform of American medicine (Medicare) was first proposed. Then, at the urging of the big insurance companies, the AMA strenuously opposed Medicare, calling it ‘socialized medicine.” Had we learned nothing from the tobacco company fiasco? Perhaps one way to understand why physicians get repeatedly conned by commercial interests like tobacco and insurance companies is to acknowledge that we are often torn between two deeply held values. First is that we believe strongly in Capitalism, “free-markets.” Cigarette companies ought to be able to advertise when and where they want. Insurance companies ought to be able to go about their business without interference from government. Our second deeply held value, a value that was already around for 3,000 years when Capitalism was invented, is that the patients’ welfare comes first. In the case of smoking, ultimately the latter value prevailed. continued on page 7

Our economy spends two or three times as much on healthcare as any other advanced economy on the planet, and experiences, if anything, worse health outcomes.

The Bulletin | November 2019

MEDICAL MISSION ARTICLES NEEDED

continued from page 6

In the upcoming debate, the insurance companies will no doubt use the age-old argument about free markets, and it is certainly a good argument, and we ought to consider it here. We ought to ask, though, if that argument has sabotaged our more ancient enduring value by perhaps: • Creating an insurance system with layers on layers of bureaucracy, and ever more complicated insurance plans that neither patients nor doctors could ever understand. • Denying, or delaying paying for lifesaving treatments. • Spending enormous sums of money advertising how they ‘care’ about their customers when we know that their customers (and we’re their customers as well) can’t even get them on the phone. • Flooding the media with messages about how ‘their’ doctors are better than the other insurance company’s doctors when we know that they’re both using the same doctors. • Wasting money by paying their executives tens of millions or even hundreds of millions of dollars and giving them bonuses to create systems solely designed to deny paying claims. I predict that, like physicians in the 1930’s and 1960’s, physicians of our age will soon be called upon to make the choice on a big pivotal issue. Whether to support big commercial interests who have controlled the financing of healthcare for so many decades or to support an alternative entity of some kind that is more aligned with the interests of our patients. The debate is beginning, and we should be part of it. Both of our enduring values should be considered, but the most important should be the welfare of our patients. Anything less, and I fear another unflattering Smithsonian exhibit.

The SCMS will again feature the Medical Missions of our members (physicians, residents and medical students) in the December 2019 Bulletin. If you or someone you know of has participated in a medical mission (at home or abroad) within the last year or so, please contact Joan Cramer at jmcramer@sbcglobal.net. We are looking for articles of approximately 400-800 words in length (submitted in Word format) along with photos (submitted individually as JPEGs) to publish for each Medical Mission article. The deadline for submission is Wednesday, November 20, 2019, to jmcramer@ sbcglobal.net. Depending on the number of articles received, we may need to publish some of the articles in future issues of The Bulletin.

Visit Us at www.SaginawCountyMS.com

The Bulletin | November 2019 7

Barb Smith Achieves Two Milestones Barb Smith, founder of the Barb Smith Suicide Resource & Response Network (Network), recently performed her 100th safeTALK training and her 50th Applied Suicide Intervention Skills Training (ASIST) training. The Networkâ€™s mission is to prevent suicide through education and resources, and to support those impacted by suicide. The Network has been serving communities since 1989, and is driven by the purpose found in the pain after Barb lost her brother, John, to suicide. The Networkâ€™s team of expert trainers facilitate evidenced-based prevention trainings to people where they live, work, play and learn with the goal of de-stigmatizing suicide and increasing help-seeking behaviors. Over the past several years, the Network has grown tremendously by building partnerships and collaboration. Thousands in the region and beyond have received suicide awareness or evidence-based suicide prevention training and aftercare services. In fact, as of September 2019, the Network provided 8,000 individuals with training in awareness, safeTALK or ASIST. This has been achieved through a public health model approach, which features suicide prevention tools placed in the hands of everyone. The Network has implemented a plan to facilitate one-hour depression and suicide awareness programs, tailored to any environment into the hands of anyone willing to learn. Indepth trainings such as safeTALK and ASIST authored by LivingWorks, the world leader in suicide prevention training solutions, are designated for those looking to build suicidesafer communities. While the two types of training complement each other and work best when "layered" together, Barb said ASIST is a much more in-depth process. "safeTALK is the link - you would

recognize somebody with suicidal thoughts, you ask them the question, then you immediately connect them with someone who can do more of the work," Barb said. "ASIST is where you ask the question about suicide, you hear more of the stories of what's going on in their life, then you start to develop a safe plan, so there's much more work that needs to be done." The "TALK" portion of safeTALK's program's title is an acronym - standing for "Talk, Ask, Listen and Keepsafe" representing the system's focus on opening a conversation about suicide, directly asking questions about the subject's suicidal thoughts, listening to why someone might have suicidal thoughts and keeping them safe by connecting them to resources in their community that will keep them on the path of choosing life. safeTALK training is open to anyone 15 years and older, and is "evidence-based," meaning the training has been highly evaluated over the years to show behavioral change. "Evidence-based means the training is proven to change your behavior and - once you took the training, you would be able to talk about suicide differently than you would without it." ASIST is a two-day face-to-face workshop that includes videos, simulations, discussion and lecture sessions. The two systems have been used by the Network for at least eight years, though the last year in particular has brought about a significant increase in the amount of sessions the Network's team hosts, going from performing training sessions a handful of times per year to doing them about once a week. Barb attributes this growth to a change in how people are discussing and dealing with suicide and mental illness. "More people are talking about suicide, and having that open conversation," she said. "Some organizations and companies are even requiring it now - I think people see the value of it." continued on page 9

How Can You Help? Do you want to raise awareness, volunteer or participate in an upcoming event? Contact Barb Smith at barb.smith@suicideresourceandresponse.net or Stacey Urbani at stacey@suicideresourceandresponse.net or call (989) 781-5260 and schedule a training or educational event or get more information.

Barb Smith Suicide Resource & Response Network is supported solely by donations and grants. To donate, please make your check payable to Barb Smith SR&RN and mail to: Barb Smith Suicide Resource & Response Network PO Box 6712, Saginaw, MI 48608-6712 The organization is a 501(c)(3) nonprofit, and your donation is tax deductible (EIN 38-3400293). 8

The Bulletin | November 2019

continued from page 8

Aftercare needs have been provided to more than 3,000 individuals through the avenues of support group, events and aftercare trainings. The Network’s Survivors of Suicide Support Group hosted at the Great Lakes Bay Health Center in Saginaw meets twice monthly to support those impacted by suicide. The Network also hosts an annual National Survivors of Suicide event, called Hope Starts Here attended by approximately 200 participants each year. The Network exists with significant financial support from local Foundations, generous private sponsors and its annual “Walk for Hope” depression and suicide awareness event, but it flourishes due to the deep personal commitment of countless individuals who walk alongside to bring light to the issues of mental wellness and suicide prevention. The Network is and will remain committed to leading the way in eliminating suicide.

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.

All statements or comments in The Bulletin are those of the writer, and not necessarily the opinion of the Saginaw County Medical Society.

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The Bulletin | November 2019 9

SAVE THE DATE! CMU Seeks Clinical Educators and Partnerships in MAT to Treat Opioid Use Disorders

Opioids (including prescription opioids, heroin, and fentanyl) killed more than 47,000 people in 2017, and 40% of all opioid overdose deaths involved a prescription opioid. The opioid epidemic is hitting close to home – Michigan has experienced a 21% cumulative increase in drug overdose deaths since 2013. Central Michigan University (CMU), has a goal to combat the opioid epidemic by training medical and PA students with 8-hours of mandatory classroom learning using the American Society of Addiction Medicine’s (ASAM)-accredited curriculum with medication-assisted treatment (MAT) Drug Addiction Treatment Act (DATA) waiver training requirements. Additionally, CMU is seeking partnerships with clinical educators at certified opioid treatment facilities or primary care offices that offer MAT to host our students for clinical experience. CMU is offering community educators free 8-hour MAT DATA waiver training through ASAM on: Saturday, April 25th, 2020 9:00 am – 5:30 pm CMU College of Medicine 1280 E. Campus Drive, Room 2403 Mt. Pleasant, MI 48859 Registration Link: https://elearning.asam.org/p/mtpleasant425 Participants will receive a $25 gift card for participating and completing a brief questionnaire along with 8 Category 1 CME hours. Livestreaming will also be available at the CMU College of Medicine building in Saginaw located at 1632 Stone St., Saginaw, MI. For additional information, please contact the project coordinator, Alyson Hill at Alyson.hill@cmich.edu or at 989-746-7506 for any questions or if you are interested in hosting student(s) to learn about MAT in your practice setting.

CMU’s clinical sites and MAT (M) partnership sites as of 10/2019

10 The Bulletin | November 2019

SAVE THE DATE! SEP 16, 2017 8:00 am – 12:00 pm The Pyle Center, UW-Extension 702 Langdon St Saturday, Madison, WI 53706

COST - $199 LOCATION LIVE IN-PERSON

April 25, 2020 | 9:00 am – 5:30 pm SEP 16, 2017 | 8:00 am – 12:00 pm

Central Michigan University College of Medicine Room 2403 1280 East Campus Drive Mt. Pleasant, MI 48859

LIVE STREAM LOCATION

Central Michigan University College of Medicine Educational Building 1632 Stone St. Room 1008 Saginaw, MI 48602

COST FREE

REGISTRATION

https://elearning.asam.org/p/mtp leasant425

CONTACT

Email: education@ASAM.org Call: 301.656.3920

The ASAM Treatment of Opioid Use Disorder Course covers all evidence-based practices and medications for treating patients with opioid use disorder. The ASAM Treatment of Opioid Use Disorder Course is designed for: 



Physicians, Nurse Practitioners, Physician Assistants, Certified Nurse Midwives, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists who wish to obtain a waiver to prescribe buprenorphine in an office-based setting for opioid use disorder. Clinicians and healthcare team members such as RNs, MA/LPNs, social workers, pharmacists, counselors, clinic administrators/office managers, and others working with providers who prescribe buprenorphine in an office-based setting to treat opioid use disorder.

Course Format: 8 hours live This training satisfies eight hours of education requirements for providers to qualify for a DEA DATA2000 waiver. Upon completion of this course, physicians qualify for the waiver to prescribe buprenorphine in an office-based setting. NPs and PAs can qualify after completing an additional 16 hours provided by ASAM, the American Association of Nurse Practitioners, and the American Academy of PAs.

Are you an NP or PA? ASAM also provides the additional 16 hours required for NPs and PAs to qualify for a waiver free of charge.

ASAM is an approved provider by CSAT/SAMHSA of DATA 2000 training. ACCME ACCREDITATION STATEMENT: The American Society of Addiction Medicine (ASAM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. AMA CREDIT DESIGNATION STATEMENT: The American Society of Addiction Medicine designates this live activity for a maximum of 8 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Bulletin | November 2019 11

SCMS, MSMS and AMA Present to M1 and M2 Students

Dr. Mukkamala talks about the AMA

Drs. Mukkamala and Arsiwala with some of the students who participated in the event.

On Monday, October 28, MSMS President, Mohammed A. Arsiwala MD, and MSMS President-Elect, S. Bobby Mukkamala MD met with a group of nearly 25 M1 and M2 students at the CMU College of Medicine in Mt. Pleasant about membership in the SCMS, MSMS and AMA. Frances Greathouse and Sally Nagia, medical student leaders in Mt. Pleasant, coordinated the event. Dr. Arsiwala presented information on MSMS membership, and with Joan Cramerâ€™s assistance, spoke about the benefits of membership in the SCMS. Dr. Mukkamala, who also serves as an AMA Board member, presented information on the AMA. Students asked many interesting questions about organized medicine, how to get involved and how policy is made. The SCMS welcomes CMU medical student members to all SCMS Membership Meetings at no charge, offers mentorship with physicians in Saginaw, and an opportunity to sit in on a SCMS Board Meeting and represent CMU medical students, among other things. Students were given a recent issue of The Bulletin, along with a current Membership Directory. The SCMS Foundation offers low interest loans to medical students with ties to Saginaw, research grants, funds monetary awards for the annual CMU Research Symposium, and assists students with expenses in attending the MSMS House of Delegates and AMA Annual and Interim Meetings.

Dr. Arsiwala gives a presentation on MSMS

Would You Like to Mentor a Medical Student? The SCMS Board encourages members to volunteer as mentors for medical students. Please consider mentoring a student or two, tell them about Saginaw and the SCMS, answer their questions, bring them to a future SCMS meeting, and guide them as needed. If you are interested in mentoring a student, please contact Michele Reynolds, MA, Assistant Director of Student Affairs at CMU College of Medicine at michele.reynolds@cmich.edu. Frances Greathouse and Sally Nagia

12 The Bulletin | November 2019

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

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Better Solutions. Better Care. 2544 McLeod Dr. N. | Saginaw, MI. 48604 Ph. 989.791.1691 | Fax 989.791.4603 healthwayrx.com The Bulletin | November 2019 13

Saturday Morning Sports Injury Clinic Now Available A new Saturday morning sports clinic in now available at Ascension St. Mary's Walk-in Clinic, 5810 Gratiot Road in Saginaw. Angel Bermudez, MD, a fellowshiptrained sports medicine physician, can address injuries immediately. He has expertise in sports injury prevention and treatment, concussion management and musculoskeletal care. No appointment is necessary. In addition to the Saturday sports clinic, Dr. Bermudez sees patients in his primary office Monday-Friday at 5275 N. Colony Drive in Saginaw. For more information, contact his office at 989-799-1350.

Ascension Medical Group Announces New Office Location

Ascension St. Mary’s Breaks Ground for New Emergency Care Center Ascension St. Mary’s broke ground for a new Emergency Care Center on October 8. Nearly 300 people, including many physicians and community leaders, attended the event to mark the beginning of construction on the $17.6 million expansion that will add 12,600-square feet, renovate existing space and improve access for ambulances and the public. “We are so excited for this new, leading-edge Emergency Care Center,” said Dr. Stephanie Duggan, Regional President. “We have been planning for over a year since Ascension announced its reinvestment in our Saginaw hospital, as well as, Ascension Standish and Ascension St. Joseph. As part of a recent master facility planning study, the emergency entry for ambulances and the public was identified as a top priority. The investment into a new care facility will improve patient flow, increase capacity and efficiency, and provide easier access for ambulances, patients and families.” The project will be completed in six phases, and transform the facility into a modern-day emergency and Level II Trauma Care Center with 24 treatment rooms and two state-of-the-art trauma rooms. A spring 2021 opening is expected. Pictured are emergency care staff, physicians and leaders. To see event photos, view them on the Ascension St. Mary’s Facebook page.

14 The Bulletin | November 2019

To better serve patients, Ascension Medical Group physician, Adam T. Kandulski, MD and staff, have moved to a new office. Effective Monday, November 4, the care team began to see patients at the new office located at 1015 S. Washington Avenue in Saginaw. Commonly referred to as Ascension St. Mary’s Riverfront or the Michigan CardioVascular Institute (MCVI) building, Dr. Kandulski and the care team have a brand new, larger office on the 2nd floor. This new location offers more comfort and convenience with additional exam rooms, comfortable chairs and more available parking. The care team will continue to listen to individuals, working to understand what they need at each visit and provide the quality, personalized care everyone has come to expect. Dr. Kandulski and staff can be contacted at the same phone number (989) 753-5300. The office is open Monday – Friday beginning at 8 a.m. Appointments may also be scheduled online at GetAscensionMichiganCare.com.

Dr. Rao V.C. Gudipati to be honored at 25th Annual Cornette Ball The Ascension St. Mary’s Foundation Cornette Ball on Saturday, November 16, is one of the grandest black-tie galas in the region. Held at Horizons Conference Center, the festive evening includes a cocktail hour, a magnificent five-course gourmet meal and live music by Detroit’s Intrigue. The Spirit of St. Vincent Award will be presented to Rao V. C. Gudipati, MD, FACC, FAHA, in recognition of his long and noteworthy service to the Great Lakes Bay community. Tickets are still available for the event, as well as, sponsorships. For more information or details about the event, please contact Tammy Weighman at (989) 907-8875 or tamera.weighman@ascension.org, or visit https://stmarysofmichiganfoundation.org/.

Ascension Online Care Anywhere, anytime

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If you are experiencing a major emergency, go to the ER as soon as possible or call 911. © Ascension 2019. All rights reserved. The “Android” name, the Android logo, the “Google Play” brand, and other Google trademarks, are property of Google LLC. All rights reserved. Apple, the Apple logo, iPhone, and iPad are trademarks of Apple Inc. All rights reserved.

The Bulletin | November 2019 15

October Membership

he Saginaw County Medical Society Membership Meeting was held on Tuesday, October 15, 2019, at HealthSource Saginaw. Mildred J. Willy MD, President, called the meeting to order at 7:17 p.m. Dr. Willy thanked Lisa Lapham, President & CEO of HealthSource, along with her staff for hosting the meeting. She also welcomed speakers, Drs. Brad Walters and Howie Mell. Dr. Willy thanked the following Key Providers in attendance for their ongoing support of SCMS programs: • Ascension St. Mary’s Neuro – Eric Maher and Nicole Stewart • Covenant HealthCare Cardiology – Drs. Mayar Jundi, Bakri Kaakeh, Hossam Mustafa and Michael Taipale • HealthSource Saginaw – Leaders and Staff Dr. Willy welcomed and introduced new members attending their first meeting: 1) Ileana “Marie” Daly MD, CMU Health – Family Medicine Resident 2) Albert G. Linden MD, CMU Health – Internal Medicine Resident Dr. Willy then conducted the following business: • The Minutes of the September 17, 2019, Membership Meeting were attached to the Agenda and published in the October Bulletin. MOTION: Approve the September 17, 2019, Meeting Minutes as printed. MOTION APPROVED. Dr. Willy then communicated the following: • The December issue of The Bulletin will feature stories on the Medical Missions of our members, and articles are due by November 20.

The Bulletin | November 2019

• An update on the Health Can’t Wait prior authorization proposed legislation, and the need to contact lawmakers through www.Healthcantwait.org. • An update on Out-of-Network or “Surprise Billing” legislation, and the need to contact lawmakers by going to www.MSMS.org and clicking on “Advocacy.” • Monetary donations are needed for the Barb Smith Suicide Resource & Response Network’s “Hope Starts Here” event for survivors of those lost to suicide on National Survivors of Suicide Day on Saturday, November 23. • Michigan Medicine is presenting a three-part online course on Psychiatric Pharmacogenomics. Information on the course and how to register was included on the attachment to the Agenda. Dr. Willy welcomed Drs. Brad Walters and Howie Mell who presented an informative program on “Beyond Run, Hide, Fight: Workplace Violence.” A question and answer session followed.

Froedtert Hospital, Milwaukee, Wisconsin 3/12/19

Meeting

Ms. Carlie Beaudin, an oncology nurse practitioner, is coming out to her car after the end of her shift at 1 a.m. She is assaulted in the parking deck and beaten to death by a former hospital employee recently fired. The perpetrator was initially found incompetent to stand trial but, subsequently, has with treatment now been deemed competent and is facing trial for first degree homicide.

Chicago, Illinois - 2006 Dr. David Cornbleet, a dermatologist, had a one-person office without even a secretary. He was found bound, gagged, and stabbed to death in that office. The perpetrator, whose mother is a French citizen making him a French citizen, fled to the French island of Guadalupe, where authorities refused to extradite him (death penalty). But, in 2011 he was arrested there and tried. He claimed he killed Dr. Combleet because the medication that he was prescribed for his acne caused impotence. Court documents showed this former patient had called Dr. Cornbleet over 500 times. He was found guilty and sentenced to life in prison, but will be eligible for parole in 22 years - the harshest punishment in France. He is currently appealing the verdict.

Non-ER Incidents

Members were reminded to sign in at the registration table and complete the online CME evaluation through CMU OCME to obtain credit. The next Membership Meeting will be held on Tuesday, January 21, 2020, at Horizons Conference Center. There being no further business, the meeting was adjourned at 8:35 p.m. Respectfully submitted, Joan M. Cramer, Executive Director

Above (l-r): (l-r) Drs. Mayar Jundi, Bakri Kaakeh, Michael Taipale and Hossam Mustafa (l-r) Drs. Thomas Raymond and Tarek Taha, and Ronda Raymond (l-r) Drs. Therese Mead, Brad Walters, Millie Willy and Howie Mell

As the surgery intern, I was wheeling a critically injured young lady up to the OR. I was stopped by the patient's father. He was well dressed, calm, with a smile on his face as he reached out to shake my hand. I expected him to say something like, 'please take care of my daughter, best of luck, when you are done come fill me in on how the operation went,' - the common things a family member will say. As he shook my hand, I could feel a hard object in his palm that he transferred to my hand. It was a bullet. As that man turned to walk away, he told me if his daughter died there was another bullet waiting for me. His calm smile still haunts me. An attending surgeon's anecdote, Denver, Colorado

Recommendations from the Experts • Have an alternative means to exit your office a back door. • Have a locked door between your waiting room and the examination area. • Consider alert buttons in the exam rooms. • Try to keep your wait times as short as possible. • Telephone answering as quickly as possible (call your own office every once in awhile and see how your receptionist(s) answer the phone). • Meet with your staff regarding a response to a threatening patient or family member including evacuation of the office, calling police. • Shooter drills - run, hide, fight.

It Was a Busy Legislative Advocacy Week November 1, 2019 - Key Takeaway: The Health Can’t Wait prior authorization legislation was introduced in the Senate as Senate Bill 612, and the next day, MSMS convened members, practice managers and Health Can’t Wait coalition partners from across the state to meet with legislators and explain the need for the legislation. While the Health Can’t Wait action day was happening, MSMS and our specialty society partners testified about concerns regarding the surprise out-of-network legislation.

Senate Bill 612: Health Can’t Wait Act of 2019 The Health Can’t Wait Act of 2019 was introduced as Senate Bill 612 on Tuesday, October 29, by Senator Curt VanderWall (R-Ludington). The next day, nearly 100 physicians, medical professionals and patients flooded the Capitol to meet with lawmakers. The day started at 9 a.m. with a welcome from Trudy Ender, Executive Director of the Susan G. Komen Foundation of Michigan. An overview of SB612 and tips on how to engage with the lawmakers was provided by Josh Richmond.

Meeting with State Rep. Rodney Wakeman

Meeting with State Rep. Vanessa Guerra

There were 54 lawmaker meetings between the House and the Senate, all with positive outcomes. Mid-Michigan area physicians, practice managers and Joan Cramer of the SCMS met with State Reps Vanessa Guerra and Rodney Wakeman in the morning, and with Sen. Ken Horn’s Chief of Staff in the afternoon. Meetings in the House of Representatives began at 10 a.m., at the same time a press conference was held. The media present for the press conference were Michigan Information & Research Service Inc. (MIRS), Gongwer, Lansing State Journal and WLNS TV. The following link shows the extensive media coverage for Health Can’t Wait. 18

The Bulletin | November 2019

Health Can't Wait Media Clippings Over the lunch hour, Sen. VanderWall welcomed everyone back and thanked them for their action. Zach Gorchow, Gongwer editor, provided an overview of Michigan politics. Meetings in the Senate began at 1 p.m. An Action Alert is now live and ready for you to write your Senator at http://healthcantwait.org/take-action.

Suprise Out- of -Network Billing Legislation Debate around surprise out-of-network (OON) billing legislation continued this week in both the House and the Senate. The Senate Insurance and Banking Committee held a hearing on Senate Bills 570-573, which essentially mirror the House bills that MSMS currently opposes. As substituted, the legislation covers emergency and non-emergency settings when a patient does not have the opportunity to choose or the only provider available is OON. In those cases, the reimbursement rate for physicians would default to 150 percent of Medicare or the average (l-r): Christin Nohner, MSMS Director of State contracted rate, and Federal Government Relations; MSMS whichever is greater. member Christopher Abood, MD; MSMS The package also Board of Director's member and SCMS Past includes provisions President, Thomas Veverka, MD; and Michigan Society of Anesthesiologists member around notification Courtney Abernathy, MD testify on October and a written 17. Photo courtesy of MSMS. estimate of charges, as well as, penalties for not complying with the notification requirements. MSMS President Elect, S. Bobby Mukkamala, MD testified before the Senate Insurance Committee on October 30 to express concerns with the legislation, as introduced, and offer solutions to improve the bills while still keeping the patient out of the middle. On October 31, the House Health Policy Committee heard its second week of testimony from Blue Cross Blue Shield of Michigan (BCBSM) and the Michigan College of Emergency Physicians (MCEP). Christin Nohner gave brief remarks to provide some points of clarification following BCBSM's testimony. The legislation is scheduled for discussion and a potential vote in the Senate Insurance and Banking Committee the first week in November. It is likely the House Health Policy Committee will take a vote on the bill during that time as well. MSMS continues to deploy grassroots action alerts, and engage in discussions with legislative staff and lawmakers, continued on page 19

continued from page 18

including leadership in an effort to - at the very least - slow the process down. A letter to the quadrant leaders, signed by all of the presidents of the various medical societies, asking for the legislature to consider slowing the process to first and foremost consider the scope was also circulated recently. Separately, MSMS is working with Senator Bizon's office to draft alternative language for possible inclusion in the bills. Click HERE to Write the Committee Members NOW

Engagement Makes a Difference – Remembering the Physician Tax Rally It was an October not unlike last month. The weather in Lansing had turned cooler. Republicans and Democrats were still trying to navigate divided government in the state Capitol. Physicians from across the state were using their voices to change the legislative landscape over a critical bill in the House and Senate that would make a real and lasting difference for Michigan patients. Ten years ago this October, nearly 800 Michigan physicians arrived in Lansing for a landmark legislative battle, supported by thousands of others in districts back home. That October, they proved that when Michigan physicians stand together and speak out, they can make an incredible difference. It’s a lesson that’s more important to remember than ever, as providers across the state begin the fight to protect their patients by reforming prior authorization and step therapy requirements, and tell their lawmakers that Health Can’t Wait. A decade ago, Lansing was considering legislation to tax physicians in order to generate $300 million in new revenue for the state’s Medicaid program, but in the process, the bill would have devastated the state’s health care system. The tax would have reduced the state’s ability to attract and retain physicians. It would have forced older physicians to retire early and pushed younger physicians into other states. It would have

limited or reduced patients’ access to care. The tax would have caused layoffs for essential health care staff, including nurses, office administrators and navigators who helped patients deal with billing and insurance issues. Every citizen in the state was set to suffer the consequences of the physician tax, with access to quality health care on the verge of diminishing. But the battle was only beginning. In an incredible display of commitment to their patients and their practices, on October 20, 2009, the state’s physician community stood up and spoke out. Doctors traveled from across Michigan to rally on the steps of the state Capitol, urging lawmakers to abandon the disastrous health care tax hike. Back at home, countless others called their lawmakers, sent letters to their local newspapers, invited legislators to visit their offices, and spoke with the media to defend their patients. "As America debates reforming our health care system, Lansing is working to tax it. What's wrong with this picture?" asked thenMSMS president Richard E. Smith, MD, a Detroit obstetrician/ gynecologist. "This tax would hurt patients' access to doctors in communities all across our state. The State House was wrong to pass it; the State Senate will do right by stopping it." Overwhelmed by pressure from MSMS members, and physicians from more than 30 specialty societies and county medical societies, that’s exactly what they did. The State Senate, by a staggering and bipartisan 32-4 vote, rejected the health care tax. They didn’t do it because it was easy. They did it because doctors and providers stood up and spoke out. In 2019, just ten years later, Michigan physicians are embarking on another landmark effort to improve patients’ access to care. The fight to reform prior authorization and step therapy burdens, to simplify access for Michigan patients is just beginning. Helping lawmakers understand that Health Can’t Wait won’t be easy, and it’s going to take all hands-on deck. We’ve done it before. Together, we can make change happen and ensure that better than ever, Michigan health care policy puts the needs of Michigan patients first.

Photo courtesy of MSMS

DIRECTORY UPDATE Died 10/20/19 Edgar L. Allport MD Retired – Surgery - Plastic

Reactivated Member James J. Jesko DO Covenant Orthopaedics 5483 Gratiot Road Saginaw, MI 48638-6037 Office (989)-799-5557 Fax (989)-799-2840 www.covenanthealthcare.com Surgery - Orthopaedic, Sports Medicine

Pager Added Phillip W. Lambert MD 341 Canterbury Saginaw, MI 48638-5812 Pager (989)-222-3517 Endocrinology, Metabolism

Died 10/12/19 New Member Elizabeth M. Marshall MD Robert J. Toteff MD Ascension Frankenmuth Family Retired – Family Medicine Physicians 1027 W. Genesee P.O. Box 265 Frankenmuth, MI 48734-0265 Office (989)-652-5230 Fax (989)-652-3741 healthcare.ascension.org Family Medicine

Covenant Lung Cancer Screening Program Lung cancer is the leading cause of cancer deaths in the United States. More than 200,000 people are diagnosed with it each year. Because lung cancer is often not found until it is at an advanced stage, nearly 71 percent of those who develop it will die from the disease. Early detection offers the best possibility for survivorship.* At the Covenant Cancer Care Center, lung cancer screening is performed with state-of-the-art Low-Dose Computerized Tomography (LDCT). The LDCT exam is quick and painless and is performed without using x-ray dye or contrast. Our program includes a team of caring specialty physicians and dedicated professionals. The Covenant Lung Cancer Screening program has received American College of Radiology designation. This is a voluntary program that recognizes facilities that have committed to practice safe, effective diagnostic care for individuals at the highest risk for lung cancer. To receive this elite distinction, facilities must be accredited by the ACR in computed tomography in the chest module, as well as, undergo a rigorous assessment of its lung cancer screening protocol and infrastructure. Also required are procedures in place for followup patient care, such as counseling and smoking cessation programs. Lung Screening Exams The purpose of a lung screening exam is to look for nodules or masses in the lungs of people who do not have symptoms but are at a greater risk for the disease. Smoking is the biggest risk factor for lung cancer – increasing with the amount and length of time a person has smoked. Lung cancer screenings are recommended by the U.S. Preventive Services Task Force for: • Anyone 55-77 years of age, and • Current smokers or former smokers who have quit in the last 15 years, and • Heavy smokers with a history of 30 pack years or more. A pack year = smoking an average of one pack of cigarettes per day per year (i.e., a 30 pack year = one pack a day for 30 years or two packs a day for 15 years) Lung screenings are not offered to people who have had a CT scan in the past year, are on home oxygen, have a pacemaker or have metal rods in their spine. It is recommended for people to be screened annually. Prior to scheduling an appointment, patients must have a written order from their physician. In addition, patients need to participate in a lung cancer screening, counseling and shared decision-making appointment with a physician or qualified non-physician practitioner. 20 The Bulletin | November 2019

To learn more, please contact Ann Werle, RN, ONN-CG(T) Thoracic Nurse Navigator at 989.583.5014. *American Cancer Society. Cancer Facts and Figures, 2014.

Covenant Bariatric Program Renews National Accreditation Covenant HealthCare is excited to announce the Bariatric Program has been reaccredited as a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®) Center through August 2022. The American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS) combined their respective national bariatric surgery accreditation programs into a single, unified program to achieve one national accreditation standard for bariatric surgery centers, the MBSAQIP®. Chad D. Ringley, MD, FACS, is now joined by Kimiko D. Sugimoto, MD, FACS, as a MBSAQIP® Verified Surgeon for Covenant. MBSAQIP® works to advance safe, high-quality care for bariatric surgical patients through the accreditation of bariatric surgical centers. A bariatric surgical center achieves accreditation following a rigorous review process during which it proves that it can maintain certain physical resources, human resources and standards of practice. All accredited centers report their outcomes to the MBSAQIP® database. The program accredits inpatient and outpatient bariatric surgery centers in the United States and Canada that have undergone an independent, voluntary and rigorous peer evaluation in accordance with nationally recognized bariatric surgical standards. Bariatric surgery accreditation not only promotes uniform standard benchmarks, but also supports continuous quality improvement. In the United States, more than 11 million people suffer from severe obesity, and an estimated 93 million people are obese. The comorbidities associated with obesity range from diabetes and heart disease to certain types of cancers. Bariatric surgical procedures have been shown to reduce obesity, improve mortality and decrease the health risks from chronic diseases such as cardiomyopathy and diabetes. For these reasons, the MBSAQIP® will recognize those facilities that implement defined standards of care, document their outcomes and participate in regular reviews to evaluate their bariatric surgical programs. Covenant Medical Group Welcomes New Physicians Drs. Kaakeh, Mustafa and Taipale Join Covenant Cardiology Covenant HealthCare welcomes Bakri Kaakeh, MD, as a member of the Covenant Medical Group. Dr. Kaakeh joins the Covenant Cardiology team as a Cardiothoracic Surgeon. He specializes in surgical treatment of coronary artery disease continued on page 21

continued from page 20

and cardiac valve disease (coronary artery bypass grafting, cardiac valve replacement/ repair), management of the thoracic aorta including aortic dissection repair, a team approach to structural heart disease management including TAVR, surgical treatment of arrhythmias, as well as, diagnosis and treatment of benign and malignant lung disease (lung biopsy procedures and mediastinoscopy, video assisted thoracoscopy, wedge (segmental) resection, lobectomy, and pneumonectomy). Covenant HealthCare welcomes Hossam Mustafa, MD, MSc, FACC, FHRS, as a member of the Covenant Medical Group. Dr. Mustafa joins the Covenant Cardiology team as a cardiac electrophysiologist. He specializes in management of heart rhythm disorders. His experience includes performing electrophysiology studies, complex arrhythmia ablations and comprehensive management of cardiovascular implantable electronic devices.

Covenant HealthCare welcomes Michael J. Taipale, DO, as a member of the Covenant Medical Group. Dr. Taipale joins the Covenant Cardiology team. He is a general cardiologist who manages a wide spectrum of cardiac conditions including chest pain, hypertension, hyperlipidemia and basic arrythmias including atrial fibrillation. Drs. Kaakeh, Mustafa and Taipale have offices at Covenant Cardiology, 900 Cooper, Suite 4100, in Saginaw, and the team can be reached at 989.583.4700. Dr. Pitts Joins Covenant Emergency Medicine Covenant HealthCare welcomes Eric A. Pitts, DO, as a member of the Covenant Medical Group. Dr. Pitts joins the Covenant Emergency Care Team. Offices are located at 900 Cooper, Saginaw and the team can be reached at 989.583.6521.

continued on page 22

diabetes Self Management Program

In the United States,

30.3 million

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

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

The Bulletin | November 2019

continued from page 21

Dr. Ahamed Joins Covenant Hospital Medicine Covenant HealthCare welcomes Rizwan Ahamed, MD, as a member of the Covenant Medical Group. Dr. Ahamed joins the Covenant Hospital Medicine Team. Offices are located at 1447 North Harrison, Saginaw, and the team can be reached at 989. 583.4220.

Dr. Toya Joins Covenant Pulmonary & Critical Care Covenant HealthCare welcomes Sophie Toya, MD, as a member of the Covenant Medical Group. Dr. Toya joins Covenant Pulmonary & Critical Care Associates. Offices are located at 800 Cooper, Suite 3, Saginaw and the team can be reached at 989.583.7380.

Dr. Richter Joins Covenant Neurosurgery Covenant HealthCare welcomes Erich O. Richter, MD, as a member of the Covenant Medical Group. Dr. Richter joins the Covenant Neurosurgery team of Drs. Schinco and Udehn, bringing his knowledge of stereotactic and functional neurosurgery to the Great Lakes Bay Region. His services include tremors, Parkinson’s disease, seizures and epilepsy, complex pain disorders including cancer pain, brain tumors, spine and spinal cord abnormalities, brain and spinal cord injuries, neuro rehabilitation, spasticity and frozen shoulder - neurostimulation, deep brain stimulation, cortical mapping and surgery to treat epilepsy, vagal nerve stimulation, normal pressure hydrocephalus, pain relief after failed back surgery, peripheral nerve stimulation for intractable headache disorders, intrathecal drug delivery, movement disorders, dystonia, gait disorders, spasticity, Cerebral Palsy, neurotrauma, Brachial Plexus injuries resulting from shoulder trauma, tumors or inflammation, and Multiple Sclerosis. Offices are located at 800 Cooper, Suite 8, Saginaw and the team can be reached at 989.752.1177.

Dr. Sharpe Joins Covenant Surgical Group Covenant HealthCare welcomes John Sharpe, MD, MS, FACS as a member of the Covenant Medical Group. Dr. Sharpe joins the Covenant Surgical Group bringing his knowledge of trauma and general surgery. His services include basic and complex hernia repair, complex trauma and critical care surgery, emergency and general elective surgery, feeding tube placement, gallbladder disease, laparoscopic and robotic surgery, soft tissue masses, and tracheostomy placement. Offices are located at 5415 Cardinal Square Blvd., Saginaw, and the team can be reached at 989.790.4855.

Dr. Franklin Joins Covenant Primary Care Covenant HealthCare welcomes Karensa L. Franklin, MD, as a member of the Covenant Medical Group. Dr. Franklin joins the Covenant Primary Care team. Offices are located at 600 N. Main Street, Suite 210, Frankenmuth, and the team can be reached at 989.652.1440.

Veterans, Thank You for Your Service. Covenant HealthCare was honored to once again recognize those physicians, employees and volunteers who not only work to care for our patients, but also have served honorably in the military. On Monday, November 11, physicians who are veterans were invited for a brief recognition ceremony beginning promptly at 8 a.m. by the flagpole at Entrance A of the 700 Cooper building. On behalf of Covenant HealthCare, thank you for your service.

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The Bulletin | November 2019

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

2020 Seminar Info • January 9, 6:00 - 8:00 pm • April 16, 6:00 - 8:00 pm • September 17, 6:00 - 8:00 pm Covenant HealthCare Mackinaw 5400 Mackinaw Third Floor Conference Room A Saginaw, Michigan 48604 Space is limited. To reserve your seat, call

1.866.COVENANT (1.866.268.3626)

College of

Medicine Dr. John Blebea Inducted into the American College of Surgeons John Blebea, MD, MBA, professor of surgery and chair of surgical disciplines, was inducted into the American College of Surgeons Academy of Master Surgeons on October 4, 2019, at the John B. Murphy Memorial Auditorium in Chicago. He was one of 79 surgeons nationwide of all surgical specialties selected for this honor. The Academy recognizes surgeon educators who have devoted their careers to surgical education following stringent peer review. The Academy’s mission is to play a leadership role in advancing the science and practice of education across all surgical specialties, promoting the highest achievements in the lifetimes of surgeons. Congratulations, Dr. Blebea!

CenteringParenting® Open House on November 21 CMU Health, in partnership with the Michigan Health Improvement Alliance (MiHIA), would like to invite our faculty, staff, students and community members to an open-house celebrating the launch of our new CenteringParenting® program in Saginaw. CMU Health Centering Open House Thursday, November 21, 2019 | 4:30 – 6:30 p.m. 1000 Houghton Ave., Saginaw, MI 48602 CenteringParenting® is a group-care model for newborns, which is a continuation of our CenteringPregnancy® program. This program replaces traditional childcare and brings six to eight moms, partners, support people and their infants (age 0 2 years) together in community with their health care providers and other parents of same-age infants, who are experiencing similar milestones at the same time. Our Centering programs in Saginaw foster a safe and supportive environment to ask questions and create lifelong bonds between families. For more information, visit www.cmuhealth.org/centering.

College of Medicine Team Places First in Saginaw Downtown Rotary Fundraiser Bianca Jenkins and Aaron Sifuentes, M3 medical students, brought home first place at the Saginaw Downtown Rotary fundraiser golf outing. The team came in at an outstanding nineunder par 62. Playing with them were David Thiel and Dr. Steve Vance. The Downtown Rotary is one of three local Rotary Clubs that award scholarships annually to CMU College of Medicine students who match to residency programs in the region. Congratulations!

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If you are interested in mentoring a student, please contact Michele Reynolds, MA, Assistant Director of Student Affairs at CMU College of Medicine at michele.reynolds@cmich.edu.

call 989-799-5700

The Bulletin | November 2019

LEASING@SHAHEENDEVELOPMENT.COM

“Empowering Patients: A Key to Successful Diabetes Management” Zeina Habib, MD CMU Health – Houghton Endocrinology During National Diabetes Awareness Month, it is imperative for us providers to recognize and support the people who are at the forefront of diabetes care - our patients. They are the ones tasked every day with monitoring and managing the ups and downs of their blood sugars, along with their other life responsibilities. Diabetes Self-Management Education and Support (DSMES) is a simple intervention that has the potential to lighten the burden of living with diabetes. With DSMES, we can empower our patients by providing them with the knowledge and skills needed to manage their diabetes on a daily basis. When discussing diabetes management with our patients, it is important to 1) define treatment goals, and 2) discuss strategies to achieve those goals. For many non-pregnant people with diabetes, a target glycated hemoglobin (A1C) of less than seven percent is appropriate. Blood glucose levels, when monitored, should generally be maintained between 80 and 130 mg/dL fasting and before meals, and less than 180 mg/dL one to two hours after meals, without significant hypoglycemia. Lower or higher targets may be reasonable depending on comorbid conditions, risk of hypoglycemia, duration of diabetes and other factors. To achieve glycemic targets, a combination of lifestyle and pharmacologic interventions are usually required. Lifestyle changes such as nutrition therapy, physical activity and weight management are known to improve glycemic control and should be an integral and ongoing aspect of management for all patients with diabetes. On the other hand, pharmacologic therapy can be more individualized. Compared to one or two decades ago, we have many more

P 989.755.2116 F 989.755.2120 Let us build a relationship with you. Please call Dornbos for your printing needs!

insulin and non-insulin glucose lowering agents available nowadays to help manage glycemia. In addition, diabetes technology now provides us with more tools (continuous glucose monitors, insulin pumps with closed loop features, etc.) than ever before to help monitor and improve glycemic control. All of these factors make diabetes care a complex system to navigate, requiring extensive and ongoing patient education. According to the CDC (Center for Disease Control and Prevention), “It is unrealistic to expect people with diabetes to make lifestyle changes without access to services and support.” DSMES can be provided by a variety of diabetes educators (dieticians, nurses and pharmacists), and in a variety of settings (individual, group, in-person or online). The American Diabetes Association recommends that all newly diagnosed diabetes patients receive DSMES, with reevaluation for further education needs at least once a year, and sooner in cases of care transitions, changing treatment regimens, arising complications or other new challenges. This recommendation is based on evidence linking DSMES to better glycemic control, improved quality of life and reduced all-cause mortality. In addition, patients who receive DSMES are more likely to use primary care and preventive services, and less likely to require acute care and hospitalization, therefore, resulting in lower health care costs. With all the benefits it offers, DSMES has become a fundamental component of standard diabetes care. With this simple intervention, we can help our patients better manage their diabetes, and live longer, healthier lives. Bibliography

American Diabetes Association. (2019, January). Glycemic Targets: Standards of Medical Care in Diabetes-2019. Diabetes Care, 42 (Supplement 1), S61-S70. American Diabetes Association. (2019, January). Lifestyle Management: Standards of Medical Care in Diabetes-2019. Diabetes Care, 42 (Supplement 1), S46-S60. Centers for Disease Control and Prevention. (2018, March 6). Diabetes Self-Management Education and Support (DSMES) Toolkit. Retrieved October 2019, from www.cdc.gov: https://www.cdc.gov/diabetes/ dsmes-toolkit/index.html

COMPLETE DESIGN SERVICES Letterheads • Business Cards Envelopes • Brochures • Calendars Flyers • Cookbooks • Annual Reports Note Sheets • Newsletters • Mailings Large Format Posters • and much more… PRINT SERVICES Offset Printing • Die Cutting Foil Stamping • Embossing • Film Output Thermography • Black & White Copies Color Copies • Laminating • Union Bug The Bulletin | November 2019 25

DECEMBER BIRTHDAYS Waheed Akbar MD Syed S. Akhtar MD Anisah Al-Qadi (Student) Syed K. Alam MD Arshad Aqil MD Gretchen E.R. Augustine DO Catherine M. Baase MD Nathanial Bartosek (Student) Kayla Bennett (Student) J.G. Marc Bertrand MD Happy Special Birthday! Wendy S. Biggs MD Marshall A. Brown MD Sarah Bunker (Student) Thomas M. Burkey MD Shing Chao (Student)

John F. Cherry MD Sanjay Das (Student) Virginia R. Dedicatoria MD Libing K. Dong (Student) Elise Edwards-Cavalieri (Student) Rosalinda A. Elazegui MD Maria Florendo (Student) Walker N. Foland DO Frederick W. Foltz MD Jack E. Goodwin MD Duane B. Heilbronn, Jr. MD Jennifer A. Henrich MD Steven L. Jensen MD Nancy E. Joy MD Safwan Kassas MD Dalia Khader (Student)

Sura S. Khuder MD Jason T. King (Student) Sambasiva R. Kottamasu MD Yanyu Long MD Emmanuel Luciano Lorenzo MD Carlotta M. Maresca MD Nicole T. McCadie DO Andrew C. Ostosh MD B. Babu Paidipaty MD Mark S. Pankonin MD Che Song Park MD Christa M. Persyn MD Manasvi Pinnamaneni (Student) Nivin A. Qudeimat MD Lekha K. Richardson MD Brian M. Shear (Student)

James F. Shetlar MD Farhad K. Shokoohi MD Logan A. Steffke (Student) Gregory P. Sutton MD Tarek A. Taha MD Tamera C. Tennant (Student) Michael J. Tucker, Jr. DO Monique S. Turner DO Andrew S. Wagner MD Quintisha Walker MD Julia M. Walter MD Liaqat Zaman MD

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.

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The Bulletin | November 2019

Patient Safety By Louis L. Constan, MD True story: Our patient, post-surgery, sees an oncologist who, perusing the pathology report, sees that cancer cells have apparently “penetrated the capsule.” Ordinarily, this means the cancer is invasive and our patient will require a full-bore treatment regimen of chemotherapy with radiation. OK then, but first, the patient asks, please, may I have a copy of that Path report. Sure. (Very accommodating oncologist here). Our patient, who is not a doctor, reads the report very carefully and determines the wording of the report is actually ambiguous. The rather long sentence describing the neoplastic cells and the organ capsule contains two negative statements, and is therefore easy to misinterpret. He calls and asks the oncologist to please doublecheck with the pathologist on this because it’s rather important to get this right. After a one-on-one talk between the two doctors determined there was, in fact, no invasive cancer, just poor wording on a report, and no further treatment was necessary, you can imagine that the pathologist was quite embarrassed. Our patient, on the other hand, was quite relieved. He had dodged a bullet. And how had he done it? By simply being engaged and involved in his care…and by having a supportive doctor. It’s chilling to think that this patient could very well have suffered through several bouts of chemotherapy and weeks or months of painful radiotherapy to no good purpose. Real harm could very well have happened. It’s also chilling to think that, so few of us being English majors, and the reading and writing of reports being sometimes so difficult, that somewhere along the line such a fate might have befallen one of our own patients. Does this mean every patient should be reading his Path report? Or his consultant’s letter? Certainly not. Many patients are not intellectually or emotionally equipped to contribute to their care in this way. But, given the paramount importance of avoiding errors, especially errors that compromise patient safety, we should think about possible scenarios in which taking patient involvement to the next level might be appropriate: If you have a complicated patient in the hospital; and there are multiple consultants seeing the patient, including Residents, rounding at different times; and you see a smart young family member in the room who wants to write down everything you say about his relative (and everything the other doctors say as well) and he happily points out to you

that you say something that contradicts something one of the other doctors said; well then, perhaps you have a situation where the “patient” has helped you avoid harm. And that’s good! And if you have a patient in your office whose case generates reams of lab data; and if that patient shows an interest in looking at every single one of those reports even though he has only a high school education but is eager to spend hours and hours of his time scouring every single test’s ranges of normal, or even “confidence levels,” striving to understand them all by cross-checking with Dr. Google, or perhaps with a cousin who is a chemistry professor; and will happily point out to you when you missed something; then perhaps you have a situation where the patient has helped you avoid harm. And that’s good. Truth be told, the practice of medicine is getting more and more complicated. The scenarios above could easily become the norm, and the possibility of patient harm from data overload, overwork, inattentiveness, computer error, staff error…any number of reasons, is always hovering over us. The conventional way we’ve taught to avoid mistakes is to put more and more pressure on ourselves and our supporting staff to check, check, then double check. That’s a lot. The computer was supposed to help. But has it really? Or has it made things worse? So perhaps one solution to our problem is to enlist patients to help us. Many are eager to be more involved. The usual push-back I hear is that, by giving patients more information, we will generate more questions, taking up more time, which we don’t have. Yes, that may happen; but maybe not. With encouragement, and with Google easily available, most questions patients ask can be answered without our help. And by making the effort themselves, patients can learn a great deal about anatomy, pharmacology, and biology, which could be helpful to all of us going forward. It goes without saying that a patient who better understands his own disease can better understand his treatment regimen, the side effects he is likely to experience, and when he should and should not panic over a new symptom (and call in the wee hours). All of this could lead to incredible time savings, as well as, considerable improvements in patient care and patient safety. We are very fortunate in our area to have a Patient Safety Taskforce, convened by THRIVE , comprised of local healthcare executives, physicians, nurse leaders and community advocates. They recognize that medical errors are the third leading cause of death in the United States but, by creating a robust and highly reliable culture of safety in our healthcare systems, every patient will be able to approach their care with full confidence that they and their loved ones will always be safe.

The conventional way we’ve taught to avoid mistakes is to put more and more pressure on ourselves and our supporting staff to check, check, then double check. The Bulletin | November 2019 27

IN MEMORY Edgar L. Allport, MD Edgar passed away at his home on Sunday, October 20, 2019, at the age of 77. He was born in Alexandria, Virginia in 1942. He married Deborah, whom he met while serving in the United States Navy. Ed graduated second in his class from Francis C. Hammond High School in 1960, at which time he also ran track and cross country. During his senior year, his team won the Virginia State Cross Country Championship. He was active in the Boy Scouts and achieved the rank of Eagle Scout. Later in life, he would return to the Boy Scouts and serve in committee for Frankenmuth Troop #275. Following high school, Ed spent a year at the Air Force Academy but ultimately decided in favor of completing his undergraduate education at the University of Virginia. He studied Biology, and completed his program in two years graduating at the top of his class as a member of Phi Beta Kappa. He remained at the University of Virginia for medical school, as well as, his medical internship and residency. He was number two in his class in medical school. Honors received included election to the Alpha Omega Alpha Society, the Omicron Delta Kappa Society, the Society of Sigma Xi and the Raven Society. While at the university, Ed often found time to hike in the Shenandoah National Park with his beloved hiking companion, Brutus the Labrador Retriever. This enthusiasm would eventually lead him to scale the Matterhorn in the Swiss Alps.

Upon moving to Frankenmuth, Dr. Allport occupied himself as a plastic surgeon at St. Mary's of Saginaw before going into private practice. He was an active member of the Frankenmuth United Methodist Church. Following his retirement, he joined the coaching staff for the boys and girls track teams at E.F. Rittmueller Middle School in Frankenmuth. Ed also worked as a local crossing guard. His myriad hobbies and interests included the study of the American Civil War and World War II, amateur (ham) radio and following the Detroit Tigers. His usual practice was to put the television on mute and to instead listen to the radio broadcast. His rationale was that the radio commentary was more clever and insightful. That it was out of sync with the television and greatly amused his family as a result did not bother him much at all. Ed is survived by his wife Deb, his daughter Amy of South Lyon, his son Charles of Frankenmuth, his brother Braxton (Cathie) Allport of Williamsburg, Virginia, and his sister Sarah (Greg) Robertson of Nellysford, Virginia, as well as, his many nieces and nephews. Funeral services took place on Monday, October 28, 2019, at Frankenmuth United Methodist Church. Those planning an expression of sympathy may wish to consider memorials to Frankenmuth United Methodist Church or to the Field Neurosciences Institute. Donations to the Field Neurosciences Institute can be made through the following link: https://fni. org/?page_id=70.

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The Bulletin | November 2019

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Robert J. Toteff, MD Dr. Robert J. Toteff passed away on Saturday October 12, 2019, at age 91. He was a beloved husband, son, father, grandfather, greatgrandfather and was a role model for both family and community. Dr. Toteff was born in Duquesne, Pennsylvania on March 7, 1928, the second son of George and Mary Toteff, brother to George Toteff (deceased) and Mary Ann (Toteff ) Miller. Bob moved to Detroit with his family during high school. He went to Wayne State University for both his undergraduate education and medical school, from which he graduated in 1955. Bob was married to his college sweetheart, Yvonne Wesley, for 44 years before her death in 1996. They had four daughters: Lynn (Ed) Taylor of Saginaw; Kathy (Jerry) Passiak of Austin Texas; Lisa (Fred) Arthur of Brighton; and Tracy (Jim) Zboril of Winter Park, Florida. Dr. Toteff is also survived by 12 grandchildren: Dr. Stephanie (Erik) Peterson, Sarah (Bill) Rickley, Rebecca (Frazer) Burton, Megan (Andy) Schlicker, John (Annie) Passiak, Stephen (Brittany) Passiak, Josh Arthur, Christian Arthur, Wes Arthur, Rosie Arthur, Lexy Arthur, Jack Zboril and eight great grandchildren. Dr. Robert Toteff did his internship and residency in general practice at St. Luke’s Hospital in Saginaw from 1955-1957. Shortly thereafter, he served in a medical unit in Germany as a Captain in the United States Air Force until 1959. He returned to Saginaw and opened up a private practice.

He then partnered with Drs. Clyde Davenport and Walter Averill to develop one of the first partnership group practices in Saginaw. Dr. Toteff helped the families in Saginaw for 23 years. He then began teaching and served as Director of the first Family Practice Residency Program in Saginaw. He also became a full-time faculty member of Michigan State University College of Human Medicine from 1977-1982. Subsequently, Dr. Toteff became Director of the Family Practice Residency Program at Wayne State University, and also Director of the Family Practice Residency Program at Beaumont Hospital Royal Oak/Troy until his retirement in 1991. Dr. Toteff served as President of the Saginaw County Medical Society in 1975, and most recently, served as a Trustee of the SCMS Foundation. He was active in volunteer work and in the community, serving the Saginaw Soup Kitchen, Church cantor/choir, Community Theatre of Gaylord and much more. His cherished cottage on Big Bass Lake near Gaylord was a place of retreat and serenity. His greatest reward was encouraging others to experience the value of giving back. A Celebration Memorial Service is being planned for Spring/ Summer 2020 at St. Mary’s in Gaylord. In remembrance of him, please pass on any stories that mean something to you and will help the family through this loss. The family will be making a story book for the Memorial. Send stories by email to etaylor317@aol.com. He will be dearly missed by his family and the many peoples’ lives who he touched over his life and career as a physician. You may also share your thoughts and memories with Dr. Toteff’s family through www. DeislerFuneralHome.com. Those planning an expression of sympathy may wish to consider memorials to the SCMS Foundation, 350 St. Andrews Road, Suite 242, Saginaw, MI 48638-5988 whose mission is to support Saginaw medical students and residents, or to the charity of your choice.

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

Caduceus meetings are available to health care industry professionals, and have adopted many of the principles of 12-Step programs. Caduceus meetings are “closed” meetings for recovering health care professionals including, but not limited to, nurses, doctors, dentists and pharmacists. We engage in group discussions where members may want to speak up, ask questions or share thoughts with fellow members. The Bulletin | November 2019 29

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The Bulletin | November 2019

Foundation

SCMS FOUNDATION Make a Tax Deductible* Gift Today!

WHAT IS THE PURPOSE OF THE FOUNDATION? • Provides low interest loans to medical students with ties to the Saginaw area, with a maximum of $20,000 over four years. The Foundation’s ultimate goal is to have loan recipients return to Saginaw to practice. • All interest is forgiven if the student returns to Saginaw upon completion of their residency to practice. • If the loan recipient returns to Saginaw to practice upon completion of their residency and they are a dues paying member of the SCMS/MSMS, 25 percent of the principal balance will be forgiven at the end of each year they are practicing in Saginaw County, with a maximum of $5,000 per year forgiven. • In the next seven years, the Foundation has the potential to forgive $120,000 in loans for those who are expected to return to Saginaw to practice. • Assists the SCMS Alliance (spouses of members) in awarding scholarships to Saginaw County nursing students. • Awards scholarships to high school juniors and seniors interested in becoming a physician and practicing in Saginaw County. • Provides scholarships, grants and awards to CMU medical students and residents for research projects. The annual Golf Outing raises approximately $20,000 per year for these programs, but the Foundation also relies on donations to continue to increase funding programs in order to assist as many students as possible. With the anticipation of forgiving loans for those who return to Saginaw to practice, the Foundation is calling on members to donate now so it can increase assets and continue to provide support as noted above. ➢ 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 SCMS 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): m $1,000

m $500

m $250

m $100

m $50

m Other __________

Donor’s Name ______________________________________________________________ Mailing Address ___________________________________________ City, State, Zip _____________________________________ Daytime Phone (_____) ________________ Email __________________________________________________________________ How would you like to receive your receipt?

r Email

r Postal Mail

If you wish to make your gift as a memorial or tribute, please provide the following: My gift is: m in honor of m in memory of Occasion/Person to be honored: _______________________________________ Please send notice of my gift (without specifying amount) to: Name _____________________________________________________________________ Mailing 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 | November 2019 31

PRSRT STD U.S. POSTAGE PAID Saginaw, MI 48605 PERMIT #189

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

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2019-2020 KEY PROVIDERS

These Area Businesses Support Saginaw County Medical Society Membership Meetings. When you have a need for a service, please consider our Key Providers. Please mark your calendar for the following meetings and events for the first six months of 2020. 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, August and December) at 5:30 p.m.

There is no Board or Membership Meeting in December. Happy Holidays! Tuesday, January 21, 2020 Horizons Conference Center - SCMS Board meets at 5:30 p.m. Membership Meeting joint with the Saginaw County Dental Society with Social (cash bar) at 6:30 p.m. followed by dinner and program at 7 p.m. Speaker: Darnell Kaigler, Jr., DDS, PhD from the University of Michigan Dental School. Program: ""Oral Health and Overall Health: 2020 and Beyond" Tuesday, February 18, 2020 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m. Saturday, March 14, 2020 Horizons Conference Center - 16th Annual Health Fair “The Doctor Is In!” from 9 a.m.-12 p.m. Tuesday, March 17, 2020 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m. Tuesday, April 21, 2020 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. Speaker: Molly E. Gabriel-Champine, PhD, LP, Director of Behavioral Science, Family Medicine Residency at McLaren Bay. Program: “Physician Compassion Fatigue/Burnout.”

Saturday, April 25, 2020 CMU College of Medicine, Mt. Pleasant, with livestreaming at the Saginaw Campus, 9 a.m. – 5:30 p.m. Free eight-hour MAT DATA waiver training through ASAM. See pages 10-11 for more information and to register. Saturday-Sunday, April 25-26, 2020 The Henry in Dearborn – 155th Annual MSMS House of Delegates. Tuesday, May 19, 2020 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 SCMS and SCMS Foundation Annual Meetings at 7 p.m. Program: “Update on CMU College of Medicine.” Saturday, June 6, 2020 Saginaw Country Club – 11th Annual SCMS Foundation Golf Outing. Four-person scramble. 12 p.m. Registration and Lunch, with 1 p.m. Shotgun Start. Tuesday, June 16, 2020 CMU College of Medicine, 1632 Stone Street – SCMS Board meets at 5:30 p.m.