SCMS BULLETIN - Fall 2020

The

Bulletin Saginaw County Medical Society

Fall 2020 | Volume 79 | No 1

Please Pay Your 2021 Dues!

Free CME From MSMS If Paid By 11/30! p. 7

Dr. Veverka Announces Candidacy for 2021 MSMS President-Elect p. 16

Benefits of SCMS Membership p. 17

www.SaginawCountyMS.com

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The

Bulletin Saginaw County Medical Society

2020-2021 OFFICERS AND DIRECTORS

contents 7

7 President Mildred J. Willy MD President-Elect Anthony M. Zacharek MD Past President Julia M. Walter MD Secretary Caroline G.M. Scott MD

16

Treasurer Miriam T. Schteingart MD Board of Directors Jorge M. Plasencia MD

PLEASE PAY YOUR 2021 MEMBERSHIP DUES $100 Free CME If Paid By 11/30

FREE 2021 E/M Coding Update 12/8/20 8:30-9:45 a.m.

Courtesy of OCMS Dr. Veverka Announces Candidacy For 2021 MSMS President-Elect

24

AMA Joint Cybersecurity Advisory

25

28

17

Benefits of SCMS Membership

4

President’s Letter

6

From the Editor

7

SCMS Meetings and Events

8

CMU College of Medicine CMU Health

10

Ascension St. Mary’s

23

14

Covenant HealthCare

18

Key Provider of the Month Healthway Compounding Pharmacy

HEALTH CAN’T WAIT Contact Your Lawmakers Today!

Issue Headed For Vote CMU Free Virtual Symposium “The Impact of COVID-19 on Children and Families” 11/9/20 1-3:30 p.m.

Register Now!

Tiffany K. Kim MD Mark G. Greenwell MD Harvey K. Yee MD Elizabeth A. Paulus MD Furhut R. Janssen DO Bulletin Editor Louis L. Constan, MD Resident Representative Anushka N. Magal MD MSMS Delegates Elvira M. Dawis MD Julia M. Walter MD Mildred J. Willy MD Anthony M. Zacharek MD Jorge M. Plasencia MD Christopher J. Allen MD Miriam T. Schteingart MD MSMS Alternate Delegates

19 Birthdays

Caroline G.M. Scott MD Waheed Akbar MD

20

In Memory – Thomas Anthony Egleston, MD

20

Caduceus Meeting for Recovering Health Care Professionals

21

Applications for Membership

22 THRIVE

27

Fulfill Your Board of Medicine Requirements on Your Time

MSMS Reimbursement Advocate Alert

30

Advertiser Index

32

SCMS Meetings and Events

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

Mohammad Yahya Khan MD Virginia R. Dedicatoria MD

COVER PHOTO COURTESY OF LUCIA WHITE

Steven J. Vance 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 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

EDITOR Louis L. Constan, MD EXECUTIVE DIRECTOR Joan M. Cramer DESIGNER Lori Krygier

PUBLISHER Saginaw County Medical Society 350 St. Andrews Rd., Ste. 242, Saginaw, MI 48638-5988 Telephone (989) 790-3590 | Fax (989) 790-3640 Cell (989) 284-8884 | jmcramer@sbcglobal.net Hours By Appointment | SaginawCountyMS.com

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 | Fall 2020 3

PRESIDENT’S LETTER

Defining the Gender Gap in Medicine: From EBM to FBM and Beyond

By Mildred J. Willy, MD Guest Writer: Ken Milne, MD, MSc, CCFP-EM, FCFP, FRRMS - Emergency Medicine Physician

T

he term evidence-based medicine (EBM) was originally defined by Dr. David L. Sackett 24 years ago. He defined EBM as: “The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett et al BMJ 1996).

This definition can be represented in a Venn diagram. Many people think that EBM is just about the scientific literature.

This is not correct, and EBM is more than just the published literature.

The evidence is only one of three pillars of EBM. The published literature informs and should guide our care, but it should not dictate our care. EBM also needs physicians to use their good clinical judgment based on their experience. We also need to engage with patients and ask them about their preferences and values.

It is these three components that make up EBM: The literature, our clinical judgment and the patient’s values/preferences. However, there are limitations to EBM. One is the gender inequity that can be found in each of these three pillars of EBM. The Medical Literature There are many examples of gender inequity in medical literature.

• Females are less likely to get their research funded than men.

• Women are less likely to rise to the top academic positions at universities compared to men.

• Men are more likely to rise to the top academic positions in medicine.

• Men are more likely to rise to the top academic positions in emergency medicine.

• Men are more likely to be the first author on a medical publication.

• Men are more likely to be the first author on an emergency medicine publication.

• Pediatric emergency medicine (PEM) is 62 percent female, but women are the lead author of only 42 percent of PEM papers. Women are also often

excluded from being participants in medical research.

We need to ensure that women are getting equal access to grant money, so they can ask the questions important to women and create the medical literature that informs our care of women. This will also lead to more women being first author on a medical publication. We need to include rather than exclude women as participants in medical research and not just extrapolate from male subjects.

The Clinicians There are many examples of gender inequity in the second pillar of EBM, the clinician. Men have historically been the physician in the room. Men are more likely to rise to the top leadership positions within the hospital. Only three percent of healthcare CEOs are women, six percent are Department Chairs, nine percent are Division Chiefs, and three percent are serving as Chief Medical Officers. This is despite women comprising 80 percent of the healthcare workforce. continued on page 5

Many people think that EBM is just about the scientific literature. This is not correct, and EBM is more than just the published literature.

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The Bulletin | Fall 2020

continued from page 4

There is a gender pay gap in the house of medicine. Men get paid ~$20,000 more per year in medicine than women.

Men get paid ~$17,000 more per year in academic medicine.

Men get paid ~$12,000 more per year in academic emergency medicine.

A recent study showed that female surgeons made 24 percent less per hour than male surgeons. This pay gap persisted even after adjusting for various factors (Dossa et al JAMA 2019). The Ontario Medical Association recently released a report called Understanding Gender Pay Gaps Among Ontario Physicians. It documented that male physicians on average bill 15.6 percent more than female physicians even after controlling for a number of variables. This is similar to the 17 percent gender pay gap found in the United Kingdom for hospital doctors.

Women make up at least 50 percent of medical school graduates at many institutions. A system must be in place to support those women who want leadership roles in healthcare.

Pay inequity must also end.

Dr. Michelle Cohen and Dr. Tara Kiran wrote an article called Closing the Gender Pay Gap in Canadian Medicine. It defines the problem of gender pay gap and dispels some of the myths like, is the gender pay gap real and do women just work less or less efficiently than men? They describe some of the root causes of the gender pay gap and what can be done to close the gap.

The Patients The third pillar EBM also shows evidence of gender inequity. Women are more likely to access and utilize health care compared to men. Mothers make approximately 80 percent of health care decisions for their children. Women are systematically undertreated for painful conditions. They are seven percent less likely to get any analgesia and 10 percent less likely to get an opioid compared to men. Even for a life

threatening illness like a myocardial infarction, women receive less treatment and have double the odds of dying.

We need to ensure that everyone gets the emergency care they need regardless of whether they identify as a man or woman. The emergency department is like a lighthouse. It is the one place in the house of medicine that the light is always on and will treat anyone at any time for anything.

The gender inequity discussion does dichotomize things into men and women. This is a false dichotomy. There are people who do not identify as a man or woman. Gender is complex and on a spectrum. There is how a person identifies, expresses themselves, the sex assigned at birth, who they are physically attracted to and who they are emotionally attracted to. I would suggest that Feminist-Based Medicine (FBM) is just the starting point and we need to take it one step further to Gender-Based Medicine (GBM).

The Gender Unicorn is a graphic representation demonstrating the complexity of gender and sexuality. We need to make sure that the house of medicine is not just inclusive and tolerant, but accepting and welcoming to everyone regardless of how they identify.

The progression, in my opinion, should be from EBM (male dominated) to FBM (recognizing the gender inequity) to GBM (more inclusive) and ultimately to Humanist-Based Medicine (HBM). There are other inequities in medicine besides just gender. There are problems with race, religion, socioeconomic status, mental health, physical ability, etc.

In order to provide patients with the best care, based on the best evidence we need high-quality, clinically relevant research that is inclusive and representative of everyone; remove inequities for those who generate research and provide care at the bedside; and finally, recognize everyone has value and should expect and deserve great care.

Comments from Dr. Willy: Please join me in acting to close this gender gap given that our medical school classes generally consist of >50 percent females as does the younger physician population at large, and the importance this plays for providing better patient care as well.

The Bulletin | Fall 2020 5

FROM THE EDITOR

Good Grief!

By Louis L. Constan, MD

I

f you’re feeling a bit angry these days, just go to one of those social media sites, or to any media site for that matter, to see who people are blaming for the current virus mess.

If you’re fair, as you surely are, you know that the blame-game will get us nowhere.

For my part, I tend to take a clinical approach to all this; considering the whole controversy as all-to-be-expected when patients face the prospect of loss of life or health, as described so well by Elisabeth Kübler-Ross in her 1969 book, On Death and Dying as the Five Stages of Grief. We’ve all seen these stages in our patients when they lose a loved one or receive a terminal diagnosis. In my opinion, Americans, as a society, are going through the Five Stages of Grief in an incredibly public way, displayed for all to see, every night on the nightly news:

clinic in Mexico, or take that experimental drug. COVID-19 Bargainer: We just need more ICU beds, ventilators, virus tests, contact tracers…then we’ll be fine. Or, maybe: I’ll take some hydroxychloroquine or swallow some hand sanitizer.

Stage One of Grief - Denial: No, this can’t be happening, you must be wrong.

COVID-19 Denier: It’s just the flu. It’ll be over by fall.

As they say, we’re all in this together, and if together we all fully accept the reality of this situation, we can defeat the virus. But clearly, many Americans are stuck in one of those early stages. Why? One reason might be the lack of a realistic prognosis. Truth be told, we doctors are not always forthcoming with a realistic prognosis. And our message, just like that of the media, is sugarcoated to avoid shocking the patient/ viewer/customer too much. “We’re doing everything we can” is as meaningless as “we’re bending the curve.” “We’ve got the best doctors working on your loved one”

Stage Two of Grief - Anger: This is wrong! Somebody will pay for this! I’ll sue. COVID-19 Tantrum-thrower: It’s the (Democrats’…or Republicans’) fault.

Kick-em-out! They’re taking away my rights! It’s a conspiracy!

Stage Three of Grief - Bargaining: If only I, or you had done something different, things would have turned out better. Maybe if I pray more, or go to that

Stage Four of Grief - Depression: Don’t bother me. I’m done with everything. Maybe I’ll just end it all.

COVID-19 Depressive: I’ve just lost my loved one, it’s hopeless; there’s nothing more to be done, my life is over.

Stage Five of Grief - Acceptance: It’s bad, but I’ll find a way to go on.

COVID-19 Accepter: This is a deadly disease, but there are simple steps that I can take to minimize my risk, and I am going to take those steps, and keep taking them until there is a vaccine.

is as meaningless as “heroes work here.”

“There’s always hope” is as meaningless as “vaccines are just around the corner.”

All ways of deflecting the patient/ viewer/customer from the grim reality of the situation and allowing him to remain in denial/anger/bargaining.

What if all of us, doctors, hospital administrators, mayors, governors, community leaders, politicians, all spoke with one voice, bluntly giving Americans the unvarnished truth about just how bad things really are. What if all shared (and the media could surely help us do this) the grim reality of being a COVID patient; the horrific details of respiratory failure and intubation and perhaps lifelong COPD; heart failure; secondary infections; peripheral emboli leading to amputations; strokes leading to mental impairment; physical deconditioning leading to long stays in rehabilitation centers?

Perhaps, if Americans could see and hear and feel what actually happens to these patients, they would be convinced to move out of their stage of denial, on to later stages. They would, of course, need equally clear, complete information from trusted authorities (put your name here) to learn what they need to get past the anger, bargaining and depression stages.

Our hope is the stage of acceptance; where we gird ourselves with the knowledge and practices to keep us safe while we wait for the vaccine.

If you’re fair, as you surely are, you know that the blamegame will get us nowhere.

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The Bulletin | Fall 2020

PLEASE PAY YOUR 2021 MEMBERSHIP DUES Free CME for Your SCMS/MSMS Membership Renewal by November 30

SCMS MEETINGS AND EVENTS Due to COVID-19, the SCMS has cancelled meetings and events through the end of the year. The Board continues to evaluate the state of the pandemic and the safety of meeting in person in the future.

The April 2020 Membership Meeting program, “Physician Compassion Fatigue” to be presented by Molly E. GabrielChampine, PhD, LP, Director of Behavioral Science, Family Medicine Residency at McLaren Bay, will be rescheduled in 2021 once it is safe to start meeting in person.

The 16th Annual Health Fair postponed in March will not be rescheduled in 2020. We do not feel it is in the best interests of the public who attend (many of whom have multiple medical conditions), our vendors, members and staff to bring together a large group of people.

Board meetings for the immediate future will be held virtually.

Effective January 1, 2021

CPT® Evaluation and Management (E/M) Office or Other Outpatient (99202-99215) and Prolonged Services (99354, 99355, 99356, 99XXX) Code and Guideline Changes Click HERE for more information

Complimentary E/M Coding Update for 2021 for SCMS Members/Staff SCMS members are invited to learn about the 2021 E/M guidelines for office and other outpatient service codes 99202-99215. Speaker Betsy Nicoletti, MS, CPC will provide a virtual, high-level overview on Tuesday, December 8 from 8:30-9:45 a.m.

This virtual event is being hosted by our sister county, the Oakland County Medical Society (OCMS).

All SCMS members/staff are invited free of charge with registration here. Attendees may submit questions in advance.

The SCMS thanks OCMS for their generosity in providing this course free of charge to our members and staff.

As you are aware, 2020 has been an exceptionally difficult year for all of us. As a result of cancellation of revenue-producing projects and events, the SCMS has experienced a substantial financial setback. MSMS has already sent out 2021 dues invoices for SCMS/ MSMS membership with a due date of December 31, 2020. If you have not already done so, would you kindly consider paying your 2021 dues at this time?

Dues income is currently our only source of revenue, and we appreciate whatever you can do to facilitate early payment and allow us to continue to serve our members in the manner in which you have become accustomed.

Tax Information SCMS/MSMS dues are not deductible as a charitable contribution but may be deductible as an ordinary and necessary business expense (check with your tax specialist).

SCMS dues are 100 percent deductible as an ordinary business expense, and 87.5 percent of MSMS dues are deductible because a portion of MSMS dues is attributable to lobbying activities. The SCMS and MSMS are non-profit organizations focused on improving the lives of physicians so they may best care for the people they serve.

Benefits of SCMS Membership can be found in this issue of The Bulletin on page 17.

Free CME for Your SCMS/MSMS Membership Renewal by November 30 As a thank you for your loyalty as a member of the SCMS/MSMS and for paying early all physicians who pay their 2021 dues by November 30 will receive a $100 coupon towards a free CME course at an MSMS educational session.

The strength and effectiveness of SCMS/MSMS as your professional association is predicated on strong membership.

The free CME course is just a small token of appreciation for your continued support of organized medicine.

For questions about membership or if you have not yet received your 2021 dues invoice, please contact Joan Cramer, SCMS Executive Director at jmcramer@sbcglobal.net.

Continue to elevate your voice and defend your profession by paying your 2021 dues now!

The Bulletin | Fall 2020 7

College of Medicine and University Pediatricians Expand Partnership to Include Clinical and Translational Research The College of Medicine and University Pediatricians have taken the next step in meeting a significant need for Michigan’s children by creating the CMU Clinical Research Institute.

Building upon an existing educational partnership, the College of Medicine and University Pediatricians will improve children's health care across Michigan by expanding their affiliation to include clinical and translational research.

"Physicians who do research are on the cutting edge of medicine. This expansion of CMU's educational partnership ensures the children of Michigan receive the most up-to-date care," said Kathleen Meert, MD, Chair of Pediatrics at the CMU College of Medicine and President of University Pediatricians.

Generously supported by grants and endowments from The Children's Foundation, the collaboration establishes the CMU Clinical Research Institute, based in Detroit, and includes the Detroit Medical Center Children's Hospital of Michigan.

"We are excited about the collaborative opportunities created by this new framework, because it allows both University Pediatricians and the CMU College of Medicine to reach our full potential," said George E. Kikano, MD, Dean of the College of Medicine and CMU's Vice President for Health Affairs. "We share a mission of advancing human health, and we fulfill that mission through research and education." Learn more here.

Health Infectious Disease Specialist, to its new COVID-19 Medical Advisory Group.

The committee is made up of 16 infectious disease, public health and medical experts from across the United States.

The expert panel will review emerging COVID-19 research and data and provide guidance to the NCAA regarding training, practice and competition, with a primary focus on testing and mitigating infection spread.

Learn more here.

Dr. Asim Kichloo and Research Team Publish Several Papers in 2020 Collaboratively, Asim A. Kichloo, MD, Associate Professor of Internal Medicine, and his research team have been very productive, with 18 papers published since January 2020, of which seven have been on COVID-19.

The research team included Michael Albosta, M4; Michael Aljadah, MD, class of 2020, PGY1 at Medical College of Wisconsin; Zain El-Amir, M3; Kirk Dettloff, M4; Ghazaleh Goldar, MD class of 2020, PGY1 at Cleveland Clinic; and others.

Residents closely associated with the group are Shakeel Jamal, MD, PGY3; Dushyant Singh Dahiya, MD, PGY1; Navya Vipparla, MD, PGY3; Sindhura Ananthaneni, MD, PGY2; Mohammad Ayman, MD, PGY2; and Zatmar Khan, MD, PGY3.

New Graduate Medical Education Video Series

To comply with COVID-19 safety guidelines, the Graduate Medical Education team in Saginaw will conduct more than 500 virtual interviews for the next class of residents rather than The CMU College of Medicine welcomed the class of 2024 holding traditional, in-person interviews this year. on Monday, August 3, 2020. The first day of orientation was To capture the culture, programs and facilities of CMU held on the Mount Pleasant campus with students arriving at Medical Education Partners and the CMU College of Medicine staggered times to pick up their laptops, white coats and get in a way that could be presented to interviewees in a virtual their head shots taken. The remainder of the week's orientation setting, Partners worked with a film crew from Aberro Creative was completed virtually. to produce a series of videos showcasing our residency and Images of the first day of orientation can be seen in the CMU fellowship programs in Saginaw.

College of Medicine Orientation Class of 2024 album on the The end product was 11 short videos, featuring interviews CMU College of Medicine Facebook page. from organizational leaders, program directors and learners, as well as, high-quality footage of the Simulation Lab, our partner Dr. Nicholas Haddad Appointed to NCAA COVID-19 hospitals and the Great Lakes Bay Region.

Medical Advisory Group Watch the full video series on YouTube and follow along on the CMU College of Medicine’s Facebook for new video posts The National Collegiate Athletic Association appointed every week!

Nicholas E. Haddad, MD, CMU College of Medicine Associate Professor, Internal Medicine - Infectious Disease and CMU

Welcoming the Class of 2024

continued on page 9

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The Bulletin | Fall 2020

continued from page 8

Dr. John Blebea Receives Distinguished Fellow Honor and Editorial Board Reappointment The Outpatient Endovascular and Interventional Society (OEIS) selected John Blebea, MD, Professor and Surgical Discipline Chair, as a Distinguished Fellow at its annual meeting on September 25, 2020. Dr. Blebea is one of only six individuals ever honored by the OEIS with this designation. The OEIS is a national, multi-specialty society focused on outpatient cardiovascular procedures.

He has previously received Distinguished Fellow awards from the American Venous Forum and the Society for Vascular Surgery, and, in 2019, he was inducted into the American College of Surgeons Academy of Master Surgeon Educators.

Dr. Blebea has also been reappointed to the editorial board of the Journal of Vascular Surgery – Venous and Lymphatic Disorders, effective September 2020.

ADVANCED DIAGNOSTIC IMAGING is proud to be part

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

The Saginaw County Medical Society thanks CMU College of Medicine and CMU Medical Education Partners for facilitating and advocating for the membership of all 2020 Residents!

THE RIGHT TESTS…THE RIGHT READS…RIGHT AWAY!

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3400 North Center Road, Suite 400 • Saginaw, MI 48603 LOCAL TEL: (989) 799-5600 HOURS: Monday–Thursday, 8 am to 5pm

The Bulletin | Fall 2020 9

Recognitions Highlight Ascension St. Mary’s Commitment to Quality Stroke Care Ascension St. Mary’s received the American Heart Association’s Get With The Guidelines® Gold Plus Stroke Award. This award acknowledges the hospitals’ commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines centered on the latest scientific evidence. Ascension St. Mary’s also received the Target: Stroke Honor Roll and Target: Type 2 Diabetes Honor Roll Award.

In March, Ascension St. Mary’s was designated a Comprehensive Stroke Center (CSC) by The Joint Commission, the first hospital north of Flint, and only the 11th hospital in Michigan, to earn this designation. These designations affirm Ascension St. Mary’s provides the highest level of care for stroke, and that the hospital meets the rigorous standards in providing advanced imaging and treatment for complex strokes. The Ascension St. Mary’s stroke team is available 24/7, with access to all resources, to provide patients with the best possible stroke care for the most complicated and serious strokes when seconds count.

Ascension St. Mary's Celebrates Milestone With Emergency Center Construction This summer, Ascension St. Mary's associates and officials with RC Hendrick Construction celebrated a milestone by placing one of the final steel beams for the Saginaw hospital’s new emergency care center. The beam, covered with signatures and well wishes, was raised atop the structure, signaling the completion of the framework for the expansion.

The $17.6 million expansion will transform the facility into

10 The Bulletin | Fall 2020

a modern-day emergency and Level II trauma care center.

Patient flow, capacity and efficiency will be improved and access for ambulances, patients and families will be enhanced.

Completion is expected in spring 2021.

Ascension St. Mary’s and Memorial Healthcare Create Alliance to Strengthen Stroke and Neurological Care Memorial Healthcare is bringing its nationally-recognized neurology services to Saginaw. In July, a neurology and neurosurgery service alliance with Ascension St. Mary’s Hospital was launched. Memorial Healthcare will offer access to its world-renown neurological specialists to Ascension St. Mary’s patients for sub-specialty treatment, like migraines/ headaches and multiple sclerosis, and Memorial Healthcare will gain access to Ascension St. Mary’s team of highly skilled neurosurgery specialists.

“With this new business model, we see an opportunity for healthcare providers throughout Michigan to strengthen one another and deliver best-in-class care opportunities to new communities,” said Brian Long, FACHE, president and CEO at Memorial Healthcare. “Our alliance with Ascension St. Mary’s puts the most advanced neurology sub-specialists right in the Saginaw market, providing the same compassionate quality care patients have come to expect from Memorial Healthcare but closer to their homes.”

In March, Ascension St. Mary’s was accredited by The Joint Commission as the region’s only comprehensive stroke center, meaning patients receive the highest level of care with the most advanced procedures, technologies and treatments.

“With a legacy of being a center of excellence for stroke and neuroscience care, we are excited about this alliance with Memorial HealthCare and their neurological specialists to further enhance our program and continue to raise the bar in stroke care,” says Stephanie Duggan MD, FACEP, CPE, Regional President, Ascension Michigan Northern Ministries.

For example, the Memorial Healthcare Institute for Neuroscience’s Mary Hollist, DO a board-certified vascular continued on page 11

continued from page 10

neurologist specializing in strokerelated care, is providing inpatient and outpatient services at Ascension St. Mary’s Hospital, and at a private office located at 4680 McLeod East in Saginaw.

This collaborative approach strengthens local access to specialized neurology sub services while expanding Ascension St. Mary Hollist, DO Mary’s Hospital’s range of on-site services.

“Ascension St. Mary’s, its Field Neurosciences Institute and the Memorial Healthcare Institute for Neurosciences are highly regarded programs focused on providing individuals with exceptional care for strokes and other neurological conditions and illnesses,” said Joseph Adel, MD, FAANS, cerebrovascular, endovascular and skull base neurosurgeon. “This alliance complements each organization including research initiatives focused on the development of new treatments for disease and injuries of the nervous system. We look forward to working with our colleagues at Memorial Healthcare.”

Anam Khan, MD Internal Medicine Ascension Medical Group Primary Care 4705 Towne Centre Saginaw, MI 48604 Phone: (989) 780-2455

Ascension Medical Group Welcomes New Providers

Molly McInnis, NP Ascension Medical Group Bariatric Center 1015 S. Washington Avenue, 3rd Floor Saginaw, MI 48601 Phone: (989) 907-8716

Ascension St. Mary’s is pleased to welcome our newest members to the Ascension Medical Group and hospital medical staff. These providers are now caring for individuals at their office locations and Ascension St. Mary’s Hospital in support of our mission to better serve our community.

Lisa Kieb, PA Neurosurgery Ascension Medical Group Neurosurgery 4677 Towne Centre Saginaw, MI 48604 Phone: (855) 298-9888 Nathan Krebs, DO Orthopedics/Sports Medicine Ascension Medical Group Orthopedics 5275 N. Colony Drive Saginaw, MI 48638 Phone: (989) 799-1350

James Bodrie, MD Family Medicine Ascension Medical Group Vassar Family Medicine 1212 W. Saginaw Road Vassar, MI 48768 Phone: (989) 823-5020

Taylor Sinda, PA Ascension Medical Group Plastic, Reconstructive & Cosmetic Surgery 4705 Towne Centre, Ste. 104 Saginaw, MI 48604 Phone: (989) 497-3157

Ruby Gill, MD Family Medicine Ascension Medical Group Primary Healthcare 1015 S. Washington Avenue, 2nd Floor Saginaw, MI 48601 Phone: (989) 753-5300

Quintisha Walker, MD Family Medicine Ascension Medical Group Primary Healthcare 5810 Gratiot Road, Ste. B Saginaw, MI 48638 Phone: (989) 790-3650

Nathan Hamilton, DO Family Medicine Ascension Medical Group Birch Run Family Physicians 9900 Birch Run Road Birch Run, MI 48415 Phone: (989) 624-1500

Ascension St. Mary's Hospitalist Program The hospital medicine program at Ascension St. Mary’s Hospital is growing. Effective Oct. 1, 2020, Ascension St. Mary’s partnered with CMU Health Hospital Medicine Group to provide 24/7 hospitalist care to referred inpatients. Caring for patients will continue to be a collaborative effort with Ascension St. Mary’s community-based physicians and CMU Health Hospital Medicine Group to ensure all individuals receive the comprehensive and compassionate care our patients are used to receiving at Ascension St. Mary's Hospital. continued on page 13

The Bulletin | Fall 2020 11

Welcome New Providers Ascension Medical Group welcomes new providers Ascension St. Mary’s is pleased to welcome our newest members to the Ascension Medical Group and hospital medical staff.

These providers are now caring for individuals at their office locations and Ascension St. Mary’s Hospital in support of our mission to better serve our community.

Mary Hollist, DO Hussain Aboud, MD Intensivist/Nocturnist Ascension St. Mary’s Hospital 800 S. Washington Avenue Saginaw, MI 48601

Reina Badran, MD Internal Medicine/Primary Care Ascension Medical Group Primary HealthCare 1015 S. Washington Avenue 2nd floor Saginaw, MI 48601 Phone: (989) 753-5300

Alec Bergman, PA Primary Care Physician Assistant Ascension Medical Group Frankenmuth Family Physicians 1027 W. Genesee Frankenmuth, MI 48734 Phone: (989) 652-5220

Vascular Neurologist Memorial Healthcare Institute for Neuroscience - Saginaw 4680 McLeod East, Suite 2 Saginaw, MI 48604 Phone: (989) 497-3140

David Lemos, MD Orthopedics/Sports Medicine 5275 N. Colony Drive Saginaw, MI 48638 Phone: (989) 799-1350 Also sees patients at Ascension St. Mary’s Birch Run location

Andrea O’Dell, NP Cardiology Nurse Practitioner Ascension Riverfront Cardiology 1015 S. Washington Avenue Saginaw, MI 48601 Phone: (989) 754-3000

Brittany Phala, MD Lokesh Dayal, MD Intensivist/Nocturnist Ascension St. Mary’s Hospital 800 S. Washington Avenue Saginaw, MI 48601

Andrew Hinojos, DO Cardiologist Ascension Riverfront Cardiology 1015 S. Washington Avenue Saginaw, MI 48601 Phone: (989) 754-3000

12 The Bulletin | Fall 2020

Primary Care Physician Ascension Medical Group Bay City Family Physicians 4040 N. Euclid Avenue Bay City, MI 48706 P​hone​: (989) 671-9153

Jessica Ruff, PA Primary Care Physician Assistant Ascension Medical Group Bay City Family Physicians 4040 N. Euclid Avenue Bay City, MI 48706 P​hone​: (989) 671-9153

continued from page 11

Physicians will continue to have the option to refer their patients who require inpatient care. Providers with established hospital coverage relationships will remain unchanged.

Hassan Beiz, MD serves as the interim Medical Director for Ascension St. Mary’s Hospitalist Program. He is also the chairperson of Ascension Michigan’s Clinical Care Transformation Team (CCTT) and is leading initiatives to identify and improve processes pertaining to clinical quality and patient safety.

The hospitalist office remains on the 5th floor at Ascension St. Mary’s Hospital. The office and fax numbers are unchanged.

Office: (989) 907-8215. Fax: (989) 907-8798.

Physician Achieves Milestone Performing Her 1,000th Robotic Surgical Procedure Deborah Russell, MD, a board-certified gynecologist who specializes in minimally invasive robotic-assisted surgeries, reached a milestone on Friday, September 18 as she completed her 1,000th robotic-assisted surgery at Ascension St. Mary’s Towne Centre Surgery Center.

“We are very proud of Dr. Russell for achieving this milestone,” said Bapineedu Maganti, MD, Ascension St. Mary’s Towne Centre Surgery Center’s Medical Director. “Having the ability to perform robotic surgery in an outpatient surgical center is a great option for individuals who may not need a more acute hospital setting. Often, the scheduling time is much quicker, the environment is quieter, more private, and the care is more personalized.”

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Hours: MON-FRI 9 AM to 5 PM The Bulletin | Fall 2020 13

Dr. Mahir Sati Joins Covenant Cardiology Covenant HealthCare welcomes Mahir Sati, DO, FACC, RPVI, as a member of the Covenant Medical Group.

Dr. Sati joins the Covenant Cardiology Team as an Invasive Cardiologist. He specializes in coronary angiography, pacemaker implantation, cardiac testing including echocardiography and cardiac stress testing, peripheral vascular testing including anklebrachial index (ABI), arterial Doppler and venous Doppler, and cardiovascular consultations. The office is located at 900 Cooper, Suite 4100 in Saginaw, and the team can be reached at 989.583.4700. Dr. Sati has additional practice locations in Marlette and Bay City.

Covenant Once Again Achieves American Heart Association Top Honor for Quality Stroke Care Flag raised by patient as he shares his story.

Covenant HealthCare once again achieved top honors from the American Heart Association/American Stroke Association receiving the Get With The Guidelines® Target: Stroke Honor Roll Elite Plus Gold Plus Quality Achievement Award. The Award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, researchbased guidelines based on the latest scientific evidence.

Recently a flag was raised by Bay City stroke survivor, Troy Tackett, in front of the Covenant main campus at 700 Cooper.

The flag will fly in honor of the more than 600 patients who received stroke care at Covenant in the past year.

“Two years ago, in 2018, I had a double stroke- a shower- on

both sides of my brain,” said Tackett at the flag raising. “I was at work and got to Covenant. When I was just arriving, I remembered that I went blind, and I thought ‘this is it.’ But I’m a man of faith, and I believe God puts me in the right place at the right time when tragedy strikes. And I’m going to tell you, the thirty minutes… it’s serious.”

“I’m grateful to Melissa and Dr. Smith who were on that day [and all the nurses], that they reacted and that they had their program down solid so I can be here two years later.

Not only to survive, but [also] come back from therapy, back playing my guitar, back playing my drums, I’m back workingand in fact got promoted. I’m a blessed man.”

“This Award is tied directly to meeting quality measures for stroke care including providing lifesaving thrombolytic medication to patients within 30 minutes of arriving to our hospital,” says Melissa Duchene, RN, BSN, Stroke Program Administrator at Covenant HealthCare. “Our Stroke Team works diligently every day to ensure we provide the highest quality care to every patient who enters our hospital. This Award shows our dedication to patients and the community.”

According to the American Heart Association/American Stroke Association, stroke is the fifth leading cause of death, and a leading cause of adult disability in the United States.

On average, someone in the U.S. suffers a stroke every 40 seconds, and nearly 795,000 people suffer a new or recurrent stroke each year.

Specialized Clinic for Patients at Increased Risk for Breast Cancer The Covenant HealthCare Breast High Risk Assessment and Prevention Clinic specializes in the care of women who are at an increased risk for developing breast cancer. Our breast surgical oncology team of experts provide specialized care and increased access to the necessary resources for reducing breast cancer risk and ensuring early detection and prevention. Your visit will include a discussion of your risk level, education on risk reduction and a specific surveillance plan recommendation that is personalized to you and your lifestyle.

The chances of a woman developing breast cancer in her lifetime is one in eight. For some women, the risk of developing the disease is considered much higher.

WOMEN CONSIDERED AT HIGH RISK MAY HAVE: • Previous history of breast or ovarian cancer • Family history of breast cancer • Dense breast tissue requiring specialized examinations

14 The Bulletin | Fall 2020

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• Increased ethnicity risk (Ashkenazi Jewish heritage, San Luis Valley Hispanic) • Biopsy proven atypia SERVICES PROVIDED: • Breast cancer risk counseling and education • Genetic risk assessment • Genetic testing • Screening services • Community outreach • Affiliation with MD Anderson Cancer Network®, a program of MD Anderson Cancer Center For more information or to determine eligibility for enrollment, call 989.583.5195.

Dr. Kaul Performs Robotic Cystectomy for Bladder Cancer Sanjeev Kaul, MD and the surgical team at Covenant HealthCare performed a robotic first for the area; a robotic cystectomy for bladder cancer. A robotic cystectomy is an

extensive and complicated procedure that takes a highly skilled surgeon and team.

The second most common urologic cancer after prostate cancer, bladder cancer is generally highly treatable, but often reoccurring. In some cases, it can be much more aggressive and spread to other organs.

Surgery, alone or with other treatments, is used to treat most bladder cancers. Early-stage bladder tumors can often be removed.

The procedure was performed in July using the da Vinci robotic surgery system and was a first for our area. Performing this surgery with the da Vinci robot improves the accuracy and cancer control while minimizing pain and discomfort, facilitating recovery and return to work more quickly.

The Covenant Medical Group Urology Office of Dr. Kaul, Dr. Meldrum, Dr. Mills, and Dr. Rajpurkar is located at 3875 Bay Road, Suite 2S in Saginaw can be reached at 989.583.5370.

Wound Healing Center WE LEAD IN EXTRAORDINARY CARE • Wounds that fail to respond to traditional treatment after 30 days, have become infected, or appear to heal but continue to recur • Diabetic ulcers, especially on the feet • Venous or lower leg ulcers • Pressure ulcers, such as bed sores • Skin tears or lacerations • Failing skin/muscle grafts or flaps • Slow or non-healing surgical wounds • Post-operative infections • Bone infections (osteomyelitis) • Radiation tissue injuries • Lymphedema • Burn care • Brown recluse spider bites © 2020 Covenant HealthCare. All rights reserved. PK 1/20 11672

COVENANT HEALTHCARE WOUND HEALING CENTER 900 Cooper, Saginaw, Michigan 989.583.4401 covenanthealthcare.com

The Bulletin | Fall 2020 15

Dr. Veverka Announces Candidacy for 2021 MSMS President-Elect

I

t is with pleasure the SCMS announces Thomas J. Veverka, MD as the 2021 candidate for MSMS President-Elect.

Dr. Veverka is a board certified General Surgeon, a fellow of the American College of Surgeons, and has received added certification in Surgical Critical Care. He served as the Associate Director of Trauma at North Memorial Medical Center in Robbinsdale, Minnesota before starting in private practice as a general surgeon and surgical intensivist in Saginaw in 1994. While in Saginaw, Dr. Veverka served in several physician leadership roles, primarily at St. Mary’s of Michigan Hospital, as well as, on the Steering Committee for the General Surgery Residency program as the MSU surgical coordinator for the medical students. Dr. Veverka has served the SCMS as Director, Alternate Delegate and President over the past 15 years, and currently as Region 7 Representative on the MSMS Board of Directors. Dr. Veverka is a board member of the Michigan Health Improvement Alliance (MiHIA).

Dr. Veverka has a special interest in trauma care and trauma systems development, and served as the initial medical director of the trauma program at St. Mary’s of Michigan Hospital which eventually was designated as a Level II Trauma Center by the American College of Surgeons Committee on Trauma. He subsequently became the initial Trauma Medical Director for MidMichigan Medical Center in Midland, which also successfully underwent verification as a Level II Trauma Center. He serves on the Michigan Committee of Trauma and

performs Trauma Center Level III and IV verification visits for MDHHS. He also serves on the State Committee of Trauma in Michigan.

Dr. Veverka is very passionate about addressing the opioid crisis through volunteer activities at MidMichigan Medical Center, MiHIA and through his position on the Board of Directors of MSMS. He also serves on multiple other subcommittees.

Dr. Veverka received his medical degree from the University of Minnesota in Minneapolis. He completed his surgical residency at Saginaw Cooperative Hospitals, Inc., and returned to the University of Minnesota for his Surgical Critical Care Fellowship training. He maintains a passion for general surgery, trauma care and critical care, as well as, patient safety issues. Dr. Veverka has held a clinical faculty appointment with MSU College of Human Medicine Department of Surgery for over 25 years, as well as, holding a current clinical appointment with Central Michigan University College of Medicine. He is married to Cathleen and is the father of five.

MSMS presidents have greatly impacted MSMS’ programs, position on policy issues and its prominence in Michigan. The MSMS president typically serves a term of one year and works with the Board of Directors to set the strategic agenda for the Society. Past MSMS Presidents from Saginaw are: • • • •

James H. Jerome, MD (1867 and 1881) Lyman W. Bliss, MD (1890) Vernon V. Bass, MD (1977) Jack L. Barry, MD (1994)

The SCMS is pleased to endorse Thomas J. Veverka, MD as candidate for 2021 MSMS President-Elect.

Free CME for Your SCMS/MSMS Membership Renewal by November 30 As a thank you for your loyalty as a member of the SCMS/MSMS and for paying early all physicians who pay their 2021 dues by November 30 will receive a $100 coupon towards a free CME course at an MSMS educational session.

The strength and effectiveness of SCMS/MSMS as your professional association is predicated on strong membership. The free CME course is just a small token of appreciation for your continued support of organized medicine.

For questions about membership or if you have not yet received your 2021 dues invoice, please contact Joan Cramer, SCMS Executive Director at jmcramer@sbcglobal.net.

Continue to elevate your voice and defend your profession by paying your 2021 dues now!

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The Bulletin | Fall 2020

BENEFITS OF SCMS/MSMS

MEMBERSHIP T he Saginaw County Medical Society (SCMS) is the professional association of physicians in Saginaw County, and a component of the Michigan State Medical Society (MSMS). In order to be a member of one, you must be a member of both.

I have been asked many times by both members and nonmembers “Why should I belong to the SCMS and MSMS?” “What do you do for me?” Some have responded they “don’t use their membership because they don’t attend SCMS meetings.” SCMS and MSMS membership is so much more than membership meetings. We are not only support for you, but for your office staff as well. I’m hoping the information below will help members who are on the fence about paying their dues decide to remain members, and also convince nonmembers why they should belong. We represent physicians in all specialties and in all types of practices – solo, group, employed, etc. Active membership is open to MDs and DOs. • Active physician dues are $795 per year ($495/MSMS and $300/SCMS). One hundred percent of SCMS dues and 87 percent of MSMS dues are tax deductible as a business expense.

• The SCMS offers a discount for first year physicians, and MSMS offers discounts for first, second and third year physicians, as well as, physician spouses when both are members.

• Resident and medical student memberships are also available.

What We Offer SCMS Members and Their Staff: • Five Membership Meetings per year where our members have an opportunity to network and enjoy the camaraderie of fellow physicians who love the practice of medicine and want to see progress made in the Saginaw medical community. In addition, our meetings include interesting speakers and an opportunity to earn FREE CME credit. A few recent and future program topics include: - Surviving Acts of Violence - Physician Resiliency - Ethics - Suicide Awareness Training - Human Trafficking - Second Victim - Implicit Bias - What to do if a complaint - Opioids has been filed against you • Representation of physicians in all specialties and in all types of practices–solo, group, employed, etc.

• Communication and camaraderie with physicians of other specialties in a neutral setting.

• Liaison with MSMS for assistance on practice issues, billing and coding, health information technology, legal alerts, legislative issues, insurance and much more.

• An independent voice for physicians on issues they face at the hospitals.

• The Bulletin with articles and information pertinent to SCMS members and their staff.

118 Years of Caring for Saginaw County Residents Joan M. Cramer, SCMS Executive Director

• Pictorial Membership Directory is published annually and used by members and their staff on a regular basis.

Our Private Directory provides information on your practice to other member physicians outside your specialty. In addition, a Public Directory that includes office address and phone (but not fax numbers or email) is printed and distributed to 1,000+ households in Saginaw County. The response from the public on this listing of SCMS physicians has been extremely positive.

• Website which is full of useful information and resources www.SaginawCountyMS.com.

• Referrals to patients seeking a physician.

• Contact with local, state and federal legislators regarding issues of importance in Saginaw County.

The SCMS maintains contact with local legislators to provide issue education and help them understand the impact of healthcare legislation.

• A unified voice on medical issues to our legislators, our area hospitals, insurance companies, etc.

• Political activism in support of medicine-friendly candidates.

• Loans and scholarships to local medical students, residents and nursing students.

• Community service to actively and tangibly give back to the community where you live and work through SCMS sponsored projects, such as our annual Health Fair for the Saginaw community attended by 1,100+ offering free health screenings and information, plus the opportunity for residents to speak with our member physicians directly to answer questions and promote your practice.

• An active Peer Review Mediation Committee to provide a forum for patient complaints to be heard. Peer Review reduces the number of malpractice lawsuits.

• An active Peer Review Ethics Committee for physician to physician issues.

• Confidential assistance for members with substance abuse or personal issues affecting their practice of medicine.

• And more!

WHY PAY DUES? • Because all physicians need to “fund their voice.”

• National polls show physicians as one of the most respected professions. Sadly, they don’t use their clout often enough to preserve their profession and protect their patients.

• There is strength in numbers. Together we are stronger.

If you or your office staff need assistance on an issue of any kind, please feel free to contact me at jmcramer@sbcglobal. net, (989) 790-3590 (office) or (989) 284-8884 (cell) and I will work with you to come up with a resolution for your problem through a variety of resources available to you as a SCMS/ MSMS member.

SERVING ALL SPECIALTIES AND SOLO, GROUP AND HOSPITAL EMPLOYED PHYSICIANS SINCE 1902 Visit www.SaginawCountyMS.com for a Membership Application under the “Membership” tab

The Bulletin | Fall 2020 17

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The Bulletin | Fall 2020

Now, we are honored to have the distinction of being the first compounding pharmacy in Michigan to become PCAB accredited under the new standards set forth by the Accreditation Commission for Healthcare.

Healthway Compounding Pharmacy celebrating 35 years of

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2544 McLeod Dr. N. | Saginaw, MI. 48604 Ph. 989.791.1691 | Fax 989.791.4603 healthwayrx.com

BIRTHDAYS OCTOBER (Belated Wishes) Matthew L. Abrell DPM Mahela S. Ashraf MD Alexander Bejna DO Peter J. Biggane MD Kaitlyn A. Blanchard MD Judy V. Blebea MD Micah J. Brainerd (Student) Jonathan T. Broadwell MD Ileana Marie Daly MD Rodames D. Dedicatoria MD Kirk Detloff (Student) Najiha B. Farooqi MD Gerard P. Farrar MD Jade Foldie (Student) James A. Fugazzi MD Manasa Gudur MD Marilyn T. Haupt MD Michael L. Hudson (Student) Thomas J. Hyde DMD John B. Johnson MD Bong Jung MD Priscilla Kennedy (Student) Vipin Khetarpal MD Lioudmila Kinachtchouk MD David J. Kramp MD David B. Krebs MD Paul A. LaClair MD Chris Paul Liakonis DO Bei F. Liu MD Namita Natalie-William Lopes (Student) Anushka N. Magal MD Alexandra T. Manolis (Student) Iris A. Marteja MD Ahmed Munir MD Kristi M. Murphy MD Kristin M. Nelsen MD Zenobia E. Ofori-Dankwa MD James M. Parkkonen MD Krishna J. Patel DO Aws Polina (Student) Delicia J. Pruitt MD Ryan M. Prusko (Student) Gerardo Dizon Reyes MD

Jenny M. Riepma (Student) Sara L. Rivette MD Christopher J. Robertz MD Jacquelyn A. Robinson MD Rosarita Rullan DO Alaa Shanbour MD Kamran K. Shokoohi MD Allen J. Solomon MD Chai-Yakarn Soontharotoke MD Bala Srinivasan MD Kizhakepat P. Sukumaran MD Sanjay J. Talati MD David M. Thomas (Student) George K. Tong MD Samuel S. Valia MD Noel D. Wagner MD Mark A. Zaki MD

NOVEMBER Raya C. Beiz MD Michael T. Bergeon MD Vedang J. Bhavsar MD John Blebea MD Julie Bunyard DO Michael A. Butman MD Jessica N. Buttinger (Student) Jeffery W. Carney MD Anthony deBari MD Peter Drake (Student) Matthew C. French DO Christopher M. Gill DPM Mark G. Greenwell MD Zeina Habib MD Ronald C. Hazen MD Christopher R. Heberer DO Danielle L. Hebert (Student) Eileen M. Hoban (Student) Furhut R. Janssen DO Beverly A. Jarema DO Adebambo M. Kadri MD Phadej Keopunna MD George E. Kikano MD Nikolai Kinachtchouk MD John M. Kosanovich MD Neil W. Love MD

Mona Mahmoud MD Deven McCullers (Student) Michael Megaly (Student) Asad I. Mehboob DO Kirstan K. Meldrum MD Cristina M. Nituica MD Bernard D. Noveloso MD Loretta R. O'Donnell MD Christopher J. Osterbauer DO Jorge M. Plasencia MD Tracie I. Potis MD Christopher L. Price MD Sinong Qian MD J. Eugene Rank MD Fermin Rankin MD Rita S. Ratani MD Deborah L. Russell MD Anastasiya Shchatsko MD Thomas Taugher DO Julie Taylor MD Spencer J. Thornock MD Patricia V. Valia MD Brett T. Vander Baan MD Chandler G. Veenhuis DO Melissa J. Victor MD Michael W. Warren MD Mildred J. Willy MD Pervez Yusaf MD

DECEMBER Waheed Akbar MD Syed S. Akhtar MD Syed K. Alam MD Anisah Al-Qadi (Student) Ahmad Alsughayer MD Arshad Aqil MD Catherine M. Baase MD Nathanial Bartosek (Student) Kayla Bennett (Student) J.G. Marc Bertrand MD 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) 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 Sundarachalam Pindicura MD Manasvi Pinnamaneni (Student) Nivin A. Qudeimat MD Nathan M. Razbannia MD Lekha K. Richardson MD Brian M. Shear (Student) James F. Shetlar MD Farhad K. Shokoohi MD Shipra Singh MD Logan A. Steffke (Student) Gregory P. Sutton MD Tarek A. Taha MD Cindy Tantilert (Student) Tamera C. Tennant (Student) Michael J. Tucker, Jr. DO Andrew S. Wagner MD Julia M. Walter MD Liaqat Zaman MD The Bulletin | Fall 2020 19

IN MEMORY Thomas Anthony Egleston, MD Dr. Thomas A. Egleston passed away on Thursday, September 10, 2020, at Edgewood Assisted Living Center at the age of 81. Dr. Egleston was born May 26, 1939, in Navan, Ireland, to the late James and Bridget (Cuffe) Egleston.

Dr. Egleston earned his medical degree from University College Dublin. He completed his internship at Saginaw St. Mary’s Hospital, and his radiology residency at the Cleveland Clinic. He proudly served his country in the U.S. Navy. Dr. Egleston practiced radiology in the Saginaw area for over 30 years. He served as Chief of Staff at St. Mary's Hospital, President of the Saginaw County Medical Society, and a Board Member of the Michigan State Medical Society. He was a faithful and active member of St. Dominic Parish.

Dr. Egleston was an avid sailor, flutist and cyclist. He was a founding member and Chairman of the Friends of the Saginaw Valley Rail Trail.

He is survived by his wife of 55 years, Helen; children, Brian (Patti) Egleston, Ann (Rob) Vermeer and Laura (Jeff ) Hill; eight grandchildren; one great-granddaughter; one brother, Kevin Egleston of Oxford, England; and many nieces and nephews.

A private service took place on Wednesday, September 16, 2020, at St. Andrew Cemetery. Those planning an expression of sympathy may wish to consider memorials to St. Dominic Parish, 2711 Mackinaw Road, Saginaw, MI 48602 or the Alzheimer’s Association, 225 N. Michigan Ave., Fl. 17, Chicago, IL 60601.

Deisler Funeral Home is honored to be serving the Egleston family; condolences may be expressed to the family by visiting www.DeislerFuneralHome.com.

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

Focusing our practice on the needs of our community, we provide the following services for both individuals and businesses: n Monthly Accounting n Tax Planning n Financial and Business Consulting Service n Payroll Service n Tax Preparation Service n Retirement Planning Contact us for a complimentary visit at 989-791-1040.

Three convenient locations to serve you in: Saginaw | Vassar | Frankenmuth

“Attention to detail since 1980.”

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.

20 The Bulletin | Fall 2020

APPLICATIONS FOR MEMBERSHIP SECOND READING: Applications for membership that may be recommended for acceptance at the November 17, 2020, Board Meeting: Cynthia L. Blount, DO (Advanced Diagnostic Imaging, PC) Specialty: Radiology - Board Certified 1994 and Nuclear Radiology - Board Certified 1995 Medical School: Kirksville College of Osteopathic Medicine, Kirksville, MO, 1990 Internship/Residency: Flint Osteopathic Hospital, Rotating and Diagnostic Radiology, 1990-95 Fellowship: William Beaumont Hospital, Nuclear Radiology 7/956/96 Sponsors: Doctors Steve Min and Harvey K. Yee

Derek J. Schaller, MD (CMU Medical Education Partners-Emergency Medicine Clerkship Director and Saginaw County Sexual Assault Response Program Medical Director) Specialty: Emergency Medicine - Board Certified 2014 Medical School: Wayne State University School of Medicine, 2010 Internship/Residency: Sinai-Grace Hospital Emergency Department Residency Program, Tenet Health System/Detroit Medical Center, 2010-13 Fellowship: ACEP Teaching Fellowship, Dallas, TX, 2017-18 Sponsors: Doctors Kathleen M. Cowling and Steven J. Vance

Kathryn M. Mansuri, MD (CMU Health - Psychiatry) Specialty: Psychiatry - Board Certified Medical School: University of Illinois College of Medicine, Chicago, IL, 2009 Residency: University of Illinois at Chicago, Chicago, IL, 2009-13 Fellowship: The Chicago Institute for Psychoanalysis, Chicago, IL, 2012-13 Sponsors: Doctors Christopher M. Archangeli and Furhut R. Janssen

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Healthway Compounding Pharmacy 2544 McLeod Dr. N. | Saginaw, MI 48604 | 989.791.1691 | www.healthwayrx.com The Bulletin | Fall 2020

21

By Louis L. Constan, MD Herculean Hercules was the ancient Greek hero, celebrated for accomplishing 12, yes 12 tasks, each one considered impossible by itself; so, to this day we refer to something that is really, really hard as a “Herculean task.”

Such, we might call the task of reforming our broken healthcare system…impossible in so many ways. Yet along comes THRIVE with the goal of doing just that. And THRIVE, of course, does not have a superhuman hero like Hercules in its corner. What THRIVE does have is a large group of connected, hard-working and fully engaged movers-and-shakers representing every facet of our community.

And this was never more obvious than it was in THRIVE’s virtual meeting of 650 people on May 26, including the 20th United States Surgeon General, Jerome Adams, MD. At that meeting, the organization celebrated a full year’s worth of notable accomplishments and announced its goals for the coming year.

The Surgeon General started off with a rousing speech lauding THRIVE for its vision of unifying the business and medical communities behind the shared goal of economic and physical health, which you can watch HERE. Then came the truly good stuff, where THRIVE reviewed what it has actually delivered for our community. Through community partners and shared priorities of the portfolio, THRIVE has: • Trained 25 physicians in Medically Assisted Treatment (MAT) for opioid cessation.

• Brought in 12 new Psychiatrists to our area under CMU, started a Psychiatric Residency, a Psychiatric Nurse Practitioner program and a Psychiatric Child Adolescent Fellowship.

• Showed us how to reduce our alarming rate of pre-term births, low-birth-weight infants, and NICU admissions… and how to increase breastfeeding.

• Promoted peer recovery efforts for opioid addicts and enhanced protective factors for youth.

• Brought together schools and universities to begin to figure out what to do for the many, many children who have experienced trauma during childhood.

And now, perhaps the biggest ‘Labor of Hercules’ yet performed by THRIVE was to get ALL the leaders of our healthcare community on the same page regarding the biggest embarrassment ever to hit the field of medical care: The Johns Hopkins 2016 report that showed medical errors to be the third leading cause of deaths in America. Yes, this is the report that showed how going to the doctor comes with a distinct possibility that such a visit will get you killed. There was no way to sugarcoat such a report or to reassure our patients.

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And there was no way to point a finger elsewhere. The buck stops here. With us. But blame, as you all know, is not the issue. Medical care is so very, very complicated, and certainly ‘to err is so very, very human’ that systems need to be put into place that will make it impossible for fallible humans to make those mistakes and cause those deaths. It will be hard, but it can be done. We know this. It has been done successfully in the aerospace industry and elsewhere; we have simply thus far lacked the collective will to do this in the medical field.

Until now. To be sure, since 2016, only a meager 10 percent of healthcare systems across the country have stepped up with pledges of ‘ zero harm ’ to their patients. But on May 26, 2020, OUR healthcare leaders, the leaders of OUR healthcare systems, made this pledge, signing a solemn oath, in front of 650 people present, committing to working towards zero harm to our patients; with measurable metrics, regular reporting on progress, and an eventual goal to make our area the safest area in the entire state of Michigan in which to receive health care!

THRIVE is now officially a movement…a movement that will turn around a broken healthcare system, a movement that we can be proud of…and a movement that we will all need to be a part of in some way.

Zero Harm Over the last two decades, our medical leaders have been flummoxed (and embarrassed) over how to explain why the United States, which spends twice as much as other advanced nations on health care, has a persistently lower life expectancy.

We have the best doctors, hospitals, pharmaceutical companies and biotechnology in the world; what could possibly explain this discrepancy?

One explanation, never satisfying to me, has been to blame the victims. American patients are sicker and die sooner, in spite of everything we doctors do; simply because they do not take care of themselves. They eat too much, smoke too much and don’t exercise. It’s their fault. We doctors are doing everything we can. Or perhaps it’s because we don’t spend as much as other advanced countries on social services, as such spending has been shown to improve health outcomes.

The truth is that there are several factors, and one big one is how our healthcare system handles errors. There is now clear evidence dear colleague, that some of the fault, much as we dread to hear it, lies with ourselves, or at least with our healthcare delivery system. That 2016 mega study from Johns Hopkins showed good evidence that 250,000 patients die annually in American hospitals from various errors in their care. Of the 2.4 million Americans who die annually, easily 10 continued on page 23

continued from page 22

percent die of non-natural causes while they are hospitalized, from errors somewhere in the course of their care. That 10 percent is even worse when you consider that many of those total 2.4 million deaths were older patients who died because, in some sense, their ‘time had come.’ For those 250,000, though, many were younger and clearly died ‘before their time.’ Years-of-life-lost were not calculated in this study, fortunately for us.

Doubtless you’ve struggled to wrap your head around the enormity of this number and the insidiousness of a problem that has simmered beneath the surface for so long. But when you think about the complexity of what goes on in American hospitals, it’s really not so hard to understand. Thirty-six million admissions, 145 million ER visits, 129 million surgeries.

Every one of those situations involves multiple physicians, dozens of ancillary staff, multiple medicines, tests, critically timed decisions, and easily misunderstood person-to-person hand-offs. You might be tempted to accept the tiny, tiny percentage of fatal errors as inevitable and acceptable but it is certain that your patients don’t.

Two hundred fifty thousand deaths, the third leading cause of death in Americans of all ages, is simply too, too high a number and, if we are going to continue to have the trust of our patients, we are going to have to act. The model for a solution exists… in the airline industry. Millions of miles flown, but the airline industry does not accept the occasional error, the occasional crash and death of their customers.

They aim for zero deaths, and they do it by ruthlessly rooting out any and all errors. And have they succeeded? Absolutely they have.

And we can too.

With THRIVE’s ZERO HARM INITIATIVE, which on May 26, in front of 650 witnesses, 12 top executives from our regional healthcare organizations solemnly swore to uphold. These are the powerful management people who engage actual fiscal responsibility in our hospitals. They hire and fire staff.

They set up training programs. They buy computer programs and upgrades. They reward employees who come forward with issues, small and large, before those issues lead to critical errors. They reward staff financially for ideas to fix those problems.

In summary, one clear failure of the American healthcare system is its insufficient attention and progress in addressing errors. Doing so would clearly improve the overall health and longevity of the American public. Perhaps it has never been realistic to look solely to doctors as the sole protectors of America’s health. Too many patients are being impacted by

factors beyond the control of we physicians alone, and we need a total systems solution here. We can give our all to patient care. Our best efforts, the most up-to-date treatment; the most skilled resuscitation; the most brilliant surgical technique; the most inspired diagnosis; literally pulling our patient from the jaws of death just may not be recognized because these successes are eclipsed by all the deaths caused by medical error. Perhaps every life we save is negated by a life lost to medical error? Such a terrible thought, but it would explain a lot!

Looking forward, though, we should be proud of our hospitals, and their administrators, that they have taken this step. The thought that, in the future, in our hospitals, no patients will die from avoidable causes is simply an incredibly awesome goal. It is good for all of us. For the hospitals, for us doctors, and especially for the patients!

In summary, one clear failure of the American healthcare system is its insufficient attention and progress in addressing errors. Doing so would clearly improve the overall health and longevity of the American public.

Perhaps it has never been realistic to look solely to doctors as the sole protectors of America’s health.

Fulfill Your Board of Medicine Requirements on Your Time MSMS offers numerous on-demand webinars that fulfill the Michigan Department of Licensing and Regulatory Affairs requirements for continuing medical education, including: • A series of 12 covering Pain and Symptom Management • Three on Medical Ethics • Human Trafficking Download and watch at your convenience 24/7.

For a complete list and to register click HERE

The Bulletin | Fall 2020 23

JOINT CYBERSECURITY ADVISORY Ransomware Activity Targeting the Healthcare and Public Health Sector The Federal Bureau of Investigation (FBI) and two federal agencies are warning of an "imminent cybercrime threat" to U.S. hospitals and health care providers, noting that several hospitals across the country have already been hit. In a joint advisory, the Cybersecurity and Infrastructure Security Agency (CISA), FBI and the U.S. Department of Health and Human Services (HHS) said they have "credible information" that cybercriminals are taking new aim at health care providers and public health agencies as the COVID-19 pandemic reaches new heights. "Malicious cyber actors" may soon be planning to "infect systems with Ryuk ransomware for financial gain" on a scale not yet seen across the American healthcare system.

Hospitals, physician practices and public health organizations should take "timely and reasonable precautions to protect their networks from these threats." Malware targeting techniques often lead to “ransomware attacks, data theft and the disruption of healthcare services." The agencies recommend several mitigation steps and best practices for health care entities to take to reduce their risk, including the

following: • Patch operating systems, software and firmware as soon as manufacturers release updates.

• Regularly change passwords to network systems and accounts and avoid reusing passwords for different accounts.

• Use multi-factor authentication where possible. o Disallow use of personal email accounts • Disable unused remote access/Remote Desktop Protocol (RDP) ports and monitor remote access/RDP logs.

• Identify critical assets; create backups of these systems and house the backups offline from the network.

• Set antivirus and anti-malware solutions to automatically update; conduct regular scans.

The AMA and the American Hospital Association (AHA) have created two resources to help physicians and hospitals guard against cyber threats. Those resources and additional cyber security information can be found at the AMA’s cybersecurity webpage.

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MSMS ADVOCACY LEGISLATIVE ALERT Health Can’t Wait is a coalition of patients, physicians and health care providers dedicated to putting Michigan patients first and ending delays in patients’ access to health care.

#FixPriorAuth because #HealthCantWait: Support SB 612 Senate Bill 612 is currently on the Senate Floor. We are preparing for a vote shortly after the election.

Prior authorization (PA) and step therapy/fail first requirements hamstring treatment, drive up nonadherence to medication and lead to diminished health. It’s onerous and needless insurance company bureaucracy, and it’s negatively affecting patients, physicians, providers and their practices.

It’s time we cut out the red tape, because at the end of the day, health can’t wait. And now we can do just that.

State lawmakers are preparing to take up SB 612, a bill that reforms PA and step therapy/fail first process by introducing new transparency, fairness and clinical validity requirements, ensuring our patients receive timely coverage decisions, and ultimately, the care and treatment they need.

This is the kind of reform our patients deserve - it’s time to put them first.

Please contact your lawmakers today and urge them to support SB 612.

Health Can’t Wait Talking Points The purpose of utilization review programs incorporating PA and step therapy is to screen for appropriateness of hospital admissions, high-cost procedures, and newer, highcost specialty drugs for which the risks, benefits and overall value are still being evaluated.

Recently, PA and step therapy have quickly expanded to include common procedures and established generic

products (e.g., topical corticosteroids, sulfonylureas for diabetes, oral antineoplastic drugs for cancer, etc.).

• 86% of physicians report PA burdens have increased over the last five years.

Physicians and other health care professionals are spending too much of their time dealing with burdensome and archaic PA requests when they should be caring for patients.

• On average, 33 PAs per physician per week.

• Physicians and their staff spend an average of almost two business days each week completing PAs. • 30% of physicians have staff who work exclusively on PA. This unwarranted intrusion into medical decision-making and the clinician-patient relationship causes real problems for patients and adds waste to the health care system.

• Hamstrings treatment and diminishes health 3 90% of physicians report PA has a somewhat or significant negative impact on clinical outcomes.

3 Prescription PA implementation for medications to treat diabetes, depression, schizophrenia and bipolar disorder has been associated with worsening disease status.

3 24% of physicians report PA has led to a serious adverse event.

3 16% of physicians report PA has led to a patient’s hospitalization.

• Drives up medication nonadherence and treatment abandonment 3 37% of prescriptions rejected at the pharmacy are abandoned, never to be picked up by patients.

3 74% of physicians report PA can at least sometimes lead to treatment abandonment.

• Results in onerous and needless insurance company bureaucracy, costs continued on page 26

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continued from page 25

3 The U.S. Office of Inspector General found Medicare Advantage Organizations overturned 75 percent of their own denials during 2014-16, overturning approximately 216,000 denials each year.

3 The U.S. consumes far more of its health expenditures on administrative tasks than virtually any other country in the world; PA requests contribute greatly to these costs that are borne by health professionals and health plans.

Time to right size, simplify, and share the “playbook” with patients and health professionals.

PA has a place in helping to ensure the right care at the right time… when it is applied properly. When it’s transparent.

When it’s timely. And, when it supports shared decisionmaking between a patient and his or her health care provider over insurance company paperwork. Health Can’t Wait supports SB 612, introduced by Senator Curt VanderWall, to reform the PA and step therapy/fail first process by introducing new transparency, fairness and clinical validity requirements, ensuring our patients receive timely coverage decisions, and ultimately, the care and treatment they need.

Senate Bill 612 (S-1) does the following:

Increases transparency in the PA process: • Sets standards and provides more transparency over how PA is utilized.

• Makes PA requirements accessible on the insurer’s public website. They also must be described in detail, written in easily understandable language, and readily available to the health provider at the point of care.

• Ensures statistics regarding PA approvals and denials are publicly available.

• Requires PA requirements to be based on peer-reviewed clinical review criteria and annually evaluated and updated, if necessary.

• Requires insurers, upon issuing the denial, to notify the health professional and insured/enrollee of the reasons for the denial and related evidence-based criteria.

Gives physicians and health care professionals fair input on the PA process: • Ensures input on changes to clinical review criteria from actively practicing physicians representing major areas of the specialty who are not employees or consultants of the insurer.

• Promotes the modification of PA requirements based on the performance of the health care providers with respect to adherence to evidence-based medical guidelines or other quality criteria (e.g., gold carding).

• Adverse determinations must be made by a physician, and appeals of such decisions must be reviewed by a physician actively practicing in the same specialty as the service provided.

26

The Bulletin | Fall 2020

Simplifies the PA process for physicians, patients, and insurers: • Establishes a clear timeline for insurers to respond to PA requests and specifies the circumstances under which a PA request would be considered granted by an insurer.

• Urgent requests must be acted upon within one business day after the time of submission. Non-urgent requests must be acted upon within two business days after the time of submission.

• Establishes a timeline for health care providers to respond to requests for additional information from insurers.

• Requires insurers to make a standardized electronic PA request transaction process utilizing an online system by April 1, 2021.

Protects patients and continuity of care: • Provides that PA requests are valid for not less than 60 calendar days and not more than one year depending on the clinical conditions of the care needed.

• Prohibits insurers from requiring that an enrollee’s health care provider participate in step-therapy protocol if the physician considers that the step therapy protocol is not in the patient’s best interest and specifies what constitutes “the patient’s best interest” (e.g., drugs are contraindicated or will likely cause an adverse reaction, drug already tried and determined to be ineffective, patient stable on a drug).

Common Sense Reforms Administrative costs of PA and step therapy apply across the board to all stakeholders including insurers. For physicians, an average of $82,975 per physician per year is attributed to insurer administrative hassles; equating to roughly $23-$31 billion dollars annually nationwide.

Health care spending for administrative costs incurred by private and public insurers is much higher in the U.S. as compared to other developed countries - 14 percent vs. 3-10 percent.

Time spent on burdensome paperwork and seeking authorizations, is time that could otherwise be spent taking care of patients.

Despite the active engagement of physicians in quality improvement initiatives and value-based care models, insurers are escalating and broadening the use of PA and step therapy to medically necessary, routine services and commonly prescribed medications, which negatively impacts care delivery and results in inappropriate denials…

• Recent studies reflect 265 million claims nationally require PAs, with the volume increasing 20 percent or more per year.

• 90 percent of physicians report PA has a somewhat or significant negative impact on clinical outcomes.

• 24 percent of physicians report PA has led to a serious adverse event.

• 16 percent of physicians report PA has led to a patient’s hospitalization.

continued on page 27

continued from page 26

• 86 percent of physicians report PA burdens have increased over the last five years.

• The Office of Inspector General found Medicare Advantage Organizations overturned 75 percent of their own denials during 2014-16, overturning approximately 216,000 denials each year. The OIG stated, “The high number of overturned denials raises concerns that some Medicare Advantage beneficiaries and providers were initially denied services and payments that should have been provided.”

Evidence suggests that PA and step therapy adversely affect patients…

• 37 percent of prescriptions rejected at the pharmacy are abandoned, never to be picked up by patients.

• 74 percent of physicians report PA can lead to treatment abandonment.

The broad application of PA and step therapy may very well be penny wise and pound foolish…

• Studies have shown that while step therapy, for example, decreased drug costs, overall health care costs remained the same or increased.

• A review of medical and pharmacy claims of nearly 300,000 Medicaid enrollees found that adherence to medication declined due to formulary restrictions, and total costs increased with formulary restrictions due to increased inpatient and medical costs, as well as, increased pharmacy costs for bipolar disorder.

• Prescription PA implementation for medications to treat diabetes, depression, schizophrenia and bipolar disorder has been associated with worsening disease status.

SB 612 (S-1) DOES NOT prohibit insurers from: • Requiring prior authorization before covering a drug or patient service.

• Requiring patients to try a generic drug if it is equivalent to the brand.

• Using step therapy, so long as the protocol is not in conflict with the “best interest” of the patient, as defined in the legislation.

Sources: 1. Bergeson JG, Worley K, Louder A, Ward M, Graham J. Retrospective database analysis of the impact of prior authorization for type 2 diabetes medications on health care costs in a Medicare Advantage prescription drug plan population. J Manag Care Pharm.

2013;19(5):374-384. doi:10.18553/jmcp.2013.19.5.374 2. Seabury SA, Goldman DP, Kalsekar I, Sheehan JJ, Laubmeier K, Lakdawalla DN. Formulary restrictions on atypical antipsychotics: impact on costs for patients with schizophrenia and bipolar disorder in Medicaid. Am J Manag Care. 2014;20(2):e52-e60.

3. 2019 American Medical Association Prior Authorization Physician Survey. https://www. ama-assn.org/system/files/2020-06/prior-authorization-survey-2019.pdf.

4. CoverMyMeds. 2019 ePA national adoption scorecard. https://www.covermymeds. com/main/insights/scorecard/impact/. Accessed November 29, 2019.

5. Office of Inspector General. U.S. Department of Health and Human Services. Some Medicare Part D beneficiaries face avoidable extra steps that can delay or prevent access to prescribed drugs. https://oig.hhs.gov/oei/reports/oei-09-16-00411.pdf.

6. Papanicolas I, Woskie LR, Jha AK. Health care spending in the United States and other high-income countries. JAMA. 2018;319(10):1024-1039. doi:10.1001/jama.2018.1150

MSMS REIMBURSEMENT ADVOCATE ALERT MSMS provides periodic updates to members and their offices on new and relevant payer policies. Please find some recent highlights below. For a comprehensive accounting of a health plans announcements, please consult the payer’s official communications.

Evaluation and Management Updates for 2021 Tuesday, December 1, 2020 Presentation: 1 - 4 p.m.

Presenter: Jill Young, CPC, CEDC, CIMC Registration Fee: $25.00

Coding Updates for 2021 Tuesday, December 1, 2020 Presentation: 9 a.m. - 12 p.m.

Presenter: Jill Young, CPC, CEDC, CIMC Fee: $25.00

For the last two years, we have been talking about the proposed changes to Evaluation and Management codes and that these changes would become effective January 1, 2021.

Understanding those changes is key in making any necessary changes in the office flow. It is also important to consider any potential software changes that may be necessary to ensure correct coding of Evaluation and Management services.

The CPT code set continues to be modified to respond to the ever-changing health care field. This year is no different.

There are 206 new codes, 54 deletions and 69 revisions to the CPT code set. As you know, there were important additions to the CPT code set for new medical testing services due to the public health response to the COVID-19 pandemic. Jill Young will present an overview of changes for 2021 to help prepare you for the new year.

NOTE: Evaluation and Management (E/M) changes for 2021 will be done in a separate session in the afternoon.

Register Today

The E/M office visit modifications include: • Eliminating history and physical exam as elements for code selection.

• Allowing physicians to choose the best patient care by permitting code level selection based on medical decision-making (MDM) or total time.

• Promoting payer consistency with more detail added to CPT code descriptors and guidelines.

Jill Young will explain these changes and allow time for questions, to help you prepare for 2021.

Register Today

Please contact Stacie Saylor or 517-336-5722 for questions or concerns.

REGISTER TODAY The impacts of COVID-19 on children and families

Free virtual symposium November 9, 2020, 1–3:30 p.m.

Gain new perspectives on the following child health issues and review strategies for building trauma-responsive communities of practice in the era of COVID-19 that address: • Rising mental and physical health risks for children • Stressors impeding protective factors for children, including caregiver/parent well-being, COVID-19 crisis coping, adult ACEs • Health inequities undermining children’s physical and mental well-being • Research work on COVID-19 impacts on children, families, and health care providers

Keynote Presentations What is the S.A.M.E. When Everything is Different?

Heather C. Forkey, M.D. Associate Professor of Pediatrics and the Joy McCann Professor for Women in Medicine at the University of Massachusetts Medical School

Symposium Agenda:

Creating Circles of Care: Driving Community Impact

by Raising the Silent Voices of Young Children

1-1:10PM

Welcome

Jeanette Betancourt, Ed.D.

1:10-1:50PM

What is the S.A.M.E. When Everything is Different?

1:50-2:30PM

Creating Circles of Care: Driving Community Impact by Raising the Silent Voices of Chidren

Senior Vice President, U.S. Social Impact, Sesame Workshop

2:30-3PM

Research Panel

3-3:30PM

Q&A

Who should attend: physicians, educators and clinicians including family medicine providers, pediatricians, physician assistants, nurses, psychiatrists, counselors and social workers.

Registration Link: https://bit.ly/33UCMU7

Central Michigan University College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Central Michigan University College of Medicine designates this live activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the activity and individual assessment of and feedback to the learner, enables the learner to earn up to 2.5 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

The Central Michigan University Social Work Program, an accredited social work educational program, is authorized by the Michigan Licensure Law Administrative Rule 338.2965 to award Michigan social work continuing education contact hours. For this program, 2.5 CE’s will be awarded.

CMU, an AA/EO institution, strongly and actively strives to increase diversity and provide equal opportunity for all individuals, irrespective of gender identity or sexual orientation and including but not limited to minorities, females, veterans and individuals with disabilities. MGX, 20050 (10/20)

28

The Bulletin | Fall 2020

The time is now as the needs of children and families are compounding during the coronavirus crisis. By concentrating our collective capacities of clinical skills and communities of support, it is possible to confront the challenges and mitigate lifelong health consequences of childhood trauma.

In 2020, physicians have encountered the great need for strategies to address and treat child and family toxic stress due to the collective trauma caused by the coronavirus pandemic. This virtual symposium will provide an opportunity for physicians and care providers (pediatric and family medicine, behavioral health, and education) to learn about approaches for implementing trauma-informed pediatric practice, learn strategies for supporting parents/ caregivers to reduce parental toxic stress which can lead to ACEs in children, and gain insights from researchers actively examining aspects of child/family trauma in hospital emergency and clinical settings responding to dynamics of providing care for COVID-19 illness, mental health, child abuse and isolation.

“Children are inherently vulnerable because they depend on adults to have their most basic needs met. When those adults

lack the wherewithal to cope with the immediate, urgent, and multiple adaptive demands a pandemic places on families and when support systems do not exist, falter, or cease, it can result in unmitigated disaster for the very young, according to a recent report examining the Impact of the COVID-19 Pandemic on Early Childhood Care and Education (Early Childhood Education, Nature Public Health Emergency Collection, July 2020).

Providers and teams will gain insights for how to provide and model concrete supports for parents and care givers that can help mitigate adult and child stressors posed

by COVID-19 illness, child isolation, and related pediatric risks, through strategies that integrate trauma-informed culturally-specific approaches into services and systems for children, youth, families.

Keynote Presentations: Session 1: 1:10-1:50 PM - Heather Forkey Presentation Title: COVID-19: What is the S.A.M.E. when everything is different?

Learning Objectives: 1. Consider how COVID-19 may be a trauma and an opportunity to build resilience 2. Identify four ways to support caregiver regulation and resilience 3. Formulate a strategy to respond to child symptoms and promote resilience despite the constraints of COVID-19 Session 2: 1:50-2:30 PM – Jeanette Betancourt Presentation Title: Creating Circles of Care: Driving Community Impact by Raising the Silent Voices of Young Children Sesame Street in Communities, activates awareness and strategies to create “Circles of Care” that integrate within community impact models to align trauma-informed practices to mitigate the effects of traumatic experiences. Adverse Childhood Experiences (ACEs) can have long-term negative effects on a child’s brain development and future wellbeing, especially when confronted with repeated traumatic experiences, such as parental addiction or incarceration, unsafe home environments, or the recent consequences of COVID-19. Yet we also know that young children are remarkably resilient, and one of the best ways to counteract the effects of traumatic experiences is by fostering nurturing connections between children and the grownups in their lives, including parents, caregivers, educators, and community service providers. With the help of loveable Muppet friends, Sesame Street in Communities is connecting and empowering these important grownups to build a “Circles of care” to help children – especially the most vulnerable – to grow and learn in ways that will last a lifetime.

Learning Objectives: 1. Identify the unique challenges young children face that are perceived as adult-only challenges and provide ways to create an integrated community impact approach to maximize service delivery; 2. Examine how caring adults – from parents to all community service providers– can build a “circles of care” to advocate for the needs of vulnerable children and families, by integrating methods to identify and respond to traumatic experiences; and 3. Review Sesame Street in Communities trauma-informed strategies, resources, and best practices to support mental and behavioral health, especially emphasizing parental addiction, with young children and their families.

Session 3: 2:30-3:00PM – Research Panel: Jocelyn Ang, M.D., Cheryl Geisthardt, Ph.D., Usha Sethuramann, M.D. Topics/Learning Objectives: Clinical Characteristics and Outcome of Pediatric COVID-19 in a Tertiary Care Children’s Hospital in Detroit 1. Present our experience in children with confirmed COVD-19 illness who were treated at Children’s Hospital of Michigan in Detroit.

2. Describe the clinical presentation, medical intervention, and outcome of these children.

Supporting Children and Families in the Medical Setting During COVID-19: Exploring the Role of Certified Child Life Specialists 1. Describe the role of child life specialists in supporting children and families in the medical setting.

2. Explain the diverse contributions of certified child life specialists to improving quality of pediatric care and promoting positive development in the medical setting during COVID-19.

The Bulletin | Fall 2020 29

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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.

SCMS MEETINGS AND EVENTS Due to COVID-19, the SCMS has cancelled meetings and events through the end of the year. The Board continues to evaluate the state of the pandemic and the safety of meeting in person in the future.

The April 2020 Membership Meeting program, “Physician Compassion Fatigue� to be presented by Molly E. GabrielChampine, PhD, LP, Director of Behavioral Science, Family Medicine Residency at McLaren Bay, will be rescheduled in 2021 once it is safe to start meeting in person.

The 16th Annual Health Fair postponed in March will not be rescheduled in 2020. We do not feel it is in the best interests of the public who attend (many of whom have multiple medical conditions), our vendors, members and staff to bring together a

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

large group of people.

Board meetings for the immediate future will be held virtually.

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