Stethoscope: The Erie County Medical Society Newsletter

Stethoscope

theStethoscope the

September 2019 Issue

Quarterly Newsletter of the Erie County Medical Society

Quarterly Newsletter of the Erie County Medical Society • March 2020 Issue

A Message From Your President

ECMS Inaugural Address 2019

by Jeffrey McGovern, MD, FCCP, FAASM

D

Jeffrey McGovern, MD, FCCP, FAASM President

Rebecca Doctrow

Executive Director rdoctrow@pamedsoc.org Phone: 814-866-6820 1438 West 38th Street Erie, PA 16508 Administrative Office/ Mailing Address: 777 East Park Drive Harrisburg, PA 17111 eriecountymedicalsociety.org The opinions expressed in this publication are for general information only and are not intended to provide specific medical, legal or other advice for any individuals. The placement of editorial content, opinions, and paid advertising does not imply endorsement by the Erie County Medical Society.

istinguished members physicians and esteemed guests of the

Erie County Medical Society, I am privileged and honored to speak with you tonight as your 141st president. It is with heartfelt gratitude to my family, the Erie County Medical Society Board, my colleagues in the community and my patients that I stand humbly before you. I want to recognize especially Dr Shawn Bhagwandien, our immediate past president. He is a dedicated physician and a devoted patriot who ably served our society in these past two years.

“ Love the truth; show yourself as you are, without pretenses and fear.”

Dr. Joseph Moscati (1880-1927) was a physician and professor wellrecognized for his scientific brilliance but better remembered for his devotion to and superb care of his patients in his native Naples, Italy. “ Charity,” he said, “changed the world, not science.” His words are at the heart of what we as physicians do every day. In the midst of another peer review, a challenging procedure, or a piece of legislation that, despite our active opposition, affects our daily practice is the face of the patient whom we serve with inexhaustible compassion, unquenchable charity and scientific rigor.

Why am I here before this august and seasoned group of physicians?

I could say that I will work for your interests, which I most certainly will. I could also say that I have an ambitious agenda, which I do. I am humbly speaking before you as your new president for several reasons.

The ominous insurance storm, the increased practice burdens we all experience and the heightened concern for physician wellness conspired to arouse in me an urge to do something, to speak on behalf of my colleagues more vigorously and in a position which I hope will have more meaning and success. Whether a gift or a curse, I could foresee the fracturing of professional and personal bonds among physicians in the community by these stressors. A smaller community such as ours has the benefit of raising physicians whose paths cross frequently in school or social gatherings or in professional societies.

Without casting blame on any specific party, the incursion of a “we/ they” force in the Erie community had the unfortunate effect of splitting and straining these relationships. Although I greatly respect my place of work, I am a physician first. My patients deserve and need that mandate.

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ECMS Inaugural Address 2019 Continued from page 1

My employer in turn needs that semblance of skill and compassion that molded me into the physician I am. Your patients deserve and need that mandate.

Your employer in turn needs that semblance of skill and compassion that molded you into the physician you are.

What will I do for you in the upcoming term? I won’t spout off bromides and tired ideas. I do want to accomplish a number of objectives through the able assistance of the Erie County Medical Board, the PAMED and the community at large.

First, let’s talk about physician wellness. While some may brush off wellness as a new item or fad, I never tire of hearing about the devastating statistics, the personal tragedies and the proposed remedies.

In the eyes of the Erie County Medical Society I can assure you that you are viewed as a vital part of this community. You are valued as a unique and compassionate physician, not plying your trade, but rather living out your vocation in care.

In the 2019 Medscape Burnout and Depression Survey over fifteen thousand physicians in 29 specialties reported on depression and burnout defined as long term and unresolvable job stress.

In their report which is now one of many added to the US database, 44% of physicians reported feeling burned out, 11% were colloquially depressed or feeling blue or sad and 4% were clinically depressed. Physicians in critical care (48%), Neurology (48%), Family Medicine (47%), Obstetrics and Gynecology (46%) and Internal Medicine (46%) were among the most burned out of specialties. Factors such as electronic health technology, administrative tasks and exhausting and long hours contribute in this study and in those available for review.

What are the remedies? Adaptive coping skills not maladaptive skills can improve function but there has to be more than group yoga. Why is it crucial to get it right? Twenty-five percent of physicians say that they may be less careful with taking patient notes. There is also less satisfaction and more job loss in general in this population. Tragically, the equivalent of one physician per day commits suicide in the United States., that is 2X the general population. The majority of doctors don’t seek help.

It’s “suck it up” which may lead to a deadly outcome. Many hospital systems and societies have become proactive and offer wellness programs. Is there more to offer? Yes. What is happening in this community? Both UPMC Hamot (Physician Thrive) and St. Vincent Hospital (Clinician Wellness) have active physician wellness programs with physician leadership with LECOM working on a model. I am pleased too that the newly elected 170th president, Dr Lawrence R. John, has a special calling and

Another president, one more eminent than I, delivered a farewell speech at the end of his administration in 1961. In this speech, President Dwight Eisenhower warned his fellow Americans about a huge industrial-military complex. He said: We should take nothing for granted. Only an alert and knowledgeable citizenry can compel the proper meshing of defense with our peaceful methods and goals, so that security and liberty may prosper together.

These were the words coming from the supreme commander of Operation Overlord, which led thousands of men and ships across the English Channel to eventual liberation of France and the end of the devastating world war. He saw as a “soldier,” however, the need for the “specialist,” the one in the trenches, to call to mind what is most important- security and liberty- not merely the process of rousing war and weapon stockpiling. Change the words a little and advance the years by fifty eight.

“Physicians in the trenches” should take nothing for granted. Only alert and knowledgeable physicians can compel the proper meshing of medical care with the needs of our vulnerable patients, so that good health and well-being may prosper together.

We want this proper meshing but we must work for it. We must not take our eyes off of the prize. If we want this objective for our vocations and patients, we have no choice but to come out of our towers and daily and diligently work in the field addressing medical, insurance and legislative issues which hamper this proper meshing. We must in short be proponents of vocation and patients.

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ECMS Inaugural Address 2019 Continued from page 2

Fourth, I will stay connected with our state representatives and state senators. It is important to remind them that we are their constituents and community leaders. I have already reached out to them and offered my unofficial services as a physician in regard to medical questions that arise in their legislative calendar. I do so as a licensed physician in the Commonwealth of Pennsylvania, not as a president of the Erie County Medical Society. I also highlighted to them in these same letters the utmost concern for physician wellness and the need to address legislatively the undue burdens on our physicians.

passion for addressing physician burnout through the PAMED. Where can the Erie County Medical Society help? It can be a resource for PAMED programs for those physicians not affiliated with any hospital. This year, Dr. Terry Lillis, a fellow board member, and I will work with PAMED to deliver an excellent and meaningful suicide prevention program to the area hospitals. Earlier experience with this program in Montgomery and Bucks Counties through their medical societies were successful.

There is great hope for burnout but keep in mind, based on the principle of subsidiarity, we as physicians will do a great deal more for each other if we just listen carefully and care for each other. We will also, along with PAMED, encourage our state representatives and senators to support and introduce legislation to address administrative burdens that doctors seem to face daily. There is currently, as of last week, no legislation specifically addressing physician burnout.

Life is a two-way street. What can you do for the Erie County Medical Society and in turn you and your fellow physicians? Stay engaged. To accelerate engagement I propose a “+1” initiative. When you work at or attend a county event, bring a colleague.

We as physicians may be independent thinkers but we cannot afford to stand alone for much longer.

Check often the excellent website (eriecountymedicalsociety.org) on which Dr. Falasca works so vigorously. I hope to provide for you there updates on the initiatives I reviewed. Tell us your ideas. What do you want the society to do for you? Expect me then to get you involved. President Reagan had two quotes on his Resolute desk in the Oval Office, one of which I am most fond. It reads: “There’s no limit to what a man can do or where he can go if he doesn’t mind who gets the credit.” As a servant leader in this role and in roles past the greater good clearly outweighs the individual kudos. Answer the email blasts you receive concerning important legislative issues. We are all busy but it takes moments to answer the email and reach out to our legislators. At the recent House of Delegates, Dr. Gallagher related that only a handful of physicians responded with important vignettes on the problems related to the vexing prior authorization issue.

Again, stay engaged. Finally and most importantly take good care of yourself as you provide unselfishly to the community.

Second, Dr. Kelli DeSanctis, another fellow board member, and I will co-chair a committee on Millennial Physicians to address specifically their increased engagement and needs. Societies, in general, and communities, in particular, often disparage the age group born between 1981-1996 without acknowledging that they will one day inherit the mantle we today carry. I can assure you that this committee is a positive force for engagement and not a plan to separate age groups. It is important that this society gets this right.

Third, I want to explore the feasibility of joining sister medical societies. Last year, PAMED made available grants to support financial and by law reviews in order to foster mergers of county medical societies. We did informally reach out to Crawford and Warren counties but the interest was not vivid enough to pursue. The advantages of a merger are a stronger and larger society at a time when more voices are a better response to our societal challenges. If PAMED does once again offer grant opportunities the Erie County Medical Society will faithfully and honestly explore the feasibility of a merger with other county medical societies. I can assure you now that it will not be at the expense of our independence or financial strength.

I thank you again with all humility and excitement for entrusting me with this privileged position. I hope with all of my vim and verve not to disappoint you.

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Millennial Engagement Committee

The Quote

Jeffrey McGovern, MD, FCCP, FAASM In my November inauguration address, I recognized the importance of the early career physicians as contributors to the daily work of medicine and as inheritors of the mantle of medicine. With this in mind, I convened a committee with co-chair, Dr. Kelli DeSanctis, to address the unique needs of this generation. This was not meant to separate generations but to encourage engagement. Committee members also include Drs. Rachel Wilkerson, Amanda Wincik, Medical Student Michael Furey and the steady hands of ECMS Executive Director Rebecca Doctrow and ECMS Meeting Manager Lauren Newmaster.

CORNER

As far as service goes, it can take the form of a million things.

To do service, you don’t have to be a doctor working in the slums for free, or become a social worker. Your position in life and what you do doesn’t matter as much as how you do what you do.

Following two productive meetings and reviewing the particular interests of the young physician, the first engagement gathering will be an informative panel addressing financial concerns of the early career physician. Seasoned physicians will make up the panel and provide personal and time-honored answers to questions about disability insurance, retirement savings and other vital issues to the younger physicians in the audience. This will be combined with a brief social time and will be held at the Cork in Erie on April 20 from 5:30 PM to 8:00 PM. Look for further details of this event and future gatherings.

—Elisabeth Kubler-Ross

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The Erie County Medical Society proudly presents

Financial Wellness: a Q&A Session for Early Career Physicians Monday, April 20, 2020 | 6:30 - 8:00 PM The Cork 1794 900 W Erie Plaza Dr, Erie, PA 16505 Join the Erie County Medical Society for a Q&A Session for Early Career Physicians on Finanical Wellness. Attendees will have the opportunity to meet with seasoned physicians and ask the burning questions about financial wellness starting out in your career.

Hors D’Oeuvres will be provided, dinner available for purchase.

Speakers Moderated by: Dr. Jeffrey McGovern, ECMS President Panelists: Dr. Cassie Harrington, Dr. Ichabod Jung, Dr. Steven Levy, Dr. Scott Lim, and Dr. Timothy Pelkowski

eriecountymedicalsociety.org/ecms-events Register online by visiting: eriecountymedicalsociety.org/ecms-events ECMS Members - Free Non-members - $20 Guests - $20

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Legislative UPDATE UPDATED MARCH 6, 2020

W

hile we enter the second phase of the current

legislative session, one thing for certain is change. The Pennsylvania General Assembly begin the 2019-2020 legislative session with 44 new faces in the House of Representatives and 7 new Senators.

Since the session has been underway, we saw scandal cost another Senator his seat and welcomed an 8th new Senator in a short time period. Over in the House, we saw the addition of a 45th new member this session with Rep. Fred Keller made the jump to Congress and was replaced by State Representative David Rowe. Both chambers are close to operating at full capacity for the first time in a while once the House conducts upcoming special elections to fill seats that where vacated in Fall 2019 elections by former Reps. Justin Walsh, Ted Nesbit and Gene DiGirolomo.

into the Spring primaries. The entire state House is up for reelection and half of the state Senate is up for reelection. This is important to note as that is where a lot of focus will be in the coming months.

Once the calendar hits June, the General Assembly will shift its focus to passing a state budget in a timely manner. They will then recess for the summer and come back for a very short fall session where it will be hard to think much else will be on anyone’s minds other than the upcoming general election. This is key to remember as bills that are not flagged to be fast tracked or those that are not already at a latter stage in the legislative process might simply lack the time needed to get to the Governor’s desk and be signed into law.

PAMED will continue to sink our time and resources into our member determined priority issues and policies. It is our hope that, together with our provider stakeholder partners, we will be able to advance important legislation such as prior authorization reform, telemedicine, credentialing, and telemedicine.

We continue to work toward protecting patients by working on key surprise billing legislation and prescription drug price transparency and affordability issues.

There will be some new faces in the Capitol hallways when the 2021-2022 regular legislative session commences but not at the same level we experienced at the beginning of this session. As of this writing, eighteen members of both chambers have announced they would not be seeking reelection at the end of their current terms. Most notably and a rarity in politics, each chamber will say farewell to their top leadership, Senator Joe Scarnati, President Pro Tempore, and Representative Mike Turzai, Speaker of the House. Additionally, it is important to note and remember that state politics can be dramatically impacted by what is happening at the national level in Presidential election year.

Election day performance by President Trump or his yet to be determined challenger in the Commonwealth can have a significant impact on those down ballot, meaning that the party of whichever presidential candidate wins Pennsylvania may seek to benefit greatly.

Looking at legislative activity of the state House and Senate, it will be interesting to see what issues they decide to prioritize as there is not a significant amount of session days remaining to advance legislation. Both chambers return to Harrisburg in mid-March and will be around sporadically leading

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Member NEWS New Members

Reinstated Members

Tina Haibach

Cassie J. Harrington, MD

Sherifia E. Heron, MD Brian L. Risavi, DO, FACEP Harshit Shah, MD Stephanie Smith-Sham, MD Joseph L. Sturdevant, MD

2019–2021 ECMS Board of Directors Jeffrey P. McGovern, MD, FCCP, FAASM President

Timothy D. Pelkowski, MD At Large Member

Narendra Bhagwandien, MD Immediate Past President

Paul Malaspina, MD At Large Member

Kelli DeSanctis, DO President Elect

Kirk Steehler, DO At Large Member

Terence O. Lillis, MD Secretary/Treasurer

Amanda Marie Wincik, DO At Large Member

Peter S. Lund, MD, FACS AMA Representative

Justin Webber, MD Resident Representative

Kathleen Anne Costanzo, DO At Large Member

Michael Furey Student Representative

Thomas Falasca, DO, FACA, FACPM At Large Member

eriecountymedicalsociety.org

The Stethoscope • Quarterly Newsletter of the Erie County Medical Society • March 2020 Issue