www.escambiacms.org SEPTEMBER/OCTOBER 2014 VOLUME 44, NO. 5
UPCOMING EVENTS Saturday, October 18, 2014 | 7:30a Fall CME Conference & Vendor Fair Holiday Inn Pensacola Beach 5 AMA PRA Category 1 Credit™ Sponsors: Safe Harbor Tax Advisory, Underwood Anderson & Associates, Inc., Dyken Wealth Strategies, Florida Doctors Insurance Company, McMahon & Hadder Insurance SAVE THE DATE 2015 ECMS Installation of Officers Saturday, January 10, 2015 Hilton on Pensacola Beach President-Elect Christopher Burton, M.D.
Founded in 1873
BULLETIN Editors: Hillary Hultstrand, M.D. Erica Huffman, Executive Director
This year has flown by. As I write this, Christmas is only three months away. But it seems that there is still so much to accomplish in 2014. We are very enthusiastic about our upcoming ECMS Fall CME Conference & Vendor Fair. If you haven’t already, please make plans to attend on Saturday, October 18, 2014. We will cover required CME including “Prevention of Medical Errors” and “Domestic Violence.” The conference will also cover “Federal and State Laws, Prescribing Controlled Substances.” You may have noticed that we tried something new this year. We consolidated meetings and instead of having a monthly meeting, we’ve created two longer CME conferences trying to cover the needs of our local physicians. ECMS is interested in meeting the needs of all of our local physicians. To that end, we plan to send out a survey to help assess unmet needs. We are interested in understanding why our members have remained members. We are also interested in understanding why our local physicians who have not chosen to become members are not joining. ECMS would like to grow our membership. We understand that there will be physicians who are not even familiar with the purpose or goals of our medical society. The mission of the Escambia County Medical Society is to promote the art and science of medicine in order to improve the health of our community. This includes tradition and honoring the history of medical care in Escambia and Santa Rosa Counties. We also strive to serve the needs of our community through service of our members in the practice of medicine. We hope that this is not mere verbiage. There have been a lot of new burdens placed on physicians. The Electronic Health Record and “achieving meaningful use” have added stress, cost and increased work hours to almost every physician’s day. In trying to create a better environment for physicians
to practice, we need unity so there is a clear voice in going to the legislature to fight for those issues that will help ease some of these burdens placed on physicians. Dr. Susan Laenger After all, our patients reap the benefits of better care when physicians are less stressed, and not burned out. On a final note, I would like to ask each of you to vote in the upcoming November election. It is important that physicians, as thought leaders, are represented well in the final outcome of the vote. I’m particularly concerned about Amendment 2. Amendment 2 provides for the use of marijuana for certain medical conditions. While it appears that the polls suggest that the majority of Florida backs the use of medical marijuana, a recent poll suggested that only 53% of probable voters back the measure. While my heart goes out to those whose medical conditions such as cancer or seizure could potentially benefit, the FMA and AMA firmly oppose legalization of marijuana for medical use. The American Psychiatric Association released a statement outlining the public harms of marijuana. “There is no scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder. In contrast, current evidence supports, at minimum, a strong association of cannabis use with the onset of psychiatric disorders. Adolescents are particularly vulnerable to harm, given the effects of cannabis on neurological development,” the statement said.
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Membership E.C.M.S. Bulletin
Contents
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The Bulletin is a publication for and by the members of the Escambia County Medical Society. The Bulletin publishes six times a year: Jan/Feb, Mar/Apr, May/Jun, Jul/Aug, Sept/Oct, Nov/ Dec. We will consider for publication articles relating to medical science, photos, book reviews, memorials, medical/legal articles, and practice management.
Page 3 - New Members Page 4 - Practice Management Page 7 - Medical/Legal Page 8 - Membership Page 10 - In the Community
Vision for the Bulletin:
· Appeal to the family of medicine in Escambia and Santa Rosa County and to the world beyond. · A powerful instrument to attract and induct members to organized medicine.
Ad placement Contact Erica Huffman at 478-0706
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View and opinions expressed in the Bulletin are those of the authors and are not necessarily those of the board of directors, staff or advertisers. The editorial staff reserves the right to edit or reject any submission.
NEW MEMBERS Amber Gordon, M.D. Neurosurgery Baptist Medical Group Neurosurgery 1717 North E Street, Suite 422 Pensacola, Florida 32501 (P) 850-469-0642 (F) 850-437-8318 Melissa Kozakiewicz, M.D. OB/GYN Baptist Medical Group Ladies First OB/GYN 3417 North 12th Avenue Pensacola, Florida 32503 (P) 850-432-7310 (F) 850-432-7320 Thomas Lawrence, M.D. Pathology Pensacola Pathologists, P.A. 5149 North 9th Avenue, Suite 122 Pensacola, Florida 32504 (P) 850-416-7780 (F) 850-416-7352
Layla Lundquist-Smith, M.D. Family Medicine Baptist Medical Group Cordova 4457 Bayou Boulevard Pensacola, Florida 32503 (P) 850-437-8485 (F) 850-437-8489 Daniel Murawski, M.D. Orthopedic Foot and Ankle Surgery Andrews Orthopaedic and Sports Medicine Center 1040 Gulf Breeze Parkway, Suite 210 Gulf Breeze, Florida 32561 (P) 850-916-8455 Carrie Steichen, D.O. Anesthesiology Pain Consultants of West Florida, P.A. 4624 North Davis Highway Pensacola, Florida 32503 (P) 850-494-0000 (F) 850-494-0001 Jeffrey Wolters, M.D. Urology Woodlands Medical Specialists 4724 North Davis Highway Pensacola, Florida 32503 (P) 850-696-4000 (F) 850-434-2647
HAVE YOU PAID YOUR DUES? In October, ECMS will mail out early county dues for 2015. Early county dues can be paid through December 31st. County dues invoices for all unpaid members will be mailed out just after the New Year. Please pay your membership dues by March 1st to be included in the 2015 ECMS Pictorial Directory. ECMS needs your help updating our pictorial directory. If you have moved or changed any of your business information since March/2014 please email info@escambiaCMS.org Name | phone | fax | address | email
Angela Ziebarth, M.D. Gynecology/Oncology Sacred Heart Medical Oncology Group 1545 Airport Boulevard, Suite 3200 Pensacola, Florida 32504 (P) 850-416-7101 (F) 850-416-7103 RELOCATION Dr. Eduardo Puente is now practicing at Baptist Medical Group Urology; his can now be contacted at: 1717 North E Street, Tower 3, Suite 430 Pensacola, Florida 32501 (P) 850-437-8711 (F) 850-437-8719 ALWAYS REMEMBERED ECMS Life Member Dr. Eric “Henry” Amos (1941-2014) passed away peacefully on Monday, September 1, 2014. Dr. Amos was an ECMS member from 1972-2002, 2006, 2007 and became a life member in 2008 when he retired.
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Practice Mgmt.
Plan to Pay Less Tax As physicians you pay hundreds of thousands of dollars in taxes over your career. Because of the busy schedule, taxes are often the afterthought – that is until April 15th comes around and you wish there was something that could be done. The good news is with proper tax planning there are ways to reduce your tax bill. The key is planning ahead. Tax planning is different than tax preparation. People go to the tax preparer in April and they are upset at the high tax bill they owe. They realize they work almost half a year to pay the taxes that is owed to “Uncle Sam” each April 15th. They ask what can be done about the high tax bill but usually get a few quick suggestions or more likely are told “nothing can be done”. That is simply not true. A Certified Tax Coach breaks the tax return down line by line and looks at every aspect of your tax return to see if any deductions are missing; any income could be moved to a different “bucket; any credits you are not taking or loosing due to high income; your choice of entity selection; and many other areas. Tax planning takes about 15-30 hours of work to do a true tax planning engagement. It is not something that is done on April 15th. It is a separate engagement but one that can save you as much as $75,000 in taxes. Therefore, many people mistakenly think they are receiving “tax planning” when they have their tax returns prepared. This could not be further from the truth. Giving just a few “hints” to reducing taxes is just that – giving you a few hints. Physicians have many options available for reducing the taxes they pay, yet less than 5% of physicians actually take advantage of all the legal deductions in which they are entitled. Even the entity choice of the business could save tens of thousands of dollars each year in taxes. This is not something many tax preparers even feel comfortable discussing. That’s why it is best to hire a specialist such as a Certified Tax Coach who is trained on all of the various tax planning ideas. The Affordable Care Act has resulted in the loss of valuable deductions because income is too high to take advantage of those. Losing the valuable Child Tax Credit is only one of the most hurtful results of higher income. A credit is a dollar for dollar reduction in taxes so anytime we lose credits it a hard “pill” to swallow. Also for 2013 we saw the return of the limited itemized
By Virginia Shelby, CPA, Certified Tax Coach Safe Harbor Tax Advisory
deduction phase out and personal exemptions. The reduction starts when adjusted gross income exceeds $305,050. Therefore, if your income exceeds $305,050 and you have 3 children under the age of 16, you not only loose the $3000 in child tax credit but you now lose their personal exemptions in the amount of $3,950 (for a total of $18,750 for a family of five). You also lose deductions for mortgage interest, charitable deductions, real estate taxes, etc. Therefore, as your income increases you can see why proper tax planning is important. Without it your tax bill could be as much as $30,000 higher than you have experienced in previous years. But with proper and “true” tax planning, you and your family can keep that extra money in your pocket rather than sending it to Washington year after year.
Practice Mgmt.
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Meaningful Use Update: Participation increased from June and 75% of providers have now received payments
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By Paul Glisson, DO, MBA
We have all heard the term meaningful use (MU) by this point. At first, the requirements were thought impossible to attain and for little return on investment. Since the announcement of requirements in 2009, most providers have since taken the steps necessary to participate and attest for reimbursement under MU. As described in the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records (EHR) can qualify for Medicaid and Medicare incentive payments. This year brought new and more stringent requirements, including the requirement to attest with a certified version of your EHR. Eligible professionals who have attested to Stage 1 of the Medicare meaningful use program for at least two years must advance to Stage 2 by the end of 2014. The 90-day attestation period for eligible professionals began on Jan. 1, and they have until the end of the calendar year to attest. In May, CMS and the Office of the National Coordinator for Health IT released a new proposal to give providers who are experiencing difficulties obtaining a certified version of their HER an additional year to upgrade EHR systems to meet reporting requirements for Stage 2 of the meaningful use program. The proposed timeline change came in response to provider’s and EHR vendor’s feedback about needing more flexibility. The proposed rule acknowledges that many software vendors have had difficulty upgrading their EHR products, receiving certification, and upgrading customers’ systems in time to attest to the meaningful use program. If you are interested in learning more about the proposed rule change and new timeline, please visit the CMS website here: http://www.cms.gov/Regulationsand-Guidance/Legislation/EHRIncentivePrograms/Stage_2.html Stage 2 requirements also focus heavily on the transitions of care (TOC). Core measure number 15 requires that providers be able to send a transition of care document to the patient’s other provider so that information can be freely shared. The Florida HIE has made this possible with their Direct DSM (direct secure messaging) service. Locally in Pensacola, Strategic Health Intelligence (SHI) and the Pensacola Health Information Exchange (HIE) offer this service. This service allows a provider to send a receive DSM messages from the local database that carries the bulk of patient information from Baptist Health Care and Sacred Heart Health System. This service can include direct EHR integration, and a more cost effective service using Direct Messaging (e-mail). For more information about these services, please contact Ashley Spikes (ashleyspikes@the-hie.com) at the Pensacola HIE. So how many providers and hospitals are attesting for MU? The latest attestation figures were revealed by CMS on August 1, 2014.
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5,365 eligible professionals, 955 of which are new participants, have attested to meaningful use for the 2014 reporting period; and 322 eligible hospitals, 131 of which are new, have attested for the 2014 reporting period.
Of those, the data show that: • 1,898 eligible professionals attested to Stage 2 of the meaningful use program, up from 972 who had attested as of the end of June • 78 eligible hospitals have attested to Stage 2 of the meaningful use program, up from 10 who had attested as of the end of June. Meanwhile, CMS notes that as of the end of June: • •
95% of eligible hospitals have registered for the program, with 92% receiving at least one incentive payment; and 89% of eligible professionals have registered for the program, with 75% receiving at least one incentive payment.
In total, the program has paid out $24.7 billion in incentives. References: (Conn, Modern Healthcare, 8/6; [subscription required]; Pedulli, Clinical Innovation & Technology, 8/7; Sullivan, Healthcare IT News, 8/7) Eligible Professional (EP) Meaningful Use Core and Menu Measures for STAGE 2 MU Eligible Professional Core Objectives (must meet all 17) 1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. 2. Generate and transmit permissible prescriptions electronically (eRx). 3. Record the following demographics: preferred language, sex, race, ethnicity, date of birth. 4. Record and chart changes in the following vital signs: height/length and weight (no age limit); blood pressure (ages 3 and over); calculate and display body mass index (BMI); and plot and display growth charts for patients 0-20 years, including BMI. 5. Record smoking status for patients 13 years old or older.
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
6. Use clinical decision support to improve performance on high-priority health conditions. 7. Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP. 8. Provide clinical summaries for patients for each office visit. 9. Protect electronic health information created or maintained by the Certified EHR Technology through the implementation of appropriate technical capabilities. 10. Incorporate clinical lab-test results into Certified EHR Technology as structured data. 11. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. 12. Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminders, per patient preference. 13. Use clinically relevant information from Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient. 14. The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation. 15. The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide a summary care record for each transition of care or referral. (CCDA) 16. Capability to submit electronic data to immunization registries or immunization information systems except where prohibited, and in accordance with applicable law and practice.
Practice Mgmt.
17. Use secure electronic messaging to communicate with patients on relevant health information. Eligible Professional Menu Objectives (must meet 3 of 6) 1. Capability to submit electronic syndromic surveillance data to public health agencies except where prohibited, and in accordance with applicable law and practice. 2. Record electronic notes in patient records. 3. Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT. 4. Record patient family health history as structured data. 5. Capability to identify and report cancer cases to a public health central cancer registry, except where prohibited, and in accordance with applicable law and practice. 6. Capability to identify and report specific cases to a specialized registry (other than a cancer registry), except where prohibited, and in accordance with applicable law and practice. All providers, regardless of their stage, are only required to demonstrate meaningful use for a 3-month EHR reporting period. For Medicare providers, this 3-month reporting period is fixed to the quarter of the calendar year. The 3-month reporting period is not fixed for Medicaid eligible professionals and hospitals that are only eligible to receive Medicaid EHR incentives.
Mark Your Calendar 2015 ECMS Installation of Officers Saturday, January 10, 2015 President-Elect Christopher Burton, M.D. Hilton on Pensacola Beach Gulf Front
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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The Escambia County Medical Society would like to congratulate Juliana Matthews. Juliana was the recipient of the 2014 ECMS Michael Redmond Scholarship Fund. Thank you for selecting me as a recipient of the Michael Redmond Escambia County Medical Society Scholarship for this year. I am honored to have been chosen and grateful for your support. This award will help me pay for tuition and interview costs throughout my fourth year. Serving as the Student Representative for the Escambia County Medical Society expanded my knowledge of political, social and economic issues affecting our field. Working with local leaders has been thoroughly educational and entertaining. ECMS board meetings have helped me see firsthand how important physician collaboration is. I admire the board member’s devotion to service and respect for colleagues, despite diverse beliefs on health care reform. The meetings constantly remind me of the integrity and responsibility this profession demands. Moreover, ECMS has reinforced my commitment to improving the delivery of healthcare. Thank you again for your support and generosity. I am excited to learn more from ECMS meetings and
events. Further, I look forward to working as the M4 Representative this year and perhaps even returning to serve on the board should I come back to Pensacola to practice. Best, Juliana Matthews Florida State University College of Medicine Class of 2015
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Membership
ECMS Women in Medicine Brunch The annual ECMS women in medicine brunch which occurred on Sunday, September 28th at Hemingways on Pensacola Beach was well attended and successful despite a rainy and windy day. The brunch was made possible by our gracious sponsors: Danna Gracey Insurance represented by Julie Danna; Edward Jones represented by Risk Lambert; Fisher Brown Bottrell Insurance represented by Jean Quisenberry; and ProAssurance represented by Barbara Daugherty. Women physicians from different specialties and practices gathered to discuss practicing medicine in Escambia and Santa Rosa Counties, put names to faces, and share similar hobby interest. “The Women in Medicine Brunch is a great way to network with other female physicians. It has enabled me to develop relationships with like-minded individuals in the medical field, and those relationships have helped build my practice. I highly recommend this social event to all female medical professionals around the area. Great event!� - Nutan DeJoubner, M.D.
2015 PICTORIAL DIRECTORY ECMS needs your help updating our pictorial directory. If you have moved or changed any of your business information since March/2014 please email info@escambiaCMS.org Name | phone | fax | address | email
Membership
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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Julianna Matthews, FSU COM M3 won the raffle for the Fisher Brown Bottrell wreath. With her is Jean Quisenberry, Medical Malpractice Specialist & Commercial Accounts Manager.
(L-R) Nutan DeJoubner, M.D.; Anita Westafer, M.D.; Pamela Svendsen, M.D.
(L-R) Monica Nall, M.D.; Layla Lundquist-Smith, M.D.; Kacey Gibson, D.O.; Hillary Hultstrand, M.D.
Barbara Daugherty, Account Executive for ProAssurance gives Dr. Angeli Saith her raffled prize.
Some of our original Women in Medicine Day founders: Nell Potter, M.D.; Paula Montgomery, M.D.; Cynthia Worrell-White, M.D.
Dr. Nutan DeJoubner won the raffled bottle of Italian wine from Rick Lambert CFP, Financial Advisor, Edward Jones.
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
In the Community
Baptist Hospital Baptist Hospital Receives 2014 Healthgrades Bariatric Surgery Excellence Award™ The 2014 Healthgrades Bariatric Surgery Excellence Award™ recognizes Baptist Hospital as among the top 10 percent of 70 selected 5-star performers in bariatric (weight-loss) surgery from across the U.S. Recipients of the award successfully perform bariatric surgeries with little to no complications after surgery. Baptist Medical Group Welcomes Internal Medicine and Pediatrics Physician Ashley Askew, M.D. Baptist Medical Group, the physician network of Baptist Health Care based in Pensacola, Fla., further expands its primary care presence in the Navarre community with the addition of internal medicine and pediatric physician Ashley Askew, M.D. Starting in September 2014, Dr. Askew joins the Baptist Medical Group Internal Medicine & Pediatrics – Navarre office, located at 8880 Navarre Parkway in Navarre. She will work alongside established Baptist Medical Group internal medicine and pediatric physician, Alison Curtsinger, M.D., caring for patients of all ages. Dr. Askew earned her medical degree at the University of Kansas School of Medicine in Wichita, Kansas and completed her residency at the University of Missouri-Kansas City in Kansas City, Mo.
Baptist Medical Group Opens New Primary Care Office in Pensacola; Welcomes Layla Lundquist-Smith, M.D., and Jose Murillo, M.D. Baptist Medical Group, the growing physician network of Baptist Health Care in Pensacola, Fla., is pleased to announce the opening of a new primary care practice location in Pensacola, Fla. The office, located at 4457 Bayou Blvd., will be the home of the newly established Baptist Medical Group – Cordova practice. Along with the opening of the new office, Baptist Medical Group welcomes two new family medicine physicians, Layla LundquistSmith, M.D., and Jose Murillo, M.D., who will offer traditional primary care appointments as well as welcome walk-ins for treatment of minor illness or injury. Dr. Lundquist-Smith joins Baptist Medical Group from Tallahassee, Fla., where she most recently completed her chief residency at Tallahassee Memorial Healthcare and earned her medical degree from Florida State University College of Medicine. She was born in Pensacola, Fla., and is eager to reestablish here with her husband and two children. Dr. Murillo joins Baptist Medical Group from Oklahoma City, Okla., after completing his family medicine residency at the University of Oklahoma, and working at an urgent care center. Prior to that, he earned his medical degree at Ross University School of Medicine in Dominica. Dr. Murillo is a native of the Gulf Coast and is looking forward to returning to the region with his wife and two children to begin serving the Pensacola community.
www.edwardjones.com
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