Mecklenburg Medicine April 2013

April 2013 • Vol. 43, No. 4

Mecklenburg Medicine A Publication of the Mecklenburg County Medical Society | www.meckmed.org

The Future of Health Care Comes

One Step

at a Time

Mecklenburg County Medical Society • Mecklenburg Medical Alliance and Endowment Mecklenburg County Medical Society

Founders of: Bioethics Resource Group, Ltd., Hospitality House of Charlotte, Teen Health Connection, N.C. MedAssist, Physicians Reach Out

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2 | April 2013 • Mecklenburg Medicine

Contents

April 2013 Vol. 43 No. 4

Features 7 An Update on North Carolina’s Implementation of the Affordable Care Act

9 New Chronic Pain Coalition Kicks Off April Conference

In This Issue -------------------------------------------------------------------------------------------------------------4 AHEC Course Offerings 5 President’s Letter: Did Someone Say the “C” Word?

8 MMAE: The Minute Clinic Mindset 8 Physicians Reach Out: We Are Many; We Are One 9 Physicians Reach Out: Answers to Your Frequently Asked Questions about Physicians Reach Out

BOARD MEMBERS Lloyd L. Bridges, MD Raymond E. Brown, PA Scott L. Furney, MD Harold R. Howe, Jr., MD Scott L. Lindblom, MD A. Miller Wilson Maxwell, MD John P. McBryde, MD Paras H. Mehta, MD Cheryl L. Walker-McGill, MD Thomas N. Zweng, MD EX-OFFICIO BOARD MEMBERS Tammy Bridges President, Mecklenburg Medical Alliance & Endowment Keia V. R. Hewitt, MD President, Charlotte Medical Society Docia E. Hickey, MD NCMS Speaker of the House Stephen R. Keener, MD, MPH Medical Director, Mecklenburg County Health Department Darlyne Menscer, MD NCMS Delegate to the AMA Douglas R. Swanson, MD, FACEP Medical Director, Mecklenburg EMS Agency

10 April National Health & Wellness Observances 11 Member News 11 Upcoming Meetings & Events 12 MedLink Update: NC MedAssist Partnering With Second Harvest Food Bank 13 At the Hospitals 15 Advertising Acknowledgement

Mecklenburg County Medical Society

OFFICERS Janice E. Huff, MD President James B. Hall, MD President-Elect Simon V. Ward III, MD Secretary Stephen J. Ezzo, MD Treasurer Maeve E. O’Connor, MD Immediate Past President

EXECUTIVE STAFF Sandi D. Buchanan Executive Director Trisha G. Herndon Director, Meetings & Special Events Stephanie D. Smith Executive Assistant

1112 Harding Place, #200, Charlotte, NC 28204 704-376-3688 • FAX 704-376-3173 meckmed@meckmed.org Copyright 2013 Mecklenburg County Medical Society

Mecklenburg Medicine is published 10 times per year by the Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204. Opinions expressed by authors are their own, and not necessarily those of Mecklenburg Medicine or the Mecklenburg County Medical Society. Mecklenburg Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Mecklenburg Medicine is not responsible for unsolicited manuscripts.

Non-members may subscribe to Mecklenburg Medicine at a cost of $30 per year, or $3.50 per issue, if extra copies are available.

Classified Ads: Open to members, nonprofits and non-member individuals only; advance approval of the Managing Editor and advance payment required. Member rate is 0, non-members $20 for the first 30 words; $.75 each additional word.

Display Ads: Open to professional entities or commercial businesses. For specifications and rate information, call Mark Ethridge at 704-344-1980. Acceptance of advertising for this publication in no way constitutes professional approval or endorsement of products or services advertised herein.

We welcome your comments and suggestions: Call 704-376-3688 or write Mecklenburg Medicine, c/o Mecklenburg County Medical Society, 1112 Harding Place, Suite 200, Charlotte, NC 28204.

MECKLENBURG MEDICINE STAFF Editor Mark E. Romanoff, MD Managing Editor Sandi D. Buchanan Copy Editor Lee McCracken Advertising Mark Ethridge 704-344-1980 Editorial Board N. Neil Howell, MD Janice E. Huff, MD Jessica Schorr Saxe, MD Graphic Design — Wade Baker

Mecklenburg Medicine • April 2013 | 3

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4 | April 2013 • Mecklenburg Medicine

President’s Letter

Did Someone Say the “C” Word?

By Janice E. Huff, MD President

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Com-mit-tee | k mite | noun; a person or group of persons elected or appointed to perform some service or function, as to investigate, report on, or act upon a particular matter. e

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f you want to elicit the entire gamut of emotions from our colleagues, no need to mention the Affordable Care Act! Simply say “committee” and stand back. Whether you agree with what is said or not, it is always entertaining.

Very few subjects bring such passion to the forefront. Some react like Beetlejuice when he hears his name spoken, “Nobody says the B (or C) word!” Others unleash a diatribe about the utter needlessness of committees, leaving one to wonder what would happen if they brought that same intensity in a constructive way to a meeting. Still others provide a litany of problems concerning any given committee (if only we could diagnose our patients so easily!).

We all have had our share of committee meetings where we left thinking, “Well, that’s time I’ll never get back.” At times, they seem to be a forum for the latest catchwords: robust, positive energy, opportunity, integration and, let’s not forget, value.

Other times we are witness to an ideological debate. An errant remark can lead us through the Looking Glass with Alice. And, more often than we like, the meeting culminates in one of two ways: the decision to meet again, or the decision to form a subcommittee. Political observer and avowed baseball fanatic George Will said, “Football combines the two worst things about America: It is violence punctuated by committee meetings.”

Yet, I will attempt a spirited defense of committees. When done correctly, they can be extremely productive, for

the collective knowledge of the many outweighs that of one. How many times have we been in a meeting and heard someone mirror our own thoughts with their comments, which gets us more engaged? Or better yet, how many times has someone said something we’ve not considered, broadening our mind? Committees can be intellectually stimulating, but often are not. I think this is what frustrates us, since medicine is the ultimate brain challenger.

Certainly we all have had miniepiphanies in our practices, when we have helped a patient in some unique way, or a patient has related something to us that we believe can be of benefit to others. At those times, we think how gratifying it would be to roll out these ideas on a larger scale. That’s where committees come in — they can take an idea, augment it if necessary, bring it to the attention of others and ultimately be of benefit to the larger community.

Everything the Mecklenburg County Medical Society has accomplished throughout its history started with an idea and then a committee.

This is a rather circuitous way of getting to my topic — enlisting some of you to serve on our MCMS committees. My aim is three-fold.

First, through a list of the committees and their functions, to impress upon you the value your Medical Society provides. Second, to pique your intellectual curiosity and convince you to sign up for one (or more). And thirdly, to discover the visionaries out there who have ideas that do not fit into our current structure and would like to spearhead committees that can bring their ideas to fruition.

All MCMS committees were listed in the February issue of this magazine with a brief description. Some committees have very defined goals and meet only once or twice a year.

These committees need new members periodically, if you are interested in their particular mission.

Many committees are more dynamic, and their goals are more fluid, depending on the healthcare issues in our community. These committees always need new members. Let me describe some of them here: The Legislative Committee, chaired

by David White and Chris Ullrich, MD, and the Meck PAC Board, chaired by John Williford, MD, stay current with the political issues of our county and state. These are great committees if you want to be an advocate for patients, physicians and physician assistants (PAs), as the ACA and insurance/ Medicaid issues, as well as other important healthcare topics, will be determined over the next few years.

Now more than ever, strong physician/ PA voices are needed in Raleigh.

The Child Health Committee always has been very active under the leadership of Jessica Schorr Saxe, MD. It currently is working on increasing exercise levels, especially outdoors, of our children; advocating for more school nurses; and they always are open to new ideas to promote good health for our kids. The Developmental and Behavioral Services Resource Guide is always being updated and is available on the MCMS website.

The Public Health Committee, co-chaired by Larry Raymond, MD, and Maeve O’Connor, MD, is working on clean air issues, including how to reduce diesel emissions in Mecklenburg County.

The Women Physicians Section, co-chaired by Katherine Pierce, MD, and Nancy Teaff, MD, plans events for women physicians and has an annual fundraiser (with the local attorneys of the Charlotte Women’s Bar) to benefit the Domestic Violence Shelter. As more

Mecklenburg Medicine • April 2013 | 5

women enter the ranks of medicine, we expect this Section to remain a lively group, always looking for networking opportunities and fresh ideas.

The Membership Committee, co-chaired by Lloyd L. Bridges, MD, and Paras H. Mehta, MD, is interested in knowing what new member services and benefits you would like, and is working on ideas generated by our consultant and focus groups to increase membership. This committee could use input from all of you — young or seasoned, new or old to Mecklenburg County, residents or attending physicians, men or women.

The Media and Public Relations Committee, ably chaired by Tom Zweng, MD, and Katherine Pierce, MD, serves many vital functions. This year, it is working on clean air issues with the Public Health Committee. For the authors out there, we need you to be

on the editorial board or write articles for this magazine. For the budding actors and actresses out there, we have TV opportunities for you!

There are special project committees, the longest-running of which is the Community Intern Program, which introduces “non-medical” community leaders to the medical world. This group needs volunteers to allow these “non-medical” people to see what your day is like. They also need to know which members of the community-atlarge you think could benefit from this experience.

Special project committees in the past have built Habitat Houses, held fundraising golf tournaments and started organizations, such as Physicians Reach Out and MedAssist.

If there is a project near and dear to your heart that would benefit patients and/or physicians and physician

assistants of Mecklenburg County, please let your Medical Society know about your idea, and we can start a committee just for you!

As you can see, there are many exciting ways to help your patients and colleagues. In fact, someone near and dear to my heart wants to start the Italian-American Section of the Mecklenburg County Medical Society.

Drs. Attori, Tellarico and Dalto, are you interested? I believe Dr. Ezzo would like to join you for a night of Barolo and Bocce!

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6 | April 2013 • Mecklenburg Medicine

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Feature

An Update on North Carolina’s Implementation of the Affordable Care Act

By Katie Benston, Chief Program Officer, Care Ring

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any patients, physicians and policy-followers are eager to know and understand what is next for healthcare reform in our state and our community. Here, we summarize some of the biggest steps next for the Affordable Care Act (ACA).

A New Health Insurance Marketplace A major feature of the ACA is the creation of regulated health insurance marketplaces, or health insurance exchanges.

A recent PricewaterhouseCoopers (PwC) analysis projects these new exchange markets will yield the largest expansion of health coverage in the United States since the creation of Medicare. While North Carolina still has many decisions to make about how the state will meet the ACA requirement for new health insurance marketplaces (in addition to a decision about whether or not to expand Medicaid coverage), implementation of the law is right around the corner. Less than one year remains before the ACA’s major coverage provisions go live; all exchanges must be ready to begin open enrollment on October 1, and be fully operational on Jan. 1, 2014.

North Carolina currently is planning to run a state partnership exchange jointly with the federal government.

The state was recently awarded $74 million to help get our health insurance exchange started, with support for IT infrastructure preparation and for the implementation of a consumer assistance program to help facilitate enrollment and ensure access to all eligible North Carolinians. While many decisions about exchange design are pending, and we can expect some adjustment in the 2013 legislative session, now is the time to review the basics of what exchanges will provide and who will be eligible to participate. These new health insurance marketplaces will allow qualified individuals and small employers (less than 100 employees) to purchase qualified health plans. State estimates suggest that more than 300,000 currently uninsured North Carolinians could gain coverage through the exchanges in 2014.

Making Coverage Affordable for Qualified Individuals

of advance premium tax credits and cost-sharing reductions, will make coverage purchased in the new health insurance marketplaces more affordable. To be eligible for these sliding-scale subsidies, individuals must have household income between 100 and 400 percent of poverty (between $23,050 and $92,200 a year for a family of four in 2012).

What is a Qualified Health Plan?

Plans offered in the new exchanges must be certified as Qualified Health Plans, meaning they must meet minimum essential benefits standards and have Interested in healthcare standardized, defined reform and policy? actuarial values (60 Follow In the Rings, a percent, 70 percent, 80 percent or 90 blog published by Care percent). These essential Ring Executive Director benefits standards will Don Jonas, PhD, at guarantee coverage intherings.org. for a set of at least 10 essential health service categories (including maternity and newborn care, mental health and substance abuse services, preventive and wellness services, and pediatric services — including oral/vision care, among others). In North Carolina, the benefits will be benchmarked to the Blue Cross Blue Shield–Blue Options PPO plan, which is the state’s largest small-group plan. Plans will be required to provide standardized information about their plans, including pricing, coverage and network providers, in order to facilitate ease of comparison shopping for consumers.

Care Ring continues to analyze the impact of ACA implementation, particularly as it relates to low-income, uninsured people in Mecklenburg County. Along with the Mecklenburg County Medical Society, Care Ring is a partner in MedLink, which hosted a community forum and companion physician education event on February 26 to explore how programs such as those offered in Mecklenburg County should prepare for full implementation of the ACA.

People without access to Medicaid or employer-based coverage that meets minimum affordability standards will be eligible to purchase coverage in the exchange. PwC analysis predicts roughly 75 percent of exchange participants previously will have been uninsured and that, initially, nine out of 10 people in the exchanges also will be eligible for federal subsidies. These sliding-scale subsidies, in the form

Mecklenburg Medicine • April 2013 | 7

MMAE

The Minute Clinic Mindset

By Tammy Bridges, MMAE President I find myself wondering if the same marketing geniuses who created minute clinics, drive-through banks, fast-food and various other forms of instant gratification, also are responsible for creating a culture of “no patience” patients.

The other day, I stopped by our local drugstore to print some photographs. While walking through the automatic doors, I almost was run down by a young woman rushing past me.

Apparently, she had a prescription to drop off at the pharmacy counter. I know this because within 10 minutes she began yelling at the top of her lungs demanding her medicine.

I looked at the photo lab tech, a UNC-Charlotte chemistry major, and asked if this sort of thing happened often. He nodded.

Then he added, “The poor pharmacist comes in earlier than I do, stays after the store closes and barely takes a lunch break.

Honestly, Mrs. Bridges, I thought I wanted to be a pharmacist but I’m changing my major. They work too hard and get no respect.”

No respect ... hmmm? I wondered how many students might drop out of the pharmacy program if they’d witnessed what I’d

just witnessed. Unfortunately, such behavior is all too common today. Pharmacists, physicians, nurses, educators, bank tellers, bus drivers — almost anyone who deals with the public, is vulnerable to a random attack by the rude and fractious customer.

What has happened to civility and patience? What makes some people think their time, their wants, their needs, are more important than that of others? Have they never heard about how, in rural areas, folks have to wait several days for the town doctor to make it to their small town or farm? Even today, we read about countries, such as Ghana, where people travel by foot and wait 10 hours or more to be seen by a mission physician from America.

I’m trying to raise children who respect their elders, other cultures and the rights of others. Do you know how difficult it is when they see adults throw a tantrum in the drugstore, scream at a cashier or bad mouth their neighbors? Isn’t the South supposed to be the last stronghold of good manners? If so, then surely we can spare more than 10 minutes waiting for a prescription or to be seen by a physician.

Physicians Reach Out

We Are Many; We Are One

By John T. Klimas, MD, Physicians Reach Out We are men; we are women.

We are PA’s, NP’s; we are dentists or physicians.

We are primary care doctors; we are specialists.

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e are many, yet we are as one, when we work together giving kind and compassionate care to the poor and sick of Mecklenburg County through Physicians Reach Out. For more than eight years, more than 1,600 physicians, PA’s, NP’s and dentists, have donated their skills to provide health care for more than 8,000 patients. In dollar amounts, an astounding $80 million in care has been donated by physicians and hospitals — but sheer numbers do not tell the whole story. Many patients have written emotional letters of gratitude, some published in this magazine, as well as in other publications.

“Thank you, Mr. Jonas, you saved my life,” said a grateful PRO patient to Don Jonas, the executive director of Care Ring, at the November annual fundraising luncheon.

During a recent office visit, a patient said the same thing to me.

“Thank you, Dr. Klimas, for saving my life.” I was confused at first, as I had not seen her as a patient before this meeting, but then I realized she was thanking me not for my services but for starting PRO. Some of your PRO patients may not express themselves as demonstratively as these patients did, but in their hearts lies a deep appreciation for what you have done to improve their health and quality of life.

8 | April 2013 • Mecklenburg Medicine

Now for the big question: What happens to the Physicians Reach Out program as we embark on 2013 and the Affordable Care Act? Looking for omens doesn’t help. The future appears a bit cloudy, and looking into a crystal ball raises more questions than answers.

• Will we see an expansion of Medicaid in North Carolina?

• Will insurance exchanges be successfully implemented?

• If there is a Medicaid expansion, what happens to the estimated 25,000-50,000 people in Mecklenburg County who will not be insured?

Individuals whose insurance costs exceed 8 percent of their household income are not required to obtain health insurance. Some people who are subject to the “individual mandate” will fail to comply. Also, undocumented immigrants are not subject to the individual mandate and are not eligible for Medicaid.

• Will healthcare providers be willing to take on more Medicaid patients?

• What effect will the Affordable Care Act have on Care Ring?

• Currently the administrator of PRO, will Care Ring transition into more of a navigator for the poor and uninsured?

Until we know differently, the Physicians Reach Out program will continue on, faithful to its original mission. As always, I extend my heartfelt gratitude to each participating doctor; it is you who have made PRO the successful program it has become. To your patients, you are the face of Physicians Reach Out and the deliverer of hope and good health.

In their eyes, you will always be the person who saved their life.

Physicians Reach Out Answers to Your Frequently Asked Questions about Physicians Reach Out

By Katie Benston Chief Program Officer, Care Ring

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any of the physicians participating in Physicians Reach Out have been donating their time since the program began almost eight years ago. During this time, practice staff has changed, and so have the procedures at Physicians Reach Out. In this issue, we tackle a few of the frequently asked questions about caring for your PRO patients. Let us know what other topics you would like addressed by emailing Katie Benston at kbenston@careringnc.org.

Translating Services One of the benefits of participating in Physicians Reach Out is that PRO provides translating services for all of our non-English speaking patients at their primary and specialty doctor’s appointments, as needed. If your office uses in-house translation services for PRO, that is fine.

For PRO patients using our translation services, it is the patient’s responsibility to call PRO a minimum of five business days prior to his/her scheduled appointment in order to ensure a translator can be present. Patients should not call PRO regarding appointments that are scheduled more than three months out or that occur after his/her eligibility expires. For those situations, it is best for the patient to call closer to the appointment. This process ensures the patient currently is an eligible PRO patient and the scheduled appointment is with a participating PRO provider.

Specialty Referrals Specialty care is one of the hallmarks of the Physicians Reach Out program. In order to help your patients receive the care they need, we ask that you follow the procedure for specialty referrals.

All requests for specialty care should be sent to PRO via fax to 704-943-3747 or MedData/MedConnect. PRO staff will schedule appointments for your patient within our network of providers. Do not schedule appointments directly with specialty providers — PRO has specific commitments from each provider, and it is important we honor those commitments and ensure patients can have continued access to specialty care. Any appointments scheduled outside of PRO either delay care for the patient or cause them to have to pay out of pocket for the

appointment. One exception: Presbyterian patients can be scheduled for physical therapy directly with Presbyterian Physical Therapy without a referral through PRO. After sending PRO the referral, allow a minimum of three days for us to process the referral and enter it into our system. If your practice desires an e-mail confirmation for receipt of the referral, provide contact information, including an e-mail address, on each referral you submit. Do not send multiple copies of the same referral, as this can delay processing and could lead to one patient being scheduled for multiple appointments for the same issue. If you are concerned a referral has been lost, or you have a question about a referral, call one of our Access Coordinators for assistance.

Toni Lee coordinates referrals for cardiology, dermatology, ENT, gynecology, neurology and neurosurgery, ophthalmology, pulmonology, sleep medicine, urology and oncology. She can be reached at 704-243-3702 or tlee@careringnc.org.

Grayson Price coordinates referrals for allergy, dental, endocrinology, gastroenterology, general, vascular and colorectal surgery, nephrology, orthopedics, physical therapy, podiatry and rheumatology. He can be reached at 704-243-3706 or gprice@careringnc.org.

Specialty providers are aided when referrals are as detailed and specific as possible. This allows specialty offices to assign patients to the appropriate providers.

Specialty requests are handled on a firstcome, first-serve basis. Due to the large volume of referrals we receive, many specialties have a waiting period before appointments can be scheduled. Actual wait time depends on a variety of factors, including volume of referrals for the specialty and provider availability. Rest assured that we request appointments as quickly as we can.

As a reminder, PRO does not have the ability to triage referrals and PRO does not provide emergency appointments with specialists.

Once an initial appointment has been made with a specialty provider, the patient schedules any subsequent care, including procedures, with the provider. Referrals are good for one year after the initial appointment. If a patient needs continued follow-up care with a provider after one year has elapsed, a new referral must be sent to PRO.

Some specific specialties are available only to certain hospital systems: Gynecological oncology, neurology — Presbyterian only Urology — CMC only Reference the following list when determining if a particular procedure requires a referral.

Requires referral: colonoscopy, endoscopy, stress test, EGD Does not require referral: mammogram, CT, MRI, X-ray Requesting Medical Records Physicians Reach Out specialty providers increasingly are requesting the medical records of patients referred by the PCPs prior to scheduling an appointment.

Therefore, not having medical records available sometimes can delay the patient being given the specialty appointment. In order to expedite the specialty appointment process, Physicians Reach Out requests you send medical records along with the referral whenever possible, but in particular for the following specialties: dermatology, endocrinology, gynecology, nephrology, oncology, orthopedics and rheumatology.

Once a specialist appointment has been made, PRO faxes a notice to the referring physician’s office regarding the specialty appointment time. Please note at the bottom of the referral, there is a fax number for you to send medical records to the specialty office (if the records were not originally sent with the referral).

Also, if your practice has an Electronic Medical Record (EMR), please indicate that on the referral form so Physicians Reach Out can inform the specialty office. Note that some specialty offices have not converted to an EMR or may not be affiliated with a particular hospital system, so paper medical records still may be needed.

Mecklenburg Medicine • April 2013 | 9

Feature

New Chronic Pain Coalition Kicks Off April Conference Community Stakeholders Partner to Decrease Opioid-Related Deaths

By Deb Sauvain, BSN, RN, Chronic Pain Coordinator, Community Care Partners of Greater Mecklenburg

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pioid analgesics are now responsible for more deaths than the number of deaths from both suicide and motor vehicle crashes, or deaths from cocaine and heroin combined, according to a recent study published by Laxmaiah Manchikanti, MD, et al. in the July 2012 issue of Pain Physician Journal. The study further explains the causes of unintentional overdose deaths as follows: 60 percent occurred in patients given prescriptions, based on prescribing guidelines by medical boards. Of these, 20 percent were due to low-dose opioid therapy equivalent to 100 mg or less of morphine, and 40 percent were from opioid therapy equivalent to 100 mg or more of morphine. The remaining 40 percent of unintentional opioid overdoses resulted from individuals obtaining multiple prescriptions, doctor shopping and drug diversion.

The obstacles facing healthcare practitioners in safely prescribing opioid medication include inappropriate prescribing patterns, lack of knowledge and limited usage of assessment tools and information.

In 2007, Wilkes County had the third highest drug overdose rate in the nation, according to the Center for Disease Control (CDC). At the same time, a Wilkes County hospice chaplain, Fred Brason, saw alarming increases in deaths from unintentional opioid overdoses. Surprisingly, they were not related to terminal illnesses.

A year later, Brason started Project Lazarus, which has been successful in reducing the epidemic of needless deaths. In Wilkes County, the success of Brason’s Project Lazarus resulted in a 47 percent decline in unintentional opioid deaths from 2009 to 2010.

The foundation of Brason’s community-based model is a coalition of stakeholders dedicated to: • Epidemiologic monitoring • Prevention • Rescue treatment • Program evaluation (process and outcomes) Brason’s model has been adopted by Community Care of North Carolina (CCNC), and local coalitions are being formed within its 14 networks. CCNC provides managed care for North Carolina’s Medicaid Access II patients. Community Care Partners of Greater Mecklenburg (CCPGM) is CCNC’s Charlotte-based network for enrollees in Anson, Mecklenburg and Union counties.

Last year, CCPGM launched a chronic pain initiative that included the formation of the Chronic Pain Coalition of Greater Mecklenburg. The Coalition now includes community stakeholders from various disciplines, including emergency department and primary care physicians, integrative therapists, pharmacists, behavioral health and addiction specialists, and ministers.

10 | April 2013 • Mecklenburg Medicine

The Coalition is hosting its first chronic pain seminar, “Chronic Pain: Visions for the Future,” in conjunction with its sponsors, The Governor’s Institute, Mecklenburg County Medical Society and Community Care Partners of Greater Mecklenburg. Seminar topics will give evidence-based strategies for managing chronic pain patients and reducing unintentional opioid drug overdoses. The four-hour seminar will be Thursday, April 25, from noon-5 p.m. at the Harris Conference Center. Lunch and networking will be noon1 p.m. The fee is $100 and registrants are eligible for up to 4.5 AMA PRA Category 1 Credits™. To register, go to www.charlotteahec.org.

For more information about the Chronic Pain Coalition of Mecklenburg, contact Deb Sauvain at deb. sauvain@carolinashealthcare.org. CCPGM currently has 168,000 enrollees in Anson, Mecklenburg and Union counties, with 205 providers serving as a medical home. It has been providing managed care for Medicaid Access II enrollees since 2002.

NATIONAL HEALTH & WELLNESS OBSERVANCES April April 1-7 National Alcohol Awareness Month National Cancer Control Month National Child Abuse Prevention Month National Counseling Awareness Month National Donate Life Month Stress Awareness Month National Minority Health and Health Disparities Month National Occupational Therapy Month National STDs/Family Planning Awareness Month

National Public Health Week April 7

World Health Day April 15-21

Medical Fitness Week National Minority Cancer Awareness Week April 21-28

National Infant Immunization Week April 22

Earth Day April 25

Take Your Daughters and Sons to Work Day

Member News New Members Ilan D. Avin, MD *General Surgery; *Surgical Oncology Carolina Surgical Clinic 2104 Randolph Road Charlotte, NC 28207 704-377-3900 Virginia Commonwealth University, 2003 Joseph L. Trask, Sr., MD *Nuclear Cardiology Mid Carolina Cardiology 10030 Gilead Road #201 Huntersville, NC 28078 704-887-4530 Medical University South Carolina, 1983 John D. Wylie, MD, PhD *Diagnostic Radiology; Neuroradiology; Pediatric Neuroradiology Charlotte Radiology 1701 East Blvd.

Charlotte, NC 28203 704-334-7800 Washington University, St. Louis, 2006

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Sponsored by the Huntersville Police

Sponsored by the Alcohol Beverage Control Law

SteeleCroft Shopping Center 13000 South Tryon Street, Charlotte

Morrocroft Shopping Center 6701 Morrison Blvd., Charlotte Stonecrest Shopping Center 7852 Rea Road, Charlotte Pikes Pharmacy 2133 Shamrock Drive, Charlotte Polymers Center for Excellence 8900 Research Drive, Charlotte (11 am-2 pm)

Sponsored by the Charlotte-Mecklenburg Police Shopping centers, unless indicated, are near Harris Teeters. Sharps/needles and biohazard materials are not accepted.

www.safekidscharmeck.org or www.levinechildrenshospital.org/operationmedicinedrop

Upcoming Meetings & Events

Meetings are at the MCMS office unless otherwise noted.

APRIL Note: No MCMS Board Meeting. n Tuesday, April 2 Charlotte Dental Society Board meeting.

6:00 p.m. n Tuesday, April 2 Women Physicians Section Fundraiser Planning Committee meeting.

Safe Alliance office.

6:00 p.m. n Tuesday, April 9 MedLink meeting.

8:30 a.m.

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Thursday, April 11 Women Physicians Section Girls Night Out. The Comedy Zone.

6:30 p.m.

Thursday, April 11 Charlotte Medical Society Membership Meeting.

6:00 p.m.

Friday-Saturday, April 12-13 AAFP Post-Graduate Symposium.

Renaissance Suites-SouthPark.

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Monday, April 15 MCMS Executive Committee meeting.

5:30 p.m.

Wednesday, April 17 MMAE Board Meeting.

10:00 a.m.

Thursday, April 18 CAMGM meeting.

Myers Park Baptist Church Cornwell Center.

Noon.

Monday, April 22 June magazine deadline.

Make the connection at

www.meckmed.org Resources for physicians, medical offices, patients and the public.

Visit us today! www.facebook.com/MecklenburgCountyMedicalSociety Sandi Buchanan@mcmsed

Mecklenburg Medicine • April 2013 | 11

Med Link Update

NC MedAssist Partnering With Second Harvest Food Bank

By Susan Royster, Associate Executive Director, NC MedAssist

I

n August 2012, NC MedAssist began a new partnership with Second Harvest Food Bank. The nonprofit organization receives shipments of over-thecounter medications and supplies from various retail pharmacies, which they then donate to MedAssist. This partnership has proven to be a huge benefit for our clients and our free clinic partners all over the state. The clients who receive these items, such as ibuprofen, allergy medicines and vitamins for children and adults, are low-income. It is an added stress in their life when they have a throbbing headache or their child has

THE 8TH ANNUAL

MELANOMA AWARENESS GOLF CLASSIC MONDAY, JUNE 17 CARMEL COUNTRY CLUB SOUTH COURSE n

11:00 am 1:00 pm 6:00 pm

Registration & Lunch Shotgun Start Reception

For more information, contact Rebecca Sheaff at Rebecca.Sheaff@carolinas.org or 704-755-4048

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SAVE THE DATE!

12 | April 2013 • Mecklenburg Medicine

a fever and they can’t afford to go to the drugstore and purchase Tylenol. Every dollar they can save makes a huge difference to their family budget.

One recent recipient was homeless and extremely grateful for Band Aids, iuprofen and some skin care products for her child. These are items you and I take for granted, as we shop in our local retail pharmacy with our flex-spending card.

Our over-thecounter initiative also is a great opportunity for small groups, families, church groups, etc., to get involved with NC MedAssist.

Not only can groups come in to help with sorting and shipping to the free clinics, but they also can volunteer at our OTC giveaway day once a month. On this day, our clients and those in need in the community can come to MedAssist and select five products to take home from our inventory, at absolutely no cost.

Some of our volunteers have been from Carolinas HealthCare System, United Way Young Leaders, Hands on Charlotte and individual families looking for a way to give back to the community.

MCMS Membership Directory The 2013 MCMS Membership Pictorial Directory is now available. If you are interested in purchasing a copy, call the MCMS office at 704-376-3688. MCMS members receive a free copy as a member benefit. If you have not received your copy, please let us know.

At the Hospitals

Novant Health Developmental & Behavioral Pediatrics Opens Novant Health Developmental & Behavioral Pediatrics opened on Feb. 21 and is accepting new patients. Developmental pediatrics is a subspecialty area that diagnoses and treats children with developmental, learning or behavioral concerns. Barbara Kissam, MD, is board-certified in developmental-behavioral pediatrics; Caitlin Rissler, NP, is board-certified in pediatrics and has completed leadership education in neurodevelopmental disabilities.

Conditions treated at this facility include: autism spectrum disorder; ADHD; learning disabilities; depression; anxiety; obsessive compulsive disorder; oppositional defiant disorder; bipolar disorder; reactive attachment disorder; developmental delays; genetic syndromes with developmental issues, such as Down syndrome, Fragile X syndrome, Angelman syndrome and Prader-Willi syndrome; NICU graduates with developmental issues; and behavioral problems.

Novant Health Developmental & Behavioral Pediatrics is the first practice of its kind in Charlotte. To schedule an appointment or refer a patient, call 704-316-1155. n

Visit www.presbyterian.org/gynsurgery or contact Pat Campbell at 704-384-4065 or ptcampbell@novanthealth.org for details. To find a Presbyterian-affiliated OB-GYN, visit www.presbyterian.org/obgyndoctor.

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Presbyterian Designated as Center of Excellence for Minimally Invasive nGynecology Presbyterian Hospital has been recognized as a Center of Excellence in Minimally Invasive Gynecology (COEMIG) by the AAGL and Surgical Review Corporation. This designation showcases Presbyterian’s commitment to new technologies, patient education and general patient awareness surrounding minimally invasive options for gynecologic surgery patients. James Hardy, MD, and Scott Schneider, MD, are co-medical directors of the center, and they also are designated as Center of Excellence surgeons, according to the standards set by COEMIG. Twelve additional OB-GYN physicians from Presbyterian Hospital, Presbyterian Hospital Huntersville and Presbyterian Hospital Matthews also have met the criteria for the Center of Excellence.

Presbyterian Neuroscience Institute Offers Support Group for Young n Stroke Survivors The Presbyterian Neuroscience Institute offers a support group for young stroke survivors. The group meets monthly at Presbyterian Neurology Center in Suite 400 of Midtown Medical Plaza, at 1918 Randolph n n

Road. All sessions meet 6-7:30 p.m.

Schedule/Topics* • Thursday, May 23 – Beating the Blues PostStroke • Thursday, July 25 – Overall Wellness • Thursday, Sept. 26 – Migraines and Stroke • Thursday, Nov. 21 – Holiday Celebration Survivors are asked to RSVP to Jaime Pimental at jlshue@novanthealth.org or 704-316-6239.

If you have questions about the young stroke support group, contact Jaime Pimental at jlshue@novanthealth.org or 704-316-6239. *Topics subject to change.

Novant Health Announces Strategic Plan for Re-Branding In an ever-changing health care industry, the need for transformation is more apparent than ever before. In 15 years, Novant Health has grown into a significant regional health care system with 13 acute care facilities, more than 100 outpatient facilities and 350 physician practices across four states.

Novant Health is reinventing the health care experience to be simpler, more convenient and more affordable, so consumers can focus on getting better and staying healthy. We are transforming care at the bedside, implementing world-class technology, enabling clinical staff to work at the top of their license and managing the finances of our system to the benefit of our patients and employees.

In February, we announced the next logical step in our transformation — our organization will unify under one name: Novant Health.

While you will see a new visual identity as a part of this re-brand, this is not a simple logo change. We have set in motion a clear, deliberate path to connect our points of access, share best practices, reduce waste and allow for recognized leadership in delivering clinical care. In short, we promise to make health care remarkable.

We publicly revealed our new logo in February, and the rollout begins April 17. To align together, our facilities will be re-named. To learn more about the branding plan and view the new visual identity, visit NovantHealth.org/remarkable. n

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CURRENT FACILITY NAME

NEW FACILITY NAME as of April 17, 2013

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Brunswick Novant Medical Center

Novant Health Brunswick Medical Center

Clemmons Medical Center

Novant Health Clemmons Medical Center

Forsyth Medical Center

Novant Health Forsyth Medical Center

Franklin Regional Medical Center

Novant Health Franklin Medical Center

Kernersville Medical Center

Novant Health Kernersville Medical Center

Medical Park Hospital

Novant Health Medical Park Hospital

Presbyterian Hemby Children’s Hospital

Novant Health Hemby Children’s Hospital

Presbyterian Hospital

Novant Health Presbyterian Medical Center

Presbyterian Hospital Huntersville

Novant Health Huntersville Medical Center

Presbyterian Hospital Matthews

Novant Health Matthews Medical Center

Prince William Hospital

Novant Health Prince William Medical Center

Prince William Hospital Haymarket

Novant Health Haymarket Medical Center

Rowan Regional Medical Center

Novant Health Rowan Medical Center

Thomasville Medical Center

Novant Health Thomasville Medical Center

Upstate Carolina Medical Center

Novant Health Gaffney Medical Center

Presbyterian Orthopaedic Hospital

Novant Health Charlotte Orthopedic Hospital

Mecklenburg Medicine • April 2013 | 13

At the Hospitals

Levine Cancer Institute Expands its Hematologic Oncology Services for n Patients With Aggressive Types of n Blood Cancer Carolinas HealthCare System’s Levine Cancer Institute has announced that it will offer a hematologic malignancies unit, the first adult treatment center of its kind, to residents in the greater Charlotte region in January 2014. This new space, where bone marrow transplant patients will be treated, is an expansion of the Institute’s hematologic and oncology division that provides local patients with access to cutting-edge technologies, high quality care and the expertise of nationally existing and newly recruited physicians.

Edward Copelan, MD, chair of the Department of Hematologic Oncology and Blood Disorders, is overseeing the development of this expansion, which will allow residents diagnosed with leukemia, multiple myeloma, lymphomas or other hematologic malignancies, to receive their treatment closer to home. Nationally recognized for his more than 30 years of research in hematology and oncology, Dr. Copelan was recruited to the Institute in 2012 from Cleveland Clinic and is currently recruiting additional specialists to the Institute for non-cancer related blood disorders. n n

Carolinas Medical Center to Participate in National Collaborative Care Initiative n for Trauma Patients Michael Bosse, MD, co-principal investigator and clinical chair of the Major Extremity Trauma Research Consortium (METRC), www.metrc.org, conducted Grand Rounds for physicians and hospital administrators at Carolinas Medical Center (CMC) while announcing the launch of a new national Trauma Collaborative Care Study. CMC is one of only six intervention centers participating in the multi-year study in the United States.

The sites will enroll patients and monitor outcomes following participation in the Trauma Survivor’s Network (TSN) collaborative care model. Other intervention centers in the study include the University of n n

Maryland, Vanderbilt Medical Center, INOVA Fairfax Hospital, MetroHealth Medical Center in Cleveland, and Wake Forest University.

METRC, funded through the Department of Defense, comprises 24 core Level 1 trauma centers, four military treatment centers, and 30 satellite centers located across the United States. Established in 2009, the overall goal of the Consortium is to establish treatment guidelines, which would then be applied for optimal care of the wounded warrior and ultimately improve the functional and qualityof-life outcomes of both service members and civilians who experience high-energy trauma.

CMC, with leadership from Dr. Bosse, is a founding member of METRC. Launching this spring, the program will be a four-year study designed to add a back-end element to the operating room, while measuring levels of satisfaction for both patients and providers alike. It also will measure cost effectiveness and cost benefits while comparing reductions in emergency room use and hospital readmissions, post-traumatic stress disorder (PTSD), and return to work and function.

The centers participating in the TSN will share the collective data and results nationally to improve future outcomes. Enrolled patients will establish baselines of information (through patient profiles) to better identify which study participants will need additional interventions by specialized teams and personnel.

Maximizing the Role of ACPs Carolinas HealthCare System is one of the first health care systems in the country to create a network-wide, comprehensive approach for optimizing the role of advanced clinical practitioners (ACPs) to help us adapt and succeed in the everchanging healthcare environment.

The three-pronged initiative includes establishing Carolinas HealthCare System’s first Center for Advanced Practice (CAP), a centralized department that will facilitate customized core services for ACPs, such as outreach, education, mentoring, communication and retention; a new graduate acute care nurse practitioner (NP) program, in partnership with UNC-Charlotte, that begins in August and will prepare graduates for the new NP certification in adult/gerontology with acute care focus; and a new ACP fellowship program that starts in October. This post-graduate program is unique — not only will the fellows

receive a stipend, they also will be temporarily hired as employees so they can receive full health benefits. The initial fellowship program will offer six acute care tracks, including urgent care, with the immediate goal of adding multiple primary care tracks.

A large team of physicians, ACPs and administrators have collaborated for more than a year to bring these three programs to life. The steering committee originating this initiative included Mary Ann Wilcox, RN, senior vice president and system nurse executive; Chris Teigland, MD, chair of the McKay Department of Urology at CMC; Ellen Sheppard, EdD, president of Carolinas College of Health Sciences; Dennis Taylor, DNP, ACNP-BC, assistant vice president of system nursing; Brian Jefferson, MSN, RN, ACNP-BC, FCCM, trauma and surgical critical care NP at CMC; Ginger Marshall, ACNP-BC, ACHPN, FPCN, director of Palliative Care Services; and Steve Wagner, PhD, FACMPE, vice president of the Physician Services Group.

Through this ACP initiative, Carolinas HealthCare System is positioned to be a national leader in health care system transformation by refining the care delivery model. This program also supports CHS’ strategic priority of providing clinicallyintegrated, coordinated care.

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14 | April 2013 • Mecklenburg Medicine

Carolinas College of Health Sciences Ranked No. 1 Two Years in a Row In 2012, the Carolinas College of Health Sciences (CCHS), a subsidiary of Carolinas Medical Center, was ranked the No. 1 twoyear college in the nation for a second year in a row by StateUniversity.com, a leading college and university information website.

The rankings analyze data from the top 2,000 colleges and universities in the U.S. and are based solely on comparisons of key statistics, including student/faculty ratio, student retention and test scores. CCHS has a 2:1 student to faculty ratio and 100 percent retention among full-time students. n n

Charlotte Radiology [1/2V] Charlotte Speech and Hearing [1/4]

Advertising Acknowledgements The following patrons made Mecklenburg Medicine possible.

Brackett Flagship Properties.......................................6 Charlotte Eye, Ear, Nose & Throat Associates.......15 Charlotte Radiology....................................................4 Charlotte Speech & Hearing Center..........................4 LabCorp.....................................................Back Cover Presbyterian Healthcare System.................................2 Tucker Boynton.........................................................15

Mecklenburg Medicine • April 2013 | 15

Mecklenburg County Medical Society 1112 Harding Place, #200 Charlotte, NC 28204 CHANGE SERVICE REQUESTED MCMS Mission: To unite, serve and represent our members as advocates for our patients, for the health of the community and for the profession of medicine.

LabCorp [1/2H]

16 | April 2013 • Mecklenburg Medicine

PRSRT STD U.S. POSTAGE PAID CHARLOTTE, N.C. PERMIT NO. 1494