Editors: Ellen W. McKnight, M.D. | Erica Huffman, Executive Director
www.escambiacms.org
Bulletin NOVEMBER/DECEMBER 2015 VOLUME 45, NO. 6
PRESIDENT’S MESSAGE We are reaching the end of the year and the end of my term as president of the Escambia County Medical Society. It has been an enjoyable experience leading the great team of physicians who make up our board, and I feel that we have made big strides in growing our medical society. Before taking on this role as president, I had planned some big goals. One goal was to have a bigger impact on our community and a second goal was to promote medical education in Pensacola. With the establishment of our $100,000 endowed scholarship with the Florida State University College of Medicine, the ECMS board and members like you are leaving a legacy that will not be forgotten. Another goal was to bring nationally renowned speakers to Pensacola to provide our members with the best learning opportunities possible. Most recently we had Dr. Kevin Pho, creator of the kevinmd blog, speak to us about how we can make a difference in healthcare through social media. He pointed out that although most of us are wary of social media, it should be important to physicians because: 1. Patients are going online to look not only for health information, but also to look for doctors, hospitals, and other healthcare entities. They check physician reviews just like you and I check reviews on restaurants or hotels. 2. Physicians can provide context to media health stories. How many times have you been frustrated by the portrayal of physicians in the media? I know I have. We can tell the rest of the story about reimbursement, physician burnout, and our struggles with insurance companies to help patients understand what is really going on in healthcare. 3. Physicians can use social media to dispel myths. Dr. Pho used the example of the anti-vaccine movement scaring people into not vaccinating their children. As physicians we can provide accurate information about the safety of vaccines and the risks associated
CONTENTS unvaccinated children. More and more people are searching for health information online. Patients still trust a doctors’ advice, but they just need to be able to find it. It is important that physicians be seen as the source of quality information. A good online presence increases patient trust and satisfaction, and satisfaction figures prominently in several large-scale initiatives that have the potential to affect both the reputation and the bottom line of every medical practice. Healthcare is becoming more transparent and – unfortunately in my opinion – future reimbursement may be tied to subjective things like reputation and satisfaction scores instead of just focusing on quality care. There are other reasons to be conscious of your online presence. Physicians are finding job opportunities by networking with other physicians online, and it provides a great opportunity for collaborating with other physicians, whether you are interested in research, publishing or other business ventures. For example, I have connected with several colleagues online who are interested in physician leadership. They found me through my LinkedIn profile and contacted me. Having a professional presence on LinkedIn can be invaluable, as it can serve as your online CV. As Dr. Pho mentioned, creating your own LinkedIn profile is a great start to developing your professional online presence. Begin by taking a look at what other physicians are doing to get an idea of what you may like to do. Setting up an account shouldn’t take too long if you already have the basic information. The first step is to fill out your profile just
Page 3 - Announcements Page 4 - Events Page 5 - Membership Page 8 - Medical/Legal Page 10 - Practice Mgmt. Page 14 - Foundation Page 15 - In the Community
SAVE THE DATE Saturday, November 14, 2015 7:30 am Hilton Garden Inn on Airport Blvd. FALL CME Conference Sponsors: Catalyst CRE, Iron Horse Wealth Strategies, Mag Mutual Insurance, Physicians Indemnity, Safe Harbor Tax Advisory, LLC., Florida Blue Saturday, January 30, 2016 2016 ECMS Annual Inaugural Ball PresidentElect Brian Kirby Pensacola Yacht Club Price TBA Founded in 1873
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
1 | ECMS
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Announcements
8880 University Pkwy., Suite B Pensacola, FL 32514 Ph: 850-478-0706 x2 Fx: 850-474-9783 Email: info@escambiacms.org www.escambiacms.org
E.C.M.S. Bulletin
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.
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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.
Mission:
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. | Tradition – Honoring the history of medical care in Escambia and Santa Rosa counties. | Service – Serving the needs of our community through the service of our members in the practice of medicine. | Leadership – Meeting the challenges of the future and safeguarding our community’s health through organized collaboration on the local, state, and national level.
Ad placement Contact Erica Huffman at 478-0706 x2 Ad rates 1/2 page: $350 · 1/4 page: $200 · 1/8 page: $150
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.
SAVE THE DATE Fall CME Conference & Vendor Fair Saturday, November 14th Hilton Garden Inn - Airport Blvd. 4 AMA PRA Category 1 Credit(s) 7:30am-8:00am Registration & breakfast 8:00am-10:00am “Prevention of Medical Errors” -Joseph A. Wilson, ESQ. 10:00am- 10:30am - snack break 10:30am- 11:30am “Grand Rounds: A Review of Professional Liability Cases and Lessons Learned”- Senior Risk & Patient Safety Consultant, Teresa McMillian 11:30am-12:30pm “Fraud in the Health Care Setting” - Assistant U.S. Attorney, Tiffany Eggers RSVP before November 4th
COST ECMS Members (Free) with advance RSVP Non-physician guest ($50) Non-Member Physician ($100 before 11/3/2015 or $150 after 11/4) Mail your check made payable to ECMS 8880 University Parkway Ste B Pensacola, FL 32514 *include your name, email, and phone # with payment This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Medical Educational Council of Pensacola (MECOP) and Escambia County Medical Society. MECOP is accredited by the ACCME to provide continuing medical education for physicians. The Medical Educational Council of Pensacola designates this live activity for a maximum of 4 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Save the Date
On Saturday, January 30, 2016 ECMS will host our Annual Inaugural Ball in conjunction with our donor gala at the Pensacola Yacht Club. The donations on this evening will benefit the Escambia/Santa Rosa County Medical Society Scholarship Endowment Fund which benefits students from the Florida State University College of Medicine Pensacola Campus. Fourth year medical students who receive the ECMS Michael Redmond Scholarship must demonstrate an interest in returning to Northwest Florida to practice medicine after completing their residency training. More information including ticket prices and sponsorship opportunities will be sent out at a later date. 2016 Inaugural Ball | President-Elect Brian Kirby, M.D. Saturday, January 30, 2016 | Pensacola Yacht Club
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
3 | ECMS
Membership On Tuesday, October 20th ECMS Hosted Kevin Pho MD at their general membership meeting. Dr. Pho spoke about making a difference in health care with social media. We thank Dyken Wealth Strategies, Regions Bank, The Doctors Company, and Iron Horse Wealth Strategies for helping to make this event possible for the ECMS.
On Sunday, September 27th ECMS Hosted the Annual Women in Medicine Brunch. We thank the following sponsors for helping to make this special event possible: Danna Gracey Insurance, Safe Harbor Tax Advisory, LLC., Fisher Brown Insurance, Plateful of Yum, Emerald Coast Hospice, Iron Horse Wealth Strategies. & Physicians Indemnity.
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like you would your CV. Here you will tell of your education, certifications, achievements, awards, etc. This is also an opportunity to highlight your specific skills and unique things about your practice. Put information about your honors received, articles published and volunteer organizations you have joined. Some people prefer to use bullet points instead of paragraph form on their LinkedIn profile, just like a standard CV. Regardless of which option you choose, make sure that you use keywords that people would type into a search box if they were looking for someone of your expertise or specialty. On my profile, I use words like leadership, communication, and coaching to make it easier for physicians and practice managers who are searching for those topics to find me. Another important step is to add a headshot photo, because people are more likely to trust and connect with someone they can see. One setting that LinkedIn will ask is if you want to make your photo and profile public. I recommend doing so to make it easy for people to find you. LinkedIn is your professional public profile, and will show up near the top online searches, so you want to have your best foot (or in this case face) forward. After you get your profile set up, send a request to connect with me. My profile is at www.linkedin.com/in/ChristopherBurtonMD. Then connect with other colleagues you worked or trained with throughout your career. You can also keep up to date with our county medical society, the Florida Medical Association, your specialty society and other healthcare organizations through social media. As healthcare continues to change, we as physicians must adapt so that we can continue to be leaders in the healthcare discussion. We must reach our patients where they are, and more than ever that is online. Doctors are notoriously slow to change, but change with the times we must. One final goal I had for our medical society was to lay out plans to update our medical society and make sure we are continuing to add value to physicians in our community. The board has considered name changes, website improvements, and changes in physical location. We are actively seeking ways to grow our membership and still keep providing the best educational opportunities to our current members. This goal can’t be met in just one year, so I am excited to see what direction our incoming president, Brian Kirby, and the rest of our board take from the groundwork we have begun. Of course we need your input along the way. Let us know what things you liked or didn’t like this year. Give us any suggestions you have for making your medical society the best it can be. This is your organization and we wouldn’t be here if it wasn’t for you our members. It has been a pleasure serving as your 2015 Escambia County Medical Society President!
Come vote for your 2016 Slate of Officers on Saturday, November 14th at the Fall CME Conference & Vendor Fair/ November General Membership meeting or online. A link will be sent via email November 9th. Voting will be open online from 11/9-11/15 at 11:59pm CST You must be an active dues-paying member to vote. ECMS | 4
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Membership
New Members Shohrat Annaberdyer, M.D. Colorectal Surgery, General Surgery Baptist Medical Group Colorectal Surgery 1717 North “E” Street Suite 425 Pensacola, FL 32501 (P) 850-437-8810 (F) 850-437-8809 www.baptistmedicalgroup.org
LIFE MEMBERS TRIBUTE It is a great honor to be listed as a life member of the medical society. Life Membership means that the physician has been a member of the medical society for 35 consecutive years or more. Many of our life members are still in practice. Thank you for your dedication to organized medicine.
Benjamin Brown, M.D. Plastic Surgery Gulf Coast Plastic Surgery 543 Suite A, Fontaine Street Pensacola, FL 32503 (P) 850-476-3223 (F) 850-855-4030 www.gulfcoastplasticsurgery.com
E.Amos, M.D. Charles Aplin, M.D. Bernard Atwell, M.D. Virgilio Barangan,M.D. Paul Baroco,M.D. Barley Beidleman, M.D. Reed Bell, M.D. William Belk, M.D. R. Scott Benson,M.D. Thomas Birdwell, M.D. Fredrick Braden, M.D. Gary Buffington, M.D. Robert Cameron, M.D. George Carr, M.D. James Carruth, M.D. Charles Clevenger, M.D. Roger Clubbs, M.D. Henry Coe, M.D. Robert Cohan, M.D. David Conkle, M.D. Gordon Couch, M.D. J. Crittenden, M.D. Richard Dalrymple, M.D. Peter Delevett, M.D. Vivian Flatt, M.D. Jack Fleming, M.D. John Garner, M.D. Victor Goeller, M.D. Ashton Graybiel, M.D. Winfried Hansen, M.D. David Harden, M.D. Henry Harden, M.D. Everett Havard, M.D. Roger Henson, M.D. Gerard Hilbert, M.D. Warren Hodge, M.D. Inge Holman, M.D. Richard Hooper, M.D. Joseph Howard, M.D. Steven Jabaley, M.D. Jimmy Jones, M.D. Bertis Jordan, M.D.
Narendra Gowda, M.D. Steve Jordan, M.D. Orthopedic Surgery Andrews Institute 1040 Gulf Breeze Parkway, Ste. 203 Gulf Breeze, FL 32561 (P) (850) 916-3700 (F) (850) 916-3710 www.andrewsinstitute.com Kevin M. Schopmeyer, M.D. Family Practice Baptist Medical Group- Florida Blue 1678 Airport Boulevard Pensacola, FL 32504 (P) (850) 479-3790 (F) (850) 479-3920 www.baptistmedicalgroup.org Hilliary White, M.D. Otolaryngology General Surgery Baptist Medical Group 1717 North ‘E’ Street Suite 239 Pensacola, FL 32501 (P) (850) 432-3467 (F) (850) 434-2308 www.baptistmedicalgroup.org William Stephen Willis, M.D. Family Practice West Florida Medical Group Primary Care- Spanish Trail 4601 Spanish Trail Pensacola, FL 32504 (P) 850-432-9224 (F) 850-433-8940 www.westfloridamedicalgroup.com
Jack Kichler, M.D. Robert King, M.D. George Knefely Jr., M.D. Gerald Kuenn, M.D. Richard Kuharich, M.D. William Langhorne, M.D. Richard Lawrence, M.D. Bruce McCraw, M.D. Reeves McLeod, M.D. Thomas Mignerey M.D. David Miles, M.D. James Miller, IV, M.D. Roy Wayne Miller, M.D. Fred Mixon, M.D. Teodoro Ortega, M.D. William Patton, M.D. William Permenter, M.D. Dennis Peters,M.D. James Potter, M.D. Nell Potter, M.D. Amos Prevatt, M.D. Michael Redmond, M.D. Geord Ricketson, M.D. Charles Riley, M.D. Joseph Saiter, M.D. Ricardo Samala, M.D. Larry Sauls, M.D. Steven Schang, Jr., M.D. Justin Shields, M.D. Charles Smith, Jr., M.D. Robert Snowden, M.D. Charles Terrell, M.D. Charles Ticker, M.D. Troy M. Tippett, M.D. Donald Todd, M.D. Adelaida Torres M.D. Dewey Torres, M.D. Lockland Tyler Jr., M.D. Norman Vickers, M.D. Leopoldo Villanueva, M.D. Joseph Weaver, M.D. Edward Westmark, M.D. William Whibbs, M.D. Thomas Williams, M.D. Calvert Williamson, M.D. Wayne Willis, M.D. Robert Wilson Jr., M.D. Cynthia Worrell-White, M.D. Richard Ziemba, M.D. William Zimmern, M.D.
2016 MEMBERSHIP DUES Early County Dues: October 1 - December 31, 2015 County Dues: January 1, 2016 ECMS Annual Pictorial Directory Published in April. Please pay your dues before March 1st to be included in the next edition of the ECMS Annual Pictorial Directory. ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
5 | ECMS
Membership Moved/Relocated Dr. Jennifer Miley, Dr. Karen Snow, Dr. Hillary Hultstrand, and Dr. Vishnu Behari have now joined Woodlands Medical Specialist formally known as Gulf Coast Primary Care Walter Bew, M.D. Family Practice Sports Medicine West Florida Medical Group 2360 US Hwy 29 South Cantonment, FL 32533 (P) (850) 968-2083 (F) (850) 479-9180 www.westfloridamedicalgroup.com William Clark, M.D. Otolaryngology ENT Associates of Northwest Florida 4616 North Davis Highway Pensacola, FL 32503 (P) (850) 484-0520 (F) (850) 484-9936 www.entassociatespensacolafl.com Issa Ephtimios, M.D. Infectious Diseases Infectious Diseases Group of NW FL 4724 North Davis Highway, Suite 200 Pensacola, FL 32503 (P) (850) 912-8433 (F) (850) 912-8584 Keith Golden, M.D. Cardiology/Interventional Cardiac Electrophysiology Sacred Heart Medical Group 5151 North 9th Avenue Ste. 200 Pensacola, FL 32504 (P) (850) 416-4970 (F) (850) 416-4969 www.sacred-heart.org Andrea Hackel, M.D. Geriatrics Baptist Medical Group-Senior Health 1717 North ‘E’ Street Suite 227 Pensacola, FL 32501 (P) (850) 437-8600 (F) (850) 437-8601 www.baptistmedicalgroup.org
Christopher LeCroy M.D. Vascular Surgery Coastal Vascular and Interventional, PLLC 5149 North 9th Avenue, Ste. 120 Pensacola, FL 32504 (P) (850) 479-1805 (F) (850) 479-1829 www.coastalvi.com
William Shanahan M.D. General Surgery Vascular Surgery Gary Gotthelf, M.D., PA 4511 North Davis Highway Suite C-1 Pensacola, Florida 32503 (P) 850-477-3252 (F) 850-477-2659
Gerald Lowrey, M.D. Radiation Oncology Sacred Heart Cancer Center 1545 Airport Boulevard, Suite 1000 Pensacola, FL 32504 (P) (850) 416-6700 (F) (850) 416-7770 www.sacred-heart.org Karen Pennington, M.D. Internal Medicine Baptist HospitalHospitalist 1000 W. Moreno Street Pensacola, FL 32501 (P) (850) 469-7406 (F) (850) 437-8283 www.baptistmedicalgroup. org Angeli D. Saith, M.D. Family Medicine Escambia Community Clinics, Inc. 14 West Jordan Street Pensacola, Florida 32501 (P) (850) 607-8507 (F) (850) 436-2095 www.ecc-clinic.org
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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Medical/Legal OVERCOMING THE STRESS OF MALPRACTICE LITIGATION: SOLUTIONS TO HELP PHYSICIANS STAY HEALTHY AND ENGAGED by David P. Michelin, MD, MPH Imagine the scene: You’re in your busy office on a typical day when a letter arrives—a letter of intent. A patient is suing you for malpractice. From the moment you receive that letter, everything changes. The malpractice claim begins to affect all aspects of your life. You don’t sleep well. You don’t interact well with family members, friends, or colleagues. You remain dedicated to providing the best possible care, but you find yourself taking a more conservative approach with patients, asking yourself, “How might this patient attempt to sue me?” Or, “If I were standing in front of a judge, what evidence would I need to defend what I’m doing?” You know you did nothing wrong—that the claim against you is unreasonable—which only adds to your frustration and sense of injustice. If the lawsuit proceeds to trial, you’ll face the uncertainty that accompanies any courtroom process. And that process can be lengthy, dominating your personal and professional life for a year, two years, or more. For most doctors, this scenario will play out at least once during their career. In fact, a typical doctor spends nearly 11 percent of a 40-year career with open malpractice claims.1 Facing a medical malpractice lawsuit will almost certainly be one of the most trying experiences you encounter as a physician, adding to the pressures of an already demanding profession. The lawsuit will generate an array of negative emotions, from self-doubt to high levels of stress and anxiety. But as I learned during my own litigation experience, there are steps you can take to ease the strain you’re under and limit these symptoms, allowing you to continue to serve your patients and maintain healthy relationships with those around you. Prepare Thoroughly First, take a deep breath—and then prepare. Approach the lawsuit simply as an unfortunate consequence of practicing medicine, the price of being a physician. In today’s medical climate, a lawsuit is essentially inevitable, especially if you conduct procedures. Treat the litigation as another necessary part of your career, and take the same approach as you would toward other hurdles like a board exam. Be meticulous. Go over your chart. Familiarize yourself with every aspect of the case. Be ready for your meetings with your attorney, and take an active role in your defense. If you go to trial, the plaintiff’s attorney will make every effort to belittle you, anger you, and make you question yourself. When I took the stand, the plaintiff’s attorney attempted several techniques to unnerve me, even using his physical stature to try to intimidate me as I sat in front of the jury. He tried to chip away at my reputation, and he sought to create in the minds of the jurors the expectation that every case should have a perfect outcome. Remember, in that situation, no one in the room knows the case better than you. Approach your testimony the same way you approach a talk at a conference—you are the expert, the master of that topic. This is your case, and you took care of the patient. That will reinforce your confidence and help you stay calm in the face of aggressive questions from the opposing attorney. Above all, prepare for the witness chair by taking part in litigation education, especially a mock deposition. During the mock deposition I participated in, the attorney asked me the same types of questions and adopted the same approaches I would later face at trial. We were then able to evaluate my responses on video. My eyes were opened to what I could expect from a trial—I got deep insight into the real nuts-and-bolts mechanics of it. That helped me prepare for the moment when the plaintiff’s attorney would challenge me. I referred to my notes from the training prior to my deposition and prior to going on the stand during trial. This was a huge stress reliever. You can’t lose your cool on the stand, and falling back on those techniques helped me stay calm. Reach Out When confronted with a malpractice claim, doctors experience anger and embarrassment. These are natural reactions. Doctors are often reluctant to talk about past litigation because they’re afraid it reflects poorly on them—fearful that somebody will feel they did something wrong. To ensure defensibility, physicians will wisely avoid discussing an ongoing claim with anyone other than their claims specialist or defense attorney. But after my litigation was over, whenever I brought it up to other physicians—even speaking in general terms—I could sense their discomfort and unwillingness to acknowledge their own past litigation experiences. This was especially true in group settings. However, it can be a huge benefit if you can find a colleague willing to share: a person you respect and are comfortable with, someone who has battled a malpractice claim themselves. A colleague can offer advice and expertise on how to move forward from your ordeal. Talking with your family is another vital step. The impact on family members can be substantial. During my litigation, over Christmas break our dining table resembled a war room, covered with multiple computers and an array of charts and other materials. I’d meet with my defense attorney at home, and I’d often wake up at 4:00 AM so I could review the 8,500-page medical record. Because of the length of my litigation, this significantly impacted my family over two successive Christmases—times when I wasn’t really there for them emotionally. Although you can’t divulge the clinical details of a current claim to family members, you can talk with them about how it is affecting you. By opening up to your spouse, children, and other family members, you can help prepare them and ease your own burden. Be completely open about what’s happening and how it could impact both you and them. Seek their input and advice. This can help you overcome the feelings of isolation that often accompany a malpractice claim. Doctors often have a tough, go-it-alone mentality. But this is the bottom line: Don’t go into a shell. Talk to somebody. ECMS | 8
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Medical/Legal Make Yourself a Priority Every profession has its stresses, but doctors’ stresses are unique. Overwhelmed patients share with us their innermost thoughts and concerns. Faced with difficult decisions—sometimes those that are life-and-death—they trust our expertise and rely on us to always take the right action. Added to that is the stress of delivering bad news, something I frequently encounter in my role as a gynecologic oncologist. I often need to tell patients that their lifestyle decisions are harming them, a message that isn’t always well received. And while many of my patients do well, I need to tell some that cancer will ultimately take their life, even if their outcome is positive in the short term. Depending on your personality, these interactions can be incredibly draining. To these everyday stresses of our profession, add the stress of fighting a lawsuit to defend your reputation—more than ever, it becomes imperative that you take care of yourself. Don’t hesitate to make yourself your first priority. Do whatever you need to do to unwind. This might be physical exercise like running or biking, or it might simply involve becoming more engaged in other personal interests. If you’re not blocking out time to decompress, you’re doing a disservice to yourself, your case, and your patients. Rising Above the Challenge Ultimately, after two trials spanning two-and-a-half years, I was completely exonerated by the jury. I was thrilled with the outcome, but I had endured a long period in which my personal and professional relationships were impacted. Having never been sued before, I found it very difficult to handle being accused of doing something wrong. But the emotional toll could have been much worse. By adopting certain strategies, I was able to mitigate many of the negative effects so many doctors experience. Litigation will inevitably be an intense and challenging experience, but you can avoid it becoming a crisis. You can still maintain your selfassurance, keep your relationships intact, and continue to provide the vital medical care on which your community relies. David P. Michelin, MD, MPH, is a gynecologic oncologist in Traverse City, Michigan. For information on litigation education, read about The Doctors Company’s Litigation Education Retreats. Contributed by The Doctors Company. 1. Seabury SA, Chandra A, Lakdawalla DN, Jena AB. On average, physicians spend nearly 11 percent of their 40-year careers with an open, unresolved malpractice claim. Health Affairs. 2013;32(1):111–9.
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Practice Management BEST PRACTICES FOR THE PREVENTION AND INVESTIGATION OF SEXUAL MISCONDUCT ALLEGATIONS AGAINST PHYSICIANS AND OTHER HEALTHCARE PROVIDERS from the Desks of Georgette Samaritan, RN,BSN, CPHRM; Mary Gregg, MD, FACS, MHA, Chief Medical Officer, SVP; Laura Martinez, BSN, RN, MS, CPHRM, FASHRM,VP Risk and Patient Safety
Complaints against physicians and other healthcare professionals alleging sexual misconduct and battery are ongoing. In some states, sexual assault is referred to as rape, sexual abuse or sexual battery. Sexual abuse may occur when physicians, or other providers, become involved in personal relationships with their patients; when using their position of power; when they represent sexual contact as part of care or treatment; and when they assault vulnerable people, as in the case of minors, disabled or unconscious patients. “Sexualization” of the physician-patient relationship is never acceptable. Predators exist in every profession and the true prevalence of sexual assault committed by physicians and others against their patients is difficult to discern due to a lack of current, readily accessible research on the issue. Victims who are sexually assaulted by their physicians are less likely to report the assault than other victims of assault; therefore the prevalence of sexual assault by physicians may be higher than what is known.1 When a sexual assault claim is made public, it may receive extensive publicity, creating the impression that sexual assaults are a common problem. News headlines border on the sensational and public tolerance is low. Some examples include: “Sexually Assaulted While Under Anesthesia”, “Patients Allege Sexual Battery by Doctor”, “A Plastic Surgeon Sexualized My Exam”, “Pediatrician Charged with Molestation of 103 Children”, to name a few recent news stories. When a physician is accused of sexually assaulting a patient, there may be a devastating effect on the physician’s life, including serious harm to reputation, harm to career and personal relationships. The accusation may result in civil suits, license revocation, family consequences, and criminal charges. Depending on the severity of the victim’s allegations, sexual assault can be classified as a felony. A sexual assault conviction can follow a physician for the rest of his life. If convicted, the physician can suffer severe criminal penalties. Regardless of the severity or circumstances of the offense, the sex offender registration becomes public record. Many medical malpractice insurance policies exclude coverage for criminal activity. However, plaintiffs’ attorneys sometimes include allegations against physicians that the assault was a breach of medical standards, as well as a criminal act. This may create a dilemma for the defense. Regardless, a sexual assault claim stigmatizes the physician, and could give the plaintiff a strategic advantage in what might otherwise be a weak medical malpractice case. A physician, who fails to use a chaperone during sensitive physical examinations, or allows a male nurse or physician’s assistant to examine a female patient unattended, may find a sexual assault claim more difficult to defend. Allowing an unattended examination of a female patient may be viewed as bad judgment on the part of the physician. AMA guidelines state, “From the standpoint of ethics and prudence, the protocol of having chaperons available on a consistent basis for patient examinations is recommended.” 2 Despite this recommendation, adherence to this rule varies widely. The MagMutual Patient Safety Institute has published a Patient Safety Advisory which outlines the formulation of a “chaperone” policy for both adults and minors. 3 Rarely, there are eyewitnesses to allegations of sexual assault; these are typically “he said, she said” cases, so thorough investigation is a must. Credibility can be a key point, and expert witnesses are often a useful tool for the defense. DNA and other forensic evidence may be used to defend a sexual assault claim. The Federation of State Medical Boards (FSMB) states, “...sexual misconduct will not be tolerated,” and state medical boards should “take prompt and decisive action against any licensee found to have participated in such conduct.” Each case, it states, “should be investigated.” The FSMB lays out clear guidelines for investigating each complaint and recommends specific discipline measures in its publication, Addressing Sexual Boundaries: Guidelines for State Medical Boards. 4 In addition, physicians are encouraged to check with their state medical boards for any state-specific guidelines regarding the use of chaperones and for other material related to allegations of sexual abuse.
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Practical guidance for physicians accused of sexual abuse Because of the emotional and personal nature of such allegations, a physician’s first reaction is usually to hide the existence of the charges, and try to deal with it alone. This is a mistake. The physician must involve his professional liability carrier and his attorney from the start. Experienced counsel may be able to convince the plaintiff’s attorney that discretion is also in the patient’s best interests. The key to managing allegations of sexual abuse is early and active intervention, with the goal of preventing a lawsuit from being filed, preventing the allegations from being made public, and preventing a complaint to licensing authorities. As all physicians and healthcare providers know, physicians should never become sexually involved with a patient. The information presented in this Article is intended as general
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The recommendations and advice published herein do not reflect or medicine. The publication of this information is not intended as an offer to insure such conditions or exposures, or to indicate that MAG Mutual
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References: 1 Sexual Victimization of Patients by Physicians: A Factsheet for Survivors & Advocates, , Ohio Alliance to End Sexual Violence, http://www.oaesv.org/wp-content/ uploads/2013/02/Sexual-Assault-of-Patients-byPhysicians-factsheet.pdf 2 American Medical Association, Opinion 8.21 - Use of Chaperones during Physical Exams, Issued December 1998 based on the report”, Use adopted June 1998. http://www. ama-assn.org/ama/pub/physician-resources/medicalethics/code-medical-ethics/opinion821.page 3 Use of Chaperones, Patient Safety Advisory, MagMutual Insurance Company, December 2014; http://www. magmutual.com/use-chaperones 4 Federation of State Medical Boards, Addressing Sexual Boundaries: Guidelines for State Medical Boards, http:// library.fsmb.org/pdf/GRPOL_Sexual%20Boundaries.pdf
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Love, Loss and . . . . . . . . . . . . . . . . . . . Jan 15-17 & 21-23, 2016 What I Wore Quilters . . . . . . . . . . . . . . . . . . . . . . . . . . . Jan 29-31 & Feb 4-7, 2016 Short Attention . . . . . . . . . . . . . . . . . .Feb 12-14 & 18-20, 2016 Span Theatre
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Additional Reading: Sexual Abuse of Patients by Health Care Professionals, Harvey A. Schwartz, Matthew Bender and Company, http://forensicpsychiatry.stanford.edu/Files/Sexual%20 Sexual%20Abuse%20Patients%20by%20Health%20 Care%20Professionals.htm
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information of interest to physicians and other healthcare professionals. establish a standard of care and do not establish rules for the practice of
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Practice Management Isn’t it time you called the med mal and cyber insurance specialists? Julie Danna and Arlene Gardner, your local medical malpractice specialists, have become well known throughout the state as strong advocates for health care providers, as well as creators of society and network insurance purchasing programs. Danna-Gracey is an independent insurance agency with a statewide team of specialists dedicated solely to insurance coverage placement for Florida’s doctors and healthcare providers, including medical malpractice, workers’ compensation, and cyber liability insurance. For a no-obligation assessment of your current coverage, call Julie or Arlene at 850.995.9119.
Delray Beach • Jacksonville • Miami • Orlando • Pensacola julie@dannagracey.com • 850.995.9119 • www.dannagracey.com
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Foundation GO SENIORS! Effective November 2015 there will be changes to the ECMS Foundation Go Seniors Voucher Transportation Program. If you are currently using the voucher program please call Executive Director Erica Huffman to schedule an appointment to install these new changes. If you are interested in learning more about the program you can call Erica Huffman 850-478-0706 x2. Vouchers must be distributed through the physician office. The ECMS Foundation’s goal is to meet the needs of underserved populations. The goal of this voucher program is to keep our vulnerable elderly population consistently receiving care when they need it and helping physicians’ better treat a population with limited resources. Criteria: 60 years or older Have a healthcare transportation need Visit your doctor’s office Each patient is eligible for two vouchers per visit
DON’T FORGET ABOUT YEAR-END INVESTMENT PLANNING Provided by Rick Lambert, MBA, CFP® As the year draws to a close, there might be a slew of tasks on your to-do list. One task to consider is setting up a meeting with your financial professional to review your investments. If you take the time to get organized now, it may help you accomplish your long-term goals more efficiently. Here are some steps that might help. Evaluate your investment portfolio During the meeting with your financial professional, review how your overall investment portfolio fared over the past year and determine whether adjustments are needed to keep it on track. Here are some questions to consider: • How did your investments perform during the year? Did they outperform, match, or underperform your expectations? • What caused your portfolio to perform the way it did? Was it due to one or multiple factors? • Were there any consistencies or anomalies compared to past performance? • Does money need to be redirected in order to pursue your short-term and long-term goals? • Is your portfolio adequately diversified, and does your existing asset allocation still make sense? Addressing these issues might help you determine whether your investment strategy needs to change in the coming year. Aim for balance During the portfolio review process, look at your current asset allocation among stocks, bonds, and cash alternatives. You might determine that one asset class has outperformed the others and now represents a larger proportion of your portfolio than desired. In this situation, you might want to rebalance your portfolio. The process of rebalancing typically involves buying and selling securities to restore your portfolio to your targeted asset allocation based on your risk tolerance, investment objectives, and time frame. For example, you might sell some securities in an overweighted asset class and use the proceeds to purchase assets in an underweighted asset class; of course, this could result in a tax liability. If you own taxable investments that have lost money, consider selling shares of losing securities before the end of the year to recognize a tax loss on your tax return. Tax losses, in turn, could be used to offset any tax gains. When attempting to realize a tax loss, remember the wash sale rule, which applies when you sell a security at a loss and repurchase the same security within 30 days of the sale. When this happens, the loss is disallowed for tax purposes. If you don’t want to sell any of your current investments but want to change your asset allocation over time, you might adjust future investment contributions so that more money is directed to the asset class you want to grow. Once your portfolio’s asset allocation reaches your desired balance, you can revert back to your previous strategy, if desired. Keep in mind that asset allocation and diversification do not guarantee a profit or protect against loss; they are methods used to help manage investment risk. Your financial professional can help you understand how your investments may be affected by capital gains and other taxes. You can learn more about current tax laws and rates by visiting www.irs.gov. Set goals for the coming year After your year-end investment review, you might resolve to increase contributions to an IRA, an employer-sponsored retirement plan, or a college fund next year. With a fresh perspective on where you stand, you may be able to make better choices next year, which could potentially benefit your investment portfolio over the long term. Note: There is no assurance that working with a financial professional will improve investment results. All investing involves risk, including the potential loss of principal, and there can be no guarantee that any investing strategy will be successful. Rick Lambert is a Wealth Strategist and the President/CEO of Iron Horse Wealth Strategies located at 3000 Langley Ave., Suite 200 Pensacola, FL 32504 (O) 850.361.4978 // www.ironhorsews.com ECMS | 14
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
In the Community SACRED HEART NEWS Biplane Imaging Technology Sacred Heart will soon have the latest biplane imaging technology for neurointerventional procedures. The biplane system produces highly detailed threedimensional views of blood vessels leading to the brain and within the brain, and their relationship to the tissues of the head and neck. Sacred Heart Hospital is constructing a new three-story building next to its Emergency/Trauma Center that will house the biplane system. Procedures are expected to begin in late February Cerebrovascular Neurosurgeon Sacred Heart Medical Group welcomes Dr. Lincoln Jimenez, a cerebrovascular neurosurgeon and an assistant professor of neurosurgery at the University of Florida College of Medicine in Jacksonville. Among other things, he is able to treat brain aneurysms both with endovascular techniques and through open surgery. Sacred Heart First to use World’s Smallest Heart Pump Cardiologists at Sacred Heart Hospital in Pensacola were the first in Florida and Alabama to use the world’s smallest heart pump that can be implanted into the right side of the heart to support it during high-risk procedures. “This is a less invasive, potentially life-saving device
for treating patients with acute heart failure occurring on the right side of the heart,” said Dr. Rohit Amin of Sacred Heart Cardiovascular Specialists, who became the first physician in Florida and Alabama to implant the Impella RP device in a patient. “It helps to stabilize patients who have experienced significant right-sided heart attacks and improves their potential for survival.” Sacred Heart cardiologist Dr. Mark Grise called the device “a potential game changer and a non-surgical option that could save the lives of some patients with heart blockages that are difficult to treat. Physicians can now treat acute right-side heart failure with minimally invasive procedures.” Stroke Research Study Sacred Heart Hospital Pensacola will collaborate with the American Heart Association/American Stroke Association and the University of Miami Miller School of Medicine as a participant in the first, large standardized research study to evaluate long-term outcomes of people who experience mild strokes. The goal of the three-year Mild and Rapidly Improving Stroke Study is to evaluate the long-term outcomes of people with mild stroke symptoms, determine the factors associated with poor outcome, and to examine the effect of treatment with tPA.
BAPTIST HEALTH CARE NEWS Baptist Health Care Selected to Participate in Yale Research Initiative Baptist Health Care (BHC) is one of only 10 hospitals nationwide chosen to participate in the Leadership Saves Lives (LSL) research initiative, in partnership with Yale University’s Global Health Leadership Institute. The overall goal of the research initiative is to reduce heart attack mortality through organizational culture change and leadership development. The LSL research initiative is a two-year team-based leadership development program to improve hospital care for patients. BHC is participating with in-depth interviews of team members, reviews of relevant hospital policies and protocols, and observations of key staff
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
interactions such as management meetings and clinical rounds on patients with acute myocardial infarction (AMI). The project’s guiding coalition and BHC team members meet on a regular basis to take a global approach to address the issue of AMI mortality. Physicians and team members – both clinical and non-clinical—make up the teams. Community partners, such as referring hospitals, emergency medical services, and nursing homes also are being tapped for involvement and insight. The Leadership Saves Lives research initiative will be ongoing at BHC until Fall of 2016.
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YOU TEND TO YOUR PATIENTS, WE TEND TO YOUR FINANCIAL WELL-BEING.
Announcing the establishment of a new financial planning and wealth management team that specializes in the unique needs of physicians in the Pensacola area. With a CERTIFIED FINANCIAL PLANNER™ professional and a team that has 28 years of combined investment industry experience, we have the skills you need to help navigate your financial goals.
OUR TEAM’S EXPERTISE INCLUDES Asset Protection
Estate Planning
Financial Planning
Tax Planning
Retirement Planning
Risk Management
Investment Management
Give us a call and see what a customized plan tailored specifically to you looks like.
We’re also able to create business retirement plans (including 401(k) and defined benefit plans) and succession plans (including buy/sell agreements, key person insurance and other catastrophic risk considerations). So whether you’re affiliated with a hospital or have your own practice, we have solutions for you. We know you work long hours and that it’s not always convenient to meet during the business day; therefore, we are happy to meet at a time and location that’s convenient for you. Our technology allows us to meet with you virtually anywhere.
RICK LAMBERT, MBA, CFP® Wealth Strategist rick@ironhorsews.com 3000 Langley Avenue, Suite 200 // Pensacola, FL 32504 O 850.361.4978 // F 850.466.3382 // ironhorsews.com Securities offered through Raymond James Financial Services, Inc., member FINRA/SIPC. Certified Financial Planner Board of Standards Inc. owns the certification marks CFP®, CERTIFIED in the U.S., which it awards to individuals who successfully complete CFP Board’s initial and ongoing certification requirements. FINANCIAL PLANNER™ and federally registered
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ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY