Editors: Ellen W. McKnight, M.D. | Erica Huffman, Executive Director
www.escambiacms.org
Bulletin SEPTEMBER/OCTOBER 2015 VOLUME 45, NO. 5
PRESIDENT’S MESSAGE MENTORING AND COACHING IN MEDICINE
As physicians we are called into leadership roles, whether within our own practice or for healthcare teams and organizations. However as a group we have a relative lack of leadership training. That is why it is so important to develop good leadership skills now. One of the best ways of establishing your leadership identity is by finding a mentor or coach who can teach you the ropes. This is true whether you are a medical student or a seasoned physician. Think about the benefits you have received from mentors you have had in your life. My attending physicians mentored me on the wards in medical school, and I learned a lot from my department chair in residency. Now as a (still relatively) young physician, I continue to learn from my colleagues. I never would have achieved all the leadership positions I now hold if it were not for the support and encouragement of these people. I have had been excellent mentors within organized medicine as well. When I first arrived in Pensacola, Dr. Michael Redman encouraged me to get involved with the Florida Medical Association and the county medical society. He was kind enough to show me the ropes when it came to writing a resolution and getting it submitted. That got me started on my journey to holding my current position as president of our county medical society – and writing this article for the newsletter! When it comes to mentorship, we need to be more like a river than a reservoir. There comes a time when we need to pass along what we have learned and mentor those who are coming after us instead of just keeping the information to ourselves. Here locally, we have many great teachers who work regularly with the medical students and residents. Many of these physicians go beyond just teaching and truly mentor the students along their career journey. After mentoring, the next step in career development and leadership growth is professional coaching. Coaching is the best way to develop personally and professionally. Coaching can help you find success, and find it faster and more efficiently than you can on your own. Coaching saves you time and money by helping you avoid costly mistakes. It can also be tailored to the specific areas you need to work on, whether it is career development, managing your practice, finances, staff, or relationships with colleagues. The confidential and professional coaching process can get you over the obstacles that keep you from reaching your goals. As Greg Turner, Associate Dean for Faculty Development at Florida State University College of Medicine points out, “Coaching is a skill set of questioning, effective listening, and giving feedback to promote learning, self-awareness, and action.” Through training and experience, a good coach assembles a ‘tool kit’ of skills and resources that are beneficial for enabling him or her to look at the issues a client presents in an objective manner and take effective action.
CONTENTS Coaching has been big in the business community for years, but is still relatively new in the healthcare industry. The coaching process brings out the best in you, whether you are a professional athlete, entertainer, CEO or a physician. If you want to achieve your full potential and reach the goals you have for your career and your life, then coaching is right for you. Bob Nardelli, CEO of Home Depot stated, “I absolutely believe that people, unless coached, never reach their maximum capabilities.” That holds true for physicians as much as it does for a CEO. We need leadership and business training, just like we needed training to become a doctor. Our current healthcare environment makes these skills a necessity in order to succeed. Coaching has allowed me new experiences that I never would have had without participating in a formal program. When I first started practicing, I would not have believed I would become president of a county medical society or serve at the state level. My goal was just to get started seeing patients and hopefully make enough money to pay off those pesky student loans. But the right mentors and the right coaches made a world of difference for me For instance, in 2013, I was invited by John C. Maxwell to go with him to Guatemala to teach leadership values to people in business, healthcare, government, and other areas of influence. How many people do you know who get invited by the world’s #1 leadership guru to transform leadership in an entire country? I don’t tell you that story to pat myself on the back for being a great leader or teacher. I tell you because, in my experience, even though I may not be the best, by learning from the best, doors were opened to opportunities I never thought possible. I know you are busy. What doctor isn’t? But we should all be intentional about finding time in our schedule on a regular basis to do something that will improve our leadership abilities, just like we do for keeping up with our specialties. Coaching and mentoring are tools that physicians can use to get the most out of their practices and their careers. Healthcare is a business, and it requires leaders. It is time for us as physicians to prepare for those roles. If you are interested in resources on mentoring or coaching, feel free contact me or your other county medical society representatives.
Page 3 - Announcements Page 4 - Membership Page 8 - Medical/Legal Page 9 - Practice Mgmt. Page 14 - Foundation Page 15 - In the Community SAVE THE DATE Sunday, September 27, 2015 Hemingway’s Bimini Beach Bar Women in Medicine Brunch 11:30am- 1:30pm Sponsors: Danna Gracey Insurance, Emerald Coast Hospice, Iron Horse Wealth Strategies, Fisher Brown Insurance, Safe Harbor Tax Advisory, Physicians Indemnity, Plateful of Yum Tuesday, October 20, 2015 Pensacola Little Theater 6:00pm Kevin Pho, M.D. 1 AMA PRA Category 1 Credit™ Sponsors: Regions Bank, Dyken Wealth Strategies, Iron Horse Wealth Strategies Saturday, November 14, 2015 | Hilton Garden Inn on Airport Blvd. FALL CME Conference 4 AMA PRA Category 1 Credit™ Sponsors: Catalyst CRE, Iron Horse Wealth Strategies, Mag Mutual Insurance, Physicians Indemnity, Safe Harbor Tax Advisory, LLC. Founded in 1873
RETURN SERVICE REQUESTED PRSRT STD U.S. POSTAGE PAID PERMIT #258 PENSACOLA, FL
Founded in 1873
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
1 | ECMS
We have the space for you EVENTS | MEETINGS | DINING
850.466.5855 29 Palafox Place VPauls.com
ECMS | 2
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
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.
•
•
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.
Announcements 2015 Calendar of Events Sunday, September 27, 2015 | Hemingway’s Bimini Beach Bar Women in Medicine Brunch | 11:30am- 1:30pm Sponsors: Danna Gracey Insurance, Emerald Coast Hospice, Iron Horse Wealth Strategies, Fisher Brown Insurance, Safe Harbor Tax Advisory, Physicians Indemnity, Plateful of Yum Tuesday, October 20, 2015 | Pensacola Little Theater | 6:00pm Kevin Pho, M.D. 1 AMA PRA Category 1 Credit™ Sponsors: Regions Bank, Dyken Wealth Strategies, Iron Horse Wealth Strategies Saturday, November 14, 2015 | Hilton Garden Inn on Airport Blvd. FALL CME Conference 4 AMA PRA Category 1 Credit™ Sponsors: Catalyst CRE, Iron Horse Wealth Strategies, Mag Mutual Insurance, Physicians Indemnity, Safe Harbor Tax Advisory, LLC.
Save the Date October 20, 2015, Pensacola Little Theatre Kevin Pho, MD
ECMS Members: FREE | Non-member physicians $40/pp | guest: $20/pp 6:00 pm book signing reception | 7:00 pm presentation
RSVP by 10/12 “Connect and be heard: Make a difference in health care with social media” 1 AMA PRA Category 1 Credit™
NEW MEMBERS
Saurabh Sanon, M.D. Interventional Cardiology, Cardiovascular Diseases Cardiology Consultants 1717 North “E” Street Ste. 331 Pensacola, FL 32501 (P) 850-484-6500 (F) 850-857-1747 www.cardiologyconsultants.com
REJOINED
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.
Barry Ripps, M.D. New Leaders in Fertility & Endocrinology, LLC 4400 Bayou Blvd., Ste. 36 PENSACOLA, FL 32503 P: 850-857-3733 F: 850-857-0670
CLOSING PRACTICE
Dr. William J. Shanahan, M.D. will be closing his practice of General Surgery as of August 27, 2015. He will be joining Dr. Gary Gotthelf’s practice part-time effective October 1, 2015. Patient records will be kept at Dr. Gary Gotthelf’s office effective October 1, 2015
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
3 | ECMS
Membership “HOW TO WIN THE MEDIA” On August 11th, Pat Clark spoke to ECMS about “How to Win the Media” at V.Paul’s Italian Ristaurante. Below are some photos from our event. We thank our event sponsors FD Insurance & Iron Horse Wealth Management!
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 ECMS | 4
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Membership CURRENT E.C.M.S. MEMBER ROSTER Adams, James Ahmed, Irfan Allison, Allessa Alphonse, Paul Al-Sheikh, Thabet Altenhofen, Dean Amos, Heather Andrews, Carol Andrews, Robert Antonious, George Askew, Ashley Aycock, G. Ayli, Elias Bailey, Jr., William Balchunas, William Barber, Laura Barnes, Leslie Beasley, Michelle Behari, Vishnu Belk, William Benson, Elizabeth Bentz, Philip Bernstein, David Bew, Walter Bouchard, Jr., Maurice Branco, Marcelo Brandhorst, Michelle Brennan, Frances E. Brown, Rachel Buchalter, Jeff Bujnoski, Joanne Bunting, Douglas Burton, Christopher Butler, Peter Callahan, Barry Cartee, Wayne Celigoj, Micheleann Chandler, David Clark, William Cleveland, Jr., Crawford Coleman, Alexander Comitalo, Jeffrey Concepcion, Pablo Coyle, Michael Crosby, Tommye Crosswright, Earl Dadisman, Christopher Daum, Michael Davis, Joshua Davis, Kristen De Joubner, Nutan DeCampos, Juliet
DeCesare, Julie DeJong, John Delaune, Rex Denby, Donald DeRaimo, Anthony Dewey, Donald Dial, Patrick Diaz, Carlos Dillon, Vincence Dixon, Joshua Doenlen, Henry Doerr, Anthony Dorvault, Christopher Doty, william Driscoll, Jennifer Dunn, Joe Eckert, Jeanne El Goweni, Heba Ephtimios, Issa Espinal-Witter, Rosanny Farmer, Charles Fernandez, Julia Fetzer, John Fleischhauer, Franklin Fletcher, Carie French, Barbara Friedland, Edward Frost, James Fuller, Anna Galinis, Andrius Garrett, Rodger Gary, John Gibson, Kacey Golden, Keith Gooden, Timothy Gopal, Lakshmi Gotthelf, Gary Grammer, John Greskovich, III, Frank Grier-Hall, Pamela Guitian, Jose Gutierrez Diaz, Miguel Hackel, Andrea Hackel, Josh Hakim, Fares Ham, Philip Hanline Jr., Manning Harlin, Stuart Harris, Michael Havard, Benjamin Hawkins, Bradley Hawthorne, Richard
Hawthorne, Serda Henchey, Ruth Henghold, II, William Herip, Don Hilliard, Nicholaus Hoffman, Julia Holdt, Adam Hultstrand, Hillary Hultstrand, Victor Humeda, Humam Irvin, E. Coy Jabaley, Steven Jacenyik, Marta Jackson, Frederic Jacobi, Donna Jacobsen, Brenda Jaffri, Shabana Jeffries, Cheryl Jensen, Robert Jimenez, James Jones, Cheryl Jones, Derek Joudeh, Jamal Kaderis,David Kafie, Fernando Kasabian, Michael Kattner, Max Kennedy, Karen Ketchum, Georgia Kimura, Stephen Kirby, Brian Kotlarz, Jack Kozakiewicz, Melissa Krueger, Kurt Kujawski, Eric Laenger, Susan Lampone, Thomas Lanza, John LaPlace, Lillia LaRose, Paul Lasquety, Ludovic Latimer, Kelly Latourette, Chip Law, Quintin Lawrence, Thomas Le Thi, Bach-Uyen LeCroy, Christopher Lee, Tony Leibig, Jon LeMay, David Lenga, Heather Leveque, Jocelyn
Lewis, Janet Long, Kenneth Lonquist, James Lowrey, Gerald Lundquist-Smith, Layla Lusane, Henry Maguchi, Megumi Mann, David Martin, Howell Martin, Rebecca Mason, Donald Mastaw Jr,. Gerald Mauney, Weldon Mayeaux, Dennis Mayfield, Charles McDaniel, Huey McKissack, Randall McKnight, Ellen McLeod, Paul Medlock, C. Shane Mehmood, Farhat Mehta, David Mehta, Mary Messick, Chester Metzger, Clark Mickler, Casey Miles, David Miley, Jennifer Mixon, Fred Montgomery, Paula Moore, John Moraski, Roger Moriss, Nancy Mousa, Omaima Murawski, Daniel Murillo, Jose Murray, Jennifer Myers, John Nall, Monica Nalley, James Nashed, Maged Navarro, Dina Navas, Luis Neuman, Christopher Nguyen, Chi Kim Nielsen, James Nilssen, Erik Northup, Rex Noyes, Daniel Orth, Roger Osban, Wendy Oweis, Shadi
Parra, Brett Patrinely, James Patterson, Nathan Payne, Jennifer Pence, Clyde Peters Jr., C. Wade Pettyjohn, Frank Pham, Minh Phillips, Daniel Picasso, Jodi Plunkett, Joseph Porter, Henry Powell, Ronald Prafke, Jill Pruitt, Valerie Ptacek, Terry Puente, Eduardo Pyle, Paula Qader, Haitham Ramos, Tiffany Razek, Hani Reilly, Patrick Renfroe, Ben Reynolds, Matt Richards, Logan Riehl, John Riesberg, Michael Riley, Charles Ripps, Barry Roth, Charles Rowland, Gayla Rush, Christopher Sackheim, Robert Saith, Angeli Salvaggio, John Samson, Rogelio Sanders, Leslie Sandhu, Neil Sanon, Saurabh Sarkari, Neville Sauer, Samual Savoia-McHugh, Lee Ann Schang, Steven Schneider, Erika Sekhon, Davinder Sellers, Richard Shanahan, William Sholty, Nicholas Silverman, Krista Skoufis, Elias Slobodian, Stephen
Smith, Brett Smith, David Smith, George Smith, James W. Smith, Jr., William E. Snow, Karen Somesan, Andy Stallings, Linda Steichen, Carie Stein, Aaron Stockamp, Kurt Stuart, Ronald Suelflow, Jerry Sultan, Mohamed Szatkowski, Jan Szymoniak, Peter Tan, Huaiyu Tappan, Douglas Tavernaris, Michael Tenniswood, Christine Tenniswood, David Thomas-Doyle, Tracey Tillery, Carla Trezza, Scott Tucker, Elizabeth Turnage, Robert Turner, David Ullman, Saul Verbois, Glennal Villegas, Leonardo Virtusio, Lourdes Ward, James Watson, Amy Weisburg, Ian Welch, Kevin Wells, Alka Westafer, Anita Westbrook, Thomas White, Andy Whittingham, Erica Wiles, Ronald Wilkinson, diane Willert, Jessica Winchester, Sara Witter, Frank Wolters, Jeffery Yonehiro, Layne Young, David Zimmern, Jr., William Zweikoft, Stewart
THANK YOU FOR YOUR MEMBERSHIP!
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 ANNUAL FMA MEETING by Ellen W. McKnight, M.D., ECMS 2015 Secretary/Treasurer In late July, the Escambia County Medical Society sent 9 delegates to the annual Florida Medical Association meeting in Orlando. This entire weekend is filled with activities that are focused on advancing the interests of physicians and working to preserve the Doctorpatient relationship. A few weeks prior to the meeting, the delegates met to discuss all of the resolutions being offered this year and to solidify our positions on these resolutions as to best reflect our member’s interests. This process is an interesting mix of fun with a dash of tedium, a little reminiscent of those long nights of studying with friends. However, it is important to discuss these resolutions in advance to familiarize ourselves with the myriad of complicated issues facing the physicians practicing in Florida. The FMA Annual meeting starts on Friday with CME and other activities for those who want to participate. In the morning, Executive Director Erica Huffman accompanied ECMS President-Elect Brian Kirby, M.D. at a state-wide president-elects seminar. In addition, Erica Huffman attended the annual Council of Florida Medical Society Executives (CFMSE) meeting, a conference for executive director’s of medical societies statewide. At this meeting Erica was elected as Vice-Chair of the council. That puts the Escambia County Medical Society front and center as our society attempts to advance important issues and works to influence the direction of the FMA. On Friday night, there was a caucus dinner which included medical societies from Jacksonville to Pensacola. Our executive director, Erica, planned the entire evening and it was a huge success. The physicians enjoyed a fun-filled evening of great food and camaraderie. Thank you to Hancock Bank for partially sponsoring the dinner for our doctors. On Saturday and Sunday, the ECMS was responsible for hosting the Northwest Florida Caucus breakfast and making sure we had a delicious meal greeting us at such an early hour. We thank our breakfast sponsor Danna Gracey who assisted with breakfast cost. ECMS President Dr. Christopher Burton ran both morning sessions efficiently as he allowed for adequate time to discuss all of the resolutions that would be voted on during the House of Delegates. Our society endorsed resolutions authored by two of our doctors. Dr. Brian Kirby authored Resolution 15-301 which supported the rights of physicians to refer freely to the doctor of their choice. Physicians should not be subjected to rules limiting their ability to refer freely regardless of their employment situation. Basically, the physician should be able to refer to whomever he/she judges to be the best consultant and who would best fit their patient’s needs. Dr. Ellen McKnight authored resolution 15-105 which was intended to build upon our 2014 resolution In that resolution, the FMA strongly supported the physician’s right to practice medicine in the State of Florida and rejected MOC participation as a prerequisite for state licensure, staff privileges in clinics or hospitals, employment in state facilities, payment by 3rd parties and issuance of malpractice insurance. This year’s resolution focused on breaking the monopoly of the ABSM/ABIM in physician certification and advanced the concept that the FMA should endorse other methods for physician certification. Both resolutions were recommended to be considered by the Board of Governors. Both resolutions represent a strong effort by the ECMS to protect a physician’s right to practice unencumbered in the State of Florida. “For 15 years, I didn’t have an understanding of how ECMS through the FMA might affect my everyday practice,” said Dr. Jennifer Miley after she attended the FMA Meeting for her first time this year. “It was a fascinating process to see how some of the home grown resolutions by my fellow Pensacola physicians were submitted, adopted, and will go on to influence the national stage! We all share similar frustrations with the burdens of EHRs, prior auths, and payors. We all want the freedom to provide the very best patient care without the entanglements we currently face. Taking the time out of a busy practice was well worth the time to stand up for the rights of all physicians. I would recommend it to anyone!” This was my second year attending the annual FMA meeting. The ECMS is truly making a difference at the state level as we fight to preserve and protect our profession. The ECMS is allowed 1 delegate for every 40 members of the FMA in our counties. Please encourage Julie Danna and Arlene Gardner, your local medical malpractice specialists, have become well known your colleagues to join or re-join throughout the state as strong advocates for health care providers, as well as creators of society and and consider attending as one of the network insurance purchasing programs. delegates, I believe you will enjoy the Danna-Gracey is an independent insurance agency with a statewide team of specialists dedicated experience. solely to insurance coverage placement for Florida’s doctors and healthcare If you are interested in serving providers, including medical malpractice, workers’ compensation, and cyber as an ECMS Delegate or Alternate liability insurance. Delegate for 2016 please contact ECMS For a no-obligation assessment of your current coverage, call Julie or Executive Director before October 1, Arlene at 850.995.9119. 2015. director@escambiacms.org 850478-0706 x2
Isn’t it time you called the med mal and cyber insurance specialists?
Delray Beach • Jacksonville • Miami • Orlando • Pensacola julie@dannagracey.com • 850.995.9119 • www.dannagracey.com
ECMS | 6
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Membership 1
2
3
5
4
1: Dr. Brian Kirby & Erica Huffman attend an hour session on effectively running a medical society. This program was specifically geared towards medical society president-elects. 2: ECMS host a dinner at Charley’s Steakhouse with delegates from Jacksonville- Pensacola. 3: ECMS Executive Director, Erica Huffman is elected to serve as the Vice-Chair of the Council of Florida Medical Society Executives 4: Dr. Coy Irvin, Pensacola, Florida is selected to serve as an AMA Delegate 5: Bright an early, ECMS delegates gather with the Northwest Florida Caucus to review the FMA Handbook resolutions. ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
7 | ECMS
Medical/Legal SYSTEM DANGERS: HOW EHRS CAN CONTRIBUTE TO MEDICAL MALPRACTICE CLAIMS by David B. Troxel, MD, Medical Director, The Doctors Company In 2013, The Doctors Company began coding closed claims using 15 electronic health record (EHR) contributing factor codes (for system and user factors) developed by CRICO Strategies and back-coded all claims to 2007. EHR-related claims frequency is increasing. Twenty-six such claims closed in the first two quarters of 2014, 28 claims closed in 2013, 22 closed in 2012, 19 closed in 2011, and two closed between 2007 and 2010. These 97 EHR-related claims that closed from January 2007 through June 2014 are the subject of this analysis. User factors contributed to 64 percent of these EHR-related claims, and system factors contributed to 42 percent. The following tables and representative claims illustrate how EHR system and user factors contributed to the 97 closed claims. Some claims contained more than one contributing factor. EHR System Factors: Technology, Design, and Security Issues 10% Failure of system design 9% Electronic systems/technology failure 7% Lack of EHR alert/alarm/decision support 6% System failure—electronic data routing 4% Insufficient scope/area for documentation 3% Fragmented EHR Claim: Lack of EHR Drug Alert A dialysis patient transferred to a skilled nursing facility. There was an active hospital transfer order for Lovenox. A physician evaluated the patient on admission but made no comment about the Lovenox order. During the first dialysis treatment, there was active bleeding at the fistula site. Heparin (anticoagulant) had not been given. Nursing did not inform the physician of the bleeding. During the second dialysis treatment, there was uncontrolled bleeding from the fistula. The patient exsanguinated and expired. Experts were critical that there was no EHR High-Risk Medication Alert. EHR User Factors: EHR-Related Issues Attributable to Users 16% Incorrect information in the EHR 15% Hybrid health records/EHR conversion 13% Prepopulating/copy and paste 7% EHRtraining/education 7% EHR user error (other than data entry) 3% EHR alert issues/fatigue 1% EHR/CPOE workarounds Claim: Incorrect Information in EHR A patient was seen by her cardiologist for hypertension. In the written medical record, her blood pressure medication had been increased to 25 mg once a day. Office staff entered the order into the EHR as twice a day. The prescription was filled. The patient missed her follow-up appointment. Seven months later, she went to the ER with numbness and weakness. Her potassium level was low. The cardiologist corrected the prescription error and gave her potassium. We also analyzed the 97 EHR claims to determine the most common allegations. Top Allegations in EHR Claims 27% Diagnosis-related (failure, delay, wrong) 19% Medication-related: 7% Ordering wrong medication 5% Ordering wrong dose 7% Improper medication management The 2011 Institute of Medicine report, Health IT and Patient Safety: Building Safer Systems for Better Care, concluded that the information needed to analyze and assess health IT (HIT) safety and use was not available and that our understanding of the benefits and risks of EHRs was anecdotal. The report recommended creating a government agency that would systematically and uniformly collect data to investigate harm and safety events related to HIT. The Office of the National Coordinator for Health Information Technology is now developing a plan to create a Health IT Safety Center. -------------------Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety. David B. Troxel, MD, is medical director of The Doctors Company. Dr. Troxel is clinical professor emeritus, School of Public Health at the University of California at Berkeley. He is past president of the American Board of Pathology and the California Society of Pathologists. ECMS | 8
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Practice Management PATIENT TRACKING & FOLLOW UP–WHAT YOU DON’T KNOW CAN HURT YOU by Laurette Salzman, MBA, CPHRM, ProAssurance Senior Risk Resource Advisor
Lapses in patient care, including follow up, can lead to dire consequences beyond those to patient well-being. Substantial malpractice settlements and verdicts have been paid as a result of “lost” diagnostic reports and physicians’ failure to review and follow up. Patients who miss or cancel appointments risk undetected and untreated medical conditions, threatening continuity of care. If the patient later experiences an illness or injury, he or she may hold you responsible. The best way to prevent such lapses—and the corresponding malpractice allegations they create—is to develop written policies and procedures. The goal is to effectively track lab and diagnostic tests, as well as missed appointments and referrals. Lab and Diagnostic Tests Establish a tracking system that documents and follows patients referred for diagnostic imaging or laboratory testing. An effective system will verify the: • test is performed; • results are reported to the office; • physician reviews the results; • physician communicates the results to the patient; • results are properly acted upon; and • results are properly filed. It is important the physician or allied health professional (AHP) review, authenticate, and date all diagnostic test results as soon as they are available—before filing. When test results are abnormal, it is important to let the patient know both the results and the need for follow up. If the patient does not follow through as advised, it is prudent to make—and document—repeated efforts to encourage the patient’s return. Cancellations and No-Shows Tracking missed or cancelled appointments will help you improve patient care and reduce liability risk. When patients miss or cancel appointments, attempt to reschedule and document both the reason for cancellation and each of your efforts to reschedule. We suggest the AHP review all missed or cancelled appointments and discuss them with the physician to determine if follow-up is necessary. More aggressive follow up may be necessary for patients with urgent conditions. Document all such efforts in the medical record. Consultations/ReferralsPlan to develop an effective system to identify and track patients who are scheduled for referrals and consultations. Document in the patient’s medical record all recommendations that a patient see a specialist for consultation or continued care. Include any letters or other communications between physicians in the medical record. Types of Tracking Systems Tracking systems do not have to be complex or expensive; they just have to work. Many medical practices use simple and inexpensive methods, such as logbooks. Others utilize tracking functions provided in their electronic medical records system. Whatever tracking method you choose, be sure to follow up on laboratory and diagnostic tests, cancellations, no-shows, and consultations. Copyright © 2015 ProAssurance Corporation. This article is not intended to provide legal advice, and no attempt is made to suggest more or less appropriate medical conduct. ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
9 | ECMS
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
-
1 9 3 5
2 0 1 5
Celebrating 80 Years of Theatre in Northwest Florida
ONCE UPON A TIME... 400
God of Carnage. . . . . . . . . . . . . . . . . . . Sep 4-6 & 10 -12, 2015
T
Once Upon A Mattress. . . . . . . . Sep 18-20 & 24-27, 2015
SP
24 Hour Theatre . . . . . . . . . . . . . . . . . . . . . . . . . . . .Oct 17, 2015
SP
Always a Bridesmaid . . . . . . . . . . . Nov 6-8 & 12-15, 2015
MS
Irving Berlin’s . . . . . . . . . . . . . . . . . . . Dec 11-13 & 17-20, 2015 White Christmas
400
MS 400
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
T
The Paper Bag Princess . . . . . Mar 11-13 & 17-20, 2016
SP
24 Hour Theatre . . . . . . . . . . . . . . . . . . . . . . . . . . . .April 9, 2016
MS
Don’t Dress for Dinner. . . . . . April 15-17 & 21-24, 2016
400
I Love You, You’re Perfect, . . . . May 13-15 & 19-21, 2016 Now Change
MS
Vanya & Sonia & . . . . . . . . . . . . . . . . June 10-12 & 16-19, 2016 Masha & Spike
T A
Snow White and . . . . . . . . . . . . . . .July 16-17 & 23 -24, 2016 the Seven Dwarfs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
T
Shrek, The Musical. . . . . . . . . July 29-31 & Aug 4-21, 2016
MS
MS
Mainstage Theatre
T
Treehouse Family Theatre
400
Studio 400
A
Acorn Children’s Theatre
SP
Special Production
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. ECMS ECMS || 10 10
ESCAMBIA ESCAMBIA COUNTY COUNTY MEDICAL MEDICAL SOCIETY SOCIETY IN IN CONJUNCTION CONJUNCTION WITH WITH SANTA SANTA ROSA ROSA COUNTY COUNTY
Practice Management DOES YOUR MEDICAL MALPRACTICE INSURER KNOW WHAT CAUSED PATIENT DEATHS IN LIPOSUCTION PROCEDURE CLAIMS? CLAIMS? THE DOCTORS COMPANY DOES. As the nation’s largest physician-owned medical malpractice insurer, we have an unparalleled understanding of liability
18%
RESPIRATORY COMPLICATIONS
claims against plastic surgeons. This gives us a significant advantage in the courtroom. It also accounts for our ability to anticipate emerging trends and provide innovative patient safety tools to help physicians reduce risk. When
18%
PUNCTURE OR LACERATION
PULMONARY EMBOLISM
your reputation and livelihood are on the line, only one medical malpractice
SEPSIS
9% 9%
insurer can give you the assurance that today’s challenging practice environment demands—The Doctors Company.
CARDIAC COMPLICATIONS
9%
POST-OPERATIVE SHOCK
9%
To learn more, call our Jacksonville office at 888.899.9091 or visit www.thedoctors.com.
CAUSES OF DEATH CITED IN LIPOSUCTION-RELATED MALPRACTICE CLAIMS Source: The Doctors Company
ESCAMBIA ESCAMBIA COUNTY COUNTY MEDICAL MEDICAL SOCIETY SOCIETY IN IN CONJUNCTION CONJUNCTION WITH WITH SANTA SANTA ROSA ROSA COUNTY COUNTY
11 11 || ECMS ECMS
Practice Management Top 3 Reasons to choose Panhandle Medical Services:
1. Experience 2. Quality 3. Maximized Collections MEDICAL BILLING • CREDENTIALING BOOKKEEPING • AUDITING PRACTICE EVALUATIONS PAYROLL PREPARATION • CONSULTING
Since 1992
For a free billing review contact us at: 4901 Grande Drive • Pensacola, FL 32504 Phone (850) 478-1312 • Info@panhandlemedical.com
www.PanhandleMedical.com
It Happens.
You’re a good doctor. But one day you will be glad to have FD Insurance coverage. Actions against U.S. medical practices now average 85,000 cases per year. We’re a Florida leader in professional protection. We only work for medical professionals.
First for Doctors. FD Insurance is a different kind of malpractice insurer. You have a force with the resources to take on any case. We know the court system. Multiple strategic partnerships increase our success rate. Your Insurance claim resolution is rapid, private, and often without patient compensation.
Our partnership with Escambia County Medical Society (ECMS) provides a 10% discount to members.
800.352.3627 ECMS | 12
fdinsurancecompany.com
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
MMIC Ad_Escambia_07-2015.pdf
1
6/29/15
3:11 PM
32 YEARS
We have been defending our owners for more than
Staige Hoffman MagMutual 813-781-3184
Lesa Kemp MagMutual 904-813-9284
Founded by physicians, we offer: • Medical malpractice insurance for pyhsicians • The best attorneys • Peer physician claims review • Consistent dividends*
MagMutual.com
* Dividend payments are declared at the discretion of the MAG Mutual Insurance Company Board of Directors. Since inception, MAG Mutual Insurance Company has distributed more than $136 million in dividends to our policyholders. Insurance products and services are issued and underwritten by MAG Mutual Insurance Company and its affiliates.
A Healthcare Real Estate Continuum
CATALYST CRE’S
PCOM PROCESS PLAN
Real Estate Strategy Services
CREATE
Real Estate Development Services
OPTIMIZE
Real Estate Brokerage & Property Services
MAINTAIN
Facility Management Services
BRANDON MCFARREN BMCFARREN@CATALYSTCRE.COM • 850.698.6068 WWW.CATALYSTCRE.COM ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
13 | ECMS
Foundation The ECMS Foundation has elected a new Board of Directors effective immediately. After serving nearly five of years on the ECMS Foundation board and as past President of ECMS Dr. Paula Montgomery will be stepping down from her role as ECMS Foundation President. “ During the years I have served on the ECMS Foundation Board as a member and as president, I have watched with pride as our charitable outreach into the community grew wider and deeper. As I leave the board I look forward to seeing the impact of new energy from a new board on the work we have already begun. Thank you for permitting me to serve in this capacity. It has been my pleasure,” says Dr. Montgomery. The Board has elected Kurt Krueger, MD, president; Joanne Bujnoski, DO, vice-president; and Jennifer Miley, MD, Sec/Treas. Dr. Krueger, a member of the Medical Society for over 20 years, states; “I am looking forward to helping improve the Foundation’s functions. The core commitment to serve the medical needs of Escambia and Santa Rosa counties will be exciting, and we have a great staff to implement this.”
Just released! Complimentary educational video series.
Why planning for doctors is different than the general public
BREATHE. EXPERT CARE FOR ILLNESSES AFFECTING THE LUNGS, BREATHING AND SLEEP.
When you have trouble breathing or sleeping, it takes a big toll on your life. Fortunately, Bobby Simpson, D.O., is here to help. Board-certified in pulmonology and sleep medicine, Dr. Simpson treats conditions such as COPD, asthma, chronic cough, fluid around the lungs, and lung cancer. He also oversees the sleep studies at the Santa Rosa Sleep Disorders Center, and treats sleep apnea, snoring, narcolepsy, restless leg syndrome and more. For an appointment, or for information about sleep studies, call 626-5375.
5992 Berryhill Rd., Suite 206, Milton, FL Open Monday-Friday, 8 a.m.-5 p.m. SRMCFL.com/Simpson
Bobby Simpson, D.O. Pulmonology and Sleep Medicine
How to take control of your financial future
How to understand what type of planning you need
Sign up now! www.doctorswealthedu.com/cure Securities offered through First Allied Securities, Inc., a registered broker/dealer—Member FINRA/SIPC. Advisory services offered through First Allied Advisory Services, Inc.
Member of the Medical Staff of Santa Rosa Medical Center
ECMS | 14
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY 85457_SANT_Simpson_3_75x10_75c.indd 1 7/12/15 4:23 PM
In the Community
SACRED HEART NEWS New Cardiovascular Surgeon Dr. Charles Wyatt, a highly trained cardiovascular surgeon, has joined Sacred Heart Medical Group’s Cardiovascular Specialists. Dr. Wyatt is board-certified in general and thoracic surgery with clinical expertise in both open and endovascular approaches to heart and vascular disease. He earned his medical degree from Baylor College of Medicine in Houston, Texas, and completed his general surgery internship and residency from Baylor College of Medicine Affiliated Hospitals, followed by a Thoracic Surgery fellowship at the University of Miami Affiliated Hospitals in Miami, Fla. Dr. Wyatt is seeing patients at Sacred Heart Hospital and can be reached at (850) 416-4970. Sacred Heart Celebrates 100 Years September marks Sacred Heart’s 100-year anniversary of providing excellent care for all, with special attention to the poor and vulnerable. In the early 1900s, the Daughters of Charity were asked build and staff a hospital to provide “modern healthcare” for the Pensacola community. In 1915 they responded by opening the magnificent, castle-like hospital on 12th Avenue, where the Sisters cared for all patients, regardless of race, creed or ability to pay, for the next 50 years. In the late 1950s, the overcrowded hospital could not keep up with
Pensacola’s burgeoning population, nor provide the infrastructure to support advances in medical technology. With advice from local businessmen and guidance through prayer, the Sisters selected land for a new hospital on an unpaved road far north of the existing city. The new hospital opened on Ninth Avenue in 1965 and has become the headquarters for today’s regional Health System that reaches from Gulf Shores, Ala., across North Florida as far as Apalachicola. To learn more about Sacred Heart’s history and its mission, please visit www.sacred-heart.org/100years. Sacred Heart is Baby-Friendly Local mothers have access to the highest level of breastfeeding support and education available, as recognized by Sacred Heart Hospital Pensacola’s latest international recognition as a Baby-Friendly birth facility by Baby-Friendly USA. Sacred Heart Hospital is Northwest Florida’s only facility to be designated as Baby Friendly, an award that also recognizes a birthing center’s family-centered approach to maternity care. Sacred Heart also provides the area’s only Perinatal Intensive Care Center, as well as an OB Emergency Department open 24/7.
BAPTIST HEALTH CARE NEWS Baptist and YMCA Partner to Improve Community Health Baptist Health Care and the YMCA of Northwest Florida (YMCA) have formally entered into a partnership with the aim of working together to better address the health needs of northwest Florida. This new relationship recognizes Baptist as the YMCA’s primary health care and rehabilitation services partner and the YMCA as Baptist’s primary wellness partner in the marketplace. In a memorandum of understanding signed in July, the organizations agreed to collaborate in the promotion of wellness, fitness and education efforts to promote a healthier community. Jointly, Baptist and the YMCA will identify potential opportunities to develop programs that will impact a broad set of population groups, including persons with chronic conditions, at-risk pediatric populations, as well as fitness enthusiasts and weekend athletes. Together, Baptist and the YMCA have a significant geographic footprint across Escambia and Santa Rosa counties. Moving forward, the organizations will be able to reach more people and support programs more broadly in the community. The first such effort will be a presence on behalf of Baptist’s Andrews Institute within the new Bear | Levin | Studer YMCA set to open in downtown Pensacola next year. Baptist will be relocating its Andrews Institute Rehabilitation Services from the main hospital campus to the new YMCA facility. Together, Baptist and the YMCA will be able to share their respective strengths, expertise and resources to address major community health challenges such as obesity, diabetes, heart disease and more. Mayo Clinic Trained Interventional Cardiologist Saurabh Sanon, M.D., Joins Baptist Heart & Vascular Institute Baptist Heart & Vascular Institute (BH&VI) is pleased to welcome fellowship-trained and board certified cardiologist Saurabh Sanon, M.D., to its physician network, the largest cardiology practice in the area. Dr. Sanon joins BH&VI from Mayo Clinic, Rochester, Minn. Dr. Sanon earned his medical degree at Government Medical College in Nagpur, India, and completed his residency in internal medicine at the University of Texas Health Science Center in Houston, Texas. He completed a fellowship in cardiology at the University of Texas Health Science Center in San Antonio, Texas and went on to complete a fellowship in interventional cardiology at Mayo Clinic in Rochester, Minn., followed by a dedicated fellowship in advanced structural interventional cardiology, also at Mayo Clinic, Rochester, Minn. Dr. Sanon brings with him expertise in leading edge cardiovascular technology including transcatheter aortic valve replacement (TAVR),
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
transcatheter mitral valve repair (MitraClip®) and left atrial appendage occlusion in addition to percutaneous coronary intervention. He is the author of more than 25 manuscripts, book chapters and abstracts. His special interest is structural heart interventions, such as TAVR, paravalvular leak repair, balloon valvuloplasty, percutaneous valve repair and implantation and other similar therapies. Experienced ENT Physician Hilliary White, M.D., FACS, Joins Baptist Medical Group Baptist Medical Group (BMG) is pleased to welcome fellowshiptrained and board certified head and neck surgeon Hilliary White, M.D., FACS, to their multispecialty physician network. Dr. White is dedicated to the care and treatment of a variety of ear, nose and throat conditions and has special interest in head and neck oncology and reconstructive surgery. She joins BMG from the Head & Neck Surgery Center of Florida in Orlando, Fla. Dr. White earned her medical degree at Louisiana State University Health Sciences Center in New Orleans, La. and completed her residency in otolaryngology at the University of Alabama at Birmingham. She then completed a fellowship in head and neck oncology surgery and reconstruction at the University of Alabama at Birmingham in Birmingham, Ala. Andrews Institute Health Care That Works Conference Friday, Oct. 23 Andrews Athletic Performance & Research Pavilion The Andrews Research & Education Foundation presents the Andrews Institute for Orthopaedics & Sports Medicine’s Health Care That Works Conference on Friday, Oct. 23 at the Andrews Athletic Performance & Research Pavilion. Registrants can check in at 7:30 a.m. and the conference is from 8 a.m. to 4 p.m. The Health Care That Works Conference features presentations on the latest advancements in medicine. Topics will include acromioclavicular joint surgery, fragility fractures, foot and ankle advances, the hip and spine connection and much more. The conference provides 6 Continued Medical Education (CME/CE) hours for nurses, occupational therapists, physical therapists, certified athletic trainers and physicians. Space is limited, register today for $60, which includes breakfast and lunch. To purchase tickets, please visit AndrewsInstitute.com. For more information, contact Leandra Price at 850.916.8583 or by email at Leandra.Price@AndrewsREF.org. 15 | ECMS
DO YOU HAVE ENOUGH TO RETIRE ON? ENOUGH INFORMATION, THAT IS? With our retirement income expertise, we can help bring your future into focus. These days, you need more than just Social Security, investments and a pension. You need the tools, resources and expertise to plan for retirement. And you’ll find them all right here. For instance, we use an established discovery process to help determine how much you’ll realistically need each month for your retirement – and how to best meet that challenge. So let’s have a conversation. What develops from there can be a professional relationship that lasts a lifetime.
Iron Horse Wealth Strategies An Independent Firm 201 N. Palafox Street, Suite 2A Pensacola, FL 32502 (850) 361-4978 (Office) | (850) 466-3382 (Fax)
Securities offered through Raymond James Financial Services, Inc., member FINRA/SIPC Raymond James is a registered trademark of Raymond James Financial, Inc. 15-BRAXB-0003 VC 8/15 ECMS | 16
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY