Holiday/Winter Knoxville Magazine 2014

Volum e L X X I, N o. 4 • W in te r 2 0 1 4

Se r ving the Gr e ate r M e tr opolitan K noxvi l l e Area

KAM HOLIDAY SPECIAL ISSUE ACADEMY NEWS LEGISLATIVE UPDATE BME UPDATE TECHNOLOGY NEWS PLUS-TALKIN’ TURKEY, HOLIDAY MUST DO’S, HOLIDAY RECIPES & CHOOSING THE BEST HOLIDAY WINES

KAM KNOXVILLE ACADEMY OF MEDICINE

There’s no such thing as a HIPAA-compliant app Secure all modes of clinical communication

HIPAA compliance is not just simply buying and installing a specific technology – it is about assessing the risks to your organization and then developing and implementing a strategy to monitor those risks.

PHYSICIANS AND CLINICIANS USE MANY MODES OF COMMUNICATION: real-time calls

paging email

text messaging voice messaging

SMS messaging fax

Protected health information (PHI) moves along ALL of these pathways.

PerfectServe can help secure your clinical communications and reduce your HIPAA compliance risk.

Visit perfectserve.com to find out how PerfectServe turns mobile apps, pagers, texting, websites, answering services, switchboards and call centers into one powerful, secure, streamlined communications network. perfectserve.com 866.844.5484

KNOXVILLE ACADEMY OF MEDICINE KNOXDOCS.ORG

PRESIDENT’S MESSAGE

KAM

By: Pat O’Brien, MD

Academy Officers

KNOXVILLE ACADEMY OF MEDICINE

Pat O’Brien, MD PRESIDENT

Elise Denneny, MD

IMMEDIATE PAST PRESIDENT

Thomas Pollard, MD PRESIDENT ELECT

Jeff Broussard, MD SECRETARY

Neil Coleman, MD TREASURER

Roy King, MD

KAMF PRESIDENT

Kimberly Weaver, PhD CEO

Board of Trustees Thomas Haskins, MD David Harris, MD Jack Benhayon, MD Ceeccy Yang, MD Clifton Tennison, MD Ed McBride, MD

Ex- Officio Board Members Randal Dabbs, MD Richard Briggs, MD Richard DePersio, MD Roy King, MD John W. Lacey, III, MD Robert Page, MD Jacque Prince - KAMA Rep.

Publisher Kim Weaver, PhD

Editor Julie Morris

Production Coordinator Danielle DuFur

Design Jonathan Weaver ADVERTISING:

For

advertising

information,

call the Academy offices at (865) 531-2766. The magazine is published four times per year by the Knoxville Academy of Medicine (KAM). All rights reserved. This publication or any part thereof may not be reproduced without the expressed written consent of the KAM. The appearance of advertising in KAM publications is not a KAM guarantee/ endorsement of the product or the claims made for the product by the manufacturer. The fact that an advertisement for a product, service, or company has appeared in a KAM publication shall not be

It’s hard to believe it’s already the holiday season with all the hustle and bustle that comes with it. We as physicians are busy, always trying to help the next patient overcome some malady, some affliction that vexes them. We continually give the gift of healing in this and all seasons. For your dedication and hard work, I salute you.

While we have many things to be thankful for and many gifts both given and received, we must look out for those of our colleagues that need the gift of help. As many of you know, the first group of healthcare workers to be arrested for prescription medication “pill mill” issues occurred recently. I personally know some of the group. I know they probably did not think (or hope this is the case) that they were doing anything really wrong. And I’ve got to say these individuals are innocent until proven guilty. But they represent part of this huge issue of prescription drug abuse and misuse in our region. As I’ve said before, we as the physicians at the helm of healthcare must take control of this issue or others outside of medicine will show up at the door with guns and jackets with big yellow letters on the back taking some of us away! Please look out for yourself and your colleagues. Say something before it is too late. As a member of the Prescription Drug Task Force, I hear about the problems we face. Things are getting better. We still are a leader in pain management clinics in the state but the data is showing a slight trend downward. Make sure to speak up if a colleague says they are going into the “pain business” just so they do it for the right reasons and with the appropriate training.

It has been a pleasure to serve as your president of the Knoxville Academy of Medicine this year. We have made many strides that serve you, the membership, better. We have a new website, new way to pay dues, and now a new way to represent you better.

With the upcoming presidency of Tommy Pollard, MD, we have instituted a two year term of office to allow for more familiarity and advocacy on your behalf. I know Tommy will do a great job and carry on the legacy of the KAM in the years to come. Please support your officers and board and speak up, take part, and take ownership. We are the captains of the ship and don’t forget it!

Have a safe and happy holiday season.

Thanks again for a great year!

Pat

Calendar of Events DECEMBER Roane-Anderson County Holiday Party 4 Peerless, 6:30 pm

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Young Physicians/Resident Holiday Happy Hour, ICON, 5:00 pm

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KAM/KAMF Board Holiday Party Casual Pint Farragut, 6:30 pm

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Blount County Holiday Party RT Lodge, 6:00 pm

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Emeritus Holiday Luncheon Calhouns Bearden Hill, 11:30 am

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Christmas Holiday, KAM Closed

JANUARY Inaugural Party, The Foundry, 6:30 pm 23 APRIL Boot Scootin’ Ball 24

Knoxville Marriott, 6:30 pm

referred to in collateral advertising. The KAM reserves the right to accept or reject any advertising in the publication.

KNOXVILLE MED CINE | 3

ACADEMY NEWS Report of the Nominating Committee According to Chapter IV, Section 6 of the Bylaws of the Knoxville Academy of Medicine, “the nominating committee shall submit a slate to the membership with at least one nomination for each vacant office…

Any active member may oppose the slate by submitting a petition for a candidate with ten (10) signatures of Active/Veteran members to the Academy office within thirty (30) days after the newsletter is mailed announcing the slate. If after thirty (30) days there is no opposition to the slate, the Secretary shall cast an affirmative vote on behalf of the membership accepting the slate. If there is a qualified petition submitted opposing the slate, a dual slate will be sent to the Active and Veteran membership by the U.S. Postal Service with return mail ballot due thirty (30) days after it was mailed from the Academy office. Election of each office will be determined by simple majority of those ballots received. Ballots will be received and calculated by the Nomination Committee or designee.”

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2015 President Thomas Pollard, MD

President-Elect Neal Coleman, MD

Secretary Ceecee Yang, MD

Treasurer Jack Benhayon, MD

Trustee 2015-2017 Clif Tennison, MD

Trustee 2015-2017 Tim Wilson, MD

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KAM Legislative Report

By: Elise Denneny, MD

Happy Holidays. It is a season of Thanksgiving and Joy. As we close out 2014 and enter 2015, let me express many thanks to the KAM staff, whose creativity and collegiality has energized this organization and its legislative issues.

I also thank all those involved in the fight against pain pill abuse and opioid substance addiction. The recent raid and closure of Breakthrough Pain Therapy Center where medical professionals, and doctors were charged with practicing outside the standard of care, decreases our “pill mill” county by one more. The problem of abuse and addiction is a complicated problem to which we are steadily gaining ground through the joint efforts of all health care providers, law enforcement, legislators and Metropolitan Drug Commission. The drug task force works with the KAM Legislative Committee to provide naloxone and Good Samaritan protection.

On the State level looking towards 2015, we will address the need for physician-led team based health care. As Tennessee Payment Reform continues to evolve through the identification of episodic care and patient-centered medical homes the goal is to main-

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KNOXVILLE ACADEMY OF MEDICINE

tain quality care for our patients and community. Your voice and “stories” of how your patients are affected by the changing health care delivery model are significant pieces of information our state legislators need to hear as they make decisions that affect health care. Your involvement in future TAG advisory teams can make a difference.

An Interstate Medical Licensure Compact is an issue that is also on our radar. It would allow for an expedited license and reciprocity for other states in the compact. It would have its own oversight and incorporate the highest qualifications in most states and has the potential to be included in the Governors legislative package.

Additionally, we continue to address the need for physician notification for any bio similar exchange at the dispensing level and to fight for physicians impacted by narrow networks.

Many legislative issues are created, formulated and modified through your input. Thank you for your past comments and suggestions.

May you be blessed with health and peace in 2015.

KNOXVILLE MED CINE | 5

ACADEMY NEWS New Members A big welcome to our newest members! We are excited that you have decided to join the Knoxville Academy of Medicine.

ANDREA ALEXANDER, MD

GENERAL SURGERY University Surgeons Associates PC 1930 Alcoa Hwy Ste A240 Knoxville, TN 37920 ________________________________________________

SUDARSHAN DODDABELE, MD INTERNAL MEDICINE Tennessee Cancer Specialists PLLC 1415 Old Weisgarber Rd., Ste 200 Knoxville, TN 37909

________________________________________________

CARLEY FOWLER, MD

DERMATOLOGY Dermatology Associates of Knoxville 939 E Emerald Ave Ste 705 Knoxville, TN 37917

DANIEL P. GIBSON, MD

DIAGNOSTIC NEURORADIOLOGY Vista Radiology 2001 Laurel Ave Ste 304 Knoxville, TN 37916 ________________________________________________

DEBRA PERRY, MD

INTERNAL MEDICINE Summit Medical Group 2240 Sutherland Ave Ste103 Knoxville, TN 37919

FROM TOP LEFT TO RIGHT: Andrea Alexander, MD., Sudarshan Doddabele, MD., Carley Fowler, MD., Daniel P. Gibson, MD., Debra Perry, MD.

You are Cordially Invited to NOT Attend Another Holiday Gala!

We considered throwing the Fundraiser Gala of the year this holiday season, but providing coordination of healthcare to the low-income and uninsured in our community shouldn’t require good people to go through a huge expensive ordeal…

Take for example: $300: Two tickets to a swank, black-tie fundraiser. +$100: Tuxedo rental for him. +$180: Fabulous dress for her. +$120: Cost of impulsively raising your hand after the auctioneer said, “Do I hear $120?”

$700: Amount Knoxville Area Project Access just saved you by NOT throwing a black-tie fundraiser!

100% Tax Deductible Reserve Your Seat at the KAPA VIP Table! As an intelligent and altruistic person with social charms, we definitely want you at our table! Be careful when sitting in the nonexistent chair! 1. Donate online at KnoxvilleMedicine.org 2. Call 531-2766 3. Mail checks payable to “KAPA Non-Event of the Year” 115 Suburban Road, Knoxville, TN 37923

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ACADEMY NEWS Board of Medical Examiners Update by: Reeves Johnson, MD

In March of last year, thanks in part to letters of support from the KAM and TMA, Governor Haslam appointed me to serve on the Tennessee Board of Medical Examiners. Since then, it has been a steep learning curve to understand all this Board does for healthcare in our state. Among our many responsibilities which include assuring only qualified physicians are issued a medical license and disciplining those who violate our rules and statutes, we are also responsible for developing new rules to keep up with the ever changing face of medicine.

Currently, we are in the process of developing new rules regarding Telemedicine. There already is a “limited” Telemedicine license that applies mainly to radiologists, neurologists and pathologists.

Since our state legislature recently passed Public Chapter 675 which requires insurance companies to provide coverage for telehealth as they would for in-person encounters, the Board desires to insure this service is provided safely and by fully licensed physicians.

Beginning December 2014, all licensed physicians (unless practicing in a registered pain clinic or board certified in pain management, anesthesiology, PMR, neurology or rheumatology) will need to complete 2 hours of CME related to controlled substance prescribing in the two calendar years preceding their renewal year. (For example, if your license renews in 2015, the CME must be completed between 1/1/2013 and 12/31/2014.) This CME must include instruction in the Dept. of Health’s treatment guidelines. The TMA, SVMIC and others offer courses to meet this requirement.

The Board also works closely with Dr. Mitch Mutter, Director of Special Projects for the Dept. of Health. He is overseeing the efforts of the State to reduce inappropriate prescribing of controlled substances.

Tennessee is number 2 in the nation for prescribing opioids and Knox County was one of the highest of the metropolitan cities. Even though we realize this will be a marathon, not a sprint, there has already been a 25% decrease in morphine equivalents prescribed in Knox County compared with last year. Yet, despite this decrease, we are still above the state average. Also, Knox County claimed the highest number of registered pain clinics in the state with 39 last year. This year, we are down to 33 through non-renewal or not being approved. He credits much of this to the work of the Knox County Prescription Drug Task Force which is led by the Knoxville Academy of Medicine and the Metropolitan Drug Commission. The multi-disciplinary team which makes up the task force includes state, city and county officials, members of law enforcement and several physician members of the KAM including President Pat O’Brien, MD. Fortunately, our Board is served by a very well qualified and hard working staff. Our previous long-serving executive director, Rosemarie Otto (her signature is on many of your renewal licenses), was recently promoted to Director of Health Related Boards. Replacing her is Knoxville’s Maegan Martin, JD who has done an outstanding job considering the volume of responsibilities of the position. She has recently resumed the publication of the BME newsletter which can be found on our website https://health.state.tn.us/boards/Me/ This plus a lot of other useful information can be found there; I encourage you to check this out.

KAM Past President, Dr. Richard Briggs, has won the District 7 State Senate Race. CONGRATULATIONS! Briggs made a statement on his Facebook page…

“Thank you District 7. I am overwhelmed and humbled by your support. There is only one promise I will make, I will not let you down!”

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HOLIDAY SPECIAL

KAM KNOXVILLE ACADEMY OF MEDICINE

You work hard! Your life runs at 100mph most days and the Holidays just kick it up a notch. Adding some stretches to your daily routine can strengthen muscles and joints, release stress and tension, boost mood and energy levels, ease pain and stiffness, improve work performance, promote good circulation, reduce neck pain and headaches and add a sparkle to your holiday spirit.

Take a a few minutes, take a deep breath and stretch to find your inner Namaste. OM...

1) Breathe

Focusing on your breath is relaxing and restorative. Take a minute or two, close your eyes and focus on your breath. Inhale through your nose and exhale through your mouth. Repeat 10 times, for a set. Do three sets. It’s almost like taking a nap!

2) Shoulder and Neck Stretch

Sit up straight in your chair with both feet on the floor about shoulder-width apart. Place both hands behind your head at the base of your neck and interlock your fingers. Tilt your head toward the floor and press your shoulder blades together. Hold for 10 seconds, release and repeat 3 times.

3) Arm Stretches

Sit up straight in your chair with both feet on the floor about shoulder-width apart. Interlock your fingers and stretch your arms straight out in front of you. Rotate your wrists so your palms face away from your body. Hold this stretch for 10 seconds, then raise your arms over your head, hold for 10 seconds. Repeat three times.

4) Leg Stretches

Sit up straight in your chair with your feet flat on the floor. Raise one leg and straighten it in front of you. Hold for 10 seconds and rotate your ankle to the left and then to the right. Repeat with the other leg. Do 5 repetitions with each leg.

5) Lower Back Stretches

Sit up straight in your chair with your feet flat on the floor. Lean forward and try to grab your ankles with both hands. Feel the stretch in your lower back! Hold for 10 seconds and repeat three times.

Warmest Wishes for a Happy Holiday KNOXVILLE MED CINE | 11

HOLIDAY SPECIAL

TOP 10 Holiday Must DO’s in Knoxville 1. Holidays on Ice - Market Square open-air ice rink!

Open Friday, November 28, 2014 - Sunday, January 4, 2015 Located in Downtown Knoxville at Market Square Rink is open everyday, rain or shine Admission is $10 for adults & $7 for children under 12 .

2. Shadrack’s Christmas Wonderland

November 7, 2014 - January 4, 2015 Tennessee Smokies Baseball Stadium 3540 Line Drive Kodak, TN 37764 Dusk - 10PM* Every Night, Including Holidays!

Cars or Family Vans: $20 The WORLD’S LARGEST drive-through, fully synchronized, LED Christmas light and music show of its kind! Featuring hundreds of thousands of LED lights dynamically synchronized and dancing to the music, this experience is sure to be something you and your family won’t soon forget! www.shadrackchristmas.com

6. “It’s a Wonderful Life”

Tennessee Theatre December 14, 2014 1:00 p.m. & 5:00 p.m. FREE Seating is limited to the theater’s capacity; a ticket is not required Celebrate the Christmas season in the grandeur of the Tennessee Theatre as Home Federal Bank presents classic film “It’s a wonderful Life.” Doors open one hour prior to each screening.

7. East Tennessee Historical Society Holiday Open House December 13, 2014 East Tennessee History Center, 601 S. Gay Street 11:00 a.m. - 3:00 p.m. FREE Bring the family for Christmas Fun! Children and adults will enjoy holiday music, cookies, hot cider, craft demonstrations, storytelling, ornament-making for kids, book signings, and free museum admission. www.eastTNhistory.org 865-215-8824

8. KSO 28th Annual Clayton Holiday Concerts Knoxville Civic Coliseum

December 19 - December 21, 2014 Friday & Saturday: 7:30 p.m.

Saturday & Sunday: 3:00 p.m. $14.00 - $45.00 ($7.50 to $23.00 for children and students) Join Maestro Lucas Richman and the Knoxville Symphony Orchestra for the 28th Annual Clayton Holiday Concerts! There are four chances to hear warm & familiar songs to fill your hearts with cheer. www.knoxvillesymphony.com 865-291-3310

9. Holiday Festival of Lights at The Cove 3. A Christmas Carol - Clarence Brown Theatre

November 26- December 21, 2014 Show times vary Ebenezer Scrooge and the ghosts return in our long-running and most popular production. Join us for music, dancing and Dickens’ timeless tale of love and redemption. clarencebrowntheatre.com 865-974-5161

4. WIVK Christmas Parade

Friday, December 5, 2014 at 7:00 p.m.

Gay Street in Downtown Knoxville

5. Annual Christmas Tours Mabry-Hazen House

December 13 & 14, 2014 1711 Dandridge Ave. Sat: 5:00 p.m. - 8:00 p.m. Sun: 2:00p.m.- 5:00 p.m.

FREE but donations encouraged The Mabry-Hazen House invites you to join us for our Annual Christmas Tours. Rooms and other areas will be decorated by well-known Knoxville decorators. Light refreshments will be served. www.mabryhazen.com 865-522-8661

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The 2014 Holiday Festival of Lights at The Cove at Concord Park will sparkle and entertain each night from 6 to 9 p.m. from Friday, December 19 through Tuesday, December 30, excluding Christmas Day.

10. New Years on the Square

Wednesday, December 31, 2014 • Ice skating on the Holidays on Ice skating rink from 1 p.m. until midnight • Festival foods and face painting available at the ice rink • Music on the Square beginning at 11 p.m., with a big screen showing events from 2014 • Countdown beginning at 11:59 p.m., with a ball drop and fireworks • Join in the singing of “Auld Lang Syne” following the fireworks Sponsored by CBID and 93.1 WNOX

KAM Choosing The Best Holiday Wines By: Thad Cox, Jr. - Ashes Wine and Spirits

Now that the holiday season is upon us, there seems to be no end to the parties, the dinners, and the family gatherings. Sometimes the planning can become too overwhelming. That’s where I can help you make party planning a cinch by following a few simple guidelines below.

When planning your party you need to ask yourself the following questions: First, How many drinking-age guests do you plan on inviting? Second, what day of the week is the party and how long will it last? Third, the menu – is it a sit-down affair or the more popular casual cocktail and buffet? Fourth, how many bar stations do you plan on having? And finally, do you plan on serving liquor, wine and beer?

A word about measurements. Basically, a case of wine, whether it is in the .750ml size or the 1.5 liter size, contains roughly 60-65 glasses (based on a 4oz. pour). With a 1.75 liter bottle of liquor, based on a 2 oz. pour, there are 28-30 pours to the bottle (a case of six bottles would equal 180 drinks). And, with beer, they come twenty-four bottles to a case. Now let’s plan out a holiday party.

For example, if you are having a party for fifty guests on a Saturday night from 7pm ‘til 10pm, with a mix of age groups from the mid-twenties all the way to the seventies, here is an ideal plan. Start with the liquor. Because we are into the Holidays, con-

KNOXVILLE ACADEMY OF MEDICINE

sider more brown goods spirits. For this party, I would recommend two bottles of bourbon, one bottle of scotch, two to three vodkas, one small bottle of a Canadian blend, one small gin, one small rum and a small bottle of dry vermouth. If you are planning to serve after-dinner drinks, then consider having a bottle of Kahlua, Baileys, and Grand Marnier.

When it comes to the wine, picking out the right wine depends on whether you are having a sit-down meal with a specific menu, or a cocktail buffet with several different items. Either way, with fifty guests, figure that most guests will have between two to three glasses. To be safe, I would recommend four cases of wine, with roughly 50% white and 50% red.

Beer drinkers are typically brand-loyal, so sometimes the hardest part of providing beer is picking out the right brands. Usually, I will recommend two types of a light beer and one regular type. And finally, when it comes to set-ups, you will want to make sure that you provide water, ice, tonic and soda, colas and any other items that might relate to the theme of your party.

Again, the key to your party is knowing your guests. If these are people that you have entertained before, then you might be able to adjust the above estimates accordingly. But, if you don’t know your guests’ drinking habits, then it is better to be safe by buying a little bit more than you might think you need. And, as always, remember to be responsible as the host of the party. Make sure that all of your guests have not had too much to drink, and if so, call them a cab. During this festive time of year, it can be easy to celebrate too much.

Pumpkin Spice Muffins

Candy Christmas Trees

1 box Spice cake mix (do not follow the directions on the box) 2 eggs 1 can pumpkin 1 bag Hershey’s Cinnamon chips 2 cupcake pans - greased or lined with paper baking cups

For each tree 2 Miniature Reeses Peanut Butter Cups 1 Regular Reeses Peanut Butter Cup 1 Hershey Kiss Icing to decorate and stick candy together

Submitted by Lorraine Johnson

The perfect something for everyone on your gift list - a full vehicle detail from the experts at Mercedes-Benz of Knoxville, at a price that’s nice.

Customizable gift cards are available online at mercedesofknoxville.snapcerts.com or pick up at Mercedes-Benz of Knoxville, conveniently located on Parkside Drive in Knoxville. Thinking a little larger? Come in today for our Winter Event. Take advantage of exceptional lease and financing rates on select new models before season's end.

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Combine all ingredients and mix well.

Pour mixture into cupcake pans and bake according to the directions on the box for baking cupcakes.

Layer 1 miniature Reeses Peanut Butter Cup, icing, Regular Reeses Peanut Butter Cup, icing, 1 miniature Reeses Peanut Butter Cup, icing then top with 1 Hershey Kiss. Decorate as you want.

KNOXVILLE MED CINE | 13

HOLIDAY SPECIAL Stress-Busting Holiday Shortcuts Have a stash for the unexpected! Purchase a case of wine or champagne and some pre-tied stylish red bows. Put a bow and gift tag on each bottle and keep them on-hand for holiday hostess gifts and the oops, I forgot gifts. You’ll have 12 dependable, classy presents.

Accessories are everything! Promised to bring the perfect dessert to your friend’s Christmas dinner party?

Pick up some peppermint ice cream, candy canes and Ghiradelli Chocolate Squares and poof! You have a holiday dessert to rival Martha Stewart. Or, simply add some mini candy cane decoration or crunched up peppermint to the top of any store-baked item to turn it into a tasty, playful and seasonally appropriate dessert.

Plan for the leftovers! Perhaps you’ve put on a magnificent holiday party with far too much food or you just want to get a head start on your New Year’s resolution to lose weight need the leftovers GONE. Be prepared with extra plastic food containers so that at meal’s end, you’ll be able to quickly pack away leftovers for your guests to bring home.

The Gift that Keeps on Giving! Organize and share photos over email. Picasa makes it simple to touch up your photos both online and off and integrates well with popular Google products.

It's all in the Bag! If you are a wrapping nightmare with uneven edges and crumpled paper, just simplify things by investing in holiday bags or beautiful boxes Dress the bag up with a bow and pretty tissue. Voila!

A Gift is Like A Conversation It is the holidays and many of us are scrambling around trying to choose the perfect gift for a friend or relative. What do they want?

What do they need? What can we buy? We can spend hours in shops asking ourselves these questions. To quote, the Grinch... "Christmas (or insert any holiday or gift-giving occasion), perhaps, is a little bit more?"

If you boil it down, in our culture, giftgiving as an exchange of physical objects. I, however, prefer to think of it as a conversation with someone. The easiest way to find the perfect gift is to keep in mind that it should "say something" to the receiver.

Some gifts communicate intimacy and thoughtless ones can communicate distance.

Some say, "I love your creativity" or "You are beautiful" or "I appreciate you" or "Please take better care of yourself-" What the perfect gift is rarely attached to is the price tag! Some of the gifts that I have appreciated the most have been practically free for the giver to

arrange for me, but have said so much. As a young parent, I was given a pampered day of freedom from my regular responsibilities and sent to play. This gift said to me "I appreciate you and you do so much to make our lives easier."

If you harness this thinking, when you choose gifts, then you can quickly move towards the perfect gift. Ask yourself first, “What do I want to say to this person?” Then move on to “What can I give them that will communicate this?”. This is opposite to the more common “What can I buy them?” and then “What will they think of it?”.

The gifts that we come up with when we think of gifts as communication may be the same that we would think of in other ways.

The difference may simply be that we arrive at a decision faster and with more certainty that our gift is right for that person.

Try a new perspective on for size...and enjoy the gift-giving conversation. Happy Holidays!

FIVE GOLDEN RINGS to add to your holiday party playlist • • • • •

Jingle Bell Rock - Bobby Helms White Christmas - The Drifters Wonderful Christmas Time - Paul McCartney Here Comes Santa Claus - Elvis Presley What Are You Doing Christmas Eve - Ella Fitzgerald

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this Holiday Season From our family to yours Your neighborhood imaging provider 865.525.7100

601 Hall of Fame Drive • Knoxville, TN

Ashe's Wines & Spirits 4534 Old Kingston Pike Knoxville, Tennessee 37919 2013 & 2014 Voted Best Wine Store Favorite Liquor Store

Wines & Spirits: Ashe's has the finest selection of wines and spirits in East Tennessee. Ashe's proprietor, Thad Cox, Jr., has traveled around the globe seeking out the finest values to bring back to Knoxville.

Premium Cigars: Over 30 varieties including Montecristo, A. Fuentes, Padron, Macanudo. Rocky Patel, Ashton & Cohiba..

You're sure to find something delicious to pair with a fine Scotch or Bourbon!

High-Gravity Beers: Ashe’s carries an impressive collection of speciality beers for every ocassion.

For the Perfect Holiday Gift, Event & Season, Trust Ashe’s

ACADEMY NEWS Talk Turkey for the Coming Holidays!!

By: Gregory Phelps, MD

In the summer edition of Knoxville Medicine, I introduced the East Tennessee Quality Alliance/Knoxville Academy of Medicine Foundation’s work on Conversation Ready.

Conversation Ready as a health care quality improvement initiative grew out of Pulitzer Prize winner Ellen Goodman’s effort called the Conversation project. (www.theconversationproject.org) The Institute of Healthcare Improvement’s (IHI) nine month quality improvement project forced us to be data sensitive. Again and again we had to survey and assess for quick cycles of improvement.

Our data showed multiple improvements and while some were not statistically significant (due to small numbers in the re-survey) we were able to show a substantial improvement in the hospital discussion about “WHAT MATTERS” at end of life. Our little band also did over 45 presentations to professionals, church groups and general public about advanced care planning.

We also facilitated two training seminars for staff on how to “Have the Conversation about WHAT MATTERS,” not just ‘get the form signed.’

(More of these seminars to come.)

As we worked on our surveys of various groups including professionals, we’d always include a question to the effect, “Have YOU expressed what matters, have YOU done an advance directive?” To our surprise, usually only half of professional groups including doctors and nurses had done so.

There has been a surge of interest in advance directives and how we want to live the final stages of our life. There has been a shift in the national dialog. Three recent books have come out. The first is cartoonist Roz Chast’s depiction, in cartoon narrative of

KAM KNOXVILLE ACADEMY OF MEDICINE

her efforts to engage her elderly parents.

Titled Can’t We Talk About Something More Pleasant? (The title coming from her parent’s first response to trying to have the talk).

In the last month or so the Institute of Medicine has released Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. (Book is available for free download.)

Finally Dr. Atul Gawande has also released a book: Being MortalMedicine and What Matters in the End. There are now a variety of forums to discuss what matters.

There are Death Cafes where people gather to discuss end of life care. Death over Dinner another social affair. Another opportunity is April 16th- National Advance Care Directives Day. (Get it Taxes and Death?) Talk Turkey is an effort to use family gatherings to discuss what we see as a life worth living.

Remember, it is not the piece of paper, it is the discussion, thought and communication that goes into completing the form. An advance directive is a gift you give your family to spare them the agony of trying to decide what kind of care you would want in your final days. As a hospice doctor I have seen families tear themselves apart over “What would dad want?” (Up to and including fist fights) You do not need a notary or lawyer for these forms which are available at www.endoflifecaretn.org. (The Tennessee End of Life Partnership website) The Conversation Project has starter kits for free on their website. They include preparation and scripting and spots for thought and reflection about certain questions. So with the holidays coming and family coming home it is time to Talk Turkey! Remember it is always too early until it is too late.

KNOXVILLE MED CINE | 17

“WORKING WITH SVMIC HAS BEEN AN EXTREMELY POSITIVE EXPERIENCE.” — Dr. Olawale Morafa Family Practitioner Health First Family Care PC Memphis, TN Policyholder Since 2002 “With SVMIC, I am constantly reassured of having the best liability insurance coverage available. Over the years, I have also saved money with SVMIC because it is mutually owned.

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LEGAL NEWS

KAM KNOXVILLE ACADEMY OF MEDICINE

Tele-What?!

Recent Telehealth Legislation in Tennessee and Its Impact on Your Practice By: T. Mitchell Panter, London & Amburn, P.C. In response to a national trend toward electronically mediated health care, the Tennessee General Assembly recently enacted legislation that seeks to level the playing field between the traditional brick and-mortar medical practice and its cyber cousin known as “telehealth.” Although many practitioners are already familiar with the term, the new statute specifically defines “telehealth” as: the use of real-time, interactive audio, video telecommunications or electronic technology or store-and-forward telemedicine services by a healthcare services provider to deliver healthcare services to a patient within the scope of practice of the healthcare services provider when: (i) such provider is at a qualified site other than the site where the patient is located; and (ii) the patient is at a qualified site or a school clinic staffed by a healthcare services provider and equipped to engage in the telecommunications described in this section.

Telehealth is hardly new. Radiologists and pathologists, for example, have used the telehealth model for years, successfully expanding their practices to rural areas where the demand is high and competition is virtually non-existent. Aside from these diagnostic specialties, though, CMS and private health insurance entities alike have been generally reluctant to reimburse other telehealth providers for their services. With the great number of advances in video technology (and active lobbying efforts by the American Telemedicine Association and rural health care providers), attitudes toward telehealth have improved in recent years, prompting parity legislation by a number of state legislatures.

Based on Tennessee’s new statute, health insurers will be re-

quired to provide coverage for telehealth services “in a manner that is consistent with what the [insurer] provides for in person encounters for the same service.” Similarly, telehealth providers will now be reimbursed at rates that are substantially similar to those received for in¬ person services. The law makes clear, however, that the telehealth provider does not have a right under the statute to obtain reimbursement “in an amount that exceeds the amount that would be paid for the same service provided by a healthcare services provider in an in-person encounter.”

With these more accepting reimbursement standards in mind, a wider range of medical specialists may be encouraged to develop a telehealth component to their own practice. As always, though, new practice methods bring new legal challenges, and telehealth is no different. Perhaps most obviously, telehealth raises a number of HIPAA concerns that may not arise in the ordinary course of your medical practice. In the more common store-and-forward encounter, for example, the patient presents at a “qualified site” for testing or evaluation. At the conclusion of the tests, the diagnostic images and other protected health information is forwarded to the offsite medical provider for analysis. As the number of electronic transfers increase, so does the likelihood of a HIPAA breach. Similarly, telehealth providers must be familiar with the licensing standards applicable in the state in which they are performing the telehealth service. In Tennessee, the Board of Medical Examiners has created special licensure requirements for “telemedicine.” Failure to obtain this special license may result in criminal prosecution for practicing medicine without a license. With these considerations in mind, it is important that you and your practice group consult with an attorney in the state in which you plan to expand your telehealth practice.

Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.

KAM Blog Did you know that the Knoxville Academy of Medicine has a blog? We know that you are busy, so we make it our business to gather the need-toknow information for you! Posts range from trending hot topics to timely must-knows to event reminders and recaps and even kudos. We strive to be your one-stop resource!

Check KnoxvilleMedicine.org regularly for the latest. Blog posts are shared on social media as well so follow us on Facebook and Twitter too!

KNOXVILLE MED CINE | 19

TECHNOLOGY NEWS etHIN Update

By: Leigh Sterling, Executive Director Radiology images are now available to the local healthcare community through etHIN. Currently, seven Covenant Health hospitals (Fort Loudoun Medical Center, Fort Sanders Regional Medical Center, LeConte Medical Center, Methodist Medical Center of Oak Ridge, Morristown-Hamblen Healthcare System, Parkwest Medical Center, and Roane Medical Center), the University of Tennessee Medical Center, and East Tennessee Children’s Hospital are providing images through Image Gateway. Blount Memorial Hospital images are expected to be available within the next few weeks, and several imaging centers in the area have also expressed interest in providing images to the etHIN community through Image Gateway.

Accessing images for your patients is as simple as logging into etHIN’s Virtual Health Record (VHR) physicians’ portal or having a connection to etHIN through an interface to your EMR. Image Gateway offers users PACS-like manipulation tools and a real-time collaboration feature, which allows multiple clinicians to collaborate

on the same imaging exam from wherever they are.

In addition to the successful launch of image exchange, the patient information available through etHIN continues to grow. etHIN has received more than 54 million pieces of clinical data related to almost 1.2 million patients. With this volume of clinical data, there is a significant likelihood that information for some of your patients is accessible through etHIN. etHIN has also recently noted increased usage of Direct secure messaging, especially in the home health arena. Numerous home health agencies in the etHIN Region are using Direct as a method of exchanging referrals and patient data. In addition to streamlining workflows and reducing time spent faxing patient information, using Direct also allows these entities to achieve another objective within their Meaningful Use goals. etHIN is available to assist you and your practice in implementing technology that can enhance your workflows as well as supporting your Meaningful Use efforts. You can find more information at www.ethin.org, or call us at 865-691-8433.

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KAMA UPDATE Fashiondrama 2014 – Southern Vogue Knoxville Academy of Medicine Alliance (KAMA) hosted Fashiondrama 2014, Southern Vogue, on October 14 at Cherokee Country Club. This marked the 61st anniversary of the event, adding to an impressive history of fundraising and dedication to the KAMA mission of improving the health care environment in our community. Each spring, KAMA Philanthropic awards the proceeds of the event in the form of nursing scholarships and grants to local healthcare organizations. I would like to sincerely thank all the KAMA members and community partners who helped support Fashiondrama this year through their attendance and donations. Thanks to the efforts of the Fashiondrama committee, we surpassed last year’s event in dollars raised through Fashion Sponsors, Corporate Sponsors, Table Vendors, Patron Fund and ticket sales! We had an attendance of approximately 268 guests who braved the rain for a healthy dose of our “Southern Vogue” hospitality!

“A Little MORE Conversation” KAMA partnered with KAM to hold a fundraiser, “A Little MORE Conversation,” for the Conversation Ready initiative. The event, a 60’s-themed British invasion band party, was held on November 7 at NV, and featured local band The Beat Club and an Elvis impersonator. Conversation Ready is an effort to raise awareness about endof-life planning so that health care providers are prepared to receive patient’s wishes about end-of-life care. KAM would like to promote

Fashiondrama Southern Vogue

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this initiative in the Knoxville area. “The Conversation Project is a public campaign with a simple and transformative goal: to have every person’s end-of-life wishes expressed and respected….As people express their wishes, it’s critical that health care systems have the people and processes to hear and respect what’s being said. IHI calls this being “conversation ready.” (Institute for Healthcare Improvement.)

KAMA Membership Drive November 1 marked the beginning of the KAMA Membership Renewal Drive. KAMA membership renewals should be submitted between November 1 and January 31 in order for current members to maintain memberships for the upcoming year. To help with the editing and production of the KAMA Yearbook, we need every member to fill out a renewal form each year. Membership forms will be included in the KAMA newsletter beginning in November and can be printed at home. If you would like to renew your membership – or join KAMA – and do not have access to the newsletter, please contact Cynthia Gash at cynthiagash@gmail.com. All checks should be made payable to KAMA and sent to Swannee Sexton, c/o KAMA, PO Box 10551, Knoxville, TN 37939. You may also bring your renewal form and check to any KAMA meeting. Also, check out the KAMA monthly updates at knoxvillemedicine.org Cynthia Gash KAMA President 2014-2015

“A Little MORE Conversation”

“A Little MORE Conversation”

Groovy group!! Dr. Reeves Johnson, Barbara Crist, Cynthia Gash, Lorraine Johnson, and Jenny Bushkell

Elvis And The Hound Dogs

Friday, April 24, 2015 6:30 pm Knoxville Marriott

KAPA's Boot Scootin' Ball is quickly becoming one of Knoxville's most talked about charity events. The evening will be packed with great country music provided by CHARLIE DANIELS BAND, line dancing, signature drinks, a stick to your bones mouth-watering western-themed dinner, and a variety of beers in your own bottomless mason jar. A large silent auction will complete this special event with all of the proceeds to benefit Knoxville Area Project Access (KAPA). The Boot Scootin' Ball is a highend event that requires casual attire--what could be better than that?

For more info & tickets visit kapabootscootin.com or call (865) 531-2766

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