Volum e L X X II, N o . 2 • S u m m er 2 0 1 5
Se r ving the Gr e ate r M e tr opolitan Knoxvi l l e Area
KAPA’S BOOT SCOOTIN’ BALL FEATURING THE CHARLIE DANIELS BAND
KAM KNOXVILLE ACADEMY OF MEDICINE
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Academy Officers
PRESIDENT’S MESSAGE By: Thomas Pollard, MD
Thomas Pollard, MD PRESIDENT
Neil Coleman, MD PRESIDENT ELECT
Ceeccy Yang, MD SECRETARY
Jack Benhayon, MD TREASURER
Pat O’Brien, MD
IMMEDIATE PAST PRESIDENT
Kimberly Weaver, PhD CEO
Board of Trustees David Harris, MD Ed McBride, MD Clifton Tennison, MD Tim Wilson, MD
Ex- Officio Board Members Randal Dabbs, MD Richard Briggs, MD Richard DePersio, MD John W. Lacey, III, MD Robert Page, MD Cynthia Gash - KAMA Rep.
Publisher Kim Weaver, PhD
Production Coordinator Danielle Sims
Design Jonathan Weaver
New Ad Contact David Caudill
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 referred to in collateral advertising. The KAM reserves the right to accept or reject any advertising in the publication.
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Allow me to thank you for your support of the Knoxville Academy of Medicine. As medical professionals, we all have to make tough decisions regarding membership in the various local, state, and national associations, as well as, specialty societies available to us. I realize that the financial obligation that this incurs is significant. It befalls the leadership of our organization, therefore, to insure that membership in the KAM and TMA provides true value in return. Through your commitment, we have already seen this year significant progress at the state level in that serious threats to payment reform, tort reform, and professional status have been turned back in the Legislature. While locally, Knoxville Area Project Access is just one of many successful KAM programs that has improved access to quality medical care in our community. That being said, one area that we have given much attention recently is social events. One of our continuing goals at the Academy is unifying our local medical community. I have had the opportunity in the first few months of my term as your President to visit with some of the older (Okay, maybe “seasoned” is a better word!) members of our Academy about this issue. Many have expressed that they miss the regular social meetings of the Academy. In my short tenure here in Knoxville, I have to agree. Several factors have contributed over the years to challenge the social function of the Academy. As more and more physicians have become employed by the health systems in our community (myself included), it seems that we have all been put on “separate teams”. The unintended consequence is that we often view one another as competitors rather than as members of a common medical community. In addition, the move toward hospitalists in several disciplines has made it less common for primary care physicians and specialists to visit on a regular basis. Finally, physician shortages, technical challenges (I thought that computers were supposed to make our lives easier!), and the stressful business side of our practices have all contributed to less time available for Academy social functions. Rest assured, your Academy is working hard to strengthen our social bonds. Doc Rock and the KAPA Boot Scootin’ Ball are two recent, charitable events that enjoyed tremendous success in both attendance and financial return. Our Summer Welcome Picnic, scheduled for August 14th, is a great event for families and gives us the opportunity to welcome new
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KNOXVILLE ACADEMY OF MEDICINE members to the Academy and to the Alliance. Additionally, we are adding many new social events for 2015. Mark your calendars now for the KAM Family Day with the Smokies on July 26th. This is open to all KAM and KAMA members along with their family. We have a private area complete with a BBQ buffet and excellent seats to watch the Tennessee Smokies vs. Chattanooga Lookouts. KAM and KAMA members receive discounted tickets thanks to our sponsor, Southeast Bank! In August, we will be participating, hopefully with several teams, in the United Way’s “It’s Dodgeball, Y’all!” tournament on August 15. We also have a tailgate party scheduled at Circle Park for the UT vs. Georgia Game. In October, we will be taking a bus to Keeneland for the horse races. I have also been kicking around the idea of an Academy poker league (profits to benefit the Foundation) and an inter-hospital softball tournament to encourage more interaction between our different medical groups while satisfying our need for friendly competition! I welcome your feedback and ideas. For a full list of scheduled events, check out our website at knoxvillemedicine.org. Once again, I appreciate your commitment to our Academy. Over 80% of Knoxville area practicebased physicians belong to the Knoxville Academy of Medicine, a greater percentage than any other metro area in Tennessee! Please join me in recruiting the nonmembers you may work with as we strive to bring greater value to your membership.
Tommy Summer Welcome Picnic Welcoming New Members and Their Families Delicious BBQ Swimming for the Kids Lots of Fun Friday, August 14, 2015 5:00 - 9:00 PM Gettysvue Country Club Lower Pool Presented by: KAM & KAM Alliance Sponsored by: Capital Financial & Tennessee Medical Association
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ACADEMY NEWS
KAM KNOXVILLE ACADEMY OF MEDICINE
Tennessee Doctors Tackle Big Issues at TMA Annual Convention Education and Policies Focus on Public Health, End of Life Care, Payment Reforms On April 9-12, 2015, approximately 300 of the state’s leading physicians, medical practice managers and other healthcare professionals met in Nashville last weekend for MedTenn15, a medical convention sponsored by the Tennessee Medical Association. The event was held at the Opryland Resort & Convention Center and featured exclusive medical education, professional networking and social events. Delegates from Knoxville Academy of Medicine, Roane-Anderson County Medical Society and Blount County Medical Society were on hand to represent our physicians in this region. Physicians serving on the House discussed a number of policies affecting the practice of medicine in Tennessee, and patient health. Among the notable resolutions: • Build a statewide and national consensus regarding the future physician shortage crisis and ensure that an adequate supply of physicians will be available for the next generation. • Improve the state’s Controlled Substance Monitoring Database report so that each prescription reported includes the name of the midlevel prescriber as well as the midlevel prescriber’s supervising physician.
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Develop a state-specific database for drug shortages, and develop strategies to mitigate drug shortages, working with the Tennessee Department of Health, Tennessee Pharmacy Association, Tennessee Hospital Association and other pertinent stakeholders. • Pursue legislation to oversee the implementation of the Tennessee Health Care Innovation Initiative and allow physicians and other relevant parties the opportunity to address relevant issues to the General Assembly. • Use results from a membership survey on Maintenance of Certification (MOC) to improve the process for Tennessee physicians. In addition to the House of Delegates sessions, attendees could take advantage of earning many hours of CME. One of the most popular CME sessions was a panel discussion featuring KAM’s own “Conversation Ready” project in which KAM Members, Elise Denneny, MD and Greg Phelps, MD presented program successes. Nominations for delegates are accepted in the fall. If you are interested in serving as a delegate for Region 7, contact Kim Weaver at kweaver@knoxvillemedicine.org.
TMA Recognizes Knoxville Physician and Legislator Each year in conjunction with the TMA Annual Conference, special recognition is given to individuals who have contributed to the advancement of the medical profession and community wellness. The KAM Board of Trustees nominated two individuals for the awards this year and are pleased to announce the KAM member Michael D. Brunson, MD and Representative Bill Dunn were chosen among this year’s recipients.
Distinguished Service Award Michael D. Brunson, MD has practiced pulmonary and internal medicine with Summit Medical Group since 2001. He is a respected leader among his peers, staff and administrators for his continued voice in representing the interests of employed physicians, and for helping the hospital achieve necessary benchmarks without loss of the quality of care delivered, and without placing undue burdens on physicians. His involvement in this critical process has led to many new and successful procedures to be implemented, such as Supportive Care Team, Admission, Discharge and Transfer procedures with improving patient care.
Community Service Award Representative Bill Dunn has worked tirelessly to address the prescription drug epidemic in his community and throughout the state. Almost two years ago, Rep. Dunn proposed the idea of a Drug Task Force to be spearheaded by the Knoxville Academy of Medicine along with the Metropolitan Drug Commission to reduce the prescription drug epidemic in East Tennessee. The task force is comprised of physicians, medical professionals, law enforcement, and the TN Department of Health. Several pieces of successful legislation can already be attributed to the work of this group. Rep. Dunn’s commitment will ultimately help curb the tide of narcotic drug abuse.
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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. MICHAEL ADLER, MD
JAMES M. LEWIS, MD, FACS
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RYAN L. DABBS, MD
CARLO MARTINEZ TORRES, MD
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LARRY M. FIELDS, MD
VICTOR SALTER, MD
RADIOLOGY Vista Radiology 2001 Laurel Ave Ste 304 Knoxville, TN 37916
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KNOXVILLE ACADEMY OF MEDICINE No Picture Available
ORTHOPAEDIC SURGERY Tennessee Orthopaedic Clinics 9430 Park West Blvd Ste 130 Knoxville, TN 37923
OBSTETRICS & GYNECOLOGY 10810 Parkside Dr. Ste 306 Knoxville, TN 37934 ________________________________________________
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HEATHER GAGE, MBBCH
KRISTEN SHEETS, MD, FAAP
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DEANN HOLBROOK, MD
IGOR SMELYANSKY, MD
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LEWIS HOLMES III, MD
RICHARD THIGPEN, MD
PATHOLOGY UT Graduate School of Medicine 1924 Alcoa Hwy Knoxville, TN 37920
PEDIATRICS Children’s Pediatric Group 2018 Clinch Ave Knoxville, TN 37916
Center Column Top to Bottom: Lewis Holmes III, MD; Becky L. Jackson, MD; James M. Lewis, MD, FACS; Carlo Martinez Torres, MD; Victor Salter, MD Right Column Top to Bottom: Kristen Sheets, MD; Igor Smelyansky, MD; Richard Thigpen, MD
CARDIOTHORACIC SURGERY East Tennessee Cardiovascular Surgery Group 988 Oak Ridge Tpke Ste 380 Oak Ridge, TN 37830
PULMONARY DISEASES Statcare Pulmonary Consultants 2240 Sutherland Ave Ste 103 Knoxville, TN 37919
Fields Center for Women’s Health & Robotic Surgery
Left Column Top to Bottom: Michael Adler, MD; Ryan L. Dabbs, MD; Larry M. Fields, MD; Heather Gage, MD; Deann Holbrook, MD
SURGICAL ONCOLOGY University Surgical Oncology 1926 Alcoa Hwy Ste F330 Knoxville, TN 37920
NEPHROLOGY Renal Medical Associates PC 939 Emerald Ave Ste 610 Knoxville, TN 37917
PEDIATRICS Children’s Pediatric Group 2018 Clinch Ave Knoxville, TN 37916
NEUROLOGY Omega Pain Management 9217 Park West Blvd Ste E1 Knoxville, TN 37923
OBSTETRICS & GYNECOLOGY Women’s Care Group 1932 Alcoa Hwy #150 Knoxville, TN 37920
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BECKY L. JACKSON, MD INTERNAL MEDICINE UT Internal Medicine 9625 Kroger Park Dr Ste 400 Knoxville, TN 37922
Congratulations to Dr. Debbie Christiansen for being appointed to the Tennessee Board of Medical Examiners!
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KAM BME Update
By: Reeves Johnson, MD KAM Member, Board of Medical Examiners I am very excited to announce our newest member of the Tennessee Board of Medical Examiners, KAM’s own Deborah Christiansen, MD. At our meeting in March, a 4-member nominating committee was formed to seek out potential candidates following the requirements set forth in state law. Dr. Christiansen was recommended not only due to her excellent clinical abilities and experience, but also due to her extensive roles in leadership including serving as President of KAM, Chief of Staff of ETCH and East Tennessee Chapter President of the Tennessee Academy of Pediatrics. In May, the full Board unanimously voted for the committee’s recommendation. One year from our original Rulemaking hearing last May, the BME was able to complete the proposed rule regarding Telemedicine. In April of this year, the state legislature passed Public Chapter 261 which deals with Telemedicine. Because state law supersedes a rule, we adapted our proposed Telemedicine rule to conform to the new state law. Since this law does not allow our Board to establish a more restrictive standard of care for telemedicine than what is already in place, we removed the proposed restriction on prescribing controlled substances via Telemedicine. However, the new law prohibits using Telemedicine by pain management clinics and for the treatment of chronic nonmalignant pain. The proposed telemedicine rule is in the process of being sub-
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mitted to the Attorney General and once approved, will be filed with the Secretary of State and posted online at: http://tnsos.org/rules/PendingRules.php/ Fees for applying for or renewing your medical license have not changed since 2002. Because of increased expenses especially related to the BME’s share of the cost of maintaining the CSMD, a rule making hearing is being considered to increase the application fee from $400 to $500 and the biennial renewal fee from $225 to $275. In addition, license verification which has been provided free, but requires some time and effort, will cost $25. With the passage of Public Chapter 26 which deletes the Intractable Pain Act, the BME will be scheduling a rulemaking hearing to delete the aspects of the medical practice rules that pertained to this Act. The recently approved Chronic Pain Guidelines and other related laws and rules are now in place. Starting in January 2016, the BME will be required to establish and maintain an online registry for med spas which will include its name and address, information on the medical director/supervising physician and certification. This also applies to private physician’s offices if they provide cosmetic services. There were several other bills passed into law relating to medicine, especially involving pain clinics and abortion. Go to http://www.tnmed. org/, sign in and search 2015 Legislative Issues or the BME‘s legislative update at http://health.state.tn.us/boards/Me/legislative.htm/
SGR: Repealed at Last In April 2015, an important victory was achieved for our Medicare patients. SGR has finally been repealed after years of advocacy on Capitol Hill! Congress passed the bipartisan Medicare and CHIP Reauthorization Act, which will repeal the "Sustainable Growth Rate" SGR payment formula that drastically cut reimbursements to physicians and ultimately threatened patients' access to care. In addition to addressing Medicare payment, the legislation outlines several provisions that should be beneficial for physicians, including: • Medicare's current quality reporting programs will be streamlined and simplified into one merit-based incentive payment system, referred to as "MIPS." This consolidation will reduce the aggregate level of financial penalties physicians otherwise could have faced. • Protections are included so that medical liability cases cannot use Medicare quality program standards and measures as a standard or duty of care.
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Incentive payments will be available for physicians who participate in alternative payment models and meet certain thresholds. • Technical support will be provided to help smaller practices participate in alternative payment models or the new fee-for-service incentive program. While the bill supports physicians who choose to adopt new payment and delivery models, it also retains Medicare's fee-for-service model. Participation in new models is entirely voluntary. For more information regarding this important milestone, visit AMA Medwire at: http://www. ama-assn.org/ama/pub/ama-wire/ama-wire/post/medicare-payment-formula-bites-dust
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ACADEMY NEWS KAPA’s Boot Scootin’ Ball April 24, 2015
THANK YOU! Diamond Sponsors • Covenant Health • Tennova Healthcare • UT Medical Center • SouthEast Bank Media Sponsors • Bandit Lites • WBIR • MerleFM Gold Sponsors • Alphagraphics • Ole Smoky Tennessee Moonshine • Visions Private Investigation Silver Sponsors • Capital Financial Group • Colonial Life • Home Federal Bank • PerfectServe 8
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The Charlie Daniels’ Band a Hit at the KAPA Boot Scootin’ Ball On April 24, 2015, The Charlie Daniels Band performed for an excited crowd as part the KAPA’s Boot Scootin’ Ball. The annual event is hosted by the Knoxville Academy of Medicine Foundation and all proceeds benefit Knoxville Area Project Access, also known as KAPA. Over $100,000 was raised that evening. Attendees dined on a southwestern dinner buffet, bottomless beverages in souvenir mugs, and even were treated to moonshine tastings compliments of Ole Smoky Tennessee Moonshine. A silent auction boasting of more than 75 different packages gave many the opportunity of obtaining that special item and supporting the mission of KAPA. The highlight of the evening was a private concert by The Charlie Daniels’ Band followed by line dancing. An unforgettable evening was definitely had by all! KAPA is a program developed by the Knoxville Academy of Medicine Foundation to create access to healthcare for East Tennessee residents. Low-income individuals without health coverage through either an employer-sponsored or government health plan can receive a full continuum of care through KAPA. Since the program’s inception in March 2006, KAPA has assisted more than 20,000 Knox County residents and coordinated more than $150 million in donated health care. Currently, 1,300 physicians, health care professionals and all area hospitals are part of the KAPA network. Major event sponsors include: The University of Tennessee Medical Center, Covenant Health Systems, Tennova Healthcare, SouthEast Bank, Bandit Lites, and the Knoxville Academy of Medicine.
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A BIG Thank You to the Sponsors of KAPA’s Boot Scootin’ Ball! CLINCH AVENUE & CROSS PARK DRIVE Ronald L. Rimer, M.D. William F. Terry, M.D. Philip B. Stanley, D.O. Karen V. Freeman, M.D. Kurt F. Brandt, M.D. Dennis R. Solomon, M.D. Barbara J. Summers, M.D. Kathleen S. Holloway, M.D. Scott W. Brice, M.D. Ashley F. Gilmer, M.D. Kimberly Kim, M.D.
KPA
WEISGARBER ROAD & GRIGSBY CHAPEL ROAD
Knoxville Pediatric Associates, P.C.
Donald E. Larmee, M.D.
SPRINGBROOK CENTER IN ALCOA Timothy W. Thurston, M.D. Tommy E. Collins, M.D. Sarah E. Gilley, M.D. Robert W. Booher, M.D. Michael S. Reiss, M.D. Heather K. Cash, M.D. Jane E. Holt, D.O.
Cameron T. Blevins, M.D.
www.knoxpediatrics.com
Wayne D. Fogle, M.D. Gregory L. Swabe, M.D. Deanna R. Yen, M.D. Lisa B. Padgett, M.D. Susan B. Roberts, M.D. Lisa M. Herron, M.D. J. Jeff Lin, M.D. Susan C. Scott, M.D. John W. Wilkinson, M.D. Lauren N. Speckner, M.D. B. Paul Jones, M.D.
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STAY CONNECTED It’s Not Your Father’s United Way Campaign By: John W. Lacey, III, MD
I am honored to have been asked to co-chair, along with WBIR’s Robin Wilhoit, the 2015 United Way Campaign, an organization that many of you, my colleagues, have faithfully supported throughout the years. Additionally, I am pleased to have Drs. Bob Overholt, Lynn Massingale, and Bedford Waters join me this in this endeavor as part of the Healthcare Cabinet for 2015. Together we will be organizing a KAM Physicians Campaign for United Way. The GREATER KNOXVILLE UNITED WAY (GKUW) has served this community for 93 years! United Way programs cover everything from the Jaws of Life, to mentoring children with parents who are in prison, to helping the developmentally disabled find the dignity that comes with obtaining and keeping a job. It is amazing to think that in 2015, 1 out of every 5 people in our area will be aided in some way by a United Way agency. It’s a hand-up, not a hand-out. More than 50 different agencies with 102 different programs partner with United Way. In fact, in 2007, our own Knoxville Area Project Access (KAPA) was awarded the largest single grant that United Way had ever presented prior to that time. Now it’s our opportunity to give back by supporting the United Way through our own KAM Physicians’ Campaign. To-kick off our physicians’ campaign, renowned Knoxville cartoonist, Charlie Daniel, has drawn a special cartoon just for physicians (pictured above). For each KAM member who donates at least $500, we will send you a copy of this print suitable for framing. Each year, hundreds of volunteers participate with United Way to raise funds and to ensure that sponsored programs have the greatest effect on our
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community. All money allocations are discussed and agreed upon by local volunteers (over 140 in 2015). We’ve dubbed the 2015 campaign as “It’s Not Your Father’s United Way Campaign.” First, generous donors are covering United Way campaign overhead costs. This means that 99% of all dollars donated by physicians will go directly to United Way partner non-profit agency programs. Second, each potential GKUW sponsored program is thoroughly vetted by volunteers. If selected to receive one of the competitive 3 year grants, outcomes metrics are reviewed regularly to monitor progress toward program goals. Finally, the 2015 campaign is about bringing all demographics of our community together to give back by giving forward …and having fun while we do it! Beginning in mid-August we will commence with a series of events that will culminate with a one hour televised program on all the local networks highlighting United Way partner agencies, including our own KAPA. This year there is also a United Way Faith Cabinet that will organize a day of prayer and service for our community. One new event that is sure to be fun is the GKUW Dodge Ball Invitational Tournament, “It’s Dodge Ball, Y’all!” The tournament is to be held at the Knoxville Coliseum on August 15th. I would like to challenge my fellow KAM members to form several teams to compete and represent the Knoxville Academy of Medicine on that day. Play-by-play action will be announced by Bob Kesling and Bert Bertelkamp. It promises to be a great day and I hope to see you there! Information regarding opportunities to participate in the KAM Physicians Campaign for United Way will be sent to the membership soon. In the interim, please visit the KAM website at knoxvillemedicine.org to donate or sign up for a dodge ball team.
KAM Family Fun Day With the Smokies Sunday, July 26, 2015 4:30 pm - 9:00 pm
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Adult admission - $10 Children (12 and under) - $5 • • •
One ticket good for access to Calhoun’s at the Yard Pavilion located just beyond the left field fence! An all-you-can-eat buffet provided by Calhoun’s served 30 minutes before first pitch Smokie cap included Sponsored By: SouthEast Bank
TECHNOLOGY NEWS Community Patient Portal By: Leigh Sterling etHIN Executive Director
At the request of the etHIN community, etHIN is currently walking through the analysis and vetting of a Community Patient Portal product. We invited members of our community to participate in this process in order to understand the specific needs of the local healthcare community, including hospitals, primary care, and specialties in the workgroup. The workgroup has been a good setting for a community discussion about what is needed in a patient portal, and a small group of vendors will soon be selected to provide product demonstrations, based on the criteria developed by the group. An HIE-based patient portal provides many benefits for both patients and providers, including streamlining and simplifying use for patients by providing them one portal to use versus many. For providers, two significant benefits of a community patient portal are lowering costs and increasing Meaningful Use patient engagement numbers through common use of a single portal. Under Meaningful Use guidelines, Eligible Professionals, Eligible
“Taming the Dragon”-A piece on the electronic notes at UT Medical Center
By: Niva Misra-Sammons, MD PGY2 (2nd Post-graduate Year) IM Resident UT Graduate School of Medicine, Dept. of Medicine The future of medicine has brought us a versatile EMR. A new method of note-writing comes with this. The physicians and other clinicians of UT Medical Center are embarking on a new journey of writing all notes electronically. The new form of notes took over the physician’s day and somewhat took away from patient care. The conveniences of the note include vital signs and labs being downloaded easily into the note. The inconveniences include inputting radiologic findings on your own, with no quick-type way to place them. Then, there’s the “Dragon”-a technologically savvy Dictaphone using voice-recognition software that must be tamed with your voice. It is trained in the initial class to understand your personal dialect, and providers can take more time to “train” it to understand terms that are not instinctly in its dictionary. The Dragon is quite good at recognizing antibiotic names and physical exam findings. I’m really not sure why it has bad days and cannot understand the word “patient”, and replaces it with “Asian” or “she has”. Other days, it functions just fine. After daily practice and adequate support from computer staff, clinicians seem to be settling in. Conversation has been in bloom around the hospital. There is the excited resident, who inspires everyone that
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Hospitals, and Critical Access Hospitals can count patient view, download, and transmit interactions within the Patient Portal, even if the patient is looking at information submitted by another provider. CMS specifically states, “the respective eligible professional, eligible hospital, or CAH must have contributed at least some of the information identified in the Stage 2 final rule to the shared portal or online PHR for the patient. However, the respective provider need not have contributed the particular information that was viewed, downloaded, or transmitted by the patient.” This could be especially important for hospitals and specialists who likely do not have long-term relationships with most of their patients and may find it difficult to reach the proposed 50% engagement goal proposed for Stage 3 of Meaningful Use. etHIN expects to be testing a Community Patient Portal proof of concept during the fourth quarter of this year. If you are interested in participating in the Patient Portal Workgroup or the proof of concept pilot, please contact Sharon Woods at swoods@ ethin.org or 865-691-8433.
he is certain it will make note-writing faster. There is also the young attending physician, previously trained in EMR, and full of energy to make guiding templates for his department. The older physician is more skeptical as he has quickly written his notes in the same manner for many years and now must adjust to the usage of a new software to prepare these notes. Everyone has agreed the workflow would change. Note writing in the EMR brings good things to patient care. We can read each other’s notes quickly and from anywhere in the hospital. There is no question as to what was done when a patient was last admitted to the hospital with one EMR. Certain attendings have made templates for the residents to use for procedures and daily notes which has made the process easier. As a young physician, I miss the organized fashion of the written H&P. First, accounting for the history and exam, noting an abnormal lab, then recording this connection as a potential assessment, and lastly creating a potential diagnosis and plan from noting this. However, I am trying for a positive spin on the change in my routine. Taking a few handwritten notes prior to typing, which include my history and then a bulleted assessment, is slowly triggering my neurons to fire in a similar fashion to before. I have also found bolding the labs helps me to create my assessment better. Everyone has the same goal: to improve patient care through effective communication. Each clinician is making an effort and will find a way to make these notes work. In order to do so, everyone must learn to “tame their own dragon”. Special Thanks to Dr. Ronald Lands for his literary proofreading and guidance.
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KAMA CORNER By: Lorraine Johnson I am excited to be President of KAMA (Knoxville Academy of Medicine Alliance) this year and would like to introduce the Slate of Officers who will be serving with me in 2015-2016. President-Elect – Barbara Crist (Mrs. Jeffrey) Recording Secretary – Tina Callicutt (Mrs. Scott) Treasurer – Swannee Sexton (Mrs. David) Assistant Treasurer – Tamra Brown (Mrs. Jeffrey) 1st Vice Presidents – Judy Akers (Mrs. Don) and Kirstin Kropilak (Mrs. Michael) 2nd Vice President – Michele Maves (Mrs. Barry) Historian – Sandy Ange (Mrs. David) Corresponding Secretary – Poonam Harsh (Mrs. Anil)
them again next year. Mark you calendars to attend the SECOND ANNUAL SUMMER WELCOME PICNIC to be held Friday, August 14th (with a rain date – Friday, August 21st) at the lower pool area of Gettysvue Country Club. This event is co-hosted by KAMA and KAM. The picnic is for young physicians and their families in addition to physician families who are new to town. However, if you know of someone who has been here awhile and would like to introduce them to KAMA and KAM, please contact Andrea Southard at asouthard@knoxdocs.org or 865-531-2766. KAM will be sending out the invitations with more details later this summer. Hope you can attend; it was a BIG success last year! Lorraine Johnson KAMA President
The installation took place at Cherokee Country Club and Paula Kelley (Mrs. Joseph) did an outstanding job with the program! The most emotional part of that event was when my awesome husband Reeves walked into the room! His appearance was a total surprise for me and I was thrilled to have him there making that day even more special for me! We also invited our past presidents to attend the luncheon which was new for us this year. Those who attended had a wonderful time and I enjoyed their words of wisdom and support. We look forward to inviting
Lose the limitations.
edge. Keep your
We have an opening for a Full Time Family Practice Physician to work as the medical lead at our new employer health center located in Maryville, TN!
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LEGAL NEWS New Law Aimed at Improving Credentialing Process For Physicians and Patients By: Erin B. Williams, London & Amburn. P.C.
Upon hiring a new provider, a medical practice group must begin the arduous process of having the new provider credentialed with its existing health insurance entities. Under current law, waiting for the new provider to become credentialed can be financially burdensome for a medical group, as the new provider cannot bill a patient’s health insurance entity for services rendered prior to becoming credentialed. Moreover, a patient seen by a new provider before he or she is credentialed risks paying higher “out-of-network” charges or being billed for additional costs. The Tennessee General Assembly recently passed legislation, effective January 1, 2016, which establishes a framework for new providers in a medical practice to become credentialed with a private health insurance entity while still seeing patients. The law requires a health insurance entity to provide any medical group with whom they have an existing contract “a list of all information and supporting documentation required for a credentialing application of a new provider applicant to be considered complete.” After an application is submitted by a new provider, the health insurance entity will have five business days to notify the applicant in writing as to whether the application is complete. If the application is incomplete, the written notice must list the missing information or documentation necessary to complete the application. If a provider submits the requested additional documentation, the health insurance entity will again have five business days to notify the provider
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as to whether the application is complete or, if not, a list of all information that is still missing. After the application is complete, the health insurance entity must notify the new provider whether or not the application is approved within 90 days. During the pendency of the application, the medical practice group cannot submit any claims for services performed by the new provider applicant. Any claims submitted during this time period may be properly denied for payment by the health insurance entity. After a new provider is notified that his or her application has been approved, the group may submit all claims held for the 90-day waiting period, and the health insurance entity must pay them at the contracted, in-network rate. Accordingly, the law allows new providers in a group to see privately insured patients before they are fully credentialed, and submit claims for services rendered during the 90 day period between the time the provider is notified that the application is complete and the provider becomes fully credentialed. However, if the new provider is denied credentials, the health insurance entity is not obligated to reimburse the practice group for the services rendered by the new provider. Moreover, the new law prohibits medical groups from collecting any amount from the patient for services if the new provider’s application is denied. Attorney Erin B. Williams focuses her practice on health law, including compliance and regulatory matters. For more information on any health law matters, you may contact Ms. Williams at (865) 6370203 or visit www.londonamburn.com. Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.
In Memorium Clark E. Julius, MD - KAM Past President Clark E. Julius, M.D., born in Harlan, Iowa on May 2, 1939, passed away on June 8, 2015. Graduating from Irwin High School, IA, he completed his undergraduate training at Mankato State University in Minnesota and earned his medical degree from the University of Iowa. Dr. Julius completed internship at the University of Tennessee Memorial Research Center and Hospital in Knoxville. He served as a medical officer in the United States Navy at the U.S. Naval Hospital, Memphis and in Vietnam as a Battalion Surgeon and Chief of Pediatric Hospital for Vietnamese Children, from 1966-1968. He completed his dermatology training at the University of Arkansas and in 1971 returned to Knoxville and founded the Knoxville Dermatology Group. In 1975, Dr. Julius co-founded the Tennessee Dermatological Society. He served as chief of staff for the University of Tennessee Medical Center, president of the Knoxville Academy of Medicine in 1993 and later Chairman of the Board of the Tennessee Medical Association. He served as a full professor of medicine at the University of Tennessee College of Graduate Medical Education.
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What They Don’t Tell You In CPR Class By: Andrew Randazzo, NRP Director of Prime Medical Training
The thought of recertifying in CPR is less than exciting for most healthcare providers. It seems like they teach the same mundane things every two years, and if that has been your experience, that is unfortunate. Nationally, the survival rate of sudden cardiac arrest (SCA) is only 6%. However, in King County, Washington, the survival rate is over 50%. This disparity speaks to the fact that we do not know CPR as well as we think we do. The goal of this article is to introduce some new topics that you probably have never heard in your previous classes. Compressions Save Lives, Not Breaths At this point now, you should be aware that the sequence for CPR is compressions, airway, and breathing. There are several reasons why the American Heart Association has placed such a great emphasis on compressions. First, a victim of SCA already has oxygenated blood in their body, and all we have to do is circulate that with compressions. Therefore, it negates the need of having to start CPR with breaths. Second of all, high quality compressions with limited interruptions are vital because they increase perfusion pressures. Without adequate pressure, we are not able to perfuse the oxygen and carbon dioxide at the capillary level. Without compressions, a person’s blood pressure will fall to zero in 10 seconds and will take 30 seconds to regain the necessary pressure for perfusion. That is why it is critical to do a full two minutes of CPR with only 2-3 seconds of pauses for breaths and/or defibrillation analysis.
Extended pauses in compressions is without a doubt the most significant reason we fail to revitalize victims of SCA. The Pitfalls of Ventilation Ventilations are a critical skill, but when performed incorrectly, they do more harm than good. We all know that when we give ventilations, we are suppose to perform the head-tilt-chin-lift so that air goes into the trachea instead of the esophagus. However, second to high quality compressions, the next most important aspect healthcare providers need to be focusing on is NOT hyperventilating their patients. Because of the adrenaline rushing through our body, there is a natural inclination to hyperventilate which causes three significant problems. First, hyperventilation will exceed the lung capacity and cause air to overflow into the stomach which leads to gastric distention, vomiting and ultimately aspiration. This is almost always fatal for our patients. Second, hyperventilation increases thoracic pressure which squeezes against the inferior venae cavae and reduces return of blood to the heart. Third, hyperventilation also increases intracranial pressure. This results in neurological damage. So, even if we achieve return of spontaneous circulation, the patient may sustain minor to severe neurological deficit. I hope this article encourages you to not write off your next CPR class, but rather, to take vested interest and ask questions because statistics tell us that there is an 88% chance that the life you try to save will probably be someone you love. Andrew Randazzo, NRP, Director of Prime Medical Training: 865-2889011 ext. 100 / andrew@primemedicaltraining.com
Calendar of Events Tuesday, June 30
Summer Young Physicians’ Mixer Please join KAM as we welcome the New UT Residents Complimentary Drinks, Appetizers, and Great Door Prizes! 5:30 pm - 7:30 pm Five Bar Sponsored By: Capital Financial Group
Wednesday, July 22
ICD-10 Coding Camps by Specialty Knoxville Marriott For more info visit knoxvillemedicine.org
Sunday, July 26
KAM Family Fun Day with the Smokies 4:30 pm - 9:00 pm Adult admission - $10/Children (12 and under) - $5 All-you-can-eat BBQ Buffet, premium seats and a souvenir cap are included! Sponsored By: SouthEast Bank
Friday, August 14
KAM/KAMA Summer Welcome Picnic Welcoming New Members and Their Families Delicious BBQ, Swimming for the Kids..Great Fun! 5:00 - 9:00 PM - Gettysvue Country Club Lower Pool Sponsored by: Capital Financial & TMA
Saturday, August 15
“It’s Dodgeball, Y’all!” Tournament to benefit United Way. For more details or to sign up for a team, visit knoxvillemedicine.org
Thursday, October 8
Fall OSHA Seminars for Practice Staffs - Knoxville Marriott
Saturday, October 10
Young Physician Tailgate Party UT vs. Georgia
Thursday, November 11 Legislative Dinner
For more information on all events vist knoxvillemedicine.org or call (865) 531-2766
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FACILITIES FOR SALE CLASS A MEDICAL FACILITIES
Keith Williams
PRIME MEDICAL PROPERTY
4233 Hwy 411 Madisonville, TN 37354
PROPERTY FOR SALE, LEASE OR BUILD TO SUIT
Exceptional medical facility with entrance from Hwy 411 and Niles Ferry Rd. High traffic flow as a daily avg. of over 17k vehicles pass this facility. Property consists of multiple reception areas, admin. space, other physician and staff offices, counseling offices, 32 exam rooms, x-ray room, lab area, emergency treatment area, break room & 74 parking spaces with other parking nearby. Second floor consists of storage, mechanical and IT/Server room. Ideal satellite location to feed hospitals in Knoxville, Maryville, Athens or Cleveland, TN. 16,921 SF, 1.56 AC, $2,100,000 list price. Also for lease.
118 E Meeting St Dandridge, TN 37725
Former medical building. Freestanding Class A facility. Excellent condition. Reception area, multiple office and exam rooms. 118 E Meeting St, Dandridge, TN 37725 downtown historic area. 6,495 SF, 1.4 AC, $950,000 list price. Also for lease.
805 W Madison Ave Athens, TN 37303 Vacant land parcel next to Walgreens in Athens, TN in the Central Business District area. Site Ready. Other medical nearby. 1.24 AC. Owner will sell, lease or build-to-suit.
Keith Williams
FOR MORE DETAILS CONTACT: Keith Williams, 865-556-7549 Keith00Williams@bellsouth.net 14
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Direct Fax
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Main Cell
865-690-1111 865-556-7549
124 N Winston Rd Knoxville, TN 37919
Š2015 Coldwell Banker Real Estate LLC, dba Coldwell Banker Commercial Affiliates. All Rights Reserved. Coldwell Banker Real Estate LLC, dba Coldwell Banker Commercial Affiliates fully supports the principles of the Equal Opportunity Act. Each Office is Independently Owned and Operated. Coldwell Banker Commercial and the Coldwell Banker Commercial Logo are registered service marks owned by Coldwell Banker Real Estate LLC, dba Coldwell Banker Commercial Affiliates.
Protection Is Power SVMIC Protects the Most Tennessee Doctors
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57,000 Hours of free consulting services provided by SVMIC to our policyholders and their practices in 2014 alone. Our services cover everything from risk evaluation and education to practice management, governance, billing, strategy, and other business issues.
100% Of SVMIC is owned by our physician policyholders. Our structure as a mutual company ensures that your interests are our interests.
SVMIC is the exclusively endorsed professional liability carrier of
300,000+ Hours of continuing education SVMIC has provided to policyholders and their staff over the last decade. High quality, relevant risk management education is the best way to keep patients safe and prevent malpractice litigation.
Mutual Interests. Mutually Insured. Contact Deborah Hudson at mkt@svmic.com or call 800.342.2239.
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