Round up september 2014 by Maricopa County Medical Society (MCMS)

The Mission of the Maricopa County Medical Society is to promote excellence in the quality of care and the health of the community, and to represent and serve its members by acting as a strong, collective physician voice.

round-up Volume 60 • Number 9 • September 2014

Providing news and information for the medical community since 1955.

THE MEMBERSHIP ISSUE: PRESIDENT’S PAGE: Dr. Miriam Anand is usually skeptical of conspiracy theories, but, as she follows changes in medicine she is starting to believe in one of her own. Could it be that there is a plot to do away with physician power and autonomy? As she writes her monthly editorials, she is becoming more convinced that this may indeed be the case. Page 8. MEMBER PROFILE: What happens when a son who is also a physician struggles to understand the details of his father’s doctor visits from nearly two thousand miles away? He takes that experience, reflects on how he delivers care to his own patients, and creates a Medical Memory. Page 16. PUBLIC HEALTH: Introducing the Maricopa County Medical Society’s Honor Roll program. The first of its kind in Arizona, the Honor Roll program is designed to engage and educate ALL physicians and clinicians about relevant public health matters that may affect their patients and the community. Page 26.

Also featured in this issue: Executive Director Op Ed ...............................12 MCMS and Public Health ................................25 Honor Roll Update ..........................................30 The Art of Practicing Medicine .......................34 Membership Roster ........................................36 MCMS FREE Patient Referral Line...................52

Medical Student Perspective ..........................56 Practice Management .....................................59 Viewpoint .......................................................65 In every issue: Letters to the Editor..........................................................7 In Memoriam ......................................................................54 Marketplace .......................................................................66

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WHAT ARE THE RESPONSIBILITIES OF A MEDICAL PROVIDER? Effective Communication is essential to provide safe, quality healthcare, and impacts assessment, treatment, and diagnosis. Ineffective Communication causes misdiagnosis, medication errors, and inappropriate treatment. Title III of the Americans with Disabilities Act prohibits discrimination against individuals with disabilities by places of public accommodation. Title III of the ADA applies to all private and public healthcare providers regardless of the size of the office or the number of employees. Healthcare providers have a duty to provide effective communication - using auxiliary aids and services to ensure effective communication with people who have a hearing loss. Learn more about improving the quality of services to the Deaf and Hard of Hearing by contacting ACDHH: Voice: (602) 542-3323 Video Phone: (480) 559-9441 Voice/TTY: (800) 352-8161 (In State Only) www.acdhh.org info@acdhh.az.gov

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round-up Round-up Staff

MCMS 2014 Officers

Editor Jay Conyers, PhD

President-Elect Ryan Stratford, MD

Editor-in-Chief Miriam K. Anand, MD

Advertising and Production Candice Scheibel Advertising

To obtain information on advertising in Round-up, contact MCMS.

phone: 602-252-2015 advertising@mcmsonline.com Postmaster

Send address changes to: Round-up, 326 E. Coronado Rd., Phoenix, AZ 85004 mcmsonline.com

facebook.com/MedicalSociety twitter.com/MedicalSociety

President Miriam K. Anand, MD

Vice President Elizabeth McConnell, MD

Secretary Suzanne A. Sisley, MD Treasurer Mark R. Wallace, MD

Immediate Past-President Daniel Lieberman, MD Board of Censors

Nathan Laufer, MD, Chair Daniel Lieberman, MD

Michael R. Mills, MD, MPH Ryan Stratford, MD

Thomas E. McCauley, MD James R. Meador, Jr., MD Anthony T. Yeung, MD

linkedin/MaricopaCountyMedical Society

Board of Directors

Periodicals postage paid at Phoenix, Arizona.

Jennifer Hartmark-Hill, MD

Volume 60, No. 9, September 2014.

Round-up (USPS 020-150) is published 12 times per year by the Maricopa County Medical Society, 326 E. Coronado, Phoenix, AZ 85004. To subscribe to Round-up Magazine please send a check for one-year subscription of $36 to Round-up Magazine, 326 E. Coronado Rd., Phoenix, AZ 85004 or visit mcmsonline.com/subscribe.

2012-2014

Tanja Gunsberger, DO Kelly Hsu, MD

Susan Whitely, MD 2013-2015

Adam M. Brodsky, MD John L. Couvaras, MD

Steven R. Kassman, MD

Robert J. Standerfer, MD 2014-2016

Lee Ann Kelley, MD Richard Manch, MD May Mohty, MD

Anita Murcko, MD 6 • Round-up • September 2014 • A monthly publication of the MCMS

september 2014 Round-up is a publication of the Maricopa County Medical Society (MCMS). Submissions, including advertisements, are welcome for review and approval by our editorial staff at roundup@mcmsonline.com. All solicited and unsolicited written materials and photos submitted to Round-up will be treated as unconditionally and irrevocably assigned to and the property of MCMS and may be used at MCMS’ sole discretion for publication and copyright purposes and use in any publication, website or brochure. MCMS accepts no responsibility for the loss of or damage to material submitted, including photographs or artwork. Submissions will not be returned.

The opinions expressed in Round-up are those of the individual authors and not necessarily of MCMS. Round-up reserves the right to refuse certain submissions and advertising and is not liable for the authors’ or advertisers’ claims and/or errors. Round-up considers its sources reliable and verifies as much data as possible, but is not responsible for inaccuracies or content. Readers rely on this information at their own risk and are advised to seek independent legal, financial or other independent advice regarding the content of any submission. No part of this magazine may be reproduced or transmitted in any form or by any means without written permission by the publisher. All rights are reserved.

letters to the editor

Brian R. Updegraff, MD MCMS member since 1979, President 2004 Board Certified, American Board of Dermatology

Dear Editor:

Ten years have passed since the physicians in Arizona united through their state and county organizations to rally for meaningful medical liability reform. The unity and resolve demonstrated that day resulted in very meaningful changes as discussed by Dr. Anand in her [Round-up, August 2014] editorial. Malpractice filing declined from 2005 to 2006 by 27.6% in Maricopa County, 39% in Pima County and 55% in Yavapai County. An excellent review of the reasons was published in the February 2007 issue of Arizona Attorney magazine. It was written by litigation attorney Kay M. Cooper and predicted that the effects would be long-lasting, which they have proven to be.

Attorney Cooper cites the Affidavit of Merit and Expert Qualification statues as very important. However she emphasizes that the most widely discussed reason for the decline in cases is juror’s bias against plaintiffs. This was visibly impacted by tort reform publicity and it’s claimed connection with doctors leaving the practice and healthcare costs and malpractice insurance premium rising.

Today all of us involved in the delivery of good medical care face even more serious threats to that goal. The rally has shown us how effective we can be when we stand together for a cause. Our combined voices can be heard far and wide. We do really need to support our local Society. Bryan R. Updegraff, MD

Connect with your Society. Letters and electronic correspondence will become the property of Round-up, which assumes permission to publish and edit as necessary. Please refer to page 5 for our usage statement. Editor: Miriam Anand, MD manand@mcmsonline.com

Managing Editor: Jay Conyers, PhD, jconyers@mcmsonline.com

Fax: 602-256-2749 Write: Round-up, 326 E. Coronado Rd., Ste. 101, Phoenix, AZ 85004

Click: www.mcmsonline.com/contact A monthly publication of the MCMS • September 2014 • Round-up • 7

president’s page

My Conspiracy Theory Miriam K. Anand, MD

here are some very interesting conspiracy theories out there. Did you know, for instance, that some believe that there is a “reptilian elite” comprised of alien reptiles that take human shape and get into powerful government positions to control us? That one is certainly more bizarre than some of the more mundane examples, such as those surrounding the Kennedy assassination or whether Elvis is really dead. I’m usually skeptical of conspiracy theories, but, as I follow changes in medicine, I find that I am starting to believe in one of my own. Could it be that there is a plot to do away with physician power and autonomy? As I have been writing my editorials over the past few months, I am becoming more convinced that this may indeed be the case.

For example, in January I described the changes in medicine over the decades and how the physician-patient relationship has been eroded by multiple outside influences. In that article, I stated, “physicians today are allowed to exercise their medical judgment, as long as it fits within the confines of medicines on formulary, indications approved by the insurance companies, or regulations of the institution in which the physician is working.” I also stated that “in all of this change, there is one constant and that is that others not directly involved in patient care are the ones pulling the strings and calling the shots. It is the legislators, both on the state and federal level, insurance companies, administrators and others who set the tone for how we practice medicine, while we are busy trying to treat our patients (and, for some of us, run our practices).” In June I showed how physicians in private practice have more autonomy than employed physicians, although even that is limited and the cards seem to be stacked against those physicians who want to stay in private practice.

As I pointed out in April, “The hoops to get paid for our services get higher and harder to jump through, while costs of increased staff and services to keep up with the bureaucracy continue to increase. One does not need an MBA to know that decreased revenue and increased costs do not make up the recipe for success….Given the ‘headaches’ of running a practice, it’s understandable why physicians would either want to retire early, work for someone else, go into concierge medicine, or choose alternatives to practicing medicine altogether.” Could these efforts to drive physicians out of private practice be part of a plot to weaken our autonomy?

8 • Round-up • September 2014 • A monthly publication of the MCMS

president’s page The majority of physicians coming out of training are choosing not to open their own practice. Instead they work for health systems, Accountable Care Organizations (ACOs), or are employed through some other model. The result? The amount of employed physicians far outweigh those who are self-employed. Since I wrote my June editorial on employment, new statistics have shown that hospital employed primary care physicians have doubled from 10% in 2012 to 20% in 2014, so the trend towards more employed physicians continues. This is not surprising since most employed physicians do not have to be concerned with the added challenges of running a practice. However, as I said in April, “it is as if they [employed physicians] have an extra cushion of protection between them and the effects of changing laws and regulations. This cushion may give a false sense of security. While it may seem that there is a bullseye on the back of the private practitioner, the reality is that our entire profession is affected and this cushion can cause some to be lulled into thinking that they are somehow protected.” Could it be that by driving more physicians toward employment, the powers that be are hop-

ing to quiet the physician voices that might otherwise object to their plans?

Employed or not, many of us likely find ourselves spending quite a bit of time on what feels like useless busywork, such as meeting Meaningful Use requirements, insurance appeals and prior authorizations for non-formulary medications, to name a few. Despite these extra bothersome tasks, we must still keep up with our patient load. Could these be examples of efforts to keep us so busy that we lack the energy and motivation to stand together and fight against the loss of physician autonomy and power? Or could these be efforts to drive us to believe that we would be better off with a single payer system, the ultimate loss of physician power and autonomy?

Many of us belong to our specialty societies because they provide us with information and services that are relevant to our particular areas of practice. In past decades membership in organizations such as the Maricopa County Medical Society (MCMS) was much higher than it is now. One factor that likely plays a role in decreased membership

When you want the very best for your patients and families.

EASY WAYS TO REFER PATIENTS TO HOSPICE OF THE VALLEY

1. Call 602.530.6920 2. Fax 602.636.6305

3. Online: hov.org/refer-patient 4. Email intake@hov.org 5. Mobile app

Download our app to any iPhone, iPad or Android device. Search iTunes or Google Play for “Hospice of the Valley.”

Hospice of the Valley has on-duty staff available 24/7. A monthly publication of the MCMS • September 2014 • Round-up • 9

president’s page “...I hope that the power that external sources exert over medicine will finally spur us to come together and act as a group in the best interest of our patients and our profession. I am pleased to be part of an organization that has served this mission for over 120 years, and I urge you to either continue your membership, or join now and to encourage your colleagues to join.” Miriam Anand, MD

is that we have so many societies and organizations to choose to belong to that the dues start to add up quickly. And now that the majority of physicians are employed they may choose not to join organizations like ours if their employer doesn’t pay their dues. The problem is that our specialty societies are mostly concerned with fighting for the interests of our specialties, but what about fighting for physicians as a whole? Could we be hurting ourselves by relying on our specialty societies to speak with divided voices rather than supporting organizations like MCMS that act on behalf of all the physicians in our county? In February I wrote, “I know that many lost faith in organized medicine due to the AMA’s support of the ACA [Affordable Care Act] and, unfortunately, this may have trickled down to organizations such as MCMS. These types of issues, however, provide evidence now more than ever that physicians need to stand together for the benefit of our patients.” After all, the ultimate losers as the physician’s voice becomes weaker and less heard are our patients. Unfortunately, we physicians must take some blame for being complicit in allowing these changes to happen by not standing together and fighting against them. If there is indeed a plot against us, we are making the opposition’s job easy. I’ve mentioned that many of us complain to our friends, colleagues, and families about the current state of medicine. A large number also turn social media sites or sites such as Sermo, KevinMD.com or similar blogs, etc. to express our frustrations. While this may be very cathartic, it doesn’t change or affect what is happening. In January I asked, “When you interviewed for medical school and were asked why you wanted to go, did you

answer that you wanted to spend 11 plus years of your life getting an education only to have others tell you how to practice medicine?” If the answer is yes and you are not a member, then do nothing. Your dreams have been realized and your inaction will help keep this the status quo. If, as I suspect (and certainly hope) for the vast majority of you, the answer is no, then you have answered the question of why you need to participate in organized medicine. Simply by being a member and doing nothing else, you help give MCMS the power of increased membership numbers to be used when negotiating on behalf of the physician community with various entities. This allows physicians to unite and helps MCMS fulfill part of its mission of acting as a strong collective physician voice.

Last month I illustrated how actions of the MCMS and the Arizona Medical Association (ArMA) over the past decade have resulted in lower medical liability insurance premiums in Arizona. As physicians, we have a lot on our plate and may not be able to follow each and every one of the efforts that our local societies are involved in. Our local organizations are often addressing and assessing issues that potentially threaten physician autonomy and power and, ultimately, patient care. We are the voice for all physicians at a local level. We are here to speak for you and to support you, but our voice is only as strong as our membership. Without membership, we lose our power and without organizations like ours, to whom will you turn when further efforts to take away our power and autonomy are made?

I would like to believe that my conspiracy theory is unfounded, but whether or not there is truly a conspiracy to take away physician power and autonomy, it is happening. I hope that the power that external sources exert over medicine will finally spur us to come together and act as a group in the best interest of our patients and our profession. I am pleased to be part of an organization that has served this mission for over 120 years, and I urge you to either continue your membership or join now and to encourage all of your colleagues to join. ru Dr. Miriam Anand is an Allergy and Immuology specialist practicing in Tempe. She is the Maricopa County Medical Society’s 120th President, and has been a MCMS member since 1998. Contact her by email to manand@mcmsonline.com.

10 • Round-up • September 2014 • A monthly publication of the MCMS

from the excutive director

Is bigger better?

Jay Conyers, PhD

verything’s bigger in Texas, or so the saying goes. Even organized medicine. During a recent visit to Houston I spent some time with the staff of the Harris County Medical Society (HCMS), which is the largest county medical society in the nation. The membership is over 11,000 – roughly 70% of all practicing physicians in and around Houston.

So how do we stack up? Unfortunately, not so well. Although Harris and Maricopa counties are, respectively, the third and fourth most populous counties in the U.S. (close to 4 million residents live in each county), only about 20% of practicing physicians in our county are members of the Maricopa County Medical Society. That’s a far cry from the 70% that Harris County boasts. From the best I can tell, using data pulled from each state’s medical board, Harris County has roughly 2,000 more licensed physicians than we do here. For those of you who know Houston, it’s not surprising that they have more physicians than we do, especially when you consider that the world’s largest medical center is planted smack dab in the middle of the city, and lays claim to more than 7.2 million patient visits per year. All of this in roughly 2 square miles of concrete.

However, it’s not just Houston. It’s also Dallas, San Antonio and Austin. They all have membership numbers far in excess of what we have here. Compare the state numbers and you’ll see the same thing, not only in quantity but also in the percentage of practicing physicians that participate in organized medicine. They do medicine, especially organized medicine, very well in Texas. Like I said, everything’s bigger in the Lone Star State. So what’s the big difference between us, and can we do the same thing here?

The answer to the first question is a bit complex and is, I believe, largely rooted in how physicians are covered for medical liability. In 1979, the Texas legislature established the Texas Medical Liability Trust (TMLT) as a mechanism for providing coverage to physician members of the Texas Medical Association (TMA). The legislature went so far as to mandate that any policyholder must first be a member of TMA before they can purchase a policy through the trust. With TMLT as the largest medical liability provider in the state of Texas, it makes sense that membership numbers are so strong there. But it’s not just that. These medical societies strive to offer their member physicians an impressive entrée of services, ranging from legislative and regulatory advocacy to education to practice resources. They personalize membership for as many members as they can. They engage the employed physicians at the hospitals and organize roundtable discussions for the chiefs of staff to discuss emerging topics impacting care.

Obviously, we don’t have the same scenario here with how physicians are covered, but it doesn’t mean that we can’t achieve the same level of physician participation in our great state. We have the numbers, we just don’t have the participation. How do we get there? It starts with us. We at the Society have to offer you more. We have to show more value in membership. We have to monetize your return on investment (ROI) and demonstrate that membership truly does pay. We have to know what you expect to get in return for the price of membership.

I’ve spoken with many of you and asked you what it is you want and need. Many of you have responded with great suggestions. I’ve learned that what we currently offer is not necessarily what you want. Or need.

12 • Round-up • September 2014 • A monthly publication of the MCMS

from the executive director We’re determined to rebuild the Maricopa County Medical Society, which has long been a pillar in the medical community. We’re committed to offering services that you want and need and spend time trying to find each day. We have many things in the pipeline for 2015 and beyond.

In January 2015 we will be rolling out our Preferred Partner Program, which will replace the existing Preferred Vendors listing included each month in Round-up. We went to all existing business partners and asked them what they wanted in a partnership. Not surprisingly, it was access to you. They want to do business with you. They want to help you succeed.

To build this program, we first asked you what types of businesses you wanted the Society to make more accessible to you. You want business partnerships that help you run your practice, care for your patients, plan for retirement, and protect your family. You also want business partnerships that take care of those times when you’re not caring for patients, so we’re going out and negotiating discounts at retail businesses as well.

Your time is limited. We want to make your lives easier. We want to help you narrow ten or twenty or more potential vendors down to one or two or three based on the discounts and/or service offerings negotiated – on your behalf – by the Society. Why pay full price somewhere when you can get a considerable discount somewhere else by simply being a member of the Maricopa County Medical Society?

Business partners already signed up in our Preferred Partner Program include Arizona Central Credit Union, MICA, STAT Transcription, Gabriel & Ashworth, Global Financial Services, and Premier Southwest Planning Group. If you do business with these folks already, please thank them for supporting the Society.

But this is just the beginning, as we are talking with hundreds of local businesses to bring you the best discounts and services. Some are even programs that bring together multiple businesses to offer you a single service. So what else are we hoping to bring you through this Program?

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A monthly publication of the MCMS • September 2014 • Round-up • 13

from the excutive director What if we could help you plan for retirement and offer you a multiple employer plan (MEP) that will free you of the administrative burdens and fiduciary responsibilities of managing your own plan, while giving you more purchasing power through a pooling of resources? What if you could save money on your merchant card transactions and secure free business checking? Or what if you could lock in a commercial real estate loan with zero origination fees?

This is what we’re working on, and it’s what we hope to bring you in 2015, if not sooner.

What if you could buy or lease a car through the Society, and never have to step foot on a sales lot or speak to a salesman? What if you could secure special financing because of your membership in the Society, and get a guarantee on pricing? What if the car could be brought directly to your home or office, along with the paper work?

What if we could help you have fun at a better price? Discounts on golf at local courses and country clubs? Price breaks on dining at the area’s finest restaurants? Better (and cheaper) tickets to the Suns, Cardinals, Diamondbacks, Mercury, and Coyotes? Reduced prices on shows at our world-class performing arts and theatre venues?

What if we could help you buy, build, or remodel your home? Discounts on interior design, furnishings, pools, and artwork? Realtors that enhance the buying experience and help you save money? Contractors that can redesign the perfect kitchen or turn your backyard into an oasis?

For those in smaller practices, what if the Society could help you secure affordable health insurance for your employees? What if we offered a private exchange that allowed you to design your own plan to meet the size and needs of your employees and families? What if we offered an association-type plan that gave smaller practices the ability to pool risk amongst plan participants but pay premiums more consistent with a large employee base?

Here at the Society, we know that you need a lot more in return than just discounts from local businesses. You need and want a payment advocacy program that will help you with reimbursement issues. You need access to highquality CME, at an affordable price and topics most relevant to healthcare today. Our physicians want social events to meet other physicians and our students want mentoring opportunities and ‘business of medicine’ lectures. You want opportunities to volunteer in the community. We hear you. We’re working on it all.

In order for the Maricopa County Medical Society to say we do it as well as our neighbors a few states to the east, we’ve first got some work to do. Bigger isn’t always better, but in the case of organized medicine, it is. The more physicians we have as the ‘collective voice of medicine’ here in Arizona, the more impact we can have to help preserve the practice of medicine alongside our partners at the Arizona Medical Association (ArMA). We can do a lot more for you if we move the membership needle from 20% to 70%.

So sign up today or, if you’re already a member, renew your membership for 2015. We’ll help you address your needs and fill your voids. We won’t guarantee overnight success but, in time, you’ll see results. ru

Jay Conyers, PhD is the Executive Director for the MCMS and CEO of the MCMS Business Services.

Dr. Conyers holds a PhD in physical/analytical chemistry from the University of Utah and a bachelor’s degree in chemistry from Trinity University. Email him to jconyers@mcmsonline.com or call 602-251-2361.

14 • Round-up • September 2014 • A monthly publication of the MCMS

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To Hear My Father’s Doctor Physician Profile: Randall W. Porter, MD Round-up Staff

hat happens when a son struggles to understand the details of his father’s doctor visits from nearly two thousand miles away? Perhaps it all gets lost in translation. Or maybe neither father nor son really comprehends the complexity of a cancer diagnosis and treatment plan. But if the son is a neurosurgeon in Phoenix and the father is a PhD-level economist accompanied by his wife - an RN - for doctor visits in Chicago, then perhaps it’s an indication that doctors and patients don’t adequately communicate with one another.

Dr. Randall Porter Medical Director, Neurosurgery Operating Rooms Director, Interdisciplinary Skull Base Program Barrow Neurological Institute

For Randall Porter, MD, it was an eye-opening experience. “I [thought] if only I could be there, I could really help him remember and understand what the doctors were telling him,” says Porter, currently the Medical Director of Neurosurgery Operating Rooms and Director of the Interdisciplinary Skull Base Program at Barrow Neurological Institute. “I then thought, ‘Wouldn’t it be great if I had a videotaping of my father’s doctor visits?’” And so began an idea that changed the way a neurosurgeon practiced medicine.

Photos courtesy of Mike Paulson, Paulson Photo/Graphic Communications. Mike can be reached at photo@paulson.com or call 602-230-1550. 16 • Round-up • September 2014 • A monthly publication of the MCMS

member profile The Path to Phoenix

Porter’s roots in medicine began on a prairie in Saskatchewan, Canada. Born to farmers and one of sixteen siblings, Porter’s mother was sent ‘out into the world’ at 14, an age at which she and each of her brothers and sisters left the family farm on a horse drawn carriage. Through most of high school, Porter’s mother worked as a nanny for an RN who worked evening shifts, caring for her four children under the age of four, but moved to Chicago during her last year of high school, living with an aunt. At age 21, she was accepted with United Airlines as a flight attendant, but soon met Dr. Porter’s father, who was a PhD candidate at the University of Chicago School of Business. Soon thereafter they married and started a family. When Dr. Porter was three years old, his mother returned to college and completed her RN and, later, a graduate degree in social work. This landed her at Alexian Brothers Medical Center, where she cared for people suffering from eating disorders. Says Porter, “I guess she was my role model in taking care of others. She had a great reverence for physicians as well, which probably influenced me.”

For Porter, life was far from rural Canada. He was born and raised in a northwest Chicago suburb and attended Southern Methodist University in Dallas, where he met his future wife. Fortunately for Porter, her family, who at the time resided in Dallas, was transferred to Chicago and settled on a house a mere stone’s throw from where he grew up in Barrington Hills. This drew Porter back to Chicago for medical school, where he attended Rush Medical College. And it was there that he was pointed in the direction of Phoenix.

“I told a friend in medical school that I wanted to become a neurosurgeon, and he told me he had a friend that was a resident in neurosurgery in Phoenix,” Porter explains. “He was training with a famous neurosurgeon, Dr. Robert Spetzler, at the Barrow Neurological Institute. So I decided to come to Barrow for a one month sub-internship.” It didn’t take long for Porter to become impressed with the world-class facility that Barrow had long been known to be. During his short time there, he was told that he had a slim chance of getting in, but he applied anyway. “I will never forget, it was in the day before cell phones. I was down at

Dr. Porter and the surgical team during a procedure at the Barrow Neurological Institute.

A monthly publication of the MCMS • September 2014 • Round-up • 17

member profile University of Illinois, Chicago campus,â&#x20AC;? says Porter. He continued, â&#x20AC;&#x153;My wife took a cab down there to tell me I matched at Barrow. She knew how much it meant to me.â&#x20AC;?

Porter soon packed up and headed west. He completed his internship at the Maricopa Medical Center and his residency at Barrow, finishing in 2000. Despite an opportunity to join his fellow co-chief and launch a practice in Tyler, Texas, he decided to stay at Barrow and teach. Heâ&#x20AC;&#x2122;s been there ever since.

A Difficult Diagnosis to Understand

All was normal for the young neurosurgeon until 2003, when his father called with news of a cancer diagnosis. Despite years of medical training, Porter took it hard. â&#x20AC;&#x153;No matter what your training, when your family member is diagnosed with cancer, you lose your objectivity. So it was only in ret-

rospect that I realized how much denial I was in,â&#x20AC;? Porter explains.

For the next seven years, Porter learned from his fatherâ&#x20AC;&#x2122;s experience and noticed how he hung on every word his physicians would say. His father, who was accompanied by Porterâ&#x20AC;&#x2122;s mother for nearly every visit to the urologist, oncologist, or radiation oncologist, would call his son to discuss each visit. â&#x20AC;&#x153;I really had no urology background, and tried the internet for research,â&#x20AC;? recalls Porter. â&#x20AC;&#x153;But it was too generic, and as his disease progressed it was hard to figure out what it meant for him.â&#x20AC;?

â&#x20AC;&#x153;As a physician, it was very easy for me to see that he was only telling me a fraction of what was discussed, and each time I queried a layer deep about diagnostic findings or treatment plans, there was a lot of misinformation despite the fact that he took copious notes, and my mother accompanied him to every visit. I wished if

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18 â&#x20AC;˘ Round-up â&#x20AC;˘ September 2014 â&#x20AC;˘ A monthly publication of the MCMS

only I could be there, I could really help him remember and understand what the doctors were telling him.â&#x20AC;?

Porter remembers his father asking him to call the doctors to discuss his visits. He complied with his fatherâ&#x20AC;&#x2122;s request, but with some hesitation. Explains Porter, â&#x20AC;&#x153;When I called his doctors, I had two thoughts. One, I knew they were busy, and l was basically calling them to repeat what they had already told my dad, so I was asking them to redo their work. As a physician, I knew what an inconvenience it was for them to have to repeat to me what they were saying. And two, if my dad, a PhD, and my mother, an RN, had a hard time translating to me what the doctor said, then what do the people do who have only a high school education and no medical background?â&#x20AC;?

This encouraged Porter to take a look at how he delivered care to his own patients. He became more aware of how they hang on his every word and how little they actually retain and comprehend. So he poured himself into researching how doctors and their patients communicate, and was determined to come up with a solution.

His desire to have a videotape of his fatherâ&#x20AC;&#x2122;s doctor visits made him rethink his own approach to delivering complex, and often times life changing, information to his patients. Says Porter, â&#x20AC;&#x153;If I wanted that for my family member, why wouldnâ&#x20AC;&#x2122;t I be willing to offer a videotaping of my visits to my patients? So thatâ&#x20AC;&#x2122;s when I decided to start The Medical Memory.â&#x20AC;?

member profile

Dr. Porter demonstrating a new technology for spinal surgery to patient Colter Eby.

Enhancing Doctor-Patient Communication

In 2008, Porter jumpstarted his idea with a handheld video camera and a notepad. He would write the patient’s name on an index card and begin a video session by placing the card in front of the camera to ‘document’ the session. The camera was either on the doctor or the patient, and always done in a cumbersome manner that required positioning and stabilization of Porter’s camcorder. Taped sessions were burned onto discs and given to patients interested in re-hearing their visits with Porter. Continued on page 22.

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A monthly publication of the MCMS • September 2014 • Round-up • 19

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professionals begin the coordination process by obtaining medical and logistical information. Medjet also acts as a liaison between the local medical professionals and your home physician network, relaying all necessary information to you and your family. The value of a Medjet membership is clear. While domestic air-medical transport can cost over $20,000 and international transports can exceed $100,000, Medjet members pay nothing more than the membership fee, which starts at $99 for short-term memberships and $235 for annual protection. There are no additional costs on Medjet’s bedside-to-bedside air-medical transport service. Each year, one out of every 30 international travelers has their trip interrupted by a medical emergency. No matter where you go or how you travel, do so as a protected Medjet member. And, most important, have a safe trip.

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How well do your communicate with your patients? And do they hear you? The problem… Of 1,000 patients* asked what bugs them most about their doctor, more said “unclear explanation of problem” than anything else. Of 159 parents with children discharged from the ED, only 12% recalled the name of the physician – despite 93% satisfaction with the doctorpatient communication – and only 30% remembered the medication prescribed (down to 13% if more than one medication). In 67 medical malpractice suits filed, physician communication was cited as a major factor in nearly 75% of patient depositions. Of 100 patients surveyed after surgery, 44% were unaware of the exact nature of the procedure, and 27% weren’t sure which organ was operated on 20% of discharged Medicare patients are readmitted within 30 days, with primary reasons being lack of execution of discharge plan, patient education, or post-discharge care coordinate, all rooted in doctor-patient communication.

Despite high levels of reported satisfaction with communication in the ED, more than 50% of patients failed to comply with important discharge instructions. Close to 70% of patients are non-adherent to medications due to poor doctor-patient communication. Of 512 patients, 60% feel that information from the internet was as good or better than what was communicated to them by their physician.

And evidence that recordings work… Parents of children treated for fever in the ED given video discharge instructions consistently score better on information retention questionnaires at discharge and at five days post discharge as compared to those receiving standard written instructions.

Of 140 patients discharged from the ED, 78% show deficient comprehension, but only 20% of those recognize that they were deficient.

Of 201 cancer patients, 98% provided with audiotapes were positive about the experience and would recommend it to other cancer patients.

When given a number of statements, patients remember 82% when only two statements, but 36% when three or four statements are given, and a meager 12% when five or six statements are given by the physician.

Of 160 doctors, 61% feel it is beneficial to provide audiotapes and 87% do not feel that the risks of audio recording are prohibitive.

More than 66% over age 60 have inadequate or marginal literacy skills. The National Assessment of Adult Literacy indicates that 37% of American adults have limited or low health literacy.

Of 50 patients with head and neck cancer, 92% found it beneficial to audiotape the consultation. Of 165 patients receiving a personalized recording of their doctor visit, more than twothirds remember more of what the doctor told them after watching the video after leaving the office.

*Specific references for cited studies provided by Round-up upon request.

A monthly publication of the MCMS • September 2014 • Round-up • 21

member profile The approach has since been refined, and now includes a proprietary software platform built within a tablet for secure upload to the Cloud for a patient to download from nearly anywhere. The device is being distributed through Porter’s company, The Medical Memory (TMM), and is gaining acceptance throughout the medical community.

The company’s technology provides personalized recordings that aim to increase patient retention of what the physician is saying. In effect, it ensures that miscommunications are limited and patient adherence is increased. Porter believes TMM can be utilized in various doctorpatient interactions, from initial diagnosis to treatment options to discharge instructions. By affording them the opportunity to go home and rehear the discussion with their physician, by way of a true record of each engagement, patients are essentially empowered to gain a better understanding of their personal medical condition and treatment options.

“When I tell my colleagues about TMM, I get two

responses,” explains Porter. “Some are very risk averse and worry about the liability, yet others see the value immediately.” For those reluctant to go on camera, Porter asks, “Have you ever had a patient come to the office with a tape recorder in hand?”

The answer to this question is invariably yes, so Porter challenges them to give him an opportunity to explain the value of video-recording doctor-patient communications. He then sells them on the idea of it being protective, since more often than not patients don’t remember what their doctors tell them (despite heads shaking in confirmation as if they understand). Porter often points to a Journal of Oncology study showing that patients forget upwards of 75% of what they’re told by their doctors. Still, many physicians worry about forgetting to say something or that something they say – or don’t say – may be used against them in court. In response to these concerns, Porter explains “I used myself as a guinea pig and began recording in 2008. To date, I have recorded over

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member profile Patient Experiences “The entire episode with the tumor was a blur…I was able to watch again to get answers to my questions.” “Each time I re-watch the video I discover additional things. No way I could remember all this critical information without this video.” “I am 81 years old and my memory is slipping. This helps my wife and me to recall the visit.” “It helps me as a patient and also provides me peace of mind knowing [that] if my doctor is willing to be videotaped, I know he is confident with the care and information he is providing.”

Dr. Porter conducting a surgical consultation with patient Mary Beth Castle. The Medical Memory device on the table is recording the office visit.

“Having the video of my doctor visit to watch days after was a tremendous help. I wasn't expecting the diagnosis I received so when my doctor began discussing surgery, I believe I blanked out. Even though it appears that I'm fully engaged in the conversation and I even asked questions, I didn't remember much about the actual details of the recommended surgery after I got home. Being able to view the video days later was a huge help both to my understanding and my anxiety.”

1,300 visits in a very high-risk practice of neurosurgery, and have not had a single instance in which something I said was used against me, or in which a patient came and told me I left something out. The standard of care is to tell the patient about the reasonable expectations of a given diagnosis or treatment, not to read them a medical textbook or the PDR.”

Knowing that TMM is a resource for both physicians and patients alike, Porter spends time asking his patients who utilize the technology if they see value in the experience. “My patients have been very appreciative of the fact that my office offers TMM,” says Porter, “and they want more information, deserve more information, and modern ethics mandates we give it to them.” Not surprisingly, the patient feedback is overwhelmingly positive as demonstrated in the patient experiences documented above. Porter hopes that the video technology offered by TMM will become more widespread throughout the physician

community, and is convinced that once physicians see the dual utility of the approach, more will latch on. TMM will be launching the product this fall and will have two pricing models – a one-time fee, with access to added features such as ‘Notes’ and ‘Sharing’ and a subscription service with unlimited video upload. For more information, visit www.themedicalmemory.com. Regardless of how accepted TMM will become throughout the physician community, Porter still takes pride in knowing that he’s now providing his own patients with more information than what was available while he counseled his father through prostate cancer treatment years ago.

Says Porter, “To me, patient comprehension is as critical as any surgery or medication a doctor can offer. When I am seeing a patient who appears confused, I remember my father and I know why I offer The Medical Memory to my patients.” ru

A monthly publication of the MCMS • September 2014 • Round-up • 23

When you need a primary care physician or specialist

Itâ&#x20AC;&#x2122;s good to have options It has to be someone you and your family will feel comfortable with. Someone with the right credentials. Someone you can trust. The Maricopa County Medical Society offers a FREE telephone and web-based physician referral service that Whether you need a routine check-up or require highly-specialized care, call us.

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MCMS and Public Health Bob England, MD, MPH

ealthcare providers have always played an enormous role not just in the health of their own patients, but in the health of the overall population. Whether providing health education, referring to behavioral interventions, screening for risk factors or early disease, treating to prevent disease progression, diagnosing and reporting communicable diseases, on and on and on, physicians and other healthcare providers are often the front-line implementers of a wide range of population health interventions.

“Perhaps most importantly, we will be counting on the MCMS, and on you, to support our community health policy efforts – to impact the socio-environmental determinants of health – as those efforts need the input and support of the trusted voice of physicians.”

evidenced by the addition of the Director of the Maricopa County Department of Public Health (MCDPH) to its Board as an Ex-Officio member.

MCMS is an important partner in our efforts to refer patients to chronic disease self-management programs, to tobacco cessation via the ASHLine, to the Women, Infants & Children nutritional assistance program, and more. It has chosen to address Valley Fever, hepatitis A and B, and behavioral health issues in a population health manner. MCDPH is pleased to have the MCMS as a major partner in our future activities addressing opioid abuse, sexually transmitted infections and their impact on HIV transmission, even research related to latent tuberculosis infection.

Perhaps most importantly, we will be counting on MCMS, and on you, to support our community health policy efforts – to impact the socio-environmental determinants of health – as those efforts need the input and support of the trusted voice of physicians.

We look forward to continuing and deepening our partnership between MCMS and governmental public health, and we hope that some of you will see this as a mechanism to strengthen your own impact upon the health of the community within which you live and practice. ru

Bob England, MD, MPH

In Maricopa County, there has been a long history of participation, input and support from organized medicine to both County and State public health activities. The Maricopa County Medical Society (MCMS) has provided access to public health information that otherwise may not have been seen by some of its members. It has volunteered to participate in public health planning efforts and to offer the provider perspective on a variety of issues. It has invited public health updates and input into its own activities, as

Bob England, MD, MPH, is the Director of the Maricopa County Department of Public Health.

“Dr. Bob” received his medical degree from the University of Arizona and his Masters in Public Health from UCLA. He has held various positions in local health departments in Pima County, Maricopa County and Connecticut. Dr. Bob has been an MCMS member since 2007. Email him at bobengland@mail.maricopa.gov.

A monthly publication of the MCMS • September 2014 • Round-up • 25

public health — the honor roll program

The Clinician Honor Roll: A measurable marker on a path to change. Kelly Hsu, MD

hen I went to medical school and completed my training at the University of Cincinnati College of Medicine in the late 80’s and early 90’s, Hepatitis B was not perceived as an important problem facing the Asian community. After relocating to Phoenix in 1995, I became more involved in the Chinese community. Shortly thereafter, I became aware of a middleaged Chinese American gentleman who presented with three months of GI-related symptoms and was initially misdiagnosed with traveler’s diarrhea. His weight loss continued and he was belatedly diagnosed with metastatic liver cancer shortly before he died. His liver cancer was due to previously undiagnosed chronic hepatitis B (CHB) infection. Speaking with other Chinese Americans, I found that this was a common story. Most had friends or knew of some young person who had died from cirrhosis of the liver or liver cancer. A large percentage of the estimated two million Americans with CHB are foreign born typically coming from regions where hepatitis B is common.

The area of the world that has the highest prevalence of CHB is Asia. Only 600,000 of the estimated two million Americans with CHB have been diagnosed and even fewer perhaps 50,000 are receiving treatment.1 The Centers for Disease Control (CDC) estimate that one of four CHB patients will die from complications of liver disease or hepatocellular carcinoma (HCC).

In 2002, I started a grassroots non-profit organization, the Asian Pacific Community in Action (www.apcaaz.org) to provide free hepatitis B education and screening. We have now screened over 2,000 Asian Americans in the greater Phoenix area for hepatitis B and have consistently found infection rates in the 4 to 10% range. While community based screening is important work, a more efficient

method to reach a larger audience would be to educate primary care physicians on the importance of screening.

I was very excited when the Maricopa County Medical Society (MCMS) Public Health Committee decided in 2013 to recognize viral hepatitis as one of the major healthcare problems affecting our community. After searching for the

“The MCMS Honor Roll intends to add more disease topics that would benefit from greater visibility within the medical community and heightened public awareness. We are also promoting CME programs that focus on these specific diseases.” Kelly Hsu, MD

best possible method to heighten awareness of this problem within the medical community, the Committee decided to adopt the highly successful San Francisco Hepatitis B Free Clinician’s Honor Roll program. The Honor Roll program was started in 2009 and focused on having primary care clinicians sign a pledge to screen high risk patients for CHB in accordance with CDC guidelines. The goal was to get 90% of the primary care providers to pledge their participation. This initiative was implemented in coordination with the Asian Week Foundation and the San Francisco Department of Public Health. The goals of the program were reached in 2013 at

26 • Round-up • September 2014 • A monthly publication of the MCMS

public health — the honor roll program which time over 1,500 physicians had signed the pledge. The Chinese American Medical Society in New York City has launched a similar campaign. Since Phoenix has a much smaller Asian Pacific Islander population than San Francisco or New York City, the scope of the MCMS Honor Roll project was expanded to include chronic hepatitis C and Valley Fever.

The MCMS Honor Roll intends to add more disease topics that would benefit from greater visibility within the medical community and heightened public awareness. We are also promoting CME programs that focus on these specific diseases. Members of the Public Health Committee include the chair, Dr. Adam Brodsky, who also leads the Honor Roll subcommittee, Dr. Bob England, MPH, Director, Maricopa

A monthly publication of the MCMS • September 2014 • Round-up • 27

public health — the honor roll program County Department of Public Health, Dr. John Middaugh, and Drs. John Galgiani and Richard Manch, experts in Valley Fever and chronic viral hepatitis, respectively. ru

Dr. Kelly Hsu received her undergraduate degree from The Johns Hopkins University in 1978 and formal acupuncture clinical training from the Chinese Acupuncture Hospital and Veteran’s Hospital in Taipei, Taiwan. Upon returning to the United States, She took and passed the California Acupuncture licensure examination in 1981.

Realizing the importance of combining Eastern and Western medicine, Dr. Hsu pursued her medical degrees from the University of Cincinnati College of Medicine. After completion of her residency in Physical Medicine and Rehabilitation in 1993, she and her family moved from Cincinnati, Ohio to Phoenix where she started her private practice in Medical Acupuncture in Chandler, Arizona. She joined the MCMS in 2010 and currently serves on the MCMS Board of Directors.

Contact her at 480-899-9400 or dhsphoenix@aol.com. 1. Cohen C, Holmberg Sd, McMaHon, BJ et al.Is chronic hepatitis B being under treated in the United States? J Viral Hepatitis. 2011;18:377-383. Hu K, Pan CQ, Goodwin D. Barriers to screening for hepatitis B virus infection in Asian Americans. Dig Dis Sci. 2011;56:3163-3171.

About the Maricopa County Medical Society Honor Roll Program The Maricopa County Medical Society’s (MCMS) Honor Roll program is the first of its kind in Arizona. Designed to engage ALL physicians and clinicians, the Honor Roll program educates providers about relevant health matters that may affect your patients and the community. It is a voluntary program focused on the most critical health matters facing our diverse population. You do not have to be a MCMS member to enroll in the program. Clinicians are encouraged to test patients for Valley Fever, Hepatitis B and Hepatitis C. Your commitment to do so goes a long way toward encouraging all healthcare providers to follow the Centers for Disease Control, Arizona Department of Health Services, and Maricopa County Department of Public Health guidelines in these topic areas, as well as treating and preventing these serious health matters. Performance measures are in place, including statistical monitoring, public awareness and education, and clinical education programs and literature. We will be reporting on the progress of the program through Honor Roll Program updates in Round-up Magazine, InforMED Society e-newsletter, our website, Facebook and Twitter. Contact MCMS at 602-252-2015 or mcms@mcmsonline.com to learn more about the program or to sign up.

28 • Round-up • September 2014 • A monthly publication of the MCMS

Cardiovascular Disease Management: A Case-Based Approach Richard R. Heuser, MD Program Director

October 10-11, 2014 :: Arizona Biltmore Hotel, Phoenix, Arizona Register online at www.promedicacme.com or call (760) 720-2263

public health — honor roll update

Hepatitis B: Still a Serious Health Problem in Arizona Richard A. Manch MD, FACP, FACG

everal years ago I was asked to see a previously healthy man in his late twenties who had just had a surgical resection of a large tumor from his liver. The tumor turned out to be hepatocellular carcinoma (HCC), by far the most common primary malignancy of the liver. While it is becoming fairly common in people with cirrhosis, this man did not have cirrhosis, but we later found out that his mother was Korean and he had chronic hepatitis B (HBV), which had never been detected. Sadly he later died of metastatic disease. Despite the fact that very effective vaccination against HBV has been in place in the United States and many other Western countries for over 20 years, there are many parts of the world where this has not been the case. HBV infection is still widespread in many parts of Asia, Africa, and some areas of Europe and South America. Worldwide, more than two billion people have been infected with HBV; in the US, at least two million people have chronic hepatitis B – the vast majority being foreign born immigrants. U.S. estimates from year 2012: 1. Asia:

773,397

3. Caribbean:

155,852

2. Africa:

4. Europe:

5. Central America:

152,054 97,995

96,489

Hepatitis B is one of the highest reported infectious diseases in Arizona. In 2013 the state received 816 reports of chronic hepatitis B, with the highest rate in Asians or Pacific Islanders (28 cases per 100,000 population). Blacks had the second highest rate at 16 cases per 100,000 population while the rate for whites was three cases per 100,000 population1.

Hepatitis B is a DNA virus which, unlike hepatitis C, is present in varying amounts in all body fluids and also unlike Hepatitis C, can generally not be cured in those chronically infected. When exposed to the virus as an adult (often via sexual transmission or intravenous drug use) the infection is often self-limited, with an acute course characterized by jaundice, malaise, nausea and other systemic symptoms as the infected person develops immunity (Hepatitis B Surface Antibody or HBsAb). But when a newborn is exposed at the time of birth from an infected mother (vertical transmission), or when a young child is exposed via poor sanitation and/or faulty healthcare practices (early horizontal transmission), the immune system is still immature and usually the infection becomes chronic and potentially life-long. This latter scenario explains the very significance prevalence of chronic HBV infection in developing countries as noted above.

“Screening for HBsAg in your practice can admittedly be a challenge, as there can be significant language and cultural barriers, as well as difficulty in finding providers experienced in the treatment of HBV. Nonetheless, tragic outcomes such as the patient described...can be avoided in many cases with effective screening....” Richard Manch, MD

Persons who are chronically infected are easily identified by the persistence of Hepatitis B Surface Antigen (HBsAg) in their blood. Therefore, it is very important that all healthcare providers identify persons in their practice at risk for chronic HBV and screen them for HBsAg with a

30 • Round-up • September 2014 • A monthly publication of the MCMS

public health — honor roll update simple blood test. The CDC and the United States Preventive Services Task Force recommends screening the following risk groups for hepatitis B: • All persons who have are immigrants to the U.S. from areas of intermediate or high prevalence, including most countries in Asia and Africa.

• Children born in the U.S. to parents from high prevalence areas, including those not vaccinated as infants.

• HIV-positive people, injection drug users, men who have sex with men, and those living with or having sex with someone with HBV infection. • Patients with weakened immune systems or undergoing treatment for kidney failure.

Why is the early identification of chronic HBV infection (HBsAg+) so important? Because if left untreated, many persons will progress to cirrhosis or hepatocellular carcinoma or both. Large studies in Asia have shown that among untreated HBsAg+ persons followed for many years, the risk of HCC and cirrhosis rises dramatically with the level of virus in the infected persons. Progression can be prevented by treating those who are chronically infected with very effective oral antiviral agents (tenofovir or entecavir). There are a number of treatment algorithms which have been developed to assist the clinician in deciding whom to treat, since not all HBV patients require treatment. Treatment needs to be life-long for many patients to keep the virus levels suppressed, so once a patient is screened positive for HBsAg, a referral to a practice or cen-

ter treating HBV patients is essential. Once referred for further evaluation, the patient may need imaging of the liver, HCC screening, and more detailed evaluation of viral genotypes and antigen subclasses. Patients should be assured that liver biopsies are no longer needed in many cases, and not all patients need treatment, but most do need continued follow-up.

When screening for HBsAg, it is also important to screen for the antibody (HBsAb). If the antibody is absent, that person has no immunity and remains at high risk, especially if living in a high prevalence immigrant community so should be offered HBV vaccination, which is safe and effective.

Screening for HBsAg in your practice can admittedly be a challenge, as there can be significant language and cultural barriers, as well as difficulty in finding providers experienced in the treatment of HBV. Nonetheless, tragic outcomes such as the patient described above can be avoided in many cases with effective screening. While Arizona may not yet have as many HBV infected immigrants as California, Nevada, Washington and New York, there are now growing populations of persons from Vietnam,

China, Philippines, sub-Saharan Africa and other high prevalence countries now living in the Phoenix metropolitan area. ru

References: 1. Arizona Department of Health Services: www.azdhs.gov/phs/oids/pdf/raceethnicity2013.pdf

Dr. Richard Manch is a hepatologist specializing in liver diseases such as hepatitis, cirrhosis and liver cancer. Currently, he holds the positions of Chief of Hepatology, St. Joseph’s Hospital and Medical Center, Phoenix Arizona; Clinical Professor of Medicine, University of Arizona College of Medicine – Phoenix; and Professor of Medicine, Creighton University. He has lectured extensively throughout the region and serves as an advisor to many organizations and companies involved in the care and treatment of liver disease.

Dr. Manch serves on the MCMS Board of Directors and has been a member since 1977. Contact him by calling 602-406-7564 or email to richard.manch@dignityhealth.org

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A monthly publication of the MCMS • September 2014 • Round-up • 31

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Injuries 9%

Nervous system 14%

Infectious diseases 2% Circulatory system 10%

Cancer 7%

Mental & nervous disorders/ substance abuse 16%

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the art of practicing medicine

A Matter of Life and Deaf: Clear Patient Doctor Communication for the Hard of Hearing

Carmen Green

erhaps one of the most important parts of medical treatment is clear communication between a patient, their family and their healthcare provider. Being able to explain symptoms or lifestyle habits to your doctor is crucial to provide safe, quality healthcare, while ineffective communication causes misdiagnosis, medication errors and inappropriate treatment. A person’s health can be compromised if they are unable to express their worries to their doctor – an issue that millions of individuals face every day. Today, more than 55 million people in the United States are experiencing some degree of hearing loss. In Arizona alone, that number is more than 700,000 individuals. That’s nearly a million people who could face difficulties when getting a check-up, visiting the emergency room or even giving basic information to a school nurse.

As part of National Deaf Awareness Week (Sept 21 – 27, 2014), the Arizona Commission for the Deaf and the Hard of Hearing (ACDHH) is spreading the word on ways to prevent any sort of miscommunication in a doctor patient relationship.

ACDHH has implemented its Healthcare Curriculum, a free training course available to hospital staff, urgent care facilities, medical centers, etc. In this course, healthcare providers will learn the best methods for communicating with a deaf or hard of hearing patient.

The goal of ACDHH is to make sure the deaf and the hard of hearing individuals in Arizona receive the same quality of service as the hearing population. By informing deaf and hard of hearing individuals about their rights and the laws and programs available to support those rights, they, too, can become empowered as self-advocates.

Not only will this benefit patients, but the facility as well. Some healthcare centers may not be aware of the legal

requirements or are concerned with the cost that the muchneeded (and required) services will bring.

In fact, Title III of the Americans with Disabilities Act prohibits discrimination against individuals with disabilities by places of public accommodation and it applies to all private and public healthcare providers regardless of the size of the office or the number of employees. Some examples of auxiliary aids that meet ADA requirements include Licensed Interpreters, Computer-Aided Transcription Services, Open/Closed Captions and Telecommunications Devices for the Deaf.

“It is a healthcare providers’ duty to provide effective communication by using auxiliary aids and services to ensure effective communication with people who have a hearing loss. This can only be done by properly training employees...in ways that will help them to do their job as quickly and efficiently as it would be with any other patient.....” Carmen Green

It is a healthcare providers’ duty to provide effective communication by using auxiliary aids and services to ensure effective communication with people who have a hearing loss. This can only be done by properly training all employees, including doctors, in ways that will help them to do their job as quickly and efficiently as it would be with any other patient. In addition to the training curriculum, ACDHH also administers telecommunication services such

34 • Round-up • September 2014 • A monthly publication of the MCMS

the art of practicing medicine as the Arizona Relay Service and the Arizona Telecommunications Equipment Distribution Program.

Healthcare providers and individuals who are deaf or hard of hearing and need more information on ensuring effective medial communication should visit www.acdhh.org or call 602-542-3323 for more information. ru

Carmen Green is the deputy director for the Arizona Commission for the Deaf and the Hard of Hearing, as well as a member of the National Registry of Interpreters for the Deaf, Arizona Registry of Interpreters for the Deaf, National Alliance of Black Interpreters and the National Association of the Deaf.

SAVE THE DATE! for the Coccidioidomycosis

(Valley Fever) for the Primary Care Physician Conference Saturday, November 8, 2014 8 am - noon Banner Good Samaritan Medical Center Amphitheater Two-thirds of all worldwide Valley Fever infections occur in Arizona; most of those in Maricopa County. Are you testing your patients with community-acquired pneumonia for Valley Fever? The 7th Annual FREE conference is open to physicians, nurses and healthcare providers.

Register at www.vfce.arizona.edu St. Joseph’s Hospital and Medical Center designates this live activity for a maximum of 3.5 AMA PRA Category 1 CreditsTM.

Endorsed by the Maricopa County Medical Society as an Honor Roll Activity. www.mcmsonline.com

A monthly publication of the MCMS • September 2014 • Round-up • 35

mcms membership — 2014

EMPOWERING physicians. IMPROVING healthcare. Thank you for your membership in the Maricopa County Medical Society. The work of MCMS would not be possible without our members, all of whom are listed on the next fifteen pages*. Your support enables MCMS to represent the interests of physicians and healthcare providers on key legislative and public health issues, and to continue to ensure that organized medicine can be a force to improve the health and well being of all individuals. We are glad to have you as part of the MCMS family. If you are not a member, please to take a moment to contact the membership staff by calling 602-252-2015 or email to mcms@mcmsonline.com so we may explain how the Society can represent your voice in the issues that matter most to you. *Listing of members as of September 1, 2014

36 • Round-up • September 2014 • A monthly publication of the MCMS

mcms membership — 2014 Legend: Physician Member • Educational Member 68 Years Paul B. Jarrett, MD Joseph D. Sacca, MD 65 Years Frank J. Honsik, MD. Thomas Hughes, Jr., MD 64 Years Matthew Borst, MD 63 Years Gordon Greenblatt, MD 62 Years Raymond Thomas, MD 61 Years Thomas Edwards, MD S. Kent Conner, MD 60 Years Jack E. Cook, MD Douglas Frerichs, MD Robert F. Lorenzen, MD Charles Strickland, MD 59 Years Robert E. Flynn, MD Paul E. Sadler, MD John A. Jones, MD 58 Years Wilbur C. Bayham, MD Robert H. Bullington, Sr., MD Merlin K. Duval, MD Sheldon Zinn, MD Earl J. Baker, MD 57 Years Dean Rowley, MD George L. Wong, MD 56 Years J. Daniel Bullington, MD Robert J. Dunn, MD R. Donald Hagerman, MD Stanley J. Jallo, MD Arthur F. Morrison, MD Rexford Peterson, MD Halford R. Price, MD Harry Ramseyer, Jr., MD James D. Alway, MD Rudger P. Hiatt, MD William Lawrence, MD

John M. Vivian, MD John W. Moon, MD

55 Years Edward A. Brewer, MD Hugh B. Hull, MD James M. Hurley, MD Merlin W. Kampfer, MD Rudolf Kirschner, MD Sidney H. Segal, MD Floyd L. Templeton, MD Robert S. Waldman, MD Edward Waldmann, MD George A. Gentner, MD 54 Years Lawrence N. Frazin, MD Lucy S. Hernried, MD W. Ransom Kelley, MD Charles L. Levison, MD Richard MacMillan, MD Donald R. Miles, MD Carl A. Nau, Jr., MD Richard Timmons, MD Frank S. Tolone, MD 53 Years Ray Brandenburg, MD John S. Carlson, MD Carolyn Gerster, MD Josef J. Gerster, MD James Giangobbe, MD Herbert J. Louis, MD Henry Reuss, MD Phyllis S. Reuss, MD William A. Susong, MD Max L. Wertz, MD Thurl E. Andrews, MD 52 Years Avi Ben-Ora, MD Paul M. Bindelglas, MD Richard N. Boas, MD William L. Bunting, MD Ben Celniker, MD Charles P. Dries, MD Alan L. Gordon, MD William Haeussler, Md Horace S. Kent, MD M.S. MacCollum, MD Robert R. McCarver, Jr., MD Robert E. Nenad, MD George J. Samuels, MD William S. Stone, MD Luis S. Tan, MD

Raymond A. Vaaler, MD Marion Jabczenski, MD Robert A. Oster, MD 51 Years Joseph B. Buxer, MD Bill C. DeMoss, MD Jay Epstein, MD James O. Fuzzell, MD

Nelson H. Dyess, Md Howard Johnston, MD Arnold Kahn, MD A. Paul Kehle, MD Jack O. McFarland, MD Richard L. Morgan, MD P. Philip Scheerer, MD James O. Shaver, MD Robert E. Stejskal, MD

Stanley Milstein, MD Sherman Minkoff, MD James Schamadan, MD Marvin Schneider, MD Richard Adamson, MD Sam C. Colachis, Jr., MD

“I retired 20 years ago. I was an active member for over 20 years and remain a retired member. I consider the Society to be the leader in preserving outstanding practice of medicine and supporting the practitioners in AZ. I still follow the Round-up as it tries to be more supportive of members faced with major changes in the practice of medicine. I think it serves independent practitioners and those associated with hospitals and institutions. It follows the major changes which have taken place in medicine and does so with care and knowledge. I have always been proud to be a member of the Society and hope it will grow and flourish.” Robert A. Brooks, MD MCMS member since 1969 Robert F. Green, MD John P. Heileman, MD Philip Levy, MD Thomas McCauley, MD Paul E. Palmer, MD Wilfred M. Potter, MD Eugene M. Ross, MD Bruno Schabarum, MD Arnold L. Serbin, MD Daniel F. Shanahan, Jr., MD James F. Sullivan, MD Leslie G. Taylor, Jr., MD Jack H. Wilson, MD James C. Wootton, MD 50 Years Norman B. Brown, MD James G. Hopkins, MD Ray D. Hughes, MD Arthur N. Lindberg, MD Salvatore Gualtieri, MD 49 Years Lewis J. Brown, MD David L. Call, MD Allan Clemenger, MD

Ted J. Stuart, Jr., MD Donald A. Tobias, MD Herschel Richter, MD Albert Andrews, Jr., MD 48 Years David B. Cauble, MD Carlton E. Conrad, MD Salvatore J. De Francesco, MD Katalin Festy-Sandor, MD Jack O. Hubbard, MD Robert E. Kravetz, MD Thomas H. Ross, MD Sanford H. Roth, MD William R. Womack, Jr., MD Joseph M. Kennedy, MD 47 Years William P. Cornell, MD William F. Fathauer, Jr., MD John R. Hayes, MD John H. Jarvis, MD Jordan T. Leake, MD

46 Years Alberto Benchimol, MD Richard H. Daley, MD Theodore Ditchek, MD Morton H. Dubnow, MD Sheldon Epstein, MD Norman F. Fee, MD Egon V. Johnson, MD H. Belton Meyer, MD Theodore Mobley, MD Darrell D. Smith, MD Kenneth Tollackson, MD Alan Yudell, MD Robert W. Croddy, MD H. Stephens Thomas, MD 45 Years Robert A. Brooks, MD John A. Bruner, MD Thomas E. Cosmas, MD Theodore G. Dodenhoff, MD William J. Dowling, MD John L. Friedman, MD Joseph W. Hanss, Jr., MD

A monthly publication of the MCMS • September 2014 • Round-up • 37

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mcms membership — 2014 Legend: Physician Member • Educational Member Thomas F. Hartley, MD Franklin Loffer, Jr., MD Charles Meinstein, MD Laurance B. Nilsen, MD Albert Jon Scheller, MD Lola P. Shapiro, MD Otto S. Shill, Jr., MD Bertram E. Sosnow, MD Richard C. Zacher, MD Ronald D. Suiter, MD Robert E. Westfall, MD

44 Years Richard W. Abbuhl, MD Edward Abraham, MD Leo J. Ankenbrandt, MD Albert C. Asendorf, MD George E. Bandy, MD Ronald W. Barnet, MD Richard Besserman, MD Theodore Blackwelder, MD William Bohnert, MD James R. Callison, MD Richard L. Collins, MD John V. Dickson, MD Ira B. Ehrlich, MD Benjamin K. Harris, MD John A. Hodak, MD Thomas M. Hudak, MD Thomas F. Minas, MD Charles M. Rucker, MD Gerald F. Schwartzberg, MD Phon D. Sutton, MD Jerome Targovnik, MD Selma E. Targovnik, MD Norman Thompson, MD Richard H. Wohl, MD Thomas J. McNaughton, MD Jerry W. Bains, MD 43 Years Robert F. Bluvas, MD William Brainard, MD Ramon Buenaver, MD Carlos A. Carrion, MD William J. R. Daily, MD Agustin I. Estrada, MD Thomas J. Groves, MD John E. Hensler, MD Mark Kartub, MD Charles McCarver, MD Charles E. McCorkle, Jr., MD

Alan Y. Newhoff, MD Melvyn Rothman, MD Augusto A. Toraya, MD Ralph V. Wilson, MD Lowell G. Yadon, MD Paul W. Nykamp, MD Susan Rinaldi, MD

42 Years Suresh C. Anand, MD Frederick Bloemker, MD Walter A. Ceranski, MD Robert E. Cottor, MD Robert T. Daehler, MD Kenneth B. Desser, MD Roland J. Geretti, MD Samuel Goldberg, MD Marvin Goldstein, MD Harold E. Gries, MD Larry L. Griffith, MD Garron R. Hale, MD Phillip L. Hipps, MD Murray Hollenberg, MD William J. Kennell, MD Max D. Lind, MD Walter K. Lippard, III, MD Walter H. Magen, MD Arthur J. O’Connor, III, MD Gary A. Rada, MD Richard H. Reznick, MD Wolf Safrin, MD Alan P. Schwartz, MD Donald Traicoff, MD Herman F. Van Den Broeck, MD George A. Van De Wyngaerde, MD Robert H. Waldie, MD Willis A. Warner, MD Fletcher E. Zimpfer, II, MD Leon D. Zeitzer, MD James E. Campbell, MD William S. Rutti, MD Jack A. Lisiewski, MD 41 Years Earl M. Chernoff, MD John P. Creasman, MD Jack E. Games, MD David E. Gralnek, MD Robert W. Hellmers, MD William Ingram, MD Ctibor T. Kaigl, MD

Samuel S. Kaplan, MD Eli J. Krigsten, MD Ned A. Kuivinen, MD Arthur Lipschultz, MD William McCurry, MD Robert D. Mills, MD James R. Mouer, MD Joseph Priestley, Jr., MD Albert M. Schwartz, MD Arthur D. Shiff, MD

Glen Hait, MD Timothy Harrington, MD Warren H. Heller, MD Raymond A. Hurm, MD Stuart Z. Lanson, MD Robert S. Lewis, MD Bruce A. Mallin, MD James Meador, Jr., MD Richard A. Melde, MD

39 Years Lawrence Brecker, MD Albert Breland, Jr., MD Stuart B. Cohen, MD John A. Davis, Jr., MD John D. Eckstein, MD Stephen Glouberman, MD Gerald H. Golner, MD Glenn E. Good, MD

“In 1974 when I was a third year Resident at the Good Samaritan Family Practice Residency, the Director Dr. Robert Price told the graduating seniors that if we were going to practice in Phoenix that we had to go meet with Fred Mitten, the Society’s then Executive Director. I made my appointment and met with this very warm and fatherly man, Fred Mitten, who told me that living within the structure of organized medicine was the way to succeed as a physician in Arizona. That conversation has stayed with me till today and even though Fred was succeeded by his son Tony and grandson Dan, I always respected that meeting. Even though I’ve now become a leading Homeopathic Family Physician, I’ve felt welcome to be under the umbrella of the County Society with ‘a different viewpoint’ and have kept my connection to the structure of medicine as I was advised and welcomed to do.” Bruce H. Shelton, MD, MD(H), DiHom, FBIH MCMS member since 1975 Homeopathic Family Physician, Phoenix Vice President, Arizona Board of Homeopathic and Integrated Medical Examiners J. Bruce Stadwiser, MD Rolando Villareal, MD Robert Lee Wilson, MD Herbert Winograd, MD F. Darwin Zahn, MD 40 Years Robert Bleakman, MD Jon B. Coppa, MD George S. Craft, MD John R. Crowell, MD Thomas P. Foerster, MD John B. Fox, MD Jack A. Friedland, MD Hudson V. Grumbling, Jr., MD Gary A. Gustason, MD

J. Douglas Morrison, MD William Morrissey, MD Vincente G. Mortel, MD Walter J. Nieri, MD Laurence Novick, MD M. John Peachey, Jr., MD Paul M. Petelin, Sr., MD Joseph N. Portnoy, MD H. Arlene Ross, MD Kent J. Rossman, MD Darryl R. Stern, MD Robert L. Wechsler, MD Howard E. Wulsin, MD Robert V. Stephens, MD

Harry W. Gordon, MD Thomas L. Gunn, MD John R. Harlan, MD Oliver J. Harper, Jr., MD Barry A. Hendin, MD Cherryl Hofstetter, MD Brian C. Judd, MD Michael A. Lawson, MD Tom D. Linkous, MD John H. Mahon, MD Robert A. Modic, MD M. Kent Moore, MD Jack N. Poles, MD Donald E. Pont, MD William Rappoport, MD Irwin Shapiro, MD

A monthly publication of the MCMS • September 2014 • Round-up • 39

mcms membership — 2014 Legend: Physician Member • Educational Member

Bruce H. Shelton, MD Stanley R. Shorb, MD Cyril James Statt, MD Bernard Sunshine, MD J. Ulises Urcuyo, MD Amor Villareal, MD Elizabeth Wilkinson, MD Joseph T. Zerella, MD

38 Years George E. Burdick, MD Eugene J. Chandler, MD David H. Drachler, MD David D. Dulaney, MD Bertram Feingold, MD Frederick Fingerhut, MD R. Leighton Fisk, MD Daniel H. Heller, MD Ellison F. Herro, MD Barry A. Kriegsfeld, MD Marilyn Laughead, MD Michael J. Lipson, MD Keith McReynolds, MD Richard Mushorn, MD Robert B. Posner, MD Leon A. Rigberg, MD Robert Rubenzik, MD Phillip J. Rubin, MD Frederick Salamon, MD Marvin W. Silvey, MD Stephen R. Stein, MD Sood S. Suchart, MD Stewart Van Hoosear, MD Peter Voss, MD William C. Weese, MD William W. Malone, MD William Lovett, MD Jack J. Stein, MD Kenneth A. Lucas, MD 37 Years Georgetta Bidwell, MD Richard C. Christensen, MD Dennis C. Cooper, MD Timothy M. Daley, MD William J. Dunn, MD Stephen H. Garber, MD John Gibney, MD Joseph S. Gimbel, MD David Goldfarb, MD Clifford J. Goodman, Jr., MD R. Randall Grace, MD

W. William Harnischfeger, MD John M. Heyer, MD Albert D. Jacobson, MD John Paul Kelley, MD Graham Kretchman, MD Wayne E. Kuhl, MD Wayne A. Lattin, MD Marc L. Lee, MD Robert G. Leon, MD Cesar V. Maderazo, MD Alan H. Mallac, MD Richard A. Manch, MD Mary J. McGee, MD Nick Morrison, MD Victor E. Sartor, MD Charles J. Saults, MD Harold Sheinkopf, MD John A. Sosci, MD Stephen E. West, MD William L. White, MD Martin E. Zipser, MD William E. Kuchar, MD Mary D. McGuire, MD

36 Years Michael Altman, MD Steven J. Bowley, MD James C. Brown, MD Roland M. Couche, MD Ronald Creasman, MD Brian D. Fairfax, MD Ian P. Grant-Whyte, MD Lawrence Green, MD Grant A. Hertel, MD Gordon P. Holt, MD Peter A. Jolma, MD Nicholas Kramolc, MD Harold Magalnick, MD Donald Mulvaney, MD Stuart L. Posner, MD J. Michael Powers, MD Arthur B. Radow, MD William Redenius, MD David Romney, MD Morley Rosenfield, MD Mervyn B. Ross, MD Ronald B.H. Sandler, MD Andrew G. Shetter, MD Richard M. Spiegel, MD George A. Streza, MD Brendan Thomson, MD Richard A. Wall, MD Howard B. Wernick, MD Anthony T. Yeung, MD

Jon D. Zoltan, MD James J. Kennedy, III, MD M. Jamil Akhtar, MD Richard V. Albery, MD Gary M. Prince, MD 35 Years B.K. Bhatheja, MD Alvin I. Bogart, MD H. Robert Clyde, MD John K. Crowe, MD David Engel, MD John B. Giedraitis, MD Howard Ginsburg, MD Marc S. Goldblatt, MD Ronald D. Gordon, MD William H. Jackson, MD Leonard Lapenson, MD Robert A. Lewis, MD William F. Morgan, Jr., MD Stuart B. Phillips, MD Bryan R. Updegraff, MD Dora E. White, MD George Woodard, Jr., MD David W. Campbell, MD 34 Years David E. Benton, MD William A. Calderwood, MD John C. Donaldson, MD Barry Green, MD Robert Hamilton, MD Paul D. Holman, MD Allen B. Moore, MD John M. Raines, MD Christian F. Risser, MD Alan A. Schapker, MD Karikurichi S. Venkatesh, MD

33 Years Stephen Borowsky, MD Arnold B. Calica, MD Ronald D. Cox, MD Otto C. Della-Maddalena, MD Ruth L. Eckert, MD Alois Falkenstei, MD Jay S. Frankel, MD James E. Gerace, MD David J. Gulle, MD Sujatha Gunnala, MD Richard Hawkins, MD

40 • Round-up • September 2014 • A monthly publication of the MCMS

Mark L. Hoefer, MD Robert G. Hooper, MD Stanley Horowitz, MD Martin L. Johnson, MD Neal A. Klein, MD Timothy Kuberski, MD Earl A. Labovitz, MD Marc M. Lato, MD Mitchel A. Lipton, MD Dwight C. Lundell, MD James B. McLoone, MD Stephen P. Nathan, MD Simon Olstein, MD Donald E. Paxton, MD Kathern L. Plenge, MD Nagappa Sri Prakash, MD Sebastian Ruggeri, MD Vincent J. Russo, MD Larry J. Sanders, MD Henry J. Schulte, MD Marc J. Staman, MD Mark S. Stern, MD David A. Suber, MD Francis P. Surdakowski, MD Robert H. Thompson, III, MD Neil Trachtenberg, MD Gary Waddington, MD Albert G. Wendt, MD Victor John Zannis, MD Leland Fairbanks, MD 32 Years Mark E. Baldree, MD Cash R. Beechler, MD James E. Bertz, MD Robert Bloomberg, MD Kenneth R. Boren, MD Marc H. Brooks, MD Richard D. Burns, MD Joanne M. Ceimo, MD Joseph A. Ceimo, MD Jacqueline A. Chadwick, MD Ismar Cintora, MD Desmond V. Cohen, MD Richard L. Engle, MD Michael Epstein, MD John N. Glover, MD Michael Grossman, MD Farid Haddad, MD Judith W. Heath, MD Mark W. Heisler, MD

William W. Horsley, MD Jeffrey D. Isaacs, MD Richard Keightley, MD Lawrence J. Koep, MD Edmund I. Leff, MD Jay R. Long, MD William M. Marsh, MD John D. Marshall, MD Jack K. Mayfield, MD Aubrey Maze, MD David Mendelson, MD Sharon Ondreyco, MD Scott D. Palmer, MD Arcot Premkumar, MD Marc J. Rosen, MD Kurt D. Ruht, MD James A. Schnur, MD John R. Siever, MD Marshall L. Smith, Jr., MD Robert E. Sterrett, Jr., MD R. Thomas Stoffer, MD Harry S. Tamm, MD Deborah Trojanowski, MD Thomas Wilson, MD Lee S. Yosowitz, MD Mark Zachary, MD 31 Years Charles E. Basye, MD Evan G. Bauer, MD Ronald E. Borg, MD Glenn H. Brown, MD James F. Burke, MD Salvatore F. Casano, MD Ronald J. Castro, MD Ann A. Caywood, MD Glenn Cook, MD Charles Creasman, MD Judith C. Engelman, MD Carlos R. Garreton, MD Anthony K. Hedley, MD Douglas W. Kelly, MD Leonard Kirschner, MD Robert E. Leber, MD David R. Lersch, MD Lawrence Liebmann, MD Barbara Lipschitz, MD Leigh C. McGill, MD Paula F. Nadell, MD Robert V. Newman, MD Aubrey Palestrant, MD K. Joe Reid, MD

mcms membership — 2014 Legend: Physician Member • Educational Member Karen T. Robertson, MD W. Scott Robertson, MD Raymond Shamos, MD Mark A. Shucker, MD William Silverstein, MD Amy A. Silverthorn, MD Ernest R. Simon, MD Frederick Simonie, MD Dean F. Smith, III, MD Joseph L. Sun, MD Thomas J. Taylor, MD Nicholas Toronto, MD John J. Wells, MD Mark H. Wilson, MD Lisa M. Wright, MD Mark A. Wys, MD Roger Thompson, MD Mark B. Wall, MD Gary A. Adler, MD

30 Years Karla L. Birkholz, MD Richard G. Carriker, MD Michael J. Conway, MD

Andrei Damian, MD Marlin L. Dimond, MD Edward J. Donahue, MD Michael J. Dupuy, MD Daniel B. Feller, MD Federico Florendo, MD Michael H. Gordon, MD Lesley Johnstone, MD David N. Kells, MD A. Philip Melmed, MD Cecil F. Michael, Jr., MD Duane Lee Mitzel, MD Murugasu Nagul, MD Hong-Kee Ong, MD James H. Padrez, Jr., MD Scott R. Partridge, MD Larry F. Pass, MD Richard T. Perry, MD Roberto Ruiz, MD Thomas D. Runyon, MD Robert F. Spetzler, MD Andrew Wellman, MD

29 Years Eugenie Anderson, MD Richard Anderson, MD Barbara A. Berry, MD David C. Beyer, MD Gary J. Birnbaum, MD William F. Bisho, MD Arnold De Marco, MD Daniel S. Duick, MD Neal F. Junck, MD Nathan Laufer, MD Candace Lew, MD Andre C. Matthews, MD Harold Meyerowitz, MD Susan R. Pardee, MD R. Jay Standerfer, MD Francis K. Tindall, MD Susan B. Van Dyke, MD Joseph R. Volk, MD Ben J. Wilson, MD 28 Years Stephen P. Beals, MD

42 • Round-up • September 2014 • A monthly publication of the MCMS

Mary-Helene Brown, MD H. Royer Collins, MD Michael Dimler, MD Rachel H. Evans, MD Frank J. Fara, MD Jay Friedman, MD Robert P. Gervais, MD Adalberto Gonzalez, MD Terry J. Happel, MD Douglas P. Hartzler, MD John D. Holmes, MD David M. Larson, MD Jay R. Mellen, MD Camilla A. Mican, MD John M. Milligan, MD Jay S. Nemiro, MD Teresa Pavese, MD Stuart Sondheimer, MD Valerie Ann Sorkin-Wells, MD Beatriz Stamps, MD Michael R. Stamps, MD Burt Webb, MD

Caryll J. Webner, MD Glenn Yarbrough, MD Tali H. Arik, MD 27 Years Kirk B. Anderson, MD Paul R. Barnard, MD Timothy J. Bichler, MD Janice Dorn, MD Drake D. Duane, MD Robert J. Fauer, MD Howard Fleishon, MD Mary A. Friederich, MD Donna G. Horne, MD Fredrick I. Kenny, MD William Leighton, MD Richard Peairs, MD Steven Perlmutter, MD David Sanderson, MD Sergio Sotelo, MD Elton S. Thayer, Jr., MD John A.D. Ward, MD David C. Zeman, MD Charlie M. Agee, MD

mcms membership — 2014 Legend: Physician Member • Educational Member 26 Years Gustavo J. Armendariz, Jr., MD Richard Clement, MD Mary F. Fredenberg, MD Gordon L. Grado, MD Joanne B. Gurin, MD Russell I. Heigh, MD Deborah S. Mendelson, MD Craig B. Reeder, MD Anna Scherzer, MD Paul L. Schnur, MD Jean C. Schulman, MD Connie J. Sterling, MD Darrell D. Wadas, MD Javier F. Magrina, MD Medo Mirza, MD Herbert Goodman, MD John K. Bradway, MD David M. Creech, MD David M. Ott, MD Sudhir P. Agarwal, MD Thad E. Bartell, MD H. Randall Craig, MD Angelo J. Mattalino, MD George R. Reiss, MD Mark D. Friedman, MD Ann Bullington, MD Bruce L. Newman, MD 25 Years John W. Bass, MD Brian R. Riveland, MD Ronald M. Lampert, MD Jack O. Sipperley, MD Sergio A. Vie, MD Joseph M. Collins, MD Dennis H. Harris, MD James D. Borel, MD Anita C. Murcko, MD F. D. Barranco, MD Jeffrey P. Edelstein, MD Dwight S. Keller, MD Cynthia Andrews, MD Robert E. Nenad, Jr., MD Mark S. Schubert, MD Robert S. Bridge, MD Maxwell S. MacCollum, III, MD Peter J. Matthews, MD Robert Sawyer, Jr., MD David L. Simms, MD William M. Stone, MD

Jeffrey L. Cornella, MD Mariel Stroschein, MD Joseph Zabramski, MD Clarke D.K. Lambe, MD

24 Years Joseph G. Bonanno, MD Stephen E. Brown, MD

Peter P. McKellar, MD Alexander C. McLaren, MD Edward Perlstein, MD

23 Years Gary L. Berebitsky, MD Bart J. Carter, MD Michael P. Caskey, MD

“Medicine is a profession, not just a job. As Sir William Osler said, it is ‘a calling, not a business.’ In today's society, we cannot practice medicine in isolation. An important obligation we have as professionals is therefore to support our profession's infrastructure. That infrastructure, in turn, supports us and our colleagues by allowing us to practice medicine safely and effectively. It also supports students, residents, and others who are progressing through earlier stages of their medical careers. The Maricopa County Medical Society (MCMS), along with the Arizona Medical Association (ArMA), and many other medical organizations, the Arizona Medical Board, the academic medical system, hospitals, clinics, other healthcare organizations, and a substantial part of government make up the infrastructure. Each of these elements is important, and MCMS plays a particularly important role. Through its operations and affiliated businesses, MCMS supports the practices of its member physicians, as well as contributing to the health of the community and doing its best to improve medical practice. I have seen MCMS in action, through the contribution of its expertise in the development of resolutions to support medical practice at ArMA meetings, and through its participation in other meetings in our community to support the legal and ethical practice of medicine in our State. Another part of professionalism is collegiality, and the ability to mix and interact with others who have similar professional interests. MCMS provides the venue for that. In particular, the opportunity to meet with other members each year at the fall MCMS reception is always rewarding and enjoyable!” Robert Orford, MD MCMS member since 2000 Past President, Arizona Medical Association

Randall K. Tozer, MD Brad R. Bruns, MD Robert W. Dappen, MD Robert F. Guyette, MD Alan I. Leibowitz, MD Barbara MacCollum, MD Khosrow M. Nafisi, MD Richard Schlinkert, MD Gerald Yacobucci, MD Harrison Bachrach, MD Bruce K. Kimbel, MD Delwyn Worthington, MD Michael A. Urig, MD

Robert H. Bullington, Jr., MD Thomas R. Carter, MD Dan M. Chapel, MD Reed H. Day, MD Steven A. Eddy, MD Paul E. English, MD P. Gregory Foutch, DO Bruce E. Freedman, MD Michele Y. Halyard, MD Karl B. Hiatt, MD Kim D. Johnson, MD John C. Lewis, MD James H. Maxwell, MD Robert McCulloch, MD

Thomas D. Perry, MD Robert W. Phillips, MD Neal L. Rockowitz, MD J. Gregory Rula, MD Richard L. Shindell, MD Neil P. Superfon, DO Peter W. Vann, MD Stanley Mark Wehn, MD Charles F. White, MD Richard C. Martin, MD Allan M. Wachter, MD Duane W. Wong, MD John C. Peirce, MD Thomas F. Ross, MD William R. Shapiro, MD

Bruce L. Dean, MD Dean L. Gain, MD Marc E. Gottlieb, MD Rene A. Lucas, MD Michael McQueen, MD Gary Nagamoto, MD Charles R. Orozco, MD Terry A. Reeves, MD Michael Saubolle, PhD Cathlyn E. Stephen, MD Daniel O. Storch, MD Jack S. Tuber, DO Zeena I. Ubogy, MD Andrew C. Villa, Jr., MD Michele S. West, MD

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mcms membership — 2014 Legend: Physician Member • Educational Member Robert Ackerman, MD Joseph V. Cordaro, MD Carol J. Peairs, MD Robert G. Saide, MD

22 Years Robert L. Barricks, MD Steven C. Boles, DO Robert N. Brems, MD Max E. Dine, MD R. Stuart Fowler, MD Alan J. Gordon, MD Betty Jo Grajeda, MD Lourdes Tiro, MD Guillermo A. Gutierrez, MD J. Carvel Jackson, DO David C. Johnson, MD JoAnn Kolnick, MD Kevin S. Ladin, MD Hector Lopez, MD Michael Manning, MD Zoran Maric, MD Gladys T. McGarey, MD Steven Oscherwitz, MD Douglas Peterson, MD David A. Raskin, MD Brian T. Rose, MD Donald A. Schon, MD Jerry R. Shockey, MD Devinder Singh, MD Harry C. Watters, DO Helene E. Wechsler, MD James Yiannias, MD Michael J. Brennan, MD Mark Kevan Lyons, MD 21 Years John L. Couvaras, MD Edward J. Dohring, MD E. Martin Libling, MD John F. Madden, MD Vijaya S. Nabar, MD Harold H. Harrison, MD Mark R. Wallace, MD Emilio R. Giuliani, MD David N. Mowbray, MD Luis R. Argueso, MD James R. Fishman, MD Steven M. Gitt, MD Curtis P. Hamann, MD Eric J. Zeidman, MD Steve Fanto, MD Linda L. Kalivas, MD Martin B. Langford, MD Thomas Mattioni, MD

Edward Quiroz, MD Ernie Riffer, MD Padmavathy Tummala, MD Michael S. Weng, MD Jill R. Zweig, DO Steven S. Mehta, MD Jody B. Reiser, MD Charles R. Clinch, DO Raymond P. Roffi, MD Diane S. Spieker, MD

20 Years Corey L. Detlefs, MD Pravin U. Dugel, MD Stuart J. Friedman, DO Carol A. Hahn, MD Paul M. Steingard, DO Irene B. Delorenzi, MD Patricia R. Reiff, MD Judson Tillinghast, MD Brian C. Fitzpatrick, MD Peter C. Maki, MD Joseph Worischeck, MD Aubrey Chung, Jr., MD Eric Arthur Huettl, MD Thea K. Davies, MD Stephen H. Ponas, MD Allan R. Reinfeld, MD Terry A. Huff, MD John D. Macias, MD Drew V. Moffitt, MD Janet L. Mullins, MD Paul D. Angelchik, MD Louis H. Rappoport, MD William Jacobsen, MD J.F. James Davidson, MD Victor S. Dreicer, MD Sherwood Duhon, MD Richard R. Heuser, MD Lisa Rose Huff, MD Michael T. Lee, MD Jose Kanshepolsky, MD 19 Years Venkata (Bob) Evani, MD Neil E. Motzkin, MD Carolyn B. Pace, MD Dana M. Paull, MD Thomas Wareing, MD Theodore Hofstedt, MD Gerald E. Pass, DO Peter G. Price, MD Gary S. Kauffman, MD Robert Berghoff, Jr., MD

Earl L. Feng, MD Peter C. Kaiser, MD Michael I. Berman, DO John W. Milionis, DO Jesse J. Muir, MD Helen B. Trop-Zell, MD Vincent J. Honan, MD Glenn B. Rothman, MD Winston S. Thomas, MD Denis J. Frank, MD Brian K. Horsman, MD James M. Nachbar, MD Ralph P. Morone, MD Leslie K. Paulus, MD Murray H. Cohen, DO Paul M. Guidera, MD Kipling P. Sharpe, MD Bill H. Halmi, MD Richard J. Harding, MD Marvin T. Racowsky, PA Shepard J. Bryan, MD Michael Covalciuc, MD 18 Years Cameron McDougall, MD Robert A. Roback, MD Candyce Williams, MD Bertram Kwasman, MD Lanny I. Hecker, MD Deborah J. White, MD Brendan P. Cassidy, MD Kevin O. Leslie, MD Sheldon P. Wagman, DO Michael J. Yanish, MD Howard P. Tay, MD Patti A. Flint, MD Curtis D. Miller, MD Adam Prawzinsky, MD Kishore Tipirneni, MD Robin Blackstone, MD Jennifer McDonald, MD Michael Altamura, DO Ronald L. Harvey, MD H. Wayne Hansen, MD Kris A. Smith, MD 17 Years Alison K. Cooper, MD Frederick Marciano, MD Scott A. Perkins, MD Herman Pang, MD Avtar S. Bassin, MD David J. Drewitz, MD Kathleen Norman, MD Evan S. Lederman, MD

44 • Round-up • September 2014 • A monthly publication of the MCMS

Jonathan Weisbuch, MD Thomas Ritchie, MD Anne-Marie Cosijns, MD Marie N. Gronle, MD Kurt E. Heiland, MD Jay L. Schwartz, DO Bruce A. Kletscher, MD Peter J. Campbell, MD Luis L. Gonzalez, Jr., MD Leslie Akemi Kanda, MD Atul B. Patel, MD Robert A. Thomas, MD Michael W. Wolff, MD Laurie P. Erickson, MD Alexander White, MD Susan M. Whitely, MD 16 Years Sophie Bersoux, MD Mary M. Desch, MD Keith J. Haar, MD Ronald Jorgensen, MD Steven R. Kassman, MD Jon A. King, MD Bennett R. Barrios, MD Robert H. Shapiro, MD Nolawi Mengesha, MD James F. Carland, MD Glen Yo Kishi, MD Atef Mohty, MD David M. Kassel, MD Bernard M. Gburek, MD Charles Woo, MD Carrie M. Schaefer, MD Hany E. Hannallah, MD Louis G. Trunzo, MD Donald Nicolson, MD Miriam K. Anand, MD Robert C. Grayson, MD Henry Roenigk, Jr., MD Paul W. Marshburn, MD Monte Rajul Swarup, MD Andrew J. Grade, MD Timothy J. Byrne, DO Benedict B. Dayrit, MD Maria T. Reyes, MD Sally B. Alcott, MD Julie Anne Castilla, MD 15 Years Robert D. Laufer, DO

Michael R. Mills, MD, MPH Peter W. Mitchell, MD David S. Bailie, MD Paul A. Bombino, MD Jonathan Landsman, D Mark Schlotterback, MD Lee A. Frankel, MD Ivan M. Filner, DO Nellie Pardo, MD Lexine Hebets, MD David Notrica, MD Lawrence J. Damore, II, MD A. Gianni Vishteh, MD Peter Niemczyk, MD J. Michael Morgan, MD Kent M. Johnson, MD Gerald Dorros, MD Suzanne A. Sisley, MD Richard J. Chamberlain, III, MD Allison K. Kaplan, MD Charles E. Castillo, MD Chandana Mishra, MD Jorge L. Rakela, MD Lawrence W. Shaw, MD Michael Friedman, MD Jerald S. Altman, MD Shaun D. Parson, MD Marc I. Dinowitz, MD Shawn D. Blick, MD Randall Hardison, MD Bruce D. Noland, MD 14 Years Robert R. Orford, MD Ian L. Cassell, MD Julie K. Salmon, MD James A. Daitch, MD James L. Cashman, MD Lorna Honan, MD Evelyn Lee, MD David A. Hecht, MD Roscoe S. Nelson, MD Douglas Schwartz, MD Henry K. Lee, MD William R. Stevens, MD Frank W. Moussa, MD M. Theresa Stevens, MD Gary J. Dilla, MD Nedra J. Harrison, MD Donald A. Opila, MD David R. Johnson, MD Christina S. Reuss, MD

mcms membership — 2014 Legend: Physician Member • Educational Member Daniel Lieberman, MD Robert F. Mancuso, MD Jayantibhai Patel, MD

13 Years Gary C. Mallis, MD May Mohty, MD Shyamala Kumar MD Rajiv Kwatra, MD Michael F. Cleary, MD Robert H. Gross, MD Darrell Wai Wong, MD Lise Carol Walker, MD Jung T. Dao, MD Randall W. Porter, MD Eric M. Reuss, MD Mitchell Giangobbe, MD Julie B. Kwatra, MD Mary Helen Whited, MD John M. Yalam, MD Maxwell Thomas, MD Shelly R. Messer, MD Ravi P. Agarwal, MD Janice LaBranche, MD

Hugo Fazz, MD C. Laura Ispas, MD Michael Allard, MD Paul L. Vaughn, MD Staci A. Mayer, MD John G. Hansen, MD Andrew Goldstein, MD Steven R. Kanner, MD Jodie K. Labowitz, MD James A. Singer, MD Salaheddine Tomeh, MD Christopher Huston, MD 12 Years Jack A. Buhrow, DDS Kenneth Hofstetter, MD Ashish Pershad, MD Robert P. Luberto, DO D. Matthew Maddox, DO Randi E. Rubenzik, MD Martine M. Le-Bourhis-Hannallah, MD Stanley A. Gering, MD

Andrew Kassir, MD Henry B. Sanel, MD L. Jay McIntyre, MD John Adan, MD Gary A. Smith, MD Paul M. Petelin, Jr., MD Gary M. Weiner, MD Bart Demaerschalk, MD Lourdes B. Concha, MD Keith G. Zacher, MD Christopher Yeung, MD Karen C. Chaney, MD M. Michael Hayyeri, MD David A. Nyberg, MD David Grossklaus, MD Felipe Albuquerque, MD Lynn L. Juracek, MD Ashwin R. Patel, MD Pedro J. Martinez, MD Parviz Shahvar, MD Gerald A. Mandell, MD Sally T. Wareing, MD Florin Gaidici, MD

11 Years William T. Ko, MD Philip E. Gleason, MD Ann M. Langer, MD Paul J. Conomos, MD Kristin L. Hanson, MD Robert D. Kaplan, MD Brian P. McNally, MD Mavis Shure, MD Andrew J. Dodge, MD Victor Kissil, DO David A. Camarata, MD Kianoush Kian, MD Robert M. Hurwitz, MD R. Christiaan Allen, MD Nish Shah, MD Daniela Caltaru, MD Herbert D. Hitchon, DO Dawn L. Cohen, MD Wolfgang H. Goy, MD Nicholas Theodore, MD Rick Okagawa, MD Eric R. Engel, MD Juan Carlos Llusco, MD

Daniel J. Mullen, MD Daniel J. Para, MD Patricia Roberts, MD Dorothy H. Rowe, MD Brian C. Andrews, MD Lou L. Lafond, PA - C Pradipkumar Patel, MD John K. Wenham, MD Gerrit V. Henry, III, DO Ida P. Crocker-Sabbagh, MD Paul D. Snyder, MD Parag H. Chokshi, MD Nadia Comvalius, MD P. Dean Cummings, MD Donald A. Jessen, MD Mark A. Runfola, MD Rob Ashby, MD 10 Years Gregory M. Grant, MD James W. Foltz, MD Joy Schechtman, DO Stephen S. Flitman, MD

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mcms membership — 2014 Legend: Physician Member • Educational Member Byron H. Willis, Jr., MD Felipe L. Videla, MD Mark A. Blair, MD Mikhail Shtivelband, MD Edward Rotmensch, MD James S. Carpenter, MD Stephen W. Ripple, MD James Pehoushek, MD Michael Mancina, MD Marwan Sabbagh, MD Laszlo J. Csernak, MD Robert Campbell, MD Patrick L. Flyte, MD Renee D. Espinosa, MD Douglas L. Smith, MD Arlie W. Hedrick, DO Scott A. Havens, MD Michael E. Stanik, MD Jason C. Reinhart, DO Jonathan C. Komar, MD Bart T. Leyko, MD Donald L. Lamm, MD Russell J. Bartels, MD Monireh Mahboubi-Keller, MD Stephen S. Hwang, MD Jason D. Vargas, MD Paul T. Lorentsen, MD Terry R. Maffi, MD Gil M. Holland, MD Kulbhushan Paul, MD Joe A.D. Brooks, MD Madhavagopal (Gopi) Cherukuri, MD Annette L. Hasten, FNP Victoria Horstman, MD FrederickJ. Kogan, MD S. Jaffrey Kazi, MD Paul A. Babey, MD 9 Years Richard P. Flick, MD Mandip S. Kang, MD Susan R. Cortesi, MD Lawrence Kline, DO John A. Nassar, MD Patricia I. Johnson, PhD Eugene Tharalson, MD Kristina Rudgear, MD Sylvia M. Firnhaber-Bonner, MD Richard H. Rowe, MD Marlou B. Heiland, MD Brent P. Hansen, DO

Andrew P. Smith, MD David A. Fetter, MD David M. Chisholm, DO Demetrio Mamani, MD Gurdev Singh, MD Rodrigo C. Chan, MD James W. Parisian, MD Bryan J. Pimlott, MD John M. Rowley, MD Kelly H. Roy, MD Jaskamal P. Kahlon, MD Suzanne Parisian, MD Daniel T. Fang, MD Kenneth D. Osorio, MD Ole J. Thienhaus, MD BoEldridge McClain, MD Mark E. Rose, MD Luke J. Halbur, MD Brian L. Shafer, MD Andrew J. Buresh, MD Rajesh Kukunoor, MD Ryan R. Stratford, MD Audrey C. Butko, MD Christopher Labban, DO Eddie M. Lipan, MD Jeffrey A. Brink, MD Bryan W. Gawley, MD Elizabeth McKenna, MD Charlisa F. Allen, MD Lino A. Ossanna, MD N. Dean Gramstad, DO JulieAnn Heathcott, MD Adam M. Brodsky, MD Joseph L. Haber, MD Jonathan Weinrach, MD Caren L. Borjeson, DO David S. Saperstein, MD Shahab Aftahi, MD Gary A. Betz, II, MD Gordi S. Khera, MD Robert D. Jones, MD Nathaniel Zoneraich, MD Aaron J. Davis, MD 8 Years Eric Novack, MD Gerald A. Coniglio, MD Jean A. Nelson, FNP Maqbool Halepota, MD Amol N.S. Rakkar, MD Patrick DeValeria, MD Michael T. Gutman, MD Stanley Hoffman, MD

Dharmendra Patel, MD Michael Depenbusch, MD Howard M. Abrams, MD Joseph G. Dramise, PhD Peter A. Weisskopf, MD Carl E. Silver, MD Sharon L. Boyer, DO Pearl H. Browne, MD Judith A. Mello, MD Stanley Miller, MD Matthew Ziemianski, MD Heather St. Peter, MD Michael R. Kralik, MD Sumer L. Daiza, MD Robert D. Griego, MD Deepak Khosla, MD Anthony J. Bochna, MD Haider Zafar, MD T.S.S. Rajan, MD Michael R. Brady, DO Erik E. Alexander, MD Namath S. Hussain, MD ElizabethDiedrich, FNP Reginald Sutton, MD Steven A. Nelson, MD Alan M. Grossman, MD Anikar Chhabra, MD Anne M. Welch, MD Daniel D. Charous, MD Rebecca J. Dowler, DO Matthew J. Klein, DO Janet C. Leathers, DO Paula Lopez, DO Alena S. Petty, DO John A. Ozimek, DO Kent H. Chou, MD Richard P. Benedict, MD Derek Y. Kunimoto, MD James J. Dearing, DO AfeworkiO. Kidane, DO Scott A. Cannon, MD Richard Averitte, Jr., MD Sumir M. Patel, MD Radha G. Rishi, MD Bentley C. Skibell, MD Alvin C. Burstein, MD Brett I. Siegrist, MD Ravi Bhalla, MD Jon G. Sabol, MD Michael J. Orris, DO Craig H. Weinstein, MD Jon J. Hanlon, MD Edward W. Song, MD

46 • Round-up • September 2014 • A monthly publication of the MCMS

Sharon Thompson, MD Kenneth A. Feduff Matthew C. Ericksen Sarah L. Crow Matthew A. Heller Russell D. Horton Heather M. Kerns Satish S. Kumar Donald F. Lefevre II Farheen S. Qureshi Simon M. Sheard Scott G. Ahl Jane Ahn Carly R. Anderson Mallory R. Archer Danielle Asef Gursaran K. Banipal Jamie L. Beckman Jacqueline M. Bell Alexander M. Berger Brett E. Blaser Robert Boonyaputthikvl Larry P. Buglino, III Maria O. Burgin Anjan Chakrabarty Kevin T. Chamberlain Jose M. Chavez Sean P. Codier Joseph F. Georges Eric J. Groen Evan R. Halchishick Dustin C. Higgins Kevin T. Holleman Kathryn L. Houghton Eric J. Hwang Selina A. Jeanise Jesse D. Jensen Brian P. Keene Yasir Khan Meghan S. Koch Margaux H. Krempetz Phung N. Le Van S. Leavitt Linda-Michelle Ledesma Hoang U. Lim Michelle R. Littlefield Heather A. Marino Joseph P. Marquardt Christopher P. Mason Nathan W. Matthews Jake R. Maxwell Douglas L. McGraw Scott E. McMaster Michael J.E. Monson Katherine A. Parish

Callie R. Ramsey Nicholas R. Reinhart Tami J. Rollins Saul L. Rosenstein Andrew R. Sacks Jason M. Samuelian Erin Smith Samantha L. Sornsin Preston J. Sparks Scott A. Spritzer John J. Starke, Jr. Stephanie A. Sterrenberg Suzanne R. Tariot Thomas R. Taylor Jeremy L. Thompson Andrew L. Vincent Megan D. Wangh Robert B. Wieck Jonathan R. Willms John P. Yu Mark R. Peterson Rami B. Kassis 7 Years Jose A. Menendez, MD Robyn J. Gutma, MD Parminder P. Singh, MD Juan M. Acosta, MD Vikram A. Kumar, MD Kathleen Graziano, MD Douglas J. Carlon, MD Jeromy S. Brink, MD Jose IvanRago, MD Tod M. Sugihara, DO Delphi M. Rush, FNP Stanley C. Graves, MD Curtis Gapinski Jonathan Goit John D. Malouf Drew J. Maygren Ali Borhan, MD Misha Faustina, MD Michael J. Macuga, MD Dina I. Zaza, MD Douglas Mangan, MD Jeffrey McKenna, MD Anthony A. Lee, MD Robert W. Nelson Scott A. Schraff, MD David M. Bell, DO Warren Breisblatt, MD Marvin S. Siegel, DO Bradford Gelzayd, MD Charles Foreman, MD Curtis A. Erickson, MD

mcms membership — 2014 Legend: Physician Member • Educational Member Lawrence Gassner, MD James Y. Choi, MD Anne-Marie Melk, MD Shazia A. Malik, MD Ryan M. Rehl, MD Andree J. Jones, DO Jordi S. Livi, MD Shelly R. Myers, DO Daniel L. O’Brien, DO Dominic D. Tran, MD Lacey M. Marks, MD Matthew T. Nugent, MD Carl S. Galloway, MD Klee S. Bethel, MD Henry Kwong, Jr., MD Varuzhan Movsesyan, DO Mandi D. Conway, MD Gholam A. Peyman, MD Mehmud Ahmed, MD Gina R. Shirah, MD Amy N. Bissada Janelle J. Pieros Edward J. Quinlan, MD BenjaminR. Richardson Michael B. Valletta Terez A. Yonan Howard L. Lang, MD Jennifer E. Boll, MD Andrew D. Atiemo, MD Elizabeth J. McConnell, MD Mark W. Dassel, MD Tamara Lieberman, MD Jennifer Krauland Joshua S. Bentley Laura E. Ferry, MD Kristina A. Johnson Joachin U. Okafor, MD John L. Bibb, MD Akil Loli, MD Casey R. Solem Amy M. Guzek, MD Chetan Gujrathi, MD Shane Martin, MD Cynthia L. Kooima, MD Juliana M. Kling Kurt W. Sprunger, MD Bob England, MD Jigna S. Patel, MD Gino Tutera, MD Bernadette Francois, MD Eric Duquella, MD

6 Years Jennifer Geoghegan, MD Anastasia Benson Paul L. Benchwick, DO Shahan Fernando, MD Paul S. Mahoney, MD Jason A. Salganick, MD Christine Harter, MD Boo Ghee Low, MD Bilal N. Khan, MD Robert D. Lundell, DO Katherine Metzger, DO Aaron R. B. Brandis, MD Genevieve Egnatios, MD Amaal J. Starling, MD Ryan B. Miller, MD Greg M. Hrasky, MD Viktoriya V. Sharp, MD Mohammad Uddin, MD Larisa S. Speetzen, MD Gary A. Erbstoesser, DO Nasser Djavadi, MD Justin S. Field, MD Christina Kwasnica, MD Matthias Linke, DO Coralee H. McKay, MD Ashish Sadhu, MD Kerry L. Knievel, DO Adrian H. Feng, MD Jeffrey A. Stern, MD Scott W. Kemp Christopher Kweon, MD Neil J. Atodaria, MD Elizabeth Steffen, MD Raegan Vanderput, MD Zoi Russell, MD Grant D. Padley, DO Todd M. Kravetz, MD Lindsay Baumhefner, PA Catherine G. Kasper Josh A. Newby Zeena M. Rivers Truman L.Vasko, MD Aaron W. Spaugy, MD Kelly R. Kelleher, MD Jacob S. Oommen, MD Amber Hennenhoefer, DO Paul J. Lynch, MD Tory L. McJunkin, MD Kevin R. Bigelow, MD Morgan L. Brubaker Christine V. Ragay, DO Jaime R. Gaitan, MD Theresa B. Gallo

Shanna M. Rompel Lafe N. Harris Kari L. Patterson, MD Adam M. Sabbath, MD Stephen De Souza, MD Lisa D. Moore James A. Taylor Jason S. Couch Belinda K. Beck, MD Lucas Friedman 5 Years Debora J. McClary, MD Kara M. Villareal, MD Shane M. Daley, MD Jodi L. Rubin, MD Mercedes E. Agudo, MD Bernadette Quihuis, DO Adrienne Barthell, MD Laine E. Keahey, MD Kecia R. Smette, DO Robert G. Bonillas, MD David C. Patchett, DO Daniel Riesenberg, MD Robert L. Baron, MD Laura K. Lindsay Stuart D. Flynn, MD Kumash R. Patel, MD Karim N. Jamal, MD Michael Maxwell, MD Philip B. Ivey, MD Hamed Abbaszadegan, MD Mona Amini, MD Mohammad Bakkar, MD Daniel S. Buck, MD Vasanth K. Coorg, MD Morgan Crawford, MD Melissa Denny, MD Trudy L. Dockins, DO MorvaridEbrahimi, MD Katie J. Enemark, MD Laurel A. Franck, MD David P. Galloway, MD Waddah K. Hajja, MD Marilyne Hepie, MD Kelle R. Herning, MD Emiliano Higuera, MD Griselda Higuera, MD Steven M. Hopkins, DO Jennifer Kaufman, MD Brian P. Keehn, DO Jonathan C. Koning, MD Anthony D. Kuner, MD Eve A. LaValley, MD

Mary Lawless, MD Rachel D. Levitan, MD Dustin J. Lloyd, DO Kyle J. McCarty, MD David E. Milligan, MD Jennifer A. Moralez, MD Lindsey A. Morgan, MD Jose Ochoa, MD Jason A. Patterson, MD Wade H. Pinson, III, MD Eugenia G. Politis, MD Kristy Putnam, MD Melissa A. Ramirez, MD Adam Schwartz, MD Depinder Singh, MD Carmen M. Torres, MD Andrew M. Wilkis, MD Corbett D. Winegar, MD Sarah A. Engle, MD Carter B. Lipton, MD Amol R. Patel, MD Eric S. Peeples, MD Dharmashree Sreedhar, MD Elizabeth Valencia, MD Chad P. Scheller, MD Sandra L. Till, DO Eric C. Umstea, MD Gina L. Wu, DO Courtnie G. Billett, MD Radoslaw Czajkowski, MD Christopher Gordon, MD FrederickE. Herro, MD Uyen Michelle T. Le, MD Jun Z. Luo, MD Christina M. Martin, DO Erica L. Moyer, DO Patrick C. Fattouch, MD Keric C. Menes, MD Lyndsay A. Olsen, MD Jaclyn R. Brown, MD Suha A. Ayoub, MD Scott Suciu, MD James A. Thomson, MD Maulik B. Shah, MD Andrea Eickenbrock, MD Ariel M. Gavino, MD Peter Nakaji, MD Benjamin Matson, MD Danielle K. Potter, MD Benjamin Thompson, MD Meghan Whitehouse, MD

Muzna M. Naqvi, MD Katie J. Barger, MD Monique Bushman, MD Cuauhtemoc Gallardo, MD Shannon K. Gust, MD Scott Haferkamp, MD Michael J. Hervey, MD Megan Dittmann, MD Matthew Skinner, MD David Goldenberg, MD Taro Kaibara, MD David S. Bentler, DO Craig M. Stein, MD Brenda LaTowsky, MD John E. Wanebo, MD Gerard F. Leahy, MD Ruth E. Bristol, MD Todd M. Hrabak, DO Michael Saavedra, MD Robert F. Branche, MD Emily Cyr, MD John R. Ehteshami, MD Jeffrey R. Larson, MD Robert E. Fromm, MD Ashley Hineman, MD Marc J. Berkowitz, MD Joshua D. Cohen, MD Lance A. Cohen, MD Michael Fitzmaurice, MD John C. Egan, MD Lisa E. McMahon, MD 4 Years Todd W. Turley, MD Jae O. Bae, MD Naresh P.Patel, MD Vivek Khemka, MD Daniel Bauer, MD Jose M. Reynoso, MD Michael S. Domer, MD Edward K. Rhee, MD Daniel M. Caruso, MD Lisa A. Bilek, MSN Mansur A. Khan, MD Cheryl O’Malley, MD Anita P. Schadlu, MD Ramin Schadlu, MD Tristan C. Pico, MD Steven C. Kaiser, MD Ivana Dzeletovic, MD Paul A. Pannozzo, MD Jeffrey Abildgaard, MD Nawal Ahmed, MD

A monthly publication of the MCMS • September 2014 • Round-up • 47

mcms membership — 2014 Legend: Physician Member • Educational Member Malcolm Anderson, DO Pablo A. Angulo, DO Eugene A. Bachini, MD Laura M. Barth, MD Jaclyn Battistoni, MD Kimberly Becker, DO Jennifer C. Brewer, MD Kirk M. Brisnehan, DO Jillian A. Bybee, MD Bethany Carvajal, MD Christine D. Craig, MD G. Paul Dabrowski, MD Tiffany N. Davis, MD Audrey S. Dickan, MD Kevin L. Donahoe, MD Cassandra D. Foss, MD Erica C. Garza, MD Hossein Ghofrani, MD Patrick T. Glynn, MD Bahar Golestan, MD Justin Goodnight, MD Jared A. Green, MD David A. Grossblat, MD Ardeshir Khosraviani, MD Brian C. Kitamura, MD Mark M. Levin, MD Meagan L. Lewis, MD Huixu (Judy) Liang, MD Luis Medina-Garcia, MD Rahul H. Modi, MD Jennifer L. Munay, MD Anh D. Nguyen, MD Hoai-Trinh Nguyen, MD Loyd B. Olson, MD Amar Patel, MD Reena S. Patel, MD Asha K. Pathak, MD James A. Pruitt, MD Timothy Raissian, MD Amanda Reynolds, MD Funda Sonuparlak, MD Christopher Sorensen, MD Derek Stewart, MD Christopher Strawter, MD Emily A. Stuart, MD Pierrette Tantchou, MD Michael Tran, MD Angela M. Valdez, MD Ana M. Vaughan, MD Gerald A. Wilde, MD Jaclyn L. Jerz, MD Shruti Dhapodkar, MD

Melissa Hoffman, MD Andrew S. Little, MD Carolyn M. Lobo, MD Sofian J. Al-Khatib, MD Udaya K. Kakarla, MD Nader Sanai, MD Luis M. Tumialan, MD Mazen F. Odish Tapan A. Desai, MD Kody J. Smith, MD Wilson P. Tong, MD Andrea H. An, MD Hemant K. Pandey, MD Jerome J. Grove, MD Natalie K.A. Kong, MD Maurice D. Lee, MD Kathryn E. Lynch, MD David A. Horwitz, MD Onyee Chan Jonathan Chen Alicia K. Guice, MD Bryan K. Hendrickson Joshua J. Johnson, MD Maria M. Kahn Kara R. Melmed Kelley T. Saunders Marla Stump, MD, MPH Zoe L. Vomberg Jurgen P. Weber Sotiris Mitropanopoulos Annelyssa N. Johnson Andrew P. Wong Ian D. Crain Ryan K. Bleck Michelle T. Lee Danny E. McClure Vincent M. Placido Angela B. Thurston Jessica P. Bennett, DO Daina G. Ngugi Crystal E. Scott David C. Watts David W. Dixon Lindsey S. Merritt Antiem T. Bui Bob A. Ly Casey V. Philipsborn Tyler C. Roe Muhammad O. Salim Aman Seth Jordan B. Simpson Joshua K. Sirucek Charlene A. Adrian Alya Ahsan Daniel An

Ashka D. Atodaria Saleem Azad Lee A. Babbel Rachael M. Bailey Brandon R. Beck Brian T. Bentley Allison J. Blomberg Krayton G. Blower Douglas J. Bosin William Bottomley John R. Bowers Dane Boyack Steven Braun David L. Brower Heatherann Brunell Michael J. Burke Blaine C. Campbell Travis J. Canova Shaun Chatelain Eric R. Chen Khenyian Cheung Jeans L. Choi Elizabeth Clements Lindsey J. Cline Thomas M. Cox Michael H. Cronin Mariko Crum Michael J. Cupak Toren S. Davis Tim J. Degan Dominic Derenge Bryan S. Dewey Jeffrey S. Dickson Jacqueline L. Dozier Jacquelyn R. Dunn Brian J. Ebert Adam Y. Elisha Nick J. Elkins Kenneth W. Fan Matthew P.M. Fields Michael L. Fisher Loren E. Fox Nathan A. Franklin Rachel A. Giroux Stephanie A. Glapa Robert F. Gonsalves Joshua R. Goodman Christopher Gordon Danielle N. Granieri Kendra M. Gray Courtney L. Graybeal Ashley L. Grigsby Phillip B. Gunnell Nupur Gupta Tuong-Vi V. Ha

48 • Round-up • September 2014 • A monthly publication of the MCMS

Andrew A. Hinojos Jed T. Hollingsworth Austin E. Horrocks Joel J. Hughes Jeffrey T. Hunt David C. Ingram Kyle C. Jackman Jacoby D. Jacobsen Ho-An Kang Vincent Kang Christine Kao Joseph D. Kassa Tamara K. Kelly Thomas Kennedy Andy Kieu Jonathan R. King Dane M. Klein Amanda R. Kore Akhila R. Kothapalli Matthew B. Kunkel Anna K. Kuzel Ashley L. Langston Ryan Lavsted Ashley Ledger David Lew Christine Liwanpo Jentry B. Lloyd Meghan E. MacCleary Jack K. Marsh Chad Mayer Pamela K. McCloskey Mason P. McMullin Amanda C. McNally Joshua J. Millar Jeffrey V. Myers Jamal Nadeem Udai Nanda Jordan W. Neighbors Daniel H. Nelson Jon A. Nelson Jimmy Nguyen Nam V. Nguyen Robert A. Nichols Skyler W. Nielsen Josna Padiyar Troy E. Palmer Julia M. Park Laurel A. Payne Kurt R. Peterson Sarah E. Polito Christie N. Porter Nicholas J. Pytel Pooja Rathi Jeffrey A. Reese Kimberly J. Rethy

Timothy S. Roberts Jay S. Robertson Luke A. Rond Jasleen K. Saini Sanjeet S. Sandhu Emily P. Schmid Christopher Schwartz Marni E. Shear Scott D. Sholem Benjamin D. Smith A. Bianca Stashak Timothy R. Sterrenberg Alicia M. Stone-Zipse Earl W. Stuker Ben T. Stumpf Shahaya S. Suchak Clayre E. Tanis-Arens Christopher Thomas Dao M. Tran Elizabeth Van Steenwyk Erica M. Vega Rishi Vora Jenny A. Wagner Adam P. Wahlstrom Cody R. Walker Alan J. Walsh Jamie A. Whitt Nicholas Willius Kyle Willsey Stephen J. Wolfe Lucy Y. Won Inna V. Yalovetskaya Alice Yu Jessica Yu Brad S. Zurek Jimmy T.H. Pham Jenni R. Harris John A. Ebner, DO Kelly Hsu, MD Lee P. Laris, DO Stacey A. Klyn Andrew G. McBride Andreas Kyprianou, MD Jocelyn P. Stark Ronald T. Genova, MD Todd C. Hobgood, MD Matthew B. Mors David P. Kay, MD Sam S. Ahn, MD Jordan M. Graff, MD Aileen Villareal, MD Desiderio Avila, Jr., MD Jason D. Klein, MD Ryan S. Fauble, MD Vikram Jeet Deka, MD

mcms membership — 2014 Legend: Physician Member • Educational Member Diana B. Petitti, MD Sachin Mehta, MD

3 Years Davis A. Romney, MD Leo E. Bay Emina Cufurovic Brian W. Goodman Lindsay R. Karlin Roxana Rodriguez Shaun P. Garff Craig Lowthorp Mohammad Naqvi Claudia Alvarez Nicole Lum Nathaniel Poole Dorothy M. Griggs, MD Chad Brimhall, MD Aaron Kemp, MD Mark Seifert, MD A. Randolph, MD Jonathan A. Olsen Eric S. Limkemann, DO James Goldman, MD

Judith Fagen, NP Paul Berggreen, MD Joseph David, MD Daniel Meline, MD Shamil S. Patel, MD Rahul K. Reddy, MD John W. Torseth, MD Gerald B. Harris, DO Meghan Dougherty, MD Geetha Fink, MD Forrest T. Gnagi, MD Seema Kansal, MD Tsan Lee, MD Kristina Leinwand, DO Kareem I. Ahmad, MD Pedram P. Amani, MD Brian L. Apparu, MD James Buckner, II, MD Joshua Carroll, MD Jamie Lee Cichon, MD Katherine Dabbs, MD Peter J. DeBartolo, MD Meghan Donahue, MD Pratik R. Doshi, MD

Megan M. Doty, MD Celsiuskit Gesmundo, MD Natalie Estrada, MD Maryam Hazeghazam, MD Amber Van Den Raadt Amardeep S. Johar, MD Brian D. Kelly, MD Brittany Lavoy, MD Sonty Man, MD Brian Alan Miller, DO Jeffrey Henderson, MD Lauren Moore, MD Katy Lynn Mullens, MD Charles Saperstein, MD Aleksander Robles, MD Chelsi Marie Scull, MD Mark G. Sinclair, MD Dallas C. Smith, DO Shannon Ursu, MD Lauren Welch, MD Emily Wong, MD Ying Wu, MD

Rebeca E. Cavazo, MD Kimberly Shipman, MD James C. Chow, MD Brant E. Kirk, MD Frank A. Agnone, MD Sonya Y. Lee, DO Christian Sanvanson, MD Eduardo C. Aleantar, Jr. Shruti Bala Ronik S. Bhangoo Katherine H. Cavallo Aaron J. Dahl Clifton R. Ewbank Andrew W. Hennigan Tanner Kris Jugler Nathan Y. Kim Ryan Anne Murphy Sarah Serena Sims Kellie D. Wheeler Timothy Haegen, MD Madhavi Kurli, MD John W. Molina, MD Andrew M. Bergeson Mitchell L. Factor, MD

Tabitha G. Moe, MD Angelica J. Motta, MD Minh T. Luong, MD Priscilla M. Luong, ANP Vishal A. Ganesh, MD Benjamin MacQueen, MD Usma S. Ahmad, MD Priti Sud, MD Michael P. Brown, DO Mahesh Mokhashi, MD Weston Whittington, MD Shiv K. Verma, MD Brenda Dennert, MD Shiv Raj Bhandari, MD Aaron LaTowsky, MD Y. Mark M. Hong, MD Joni S. Franklin Heyoung McBride, MD Judd E. Cummings, MD Darrell K. Reed, MD Julie A. Wendt, MD

A monthly publication of the MCMS • September 2014 • Round-up • 49

mcms membership — 2014 Legend: Physician Member • Educational Member Vafa Ghaemmaghami, MD Priya Radhakrishnan, MD

2 Years Colleen Hunsaker, DO Katisuka Dos Santos, MD Brandon J. Coakley Kristen M. Lane, DO Kasra A. Rezaei, MD Ross L. Stutman, MD Howard S. Shapiro, MD John P. Keats, MD Jennifer Hartmark-Hill, MD David W. Smith, MD Phillip W. Bennion, MD Tanja L. Gunsberger, DO Satyendra K. Jain, MD Eric Schlesinger, MD Minesh R. Zaveri, DO Andres Hernandez, MD Samuel F. Brunk, MD Jeffrey M. Chen, MD Lanceford Chong, MD Christine Estrada, DO Joel L. Granick, MD David A. Litvak, MD Daniel W. Nixon, MD Walter Quan Jr., MD Richard A. Shildt, MD Karen Taylor, PA Thuy-Anh T. Le, MD Mansour Assar, MD Sina Nafisi, MD Brian L. Acord, MD Stephen D. Frausto, MD Jiaxon (Jason) Niu, MD Belinda L. Shirkey, MD Edgar D. Staren, MD Robert A. Wascher, MD Jeffrey M. Weber, MD Joshua S. Bingham, MD Luke W. Hosack, MD Prajesh Adhikari, MD Nedda Alemi, MD Lindsay Allen, MD Hayley Baines, MD Nicholas Baldwin, DO Paul Beeston, DO Stephen D. Bell, DO Rebecca Berghorst, MD Jennifer Chaffin, DO

Jagman Chahal, MD Hasan Chaudhry, MD Shannon Curry, MD Leslie A. Dietrich, MD Kimberly Eisenstein, MD Neal Hartman, MD Michael Igwe, MD Tara Johnson, MD Jacqueline Le Hunziker, MD Layla Shanah, MD Blake P. Sherman, MD Anne Guerrero, MD Cristina E. Tamez, MD Kristl Tomlin, MD Peter M. Uon, MD Oren Goltzer, MD Ricky Chang, MD Mercy C. Chong, MD Ahmad Kadhim, MD Amanda E. Pope, MD Lindsey Query, MD Amanda Saraf, DO Thomas Vernon, MD Billie Winegard, MD Yasamine Al-Kenani, MD Alicia Cowdrey, MD Brano Djenic, MD Nicholas Figueroa, MD Vennu Gupta, MD Carlos Hartman, MD Firoozeh Isfahani, MD James Palmer, DO Ming Zhang, MD Christle J. Layton, MD Lauren Duffey Rheana Techapinyawat Mandy Ward Carmel Moazez, MD Manisha A. Purohit, MD Rebecca N. Smith, MD John N. Galgiani, MD GiuseppeRamunno, MD Robert Candipan, MD Burt Faibisoff, MD Ralph T. Heap, MD Vidhyalakshmi Kannan, MD Raul Lopez, MD Rushda Mumtaz, MD Paul S. Saphier, MD Jeremy Berger, DO Charles B. Boag, III, DO

Leigh Anne Costanzo Brian McWhorter, DO Brooke G. Jeffy, MD Shantanu Thakur, MD Craig Batty Lane Dedrick Albert Hsia Katy Lockhart Michael Retzer Otto Shill Thomas Whiting Matthew Calde-Fabiszak Christina Hoang Eric Huynh Michael Schild David Hill, MD Sarika K. Desai, DO James P. Corrigan, DO Donald J. White, MD Sunita Gupta, MD Jill Kerr, DO Brandon E. Gough, MD Emily Law, MD Erica D. Wadas, MD Trenton Baker, DO Nancy H. Kim, MD Jordan R. Roberts Annemarie K. Tilton Edward Galiczynski, DO Matthew J. Welch, MD Christopher Murphy, MD Amber L. Vegh, MD Milla S. Rosen, MD Sally J. Ortega 1 Year Matthew Woods, MD M. Alejandro-Reyes, MD Jay M. Crutchfield, MD Bhavani Naginani, MD Parag Rasik Patel, MD Eric M. Ossowsk, MD Jennifer L. Hester, MD Kristine Romine, MD Tam Chu Pratik Shah, MD Hannah Sisley, MD Joanna Newton Rachel G. Simpson, MD Aqib H. Zehri, MD Bryan Glick, DO L. Markham McHenry, DO Oner A. Khera, MD

50 • Round-up • September 2014 • A monthly publication of the MCMS

Marianne Mason, MD Susan C. Horne, MD Kristin Swenson, DO Millie A. Behera, MD Molly Solorzano, MD Victoria Ainsworth, NP Cyndee Garner, NP Tarry A. Wolfe Bashar Ahmed Karen Alonso Nneka Anuligo Alicia Boone Aspen Calkins Jane Cho Shannon DeGrote Ryan A. Evand Sarah Flocks Lise Harper Benjamin Johansen Rundgren Leigh Joe Orme Nathalie Petein Masoud Sultani Kevin Vest Jennifer Weber Danny Wong Amir E. Harari, MD Kimberly L. Olson Christpher Eswar Helen Hilts Tilina Hu Seth M. Kaufman, MD Thomas F. King Vivek Malladi Akash Nabh Cory Nelson, MD Kelvin S. Panesar, MD Caroline Reynolds Shimul Sahai, MD Allison Snyder Adina Weis Tara M. Ostrom, MD Benjamin Bakall Kelly Helms, MD Limor Philipp Wall Joshua W. Hustedt, MD Craig Rundbaken, DO Richard H. Rowe, MD Stuart Kozinn, MD Matthew Wright, MD Yetunde N. Adenle, MD Abel Aguirre Andrew Barclay William Bendall Brock Bennett

Liam Bosch Bryant Brown Jaycen Brown Katherine Budoffson GiuseppeCarotenuto Weihua Chen Philip Cheung Lauren Cole Reese Darc Amy Davis Sandeep Dhadvani Rotem Fishel Josh Gordaon Alison Goulder Taylor Graber Mark Guevorkian Jawad Hussain Kelly Isbell Taylor Jenkins Ovninder Johal Ken Johnson James Kelleher Sarah Kellerhals Jeff Kim Patrick Kishi Alexander Koracs Alyssa Korenstein Jane Lg Tyler Liss Amanda Loh Christopher McCabe Joseph Moseley Alisha Nanda Erin Nelson Gregory Norris Ling-Yi Obiand Devin O’Connor Danielle Olla Brent M. Page Siddharth Pandya Jaime Perkins Lauren Quenn Casey Rosser Sarah Rubenstein, MD Muniza Siddiqui Kole Spaulding Joshua Spiro Ella Starobinska Brittany Sullivan Kelsey Wilhelm Nicole Yee Bita Zahedi Aqib Zehri Olivia Zoph Ronald Harris, MD

mcms membership — 2014 Legend: Physician Member • Educational Member

Bich-Hoa Nguyen, DO James F. Doris Nicole Konkowski BenjaminReeser John Tefteller Ryan R. Falsey Mary Forest, MD Eduardo Salazar, MD E. James Bodmer Rodney Jackson Neel Chheda, DO Brenda Gonzalez, DO Benjamin T. Rud, DO Thaxton Springfield, DO Kenneth Steil, DO Natalie Stroke, DO Roya Vahdatinia, DO Brian R. Bradford, DO Bhasker R. Pujari, MD Shidrokh Taeidi, DO Arka Chaudhury Will Goodrich, DO Marcy L. Cruz Charles T. Williams, MD Nicholas Vasquez, MD Joshua Waggoner, MD Matthew T. Witmer, MD Lee Ann Kelley, MD Mary E. Schultheis, MD

Rajan H. Patel, MD Todd M. Dreitzler, MD Michelle D. Hamilton Dustin Marshall Paul Shapiro, DPM Lindsey Westerhaus, DPM Garren Giles Ali E. Wait, MD Charles M. Schron, MD Christian Lee, MD Karen Prentice, DO Joilo C. Barbosa, MD Ronald Holgado, DPM Manish G. Amin, MD G. Alan Bracher, MD Lewis Freed, DPM Todd Haddon, DPM Sandeep C. Patel, MD Yatin R. Patel, MD Dean Clement, DPM Cara W. Talamante, MD Yebabe Mengesha, MD Jena Auerbach, DO Brooke Blumetti, DO Sarah I. Estrada, MD Travis Scott Lam, DO Debi Layton, MD Gerald Muthu, MD

2014 Members Alan J. Discont, DPM Hassam S. Makki, DO Thomas Palilla, MD Shannon M. Peters, MD Donald Cunningham, DO Charles M.T. Jost, MD Harmohina Bagga, MD Lester R. Klebe, DPM John Middaugh, MD Alexander Villares, MD Sean Brimacombe, MD Jason Arthur Barr, DO Christine C. Lin, MD Michael Cupak, DO Aaron B. Klassen, MA Peffin Lee, DO Ross F. Goldberg, MD Natasa Vojvodic, DO Gregory C. Dodar, MD Chelsea McGarvey, MD Jeff T. Mueller, MD Katherine Peterson, MD Kimberly Yeung-Yue, MD Guery Flores, MD Grace Haynes, MD Jeffrey F. Morgan, DO Herman Leung, DO Jaymus Ryan Lee

Tiana Blank Christine Chung, DO Mary Haywood, DO Chelsey Horath, DO Jennifer L. Huntley, DO Ravi Patel Joseph P. Shortall, DO Randy K. Tingle, DO Kathryn Weber, DO Eric J. Yang, DO Meghan Brombach, DO Aldo G. Estella, DO Fionna Feller Jessica Gascoigne, DO Alexander Higgins, DO Raghu Kanumalla, DO Teagan L. Lukacs, DO Sofia Mani, DO Cris Molina Sowmya Padakanti, DO Esther Quintero, DO Arielle E. Rubin Danielle Rumsey, DO Jessica Rydberg Arzoo Sadiqi, DO Catheryn Salibay Katie M. Sammons Daniel Skinner, Jr., MD Zuma N. Speakman, DO Rodney E. Till, DO

Phong T. Truong, DO Michael Van Tienderen, DO Syed Zaidi, DO Burt G. Feuerstein, MD Janet Shalwitz, MD Josh D. Burto, DO Abida Hasan, DO Bryan Imayanagita, DO Ryan H. Kirk, DO Alwin Louie, DO T. RobertA. Taylor, DO Georgia G. Hall, PhD Kenan Arkawi, PA ru

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A monthly publication of the MCMS • September 2014 • Round-up • 51

mcms — at work for you

Looking to grow your practice? Participate in our FREE Physician Referral Service.

Candice Scheibel

or a patient trying to find the right physician, not just any doctor will do. Some are not only searching for someone for their own medical needs, but also for family members in need of care. Whether they need a routine checkup or require highly specialized medical care, it needs to be someone that the patient and/or their family feel comfortable with. Someone with the right credentials. Someone they can trust.

To aid the community and help attract patients to our physician members, the Society offers a free telephone and web-based physician referral service to connect the patient with a physician that best meets their medical needs.

When an individual calls or emails to Society, MCMS membership staff asks for the type of physician or specialty, city of residence, and any other demographic information needed to identify the appropriate physician. (Upon request of the caller, we will also provide educational information and board certification(s), gender, and languages spoken.) The MCMS representative will then enter the information into our database and the results will populate a list of physician that meet the entered criteria. MCMS physician members whose profiles best match the search criteria will appear at the top, narrowing down to physicians who only have several properties that “match” the request. Each time a search is performed the referrals will shuffle as to give all those who participate in the program an equal opportunity to receive a referral. MCMS provides as many choices as the caller requests. Totals for web and phone are kept on a monthly, quarterly, year-to-date and last year basis in the physician’s profile. The final selection of a physician is up to the patient based on their needs and preferences. Referrals are provided during Society business hours, Monday through Friday,

8 am – 5 pm. Unanswered calls are sent directly to voicemail and returned the following business day.

The referral service is manned by MCMS staff that is knowledgeable about all the physicians in the program and understands the doctor/patient bond. It is operated for Maricopa County Medical Society actively practicing members whose membership is in good standing, are residency- trained, board-eligible or certified, and licensed to practice medicine in the state of Arizona. There is no charge to MCMS members or to the caller/web user for this service. New, qualifying MCMS members are asked at the time of enrollment if they would like to receive referrals. Those who check yes need to complete a series of questions such as their education, specialties and board certifications, areas of interest, languages spoken, additional offices, and gender. This information is entered into e-Society within three business days. As soon dues payment is recorded in the member’s account, the profile is “turned on” and the physician’s information is active in our referral system and online search.

Updates and/or review of existing profiles can be requested at any time by calling the MCMS Membership staff at 602-252-2015 or email mcms@mcmsonline.com. Updates are reflected within one business day and online within 48 hours. To review your current profile, go to www.mcmsonline.com/providersearch and enter your last name. For those members receiving referrals, in order to refer the appropriate patients to your practice, we need to have up-to-date biographical information on you in order to match consumer needs with your expertise. Please call or email us. We will work with you or your designated contact person to update your profile.

52 • Round-up • September 2014 • A monthly publication of the MCMS

mcms — at work for you Referral Line Fast Facts Phone number: 602-252-2844 Website: mcmsonline.com Email: mcms@mcmsonline.com MCMS membership value is in the numbers

Looking towards the future, plans to build on the existing service to provide additional member value include: • Keeping our referring physicians and their patients informed. Sending MCMS members a follow-up email to let them know we successfully referred to them. Included in the email will be the caller’s contact and/or demographic information your office needs to follow-up with the caller.

• Enhancing the online user experience. Plans to enhance the physician/provider search on mcmsonline.com include a physician map search, a map view – ability to see search results pinned on the map, a cleaner look and feel, and more.

• Improving the user experience. Building upon existing infrastructure, we will include additional information for callers such as the insurance accepted by physician members and hours of operations for the office/clinic/appointments.

If you are not currently signed up to receive FREE patient referrals, isn’t it time? Call MCMS at 602-252-2015 or email mcms@mcmsonline.com to get signed up. ru Candice Scheibel is the Director of Communications for the Maricopa County Medical Society overseeing membership, marketing/communications and the production of Round-up.

She has worked in healthcare marketing for over 15 years, including leading marketing/communications efforts for two start-up health plans.

Contact her at cscheibel@mcmsonline.com or call 602-251-2363.

• MCMS provided 12,224 physician referral in 2013. (Web and telephonic included in totals). • This breaks down to 1018 calls per month, 235 calls a week, annually. Specialty • Internal Medicine: 1626 • Family Medicine: 1033 • Gastroenterology: 1029 • Orthopedic Surgery: 872 • Ophthalmology: 552 • Psychiatry: 541 • ObGYN: 531 • Cardiology*: 410 • Dermatology: 374 *Includes Cardiovascular Disease and Interventional Cardiology.

Cost The average dollar amount for a regular office visit to a PCP under the CPT code 99213 is $75 (allowed amount) for an office visit (Medicare fee schedule is $72). Three referrals through the MCMS telephone and web-based service = $250 (active annual dues membership).

A monthly publication of the MCMS • September 2014 • Round-up • 53

in memoriam

Honoring

those we lost. The members of the Maricopa County Medical Society are the organization's greatest asset, an assemblage of the finest physicians and healthcare providers. On this page we pay homage to those members who have passed away during the last year. You will be missed.

Roberto Alvarez, MD MCMS member since 1979

Robert Forrest Easley, MD MCMS member since 1953

Stephen Milliner, MD MCMS member since 1984

Carl H. “Doc” Ault, MD MCMS member since 1976

Lee Ehrlich, MD MCMS member since 1946

John Phillip Nelson, MD MCMS member since 1989

Michael S. Balis, MD MCMS Member since 1979

George Arthur Gentner, MD MCMS member since 1959

O. Melvin Phillips, MD MCMS member since 1963

Robert D. Castillo, MD MCMS member since 1980

Clifford J. Harris, Jr., MD MCMS member since 1987

Jack Allen Pierce, MD MCMS member since 1980

Robert F. Crawford, MD MCMS member since 1961

Howard C. Lawrence, Jr., MD MCMS member since 1951

Dr. Wallace A. Reed, MD MCMS member since 1948

Charles Eugene Davis, MD MCMS member since 1963 Robert Caldwell Drye, MD MCMS member since 1993

Kurtland Ma, MD MCMS member since 2013 Thomas J. Maxwell, Jr., MD MCMS member since 1992

54 • Round-up • September 2014 • A monthly publication of the MCMS

Clive Hamilton Sell, MD MCMS member since 1989 James Cruse Zemer, MD MCMS member since 1962

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medical student perspective

A Medical Student Voice: SAILing at the State Capitol Danielle Olla

uring the first week of medical school, Jacqueline Chadwick, MD, Vice Dean, Academic Affairs, University of Arizona College of Medicine – Phoenix spoke to my class and stressed the importance of being involved as a physician. She told us that if we are not present when decisions are being made then others will determine the way we practice medicine. I appreciated the importance of what Dr. Chadwick said but I tucked it away in my mind, unsure of how I could really contribute as a medical student.

This February, during a week of shadowing for our capstone course, I had the opportunity to attend the Women’s Health Day at the Capitol. I heard from both of the physicians serving in the legislature, Senator Kelli Ward and Representative Eric Meyers, and learned about current medical legislation.

The main focus at that time was the midwifery bill. After hearing the facts and that the bill had already passed, allowing midwives to delivery high-risk births at home, I began to understand the importance of a physician presence in the legislature. I learned that facts are not seen the same way in the legislature as they are in medicine, and that anecdotal evidence is often seen as strong support.

After attending Women’s Health Day, I received an email asking for support regarding the midwifery bill. As a first year medical student I felt the only way I could show my support was to be present. I decided to skip an afternoon of classes to attend the hearing of the bill in the Senate. I heard testimony from both sides. At the end of the hearing, the bill blocking the increased range of scope barely passed to the next stage by one vote. At the end of the day, a Senator thanked all of the midwives and women who brought their babies to the hearing. Meanwhile, I had sacrificed going to lecture and was not recognized for my time.

I wondered if physicians are ever even acknowledged as present in the legislature.

I also experienced the animosity between sides. One of the supporters of the midwives looked at me with an expression full of loathing that I will never forget. I thought about how much the community would benefit if we could all work together. Midwives could turn to physicians for help if we had better relationships. This antagonism is not benefiting anyone.

Later I found out the bill blocking the midwifery bill was killed because it turned into a prolife issue. This is when I decided to do what I could as a medical student to bring about change for my generation of physicians. I started a club on campus called Students Advocating In Legislation (SAIL). I am working with our sponsor, Dr. Hartmark-Hill, to get students involved. We are planning events, which include meeting with the physicians in the legislature, a workshop on how to better advocate, attending sunrise hearings, and having a day at the capitol.

This has been my journey during my first year of medical school. I hope to inspire medical students to be a force within the Arizona legislature and I hope SAIL will be a permanent fixture at the University of Arizona College of Medicine-Phoenix. ru This column is reprinted with permission from AzMedicine, Volume 25, No. 2. Danielle Olla is a second year medical student at the University of Arizona College of Medicine - Phoenix. She is the founding member of the group, Students Advocating in Legislation (SAIL). Contact her by email to dolla@email.arizona.edu.

56 • Round-up • September 2014 • A monthly publication of the MCMS

medical student perspective

Meet the Physicians Serving in the Arizona Legislature

On September 3, University of Arizona College of Medicine - Phoenix medical students involved with the student-run advocacy organization Students Advocating in Legislation (SAIL) invited physician legislators Sen. Kelli Ward, DO (R) and Rep. Eric Meyer, MD (D) to share their unique perspective of holding a dual role of physician and politician.

During the hour and half session Drs. Ward and Meyer spoke of their journey as a physician-advocate and state legislator, their perspective on the current opportunities for advocacy in healthcare policy for students and clinicians, and their vision for the advocacy of healthcare needs for physicians in the immediate future. Event sponsors included the MCMS and the Arizona Medical Association.

Left to right: Rep. Eric Meyer, MD, Danielle Olla and Sen. Kelly Ward, DO

Jennifer Hartmark-Hill, MD introducing the featured speakers.

Event attendees enjoying the photo op. This group is all smiles!

SAIL, one of many student interest groups and organizations for medical students at the U of A College of Medicine - Phoenix, educates its members and the community on the legislative process in Arizona and current medical legislation while developing relationships and communication with the legislators in different districts. SAIL also actively advocates for Arizona health policies at the state legislature on issues related to regulation, scope of practice and other medically statutes. SAIL works closely with other members of the health community and medical organizations to advocate for the best interest of the future physicians and future patients.

SAIL’s student advisor is MCMS member and Board Director, Jennifer Hartmark-Hill, MD. ru

A monthly publication of the MCMS • September 2014 • Round-up • 57

practice management

Do you have the right person managing your practice? Gayle Petrillo, MBA

hough there are many titles for the individuals responsible for day to day medical office operations, including office manager, practice manager, and administrator, there are essential functions that this person is accountable for.

Because of the number of duties requiring administrative juggling at any given time during a day, (s)he must possess strong financial acumen and knowledge of human resource management, compliance, information technology, organizational governance, risk management, facility management, purchasing, sales and marketing, and strategic planning.

Additionally, this individual must have skills and interest in psychology, negotiation, teaching, mentoring and coaching. And if that isn’t enough to make your head spin, the ideal person in this position also has a good sense of humor, delegates and takes direction, possesses excellent written and verbal communication skills and thinks critically. Do you have the right person managing your practice? By developing or growing the following skills, your practice manager can add value to and expand the breadth of his or her role.

Financial Acumen Not only is it important that the practice manager understand overall financial management, including profit and loss, lines of credit, loans, types of accounts, EFTs, credit cards, etc., but also serve as a financial counselor to patients and help them understand their fiscal responsibility from a self-pay perspective or co-insurance. Payor contract negotiations are also key skills necessary to the success of your practice, which includes an understanding of carveouts applicable to your specialty and changes as we move from volume to value based medicine. Inventory control

A monthly publication of the MCMS • September 2014 • Round-up • 59

practice management

“Hiring and retaining the best person for a position is key to the success of any medical practice; it is not as easy as offering a breathing body an open spot. This is especially important for hiring the person to sit at the front desk, as the revenue cycle begins there.” Gayle Petrillo, MBA

would also fall into this category since the ability to manage your “warehouse” of medical and office supplies impacts your bottom line because vaccines, IUDs and other such items require an outlay of cash weighed with reimbursement timing.

The ability to manage the revenue cycle is also key because it is probably one of (if not the most) important piece of the practice management puzzle. From daily charge entry to coding and billing, payment posting, insurance follow up and collections, your practice manager has responsibility for

ensuring physicians and midlevel providers correctly document and code visits so that bills are sent out correctly (the first time) and timely so revenue is maximized; directly correlating to the overall financial health of the business, your practice. Obviously, without sufficient revenue accounts payable are negatively impacted as is payroll for physicians and staff. Whether you have an employed billing office or outsource it, oversight is critical to its success and your bottom line. What are your days in A/R? Your percent of accounts receivable

less than 120 days and larger than 10%? And your percent of accounts receivable less than 90 days and larger than 25%? What’s your payor mix? What are the number of days in receivables outstanding? These are measures of time to revenue. And what is your net collection rate, answering the question, “of the money you can collect, how much did you collect?” (This takes into account the contractual adjustments that are made to the gross charges.) Do you have a policy for budget plans to assist your patients? What about your collections process – how many bills and phone calls are generated before addressing internal and external collections? These are all questions your practice manager should be able to answer and oversee. Let’s segue here to mention patient complaints because, in my experience, they run the gamut from finance (confusion about or refusal to pay co-pay, co-insurance and/or deductible) to patient relations (such as perceived behavior on the part of an office staff member or provider) to issues with parking, signage, music, etc., and may include lengthy wait times in person or on the telephone. It is important to have someone non-clinical dedicated and available to listen to patients and/or their designees and view this feedback as an opportunity to retain patients in the practice and improve procedures, processes and/or policies. It is true that not all complaints have merit, however sometimes people just need to vent and by giving them the opportunity to do so, with your practice manager using active listening skills, you may fend off potential litigation. Tip: A non-clinical individual (i.e. your practice manager) should have

60 • Round-up • September 2014 • A monthly publication of the MCMS

practice management the responsibility for communicating financial information between the patient and practice; keep clinical and financial duties separate.

Human Resources Management Hiring and retaining the best person for a position is key to the success of any medical practice; it is not as easy as

offering a breathing body an open spot. This is especially important for hiring the person to sit at the front desk, as the revenue cycle begins there.

I’d like to start this discussion with the ‘waiting room’ being referred to as the ‘lobby’. The connotation and perception should then be clearer. This is where a patient is

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A monthly publication of the MCMS • September 2014 • Round-up • 61

practice management welcomed in to your practice. There should be a designated receptionist (more than one depending on practice size) who has responsibility to greet patients. Liken this role to that of a hotel receptionist. When you walk through the door, (s)he appears to be expecting you. Your receptionist(s) greets patients, obtains new and/or updated demographics, insurance and pharmacy information, collects monies due (including copays, deductibles and outstanding balances) and notifies clinical staff of the readiness of the patient. These staff members are critical to your patient relations because they are often the first physical impression of your practice. Malpractice insurers have collected data that proves it is frequently the ancillary personnel in a practice who patients judge the practice standards by and facilitates return visits and referrals, not necessarily the clinical decision making.

Tip: The front desk is where a patient should be welcomed in to your practice. Smiles are contagious; we know patients come to our offices nervous, scared or not feeling well, and a simple gesture of a smile can make a significant difference to your patient and positively impact the outcome of their visit. Not only is recruiting the “right” person important, but it is also necessary for the practice manager to understand labor law. For employee recruitment they must have a basic knowledge of the legal interview questions, the Family Medical Leave Act, Labor Law (wage and hour law such as lunch breaks, overtime, hourly vs. salaried and exempt vs. non-exempt employees, etc.), compensation and benefits implications, medical, dental, vision and short-and long-term insurances and 401K and pension plans. For existing employees, they must understand appropriate preparation for and carrying out of disciplinary actions, up

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62 • Round-up • September 2014 • A monthly publication of the MCMS

to and including termination to avoid potential lawsuits, EEOC complaints and the like. Not only are these skills applicable to recruiting and retaining support staff, but for physician and mid-level recruitment and retention as well. A good rule of thumb here is to remember that, as with non-clinical practices, if it isn’t documented it didn’t happen. Tip: Remember to document, document, document!

While on the subject of retention, once your practice manager has identified and hired the perfect front or back office person, what should you do to retain them? In this age of reduced reimbursement and increasing overhead (such as electricity, gas, water, rent, etc., let alone the cost of purchasing EHRs and other operational necessities), the former generosity of giving your staff an extra $1.00 an hour or even 2, 3 or 4% increases are likely days gone by. However, gestures such as recognition of a job well done, little gifts or even a simple “thank you” can increase your employees’ overall job satisfaction and loyalty. Tip: A verbal “thank you” goes a long way to let your staff and even professional colleagues know they are appreciated, as does buying Starbucks or movie tickets. Tactics like these may have to be reported on employee’s W-2s as income. This is where knowledge of accounting principles may save future headaches for the practice and its staff.

Compliance There is not enough space in this article to cover all the nuances this topic requires. Suffice it to say that every practice should have a compliance/safety officer (such as a practice

practice management manager) who is responsible to know, understand and effectively create, update and be accountable for carrying out policies involving Privacy and Security under HIPAA and HITECH, OSHA, OIG and the many other state and federal rules, regulations and laws.

Tip: Have a “Disaster Recovery Plan” – a living, breathing document that will guide you, your colleagues and staff should the unexpected occur whether it’s a HIPAA breach, EHR and/or telephone crash, or Mother Nature’s revenge (such as a flood, fire or other natural disaster) or other crisis.

Information Technology The need for knowledge of computer, telephone and security systems grows exponentially every year. With government mandates (and financial penalties for non-compliance) for consumer-driven healthcare initiatives, such as moving from paper records to electronic records or (equally important) from your current EHR to a more robust system, an understanding of these mandates and standards is imperative. Likewise, having the ability to run reports from your phone system to monitor dropped, inbound, outbound and transferred calls are vital to the success of your practice. It is important for your practice manager to handle (or hire someone to handle) your information technology in an appropriate and customer-friendly manner. Facility Management The simple acts of monitoring janitorial services, including replacing light bulbs, unplugging toilets, daily cleaning, and larger annual maintenance (i.e. interior/exterior painting, HVAC, etc.) must be acted on, coordinated and tracked by someone. These responsibilities generally fall to the non-clinical practice manager, who must be organized and aware of current and potential issues.

Strategic Planning Strategic planning discussions are necessary to the continued success of a practice. Consideration may be given to succession planning (for professional and support personnel), including keeping tabs on whether someone will be retiring or whether the workload could support additional providers and/or staff or capital and non-capital equipment. This could also include decisions about adding or growing service lines, building improvements or relocation, mergers and/or acquisitions; the list is endless and builds on the topics previously mentioned.

In Summary I strongly urge physicians to encourage their practice managers to become members of local and national organizations to assist them in keeping knowledgeable in their field, whether specific to healthcare practices (Medical Group Management Association - MGMA), human resources (Societ for Human Resource Management SHRM), and/or coding (AAPC). Other associations offer certifications that speak to the level of competencies achieved. Practice managers benefit from membership in these organizations for many reasons, from additional networking opportunities to access to resources that help practices stay up-to-date on changes and prepare for the future. The bottom line is that every practice manager is required to wear a multitude of hats throughout any given day. The more diverse experiences – and the more education (whether learned on the job, certified by a national organization or credentialed by an academic institution) – that person has, I believe the more a practice is able to benefit. ru

Gayle F. Petrillo, MBA has over 30 years of experience in the healthcare field, including hospital settings and in academic, hospital-owned and private medical groups.

Born in Upstate New York, she grew up professionally at Albany Medical Center Hospital and Albany Medical College, serving in a variety of roles including managing bed control and the information desks at the 600 bed hospital; and managing practices in the college of medicine. Additionally she worked in the clinical research arena for 10 years.

After moving to Tucson 15 years ago she obtained her MBA in Health Care Management from the University of Phoenix, and received her Professional in Human Resources certification from the Society of Human Resource Management while working at Carondelet Medical Group as their HR Director. She was the Pathology Administrator at University Physicians Healthcare before moving to Phoenix for five years, serving as a Director of Operations in Banner Medical Group, and subsequently as the Executive Director for Thunderbird Internal Medicine. After commuting between both cities, she relocated to Tucson in 2013 and is now employed by Genesis Ob/Gyn and sits on the Board of AzMGMA. Contact her by email to gaylepetrillo@earthlink.net or call 602-621-0042.

A monthly publication of the MCMS • September 2014 • Round-up • 63

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viewpoint

Pox on their houses. Rudi Kirschner, MD

nderson vs. General Motors (G.M.) is a landmark decision to say the least. The verdict by the jury was for $4.9 billion. This was reduced by the court to $1.2 million. The injuries sustained in this accident were disastrous to be sure and I have no idea how much compensation is fair, right, or appropriate. I doubt than anyone can measure in money the pain and life-long suffering an individual experiences. I am not concerned with the amount of money awarded as much as the legal maneuvering it entailed.

It’s been a while since I have engaged in one of my favorite pastimes – namely drawing attention to the vagarities of the legal system. It baffles the mind. Medicine teaches us to gather all the information, to collect all the details, to consider all the particulars, to leave no elements out in our analysis. Law, in my opinion, should be fair. Fairness within the framework of the law is an often forgotten and ignored entity. Indeed a sad situation. Worse than sad – disastrous.

Anderson vs. G.M. concerned a rear-end collision where the fuel tank exploded and engulfed the passengers in an inferno. The judge would not permit in evidence the fact that the perpetrator of the crash was driving at a speed of 70 miles an hour, well above the posted speed limit. And the fact that the guilty party had a blood alcohol level of 0.2 percent, two hours after the accident. This information appears vital, essential, of overwhelming importance and yet for whatever reason the judge ruled otherwise. Another reason also to ask “is the law fair?”

There is hardly any person around who is more opposed to smoking than I and yet it totally escapes my thought process why the tobacco companies are held irresponsible.

For example, in 1999 the court decided against the tobacco industry to the extent of $145 billion; one of the plaintiffs, a nurse, said that she had no idea there was anything wrong with cigarettes at all. Protect me from witnesses who obviously have been totally oblivious to the world of today and from judges who appear equally as oblivious. The question again surfaces, “What is fair?”

In my experience in medicine I treated, or should I say tried to treat, patients with lung disease due to smoking and patients with liver disease due to alcohol. It seems the alcohol addicts and their victims fared worse and yet I see no lawsuit against the liquor industry. To be “fair” however, nobody forces the individual to smoke or to drink so the decision rests with the individual, tobacco and liquor industry notwithstanding. Both manufacture addictive substances and yet the tobacco industry seems to be the favorite whipping boy.

For my money – pox on both their houses and while we are at it, let’s put a pox on the courthouses too. ru Dr. Rudi Kirschner is a retired Family Practice physician. He has been a member of the MCMS since 1959 and a comtributing author to Round-up for many years. He can be reached at rkirschnermd@cox.net.

Do you have a viewpoint? Share it with us and we’ll share it with our readers! Email mcms@mcmsonline.com

A monthly publication of the MCMS • September 2014 • Round-up • 65

marketplace REAL ESTATE 2,055 SF MEDICAL SPEC SUITE PARADISE VALLEY MEDICAL PLAZA Class A on campus MOB. Located At SR51 & Bell Rd. Move-in ready except flooring and paint. Six exam rooms, 2 HC restrooms, MA station, and large waiting area. Strong medical specialty mix in building. Contact Margaret Lloyd, Plaza Companies 623-344-4558 MEDICAL OFFICE BUILDING AVAILABLE FOR LEASE $12.00 SF. Just north of downtown Phoenix, walking distance to Phoenix Light Rail. Includes 7 plumbed and 7 non-plumbed office/exam rooms, kitchen, break room, and reception area. Suites ranging from 2,000-7,500 SF. Contact Beth Jo Zeitzer/Justin Cirell, R.O.I. Properties, 602-319-1326 APACHE JUNCTION MEDICAL PLAZA Second generation PT and Oncology spaces available in this beautifully landscaped medical plaza. Both suites are available for immediate move in. Excellent visibility and signage. Adjacent to Arizona Regional Medical Center. Three miles from Mountain Vista Medical Center. Contact Marina Hammersmith, CCIM, Ensemble Real Estate Solutions, 602-954-8414

SURPRISE MEDICAL PLAZA has up to 6,476 SF shell space which can be custom designed to meet your needs. It is anchored by Banner Health Women’s Center, Primary Care Center and Affiliated Dermatology. Contact Tracy Altemus, CCIM, 602-443-4030 at Ensemble Real Estate Solutions. MEDICAL OFFICE SUITES TEMPE-MESA AREA Medical office suites for lease in beautiful garden office complex. Newly remodeled 1200 and/or 1800 sq. ft. suites. Includes covered doctor parking. Excellent location with easy access to 101 & 60 freeways & close to Desert Samaritan & Tempe St. Luke’s Hospitals. Best rates in area 602-625-6298. DESERT MEDICAL I-II-III Join over 120 Practicing Physicians on the campus of Banner Desert Medical Center and Cardon Children's Medical Center. Up to 32,000 SF available on two floors. Contact Tracy Altemus, CCIM, 602-443-4030 or Marina Hammersmith, CCIM, 602-954-8414 at Ensemble Real Estate Solutions FOR SALE Family Practice Physician retiring. Beautiful office building on Ray Rd. in Chandler. Ideal for 1-2 docs or satellite. Practice also available for purchase, if interested. Contact rjpadelford@cox.net

66 • Round-up • September 2014 • A monthly publication of the MCMS

PEORIA MEDICAL OFFICE SPACE 184 ACRE MEDICAL CAMPUS Sizes ranging from 800 SF to 5,500 SF. Located just off the 101 at Thunderbird Rd. Near Boswell, Thunderbird & Arrowhead Hospitals. Strong mix of medical and dental specialties. Move-in ready suites available. Contact Margaret Lloyd, Plaza Companies 623-344-4558. MEDICAL SPACE AVAILABLE ACROSS FROM BANNER GOOD SAM Up to ±20,000 SF Medical space available. Pharmacy, Lab and Deli on site. Free patient and staff garage parking with reserved covered parking for physicians. Contact Tracy Altemus, CCIM, 602-443-4030 Marina Hammersmith, CCIM, 602-954-8414 at Ensemble Real Estate Solutions. ARROWHEAD MEDICAL PLAZA I & II are located on the campus of Arrowhead Hospital with immediate access from Loop 101. Arrowhead I has up to 10,581 RSF medical space available on the 2nd Floor. There is an excellent physician mix. Arrowhead II is an Energy Star building. Contact Tracy Altemus, CCIM, 602-443-4030 at Ensemble Real Estate Solutions.

marketplace REAL ESTATE LOOP 101 & THUNDERBIRD MEDICAL OR OFFICE SPACE Signage on Thunderbird Rd. 820 SF to 3,500 SF available for lease. Strong mix of physician specialties. Abundant parking. Aggressive rates and concessions. Contact Margaret Lloyd, Plaza Companies, 623-344-4558. MEDICAL OFFICE CONDOS FOR SALE. I-17 freeway access. Next door to Pediatrix. Northview Professional Plaza.1120-2800 SF. Contact Beth Jo Zeitzer/Justin Cirell, R.O.I. Properties, 602-319-1326.

SHARED OFFICE SPACE FOR LEASE IRONWOOD SQUARE Close to Scottsdale Healthcare Shea. Beautifully furnished large waiting area. Three furnished exam rooms and practitioner office available. Short or long-term basis. Perfect for satellite office or main practice. Call (please leave message) or text physician directly at 480-688-9252.

Beautiful Spacious Medical Office Building

367 E. Virginia Ave. Phoenix, AZ Interested in sharing office expenses/space with another physician? This property is perfect! Building is centrally located between St. Joseph’s Hospital and Banner Good Samaritan.

OFFICE SPACE FOR RENT 1000-2000 sq. ft. suites; low-rise building in Central Phoenix. Surface parking. Private entrances. Cleaning, IT support, and other amenities considered for lease. Close to 1-10, SR51, Loop 202; short driving distance to five hospitals, U of A and ASU.

Got your interest? Call 602-251-2363 or email mcms@mcmsonline.com.

Features • Convenient new parking lot • Fully built out space ±3,360 SF • Eight exam rooms and four offices • Great for Owner/User Call 602-256-6303 for more information.

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marketplace MED. EQUIPMENT

EMPLOYMENT

AFFORDABLE MEDICAL EQUIPMENT Low priced, high quality new & used equipment for: PHYSICIAN OFFICES, HOSPITAL RADIOLOGY We buy, sell, consign, service, and finance your CAPITAL MEDICAL EQUIPMENT NEEDS. GLOBAL MEDICAL SOLUTIONS

SEEKING PROVIDERS TO JOIN WOMEN’S HEALTHCARE GROUP

LOCUM TENUM DOCTOR NEEDED Weekend shift for an urgent care, 8 am to 4 pm, $90/hr. Please call 480-792-1025 or fax your resume to 480-792-1026.

Contact: Don Creedon TEL. (480) 874-0333 FAX (480) 626-4366 Member AIUM www.igogms.com

Located in downtown Phoenix, Arizona Gynecology Consultants is looking for like minded established providers to join our practice and participate in the cost sharing benefits of working within a group.

Our practices focus is women’s healthcare (no obstetrics). We provide unique specialty care for women of all ages. While remaining independent, providers will be able to work in one of our recently renovated office spaces, work with friendly/trained staff, electronic medical record system is Athena Health, and bill under our existing insurance contracts. If interested please email or call Kris Calligan at 480-516-3429 or kcalligan@azgyn.com

MORTGAGE SERVICES

Professional Program

• 5% down up to 1 MILLION loan amount • NO MORTGAGE INSURANCE • Eligible borrowers include: Resident or Practicing Physicians, Attorneys, Oral Surgeons, Dentists and CPAs Warren Potter BBVA Compass, Mortgage Banking Officer - NMLS# 221747 warren.potter@bbva.com

Branch: 7335 E Doubletree Ranch Rd, Scottsdale, AZ, 85258 Direct: 480-356-1507 g Mobile: 480-694-6444 g Fax: 205-524-1859 68 • Round-up • September 2014 • A monthly publication of the MCMS

FULL TIME MEDICAL DIRECTOR FOR DYNAMIC CHARITY CLINIC Job description available at www.stvincentdepaulnet. Link at bottom of page “careers.” For more information contact Janice Ertl, Clinic Director, at 602261-6880 or jertl@svdp-phx-az.org.

PHYSICIANS - FT & PT Occ Med clinics in Phx & Tucson. Excellent hours, CME, salary, benefits. Fax CV to Heather @ 602-773-0287 or e-mail h.wahl@mbiaz.com

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Looking for targeted traffic and exposure to your product, service or company?

Call 602-252-2015 or email roundup@mcmsonline.com

HEALTHCARE TRUST OF AMERICA, INC. Over 1.3 Million Square Feet Owned and Operated in Arizona

FEATURED PROPERTY

DEL E. WEBB MEDICAL PLAZA BUILDING B 14418 WEST MEEKER BOULEVARD, SUN CITY, ARIZONA 85375 Free Rent and Generous Tenant Improvement Allowances Available (Restrictions apply - Please Call for Details)

Healthcare Trust of America, Inc. (NYSE: HTA) is committed to providing our tenants and physicians with best in class service. Our on the ground property management, engineering, and leasing teams are focused on establishing long term relationships with our tenants. Headquartered in Scottsdale, HTA is proud to be the leading owner of medical office buildings in Arizona. 74

FOR LEASING INFORMATION PLEASE CONTACT:

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